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10 most commonly asked fertility questions
We answer your most common questions about
how to get pregnant and what to do if you're having problems …
What can my partner and I do to improve our chances of conceiving?
To maximise your chances of getting pregnant, have sex frequently throughout
your monthly cycle, especially in the first half. 'Sperm can live for
three to five days inside the cervix so we recommend having sex every
three days to make sure there is a constant supply available to fertilise
the egg when it's released,' says Family Planning Association helpline
manager Angela Reynolds. The day you ovulate and those immediately before
it are the best time to have sex, as eggs only survive 12-24 hours after
release but sperm can last several days.
It makes sense to be in good health when trying for a baby too, so cut
back on your alcohol intake, give up smoking and eat a well balanced diet
with lots of fresh fruit and vegetables. Women trying to conceive should
take a daily 400mcg (0.4mg) dose of folic acid as this has been proven
to reduce the risk of having a baby with Down's syndrome or spina bifida.
Are there any supplements or lovemaking positions that might help?
There are various theories about mineral and vitamin deficiencies contributing
to or directly causing fertility problems and a range of supplements that
you and your partner could take to, for example, boost sperm quality.
For more information on this, contact Foresight (the preconceptual care
association).
There's no evidence that certain lovemaking positions, such as having
a pillow under your bottom to tilt your uterus or keeping your legs in
the air afterwards, can help you get pregnant. Sperm can swim fast enough
without the help of gravity - in fact, the strongest sperm can swim through
the cervix and into the womb in around two minutes, given favourable conditions.
The main thing is to try to make love often and avoid becoming stressed
about the baby issue. Evidence shows that couples trying to conceive reduce
their lovemaking after a while because it has become associated simply
with making babies!
Could the length of my cycle affect my fertility? And when in each cycle
am I most likely to become pregnant?
No, not unless your cycle is irregular, making it hard for you to predict
ovulation. Most women have varying cycles throughout their life, becoming
a little longer or shorter as they get older. As long as you can pinpoint
the days in the month when you're likely to ovulate, your cycle length
shouldn't have an adverse effect on your fertility.
The average menstrual cycle is 28 days. Counting the first day of your
period (proper bleeding) as day one, you will ovulate around two weeks
before your next period starts. 'You don't have to have a 28 day cycle,
but having a very erratic cycle or less than six normal periods a year
could indicate fertility problems,' says Julian Jenkins, clinical director
of the Centre for Reproductive Medicine in Bristol.
If your cycle is fairly regular, you can work out roughly when
you're likely to ovulate so you can plan to have sex around this time
- in fact, having sex two to three days before you ovulate is ideal as
sperm can survive for this long inside the uterus. Count back 16 days
from when your period normally starts and you will have worked out the
start of a four-day time slot in which you are likely to ovulate.
Here's an example, based on a 30-day cycle:
- Day 1 (start of period)
- Day 15-19 (ovulation)
- Day 30 (day before next period)
How can I tell if I'm ovulating?
Tune into your body around ovulation time. Some women experience sharp
twinges or period like pain in the abdomen called Mittelschmerz, as the
egg is released from the ovary. Just before ovulation, your vaginal mucus
also changes in consistency to become thin, slippery and like egg white.
Ovulation usually occurs 12-16 days before the start of your next period
but remember too that you won't ovulate every month.
If you don't have a regular monthly cycle and want to pinpoint when ovulation
occurs, you could try keeping a temperature chart. Your body temperature
rises by approximately 0.4 to 0.8 degrees Fahrenheit at ovulation. But,
temperature charts are notoriously difficult to interpret and most fertility
clinics have moved away from using them. Pharmacies sell various ovulation
kits that will show when you've ovulated and, although there's no evidence
to show that they improve your chances of having a baby, you may find
it reassuring to know that you are ovulating normally.
Could a previous abortion or having been on the Pill affect my fertility?
There are medical risks associated with termination of pregnancy, although
they are relatively minor. Julian Jenkins, clinical director of the Centre
for Reproductive Medicine in Bristol, points out, 'The fact that you have
actually been pregnant before means you are more likely to achieve a future
pregnancy'.
The main risk of fertility problems from an abortion comes from possible
infection of the Fallopian tubes which can lead to scarring and blockage.
Any blockage would prevent eggs released at ovulation from moving down
into the uterus. That's why it's important that your GP and consultant
know your full medical history, so that they can decide whether internal
investigations are necessary to check for this sort of damage.
Previously using contraception shouldn't have any effect on your ability
to have children. Indeed, experts no longer believe it's necessary to
wait until you've had a cycle or two before trying to conceive. 'Your
fertility should return to normal after you stop contraception, although
how quickly depends on the particular form of contraception,' says Julian
Jenkins. 'For example, fertility immediately follows the removal of an
interuterine device (IUD) whereas it may take several months before the
effects of an implant wear off, so check with your doctor.'
How long should my partner and I try for a baby before seeking help
for infertility?
There's no wrong or right amount of time to wait before going to see
your GP, but a lot will depend on your age and personal circumstances.
'If you're a young couple under 35 and have no reason to suspect problems,
(for example, previous surgery or irregular periods), it's reasonable
to try for a year before seeking help,' says Julian Jenkins. However,
women over 35 would be well advised to seek help earlier, as the chances
of conceiving drop rapidly after 35.
What can be done to improve a low sperm count or poor quality sperm?
Sperm is classified in terms of count, (how many millions of sperm there
are per sample), and quality, including mobility. To promote better sperm
production, encourage your partner to wear loose boxer shorts and trousers
and take cool showers rather than hot baths. Excessive alcohol intake
and smoking are also bad news for healthy sperm production so encourage
your partner to cut down or quit altogether if possible. There are various
theories about the particular vitamin and mineral supplements that can
improve sperm quality, but no real research to back them up. If you want
more information on this, contact Foresight.
We've been trying without success for a year. What can our GP do to
help?
Your GP can carry out a few basic tests on the NHS to rule out obvious
fertility problems before you get into the more complex investigations
that are carried out in hospital or at a private fertility centre. Routine
fertility tests include a sperm analysis for the man and blood tests for
the woman to make sure her hormone levels are right and if she is ovulating
normally. Your GP can organise both of these for you and there's no set
time to wait before you'll be allowed these basic tests - it's just a
case of discussing your circumstances with your GP.
More complex tests, such as ultrasounds and internal investigations are
often done privately (to avoid lengthy NHS waiting times) and can be carried
out by your local hospital or private fertility clinic.
How do we know which fertility treatments are best for us?
Once the basic tests have been run and interpreted by your GP, you'll
be in a better position to discuss with him or her where to go next. It
might be a case of trying for a further few months and timing sex more
carefully around ovulation, or you may feel the time is right to be referred
on to a specialist fertility centre. To help you decide, the Centre for
Reproductive Medicine in Bristol has devised a fertility calculator, (based
on the latest research), that can work out your current chances of conceiving.
If you do go on for further investigations, you won't necessarily end
up using in-vitro fertilisation (IVF) as there are various low level treatments
which can be tried first, such as taking hormones to stimulate ovulation.
But be warned that NHS treatment is currently based on what's available
locally - not necessarily what is right for your particular circumstances!
How do we find a fertility expert and what should we be looking for
in a private clinic?
For unbiased advice and to find a fertility clinic local to you, log
onto the Human Embroyology and Fertilisation Authority's website which
has a list of the UK's registered clinics and latest success rates. Your
GP will have an opinion as to which clinics or consultants he or she would
recommend and what, if anything, is available locally on the NHS.
Once you've located potential clinics, ring up and request a new patient
pack which will detail their fees, success rates and available treatments.
You'll be able to have an informal look round to get a feel for the place,
you may also want to ask a few basics questions about what is the initial
waiting time for an appointment. 'Your GP can write you a referral letter,
detailing your medical history and the results of any initial investigations
that could help the fertility team,' says Julian Jenkins. You will then
be given an initial appointment with one of the clinic's doctors and it's
at this point if going private that you'll start to be charged.
What sort of fees can we expect to pay for private treatment?
Going for private fertility treatment is costly! Prices vary from unit
to unit, but you can expect to pay upwards of £100 for an initial consultation
and around £2,000-£4,000 for one cycle of IVF or ICSI with drug costs
of £400-£1,300 on top. And don't forget the cost of other procedures,
such as ultrasounds or blood tests, which might be needed.
By Melanie Deeprose
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