Top Ways To Overcome Fertility Challenges
Trying for a baby can be a challenge for many people, but what if there are added complications? Arlene Harris looks into possible treatments for boosting a couple’s chance of conceiving.
While many women take measures to ensure they don’t become pregnant, others would give their right arm to discover they have created a new life. It is estimated that one in ten couples have problems conceiving, with a woman’s age being one of the main factors influencing her chance of conception. But some women have added complications, which make conception even more difficult.
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Anna McCarthy (34) has been living with endometriosis (a condition where tissue resembling the lining of the womb grows outside the uterus) for most of her adult life. Up to 10% of women suffer from this condition, which is characterised by painful and irregular periods, pain during intercourse and infertility.
She has had hormone treatment to treat the symptoms but believes this impacted on her chances of conceiving as for the past year, she and her husband John have been trying for a baby to no avail.
“I got married two years ago and we decided to try for a baby about six months later. I wasn’t worried initially, but when our first anniversary came and still no sign of a pregnancy, I started to panic."
“My doctor said the first step I had to take was to stop worrying,” says the Dublin woman. “It is early days yet, but I have been told that I can have surgery to remove any traces of endometriosis and if this doesn’t improve my fertility rating, I can go down the IVF route.
“I obviously would have preferred to be able to conceive naturally but if this isn’t an option, I am happy to get help from a clinic. So I have just been referred to a fertility specialist who is very positive – and John and I have started putting money aside to pay for treatment so I am hopeful about my chances of becoming a mum.”
Endometriosis isn’t the only condition, which affects fertility as uterine fibroids; polycystic ovaries and pelvic inflammatory disease also have a detrimental effect.
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Age Is Still A Factor
But Ciara O’Keeffe from Cork Fertility Centre says age is still the biggest factor when it comes to fertility issues.
“As a woman gets older, the number of eggs in her ovaries decreases rapidly and those remaining are of a poorer quality,” she explains. “So a woman’s fertility swiftly declines and once she enters her 30s she has a 20% chance per month of successfully getting pregnant when not using contraception but by 40, this reduces to about 5%.
“However, our team has a wealth of experience resulting in world class success rates and our live birth rate for elective single embryo transfer for patients undergoing their first IVF/ICSI treatment cycle is 62% for patients of 40 years and younger.”
Treasa Meehan of the Beacon Care fertility Clinic in Dublin says a successful outcome from treatment is dependent on the individuals involved.
“Fertility is very different for each person,” she says. “Age is a big factor as is medical history (for those conditions such as endometriosis and other issues involving the reproductive system) – so it very much depends on the individual. But if the woman is aged around 30, a rule of thumb would be to wait a year before seeking advice from the GP who will then refer to a fertility clinic if necessary.
“Once someone has been referred, treatment and success rate will vary dramatically depending on each couple or individual involved as each case is decided individually by the consultant.”
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Types Of Treatment Available
- Ovulation Induction (OII) – This involves the use of medications to stimulate the development of one or more mature follicles in a woman’s ovaries. Women with irregular cycles or those who are not ovulating may be treated this way as they don’t regularly develop mature follicles themselves.The lining of the womb (endometrium) is scanned with a pelvic ultrasound to determine how the follicles are developing and blood tests also help to reveal when the woman is most fertile.
- Intrauterine insemination (IUI) – This combines ovulation induction (as above) with introduction of purified semen into the uterus on the day of ovulation using a soft, catheter. This is often recommended as a first line treatment when fertility difficulties are unexplained.
- In-vitro Fertilisation (IVF) – This refers to the process where a woman’s eggs are fertilised outside of her body in a laboratory and once embryos have been produced, they are transferred back into the uterus a few days later. This treatment is recommended for women with absent, blocked or damaged fallopian tubes or in cases of unexplained infertility.
- Intracytoplasmic Sperm Injection (ICSI) – Up to 40% of fertilisation treatments do not work if the sperm and eggs are placed together as a regular IVF. So in order to overcome this, a technique of injecting an individual sperm into the centre of the egg has been developed called Intra-Cytoplasmic Sperm Injection. This is carried out by the embryologist using a microscope under high magnification and once the procedure is complete, the eggs are monitored over a 24 hour period and then transferred back into the female as per IVF.
- Pre-implantation Genetic Diagnosis – This technique enables couples who are known to be at risk of a specific inherited condition to avoid passing it on to their children. It involves generating a number of pre-implantation embryos through IVF treatment and checking the genes of those embryos for the condition involved before transferring them to the uterus of the female partner.
- Pre-implantation Genetic Screening – This complex form of IVF treatment is recommended for couples who have experienced recurrent miscarriages or repeated unsuccessful IVF cycles. Screening embryos for genetic defects before transferring them significantly increases the chance of a successful pregnancy and decreases the chance of miscarriage. It also considerably reduces the chance of having a baby with genetic problems.
- Donor Sperm – While choosing to use a donor sperm may not be an easy decision, for some people it is the only option. Clinics will make every effort to ensure physical characteristics and blood group matches that of their client. Those who may need to use this route include: men with severe infertility who do not produce sperm, a male who is a carrier for a specific genetic disorder, single women who wish to pursue fertility treatment and same sex (lesbian) couples using IUI or IVF.
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