Female fertility treatments have dramatically improved the chances of motherhood for millions of women. Factors for female infertility and specific causes of infertility can include nutritional deficiencies, hormonal imbalances, diseases, prior medical operations, endometriosis, fibroids, uterine or cervical blockages or a host of other unexplained reasons.
The emotional, social and cultural consequences of infertility can be profound but it is important to seek advice from medical experts. Though you may have been trying to conceive for years, fertility treatments like IVF and IUI offer new hope and a new method of achieving a pregnancy.
Bourn Hall Fertility Clinic was founded by doctors and scientists who worked for more than a decade to develop new techniques to help infertile couples. This approach continues today across all Bourn Hall clinics with our medical and scientific teams dedicated to the achievement of parenthood for all our patients.
If the woman is not releasing an egg every month, this can often be solved by giving medication to gently stimulate the ovaries. Tablets such as clomiphene or letrozole can be used and in other cases, hormone injections can be more effective. The effect of the medication used is monitored by performing scans of the ovaries to check follicle development, so that the couple can then plan the best time to try to conceive.
NATURAL CYCLE IVF
Natural cycle IVF is a treatment plan where no hormone stimulating medications are used. A single egg would then be collected as a part of a women’s natural menstrual cycle.
Natural cycle IVF is a recommended option for women who do not respond well to hormonal stimulation or women who have a very low ovarian reserve, which can be detected from your initial screening blood tests. It utilises the body’s natural hormones and can be repeated more often if necessary.
The process and steps involved are similar to traditional IVF though stimulating medication is not given in the first seven to 10 days. The hCG injection is still required. The success rates are lower than traditional IVF because only one egg can be fertilised and then transferred at a time.
Mini IVF refers to minimal hormone stimulation during the treatment, using lower doses of medication over a shorter period of time. This can be a good treatment option for women who are prone to ovarian hyper stimulation.
The process and steps involved are similar to traditional IVF.
The steps involved in Mini IVF may vary from patient to patient depending on the recommended treatment plan but typically involve:
- 5-10 days of ovarian stimulation with hormone injections or tablets. Medication types and doses are monitored with regular scans and blood tests throughout this period
- On the final day of ovarian stimulation, usually 36 hours prior to your egg collection, an hCG injection will be given in order to mature the eggs
- Egg collection under sedation or a mild general anaesthetic typically at the same time as sperm collection
- Insemination or ICSI typically occurs the day of egg collection
- Embryo transfer is performed 2-5 days after egg collection, depending on the number and quality of the embryos
- A blood test to determine pregnancy is performed 14 days after egg collection
This is a procedure that involves “scratching” the lining of the uterus with a small instrument that is inserted through the cervix. It is simple to perform and requires no anaesthetic – for many patients, it is rather like having a smear test performed.
Research has shown that, in some women, causing a very minor injury to the inside of the uterus can provoke a healing reaction that may help embryos to attach during IVF/ICSI treatment. It is usually done about one week before the start of the treatment cycle, around cycle day 21, and may be combined with a hysteroscopy to check for abnormalities of the insider of the uterus.
It doesn’t seem to be helpful in the first cycle of treatment, so this is usually done for patients who have previously undergone unsuccessful IVF at least once. The research is ongoing, however, to identify those who would benefit the most, and more information will become available in time.
At Bourn Hall Fertility Clinic, we perform reproductive immunology. This is the study of how the body’s immune system interacts with the process of conception and then pregnancy. There have been a number of research studies suggesting that, in some women, abnormalities of the immune system may make it more difficult to get pregnant, or increase the risk of miscarriage. Much of this is still at the research stage, but many doctors believe it can be helpful to perform some immune tests, especially in patients who:
- Have previously had unsuccessful IVF/ICSI treatment
- Suffer from conditions which ate known to have associated immune problems, such as rheumatoid arthritis, SLE and thyroiditis
- Have previously had a number of unexplained miscarriages, early in pregnancy
If an abnormality is identified, treatment may be given in the form of steroid tablets, or with infusions of Intralipid, which is a mixture of fats and soya-based protein, given intravenously. This may increase the chance of a successful pregnancy occurring in appropriate cases.