February 22, 2018
Fertility Q&A with Dr Muhammad Fatum
We recently asked our Facebook followers to send us their fertility-related questions. Oxford Fertility’s Medical Team Manager, Dr Muhammad Fatum, gives his advice.
Q: My partner and I have been trying for a baby for 10 months with no success. What are the next steps in terms of investigating any potential fertility issues?
A: Fertility assessments and investigations are recommended after trying for 12 months. It is estimated that 90% of women will get pregnant at the end of their first year of trying, so we would recommend that you wait another two months. If by then you still haven’t fallen pregnant, you can ask your GP to refer you to an NHS fertility clinic or a private fertility unit such as Oxford Fertility. Self-referral is also an option. You can find out more about fertility assessments offered by Oxford Fertility here.
Q: On our second IVF attempt we were blessed with our amazing daughter. We tried IVF again when she was eight months old as we wanted to give her a sibling, which sadly didn’t work for us. Is it not likely to work if we were to try IVF again in next few months? Is there anything we can do to increase our chances of it working?
A: Your experience is common among IVF patients and it can take more than one cycle to get pregnant. There is no problem of you trying again. I recommend that you have a consultation with a fertility doctor in order to review the cycle to see if there are any modifications needed. Good luck!
Q: What should I expect when going through IVF treatment?
A: IVF treatment includes ovarian stimulation in order to get an increased number of growing follicles, followed by egg collection under sedation. Fertilisation is done using the partner sperm or donor sperm. This is done either naturally by putting the sperm and the eggs together overnight, or by intracytoplasmic injection (ICSI). Three to five days following fertilisation, the embryo transfer is done under ultrasound guidance. A pregnancy test is taken after nearly two weeks.
I would recommend that you explore the rest of our website and get more information about the different areas and aspects of fertility treatment, including logistics, success rates and prices. Good luck!
Q: If you’re trying to get pregnant, how long should it take naturally? At what point should you start looking at other options?
A: It is recommended that women under the age of 40 should try naturally for a year before resorting to fertility investigations and treatments. For women older than 40 we recommend that investigations and treatments should be looked into after six months of trying.
A: We conceived our first child during the first month after coming off contraception at 37 and we would love to have another child. We are now coming up to 44. Are we too old now to get help with fertility?
The chances of success do get lower with age, especially after the age of 43. The chances for a pregnancy at the age of 44 are very low, even with IVF treatment (2-3%). However, with egg donation the chances can increase up to 40-50%. I would highly recommend that you have a consultation with a fertility doctor to discuss the different options and decide whichever suits you more. Please get in touch with us if you would like to discuss your particular situation further.
Q: How do I get tested to check my fertility? I have ongoing problems and I am under the care of a gynaecologist team, however, I just want to know how bad it is.
A: As you are under the care of gynaecologists, it is worthwhile to ask to be referred for a baseline hormonal profile, tubal test and sperm count for your partner, provided you have tried for pregnancy for at least 12 months, or if your gynaecologic condition does have an impact on your ovaries or uterus. If you are talking about checking your ovarian reserve, you can also send a blood test for AMH (Antimullerian Hormone levels). You can also ask your GP for a fertility clinic referral for a face-to-face consultation.
Q: I’ve never had a period naturally and the only time I have one is by taking the pill. No reason or cause has ever been found. Does this mean having children may not be possible?
A: Not having regular cycles does not mean that you don’t have follicles and you cannot produce eggs. In most cases all that is needed is to start ovulation induction treatment. In rare cases, the ovaries are not functional and help may be needed in the form of egg donation. I recommend that you ask your GP to do a hormonal profile test to reassure you that your ovarian reserve is satisfactory.
Q: My husband and I have been trying to conceive for four years. We already have two children aged six and eight. I’m 26 and my husband is 24. He’s had his sperm counted and it has come back fine. I’ve had blood tests to make sure that I ovulate, which were also fine. Where are we going wrong?
A: It is reassuring that you already have two children and is clear evidence that things can work well for you. It is worthwhile to test for tubal patency by a hysterosalpingogram or Hycosy test. At this stage it is recommended that you seek fertility consultant advice as IVF may be your first best treatment option, particularly after having tried unsuccessfully for four years. Please get in touch with us if you would like to discuss your particular situation further.
Dr Muhammad Fatum is a Specialist and Senior Fellow in Reproductive Medicine and Surgery, and Clinical Lecturer for The University of Oxford. His areas of special interest include minimally invasive endoscopic surgery, preimplantation genetic screening and diagnosis, IVM and fertility preservation in cancer patients.
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