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Treatment of Infertility

    Getting treatment:

    If your GP refers you to a specialist for further tests, the NHS will pay for this. All patients have the right to be referred to the NHS or to attend an NHS clinic for the first investigation. However, infertility treatment is not widely available on the NHS and there can be long waiting lists. The treatment available also depends where you live in the country and what the problem is. Your GP will be able to advise you if you’re eligible for NHS treatment. At the moment, a lot of couples are referred to private clinics.

    Getting private treatment for infertility can be very expensive, and there is no guarantee it will be successful. Patient-funded clinics are private clinics that run on NHS sites, so the cost is sometimes lower. The prices at all types of clinics, NHS, patient funded and private, vary, and depend a lot on the needs of the couple.

    If you want to pursue treatment for infertility, it’s important to choose your clinic carefully. Find out what clinics are available locally, the treatments they offer, the length of the waiting list, and costs. You can ask your GP for advice and recommendations, and make sure you choose a clinic that is licensed by the Human Fertilisation and Embryology Authority (HFEA). The HFEA is a government organisation that regulates and inspects all UK clinics providing infertility treatment, including the storage of eggs, sperm or embryos.

    Treatment options:

    If you need medical help to get pregnant, this is called assisted conception. There are lots of different options including:

    • Drugs and surgery:

    Fertility drugs may be used if the female partner isn’t ovulating (making and releasing eggs) properly. It’s normally used alongside other treatments, such as IVF. There are a variety of drugs that can be used  - they work like the body’s hormones and tell the ovaries to make or release eggs. All the drugs can have some side effects, including heavy periods, nausea, headaches and weight gain.

    • Intrauterine insemination (IUI):

    If the female partner’s tubes are healthy, IUI is a simple fertility treatment that’s quite successful. Some of the man’s sperm is put into the woman’s womb at the same time as ovulation (the release of an egg), making conception more likely. The woman also takes fertility drugs to encourage eggs to be released. The healthiest sperm is selected from the man, or sperm from a donor may be used.

    For more information about IUI, please see the artificial insemination encyclopaedia topic.

    • In vitro fertilisation (IVF):

    Each year, around 24,000 infertile couples in the UK undergo IVF treatment, and about 8000 babies are conceived in this way. In IVF, fertilisation happens outside the body. The female partner takes fertility drugs to encourage the ovaries to produce more eggs than normal. Eggs are then removed from her ovaries, fertilised with sperm in a laboratory dish, and then put back inside the woman’s body to develop into a foetus. The chance of multiple births is higher with IVF because more than one embryo is often put back in the woman’s womb.

    For more information about IVF, please see the IVF encyclopaedia topic.

    • Egg donation:

    Some women cannot produce fertile eggs. They may be able to receive eggs from an anonymous donor to help them to get pregnant. Fertility treatment with donor eggs is normally carried out using IVF. However there is a shortage of donor eggs, and some couples wait for 3-5 years for this type of treatment.

    Women aged 18 to 35 can donate eggs. Information about the donor is not passed on to the couple receiving treatment or the resulting child, and neither the donor nor the child have any legal rights or relationship with each other.

    • Other techniques:

    Blastocyst transfer

    This treatment is sometimes used for women who can make good quality embryos, but which don’t attach to the womb lining where they can develop. An embryo that has developed for five to six days is called a blastocyst. Blastocyst transfer means that the embryos develop to the blastocyst stage in a laboratory before they’re placed in the womb.

    Blastocyst transfer differs from IVF because the embryos are allowed to develop for a two days longer in the laboratory. This means the ‘best’ quality embryos can be selected to put into the womb, reducing the chance of multiple births.

    Assisted hatching

    In order to attach to the wall of the womb, an embryo first has to break out (‘hatch’) from the gel-like shell it is contained in. This shell is called the zona pellucida and is harder in some women than others. Assisted hatching is when the doctor makes a tiny hole in the shell before the embryo is put back in the womb to help it to hatch.

    This technique may be used for women over 40 who are producing harder eggs, or younger women who aren’t producing many eggs at all. Results are not yet clear whether this technique has a better rate of pregnancy.