Sunday 15 December 2019

8 things you didn't know about fertility treatment

Thinking of undergoing fertility treatment to have a baby? Our reporter finds out everything you need to know

Fertility treatment includes a broad range of issues, including IVF.
Fertility treatment includes a broad range of issues, including IVF.

Vicki Notaro

Thinking of undergoing fertility treatment to have a baby? Our reporter finds out everything you need to know.

1 You are not alone

When suffering with fertility issues, it's easy to feel like you're the only people in the world that ever experienced them. Ahmed Omar, the medical director of the Beacon CARE Fertility facility in Sandymount, Dublin, says that realising many other people are living with the same issues, and that help is at hand, is surprising to many of his patients.

"Although infertility is a common problem affecting one in five in this country, there is a taboo, particularly in Ireland, around talking about it."

2 Fertility treatment covers a broad range of issues

Professor Simon Fishel of Beacon CARE explains that often patients don't fully appreciate the extent of the potential causes that may be linked to them failing to conceive.

According to Simon, infertility can be caused by a single or absolute problem like blocked fallopian tubes or the man not producing sperm, or by other more complex issues. "It could be an 'efficiency' issue - the couple may be able to conceive naturally but because of small deficiencies anywhere along the system, often in both partners, it just may not happen for a long time.

"There's also 'secondary infertility' - a major issue in that they may have had a child naturally but then for several years it hasn't worked."

3 A thorough investigation of both partners is required

"Nearly all couples or singles that we meet want to see fast results," explains Ahmed. "However, our aim is to provide the best possible treatment for the individual case and often that takes significant investigation. We start the process with a full fertility assessment, including blood tests and scans to establish if there are any obvious problems.

Depending on the patient, things can be relatively straight forward or complex. In some cases more detailed investigation is required such as immune or clotting tests and this can take longer. Also it's the couple that have to be thoroughly investigated, even if they think it is due to just one aspect in either of them."

4 Time is of the essence - even with fertility treatment

Some couples believe that fertility treatment can all but turn back time and that age isn't an issue when seeking medical help to get pregnant. But Ahmed said it's still a major issue. "Age is the biggest factor when it comes to infertility. In women fertility begins to decline at 30 with a significant drop at 35 and an even more significant drop by the time a woman reaches 40. Often the biggest problem facing patients is reduced egg quality which often leads to failed IVF or miscarriage," he says. Sometimes donor eggs can help. While many women go in to fertility treatment hopeful that their own eggs will be viable along with their partner's sperm, sometimes that sadly isn't the case and a donor egg or donor sperm is something to think about that might not have previously been discussed.

"The benefit of using donor eggs is that they are much younger and greatly improve the chances of a successful outcome," says Ahmed. The use of donor gametes, and indeed assisted conception in general, is not currently regulated by a legal framework in Ireland, however the government has announced plans to introduce comprehensive laws in the area.

5 Egg freezing is a viable option for many

Now that we're having babies later than ever, a lot of women and couples think that preserving their eggs is a good idea. "Science has moved on from what was originally perceived to be a rather inefficient process to be used in emergency cases - such as to avoid sterility as a potential side effect of some cancer treatments - to a highly efficient process, with pregnancy rates equal to the use of fresh eggs," says Simon. "The earlier eggs are frozen the better the efficiency of pregnancy because the chance of getting pregnant after IVF is directly proportional to a woman's age. But the success of freezing and thaw is not related to age, and so women could actually be freezing eggs into their late 30s. However, the chance of pregnancy with those eggs will not be as great as if she had frozen them earlier."

6 But it can be more complicated than you imagined

"For egg freezing a patient undergoes the same hormone injection process that is used for IVF," says Ahmed. "It takes approximately two to four weeks to complete the egg freezing cycle and it is consistent with the initial stages of the IVF process which may or may not include two weeks of self-administered hormone injections to down regulate the ovaries followed by a further 10-14 days of hormone injections to stimulate the ovaries and ripen multiple eggs. Once the eggs have adequately matured, they are removed and immediately frozen."

7 Your lifestyle is important

Although living better won't guarantee success, being healthier and less stressed can only help because stress is a known factor in infertility.

"Now more than ever, many of our patients are undertaking mindfulness and meditation programmes in conjunction with their fertility treatments. Many find therapies such as massage, acupuncture and reflexology very helpful also.

"While these therapies don't show any scientific impact on the outcome of fertility treatments we recommend patients undertake them if they reduce stress and help them to feel better. It is extremely important to note though that patients undertaking fertility treatments should never take Chinese herbal medicine and any additional nutritional supplements should be recommended and approved by your fertility specialist. Of course optimum diet, nutrition and exercise is extremely important also."

8 Success rates are relative

It's difficult to accurately verify success rates of fertility treatment in Ireland because there's no independent regulatory body for fertility clinics, but according to Ahmed it's around 35pc nationally for under 35s.

Once again, age is the biggest contributing factor. Some clinics offer services like pre-implantation chromosome screenings and genetic diagnosis also, which can garner higher success rates.

"Unfortunately fertility treatment is not an instant fix," Ahmed explains. Talk to your doctor in advance and ask for transparency and honesty about the likelihood of success, so false hope is not an issue.

* Fertility Awareness Day event in association with Beacon CARE Fertility will take place on February 27 from 10am-1pm at the Double Tree Hilton Hotel, Dublin 2. To register for free tickets to attend please email or call 01 2932955.

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