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Fertility 101: IUI - how it works

Fertility 101: IUI - how it works

What is IUI?

During IUI, the best and strongest-looking sperm are selected, by doctors, from a sample of your partner’s sperm (or your donor’s sperm if you’re using a donor).  They’re then injected directly into your uterus to encourage fertilisation of your egg.

IUI is quite a different treatment from IVF, which is where your eggs are removed from your body and put together with your partner’s sperm in a laboratory (see our Fertility 101 – IVF guide).

The benefits of IUI are:

  • It’s a relatively straightforward procedure and less invasive than IVF so is often a first port of call for anyone struggling to conceive
  • It requires fewer drugs than IVF
  • It’s not as expensive as IVF and can also seem more ‘natural’ – partly because are fewer drugs to take but also because once the best sperm have been placed back inside your uterus they’re left to do their own thing and will hopefully fertilise that egg naturally

 However, the success rates are lower than in IVF (see below) and you might need to undergo numerous treatment cycles so if you’ve been trying for a long time or are over 35 you may want to go straight to IVF.

Is IUI for me? 

IUI should not be considered as a straight alternative to IVF.   There are some people that it’s not a viable option for - if you’ve got blocked fallopian tubes or low-quality eggs, for example.  This treatment is all about helping the best available sperm swim to and fertilise an egg so if the sperm makes it but your egg is poor quality (due to age or other factors) then IUI just won’t work. 

IUI typically benefits couples suffering from a known male factor issue such as low sperm count or reduced sperm motility. And it’s generally the preferred route for anyone using donated sperm; single women and female couples.

It can also be a good option to consider if you’ve been diagnosed with any of the following:

  • Issues with ovulation
  • Problems with ejaculation
  • Abnormalities or an irregular shaped cervix
  • Cervical scar tissue that could prevent sperm entering your uterus easily
  • A condition affecting cervical mucus which can create an unfavourable environment for sperm
  • Unexplained infertility

What’s the process?

The average length of an IUI cycle is around 3 to 4 weeks, so it’s typically shorter than the average IVF cycle (at around 4-6 weeks).  Treatments can vary slightly depending on your history but here’s a rough step-by-step guide:

  1. Fertility drugs. While for some people, IUI treatment can be incorporated in their natural menstrual cycle, for others it’s necessary to take some fertility drugs too to help boost egg production. 
  2. Monitoring. If you are taking fertility drugs, you’ll be booked in for regular scans and blood tests during the stimulation phase – normally every few days.  The ultrasound scans are to check how many eggs your follicles are producing in response to the medication, how quickly they are growing and how big they are.  Your doctor will use this information to estimate when the eggs are likely to be ‘ripe’ and therefore when ovulation might occur.  
  3. Trigger shot. If you’re doing medicated IUI, you’ll be given a hormone injection two days before your eggs are due to be collected to trigger the final ripening of your eggs. If you’re doing IUI as part of your natural cycle, you’ll be tested regularly to pinpoint when you’re about to ovulate so insemination (see below) can be timed to perfection. 
  4. Sperm selection. The sperm from your partner or donor are washed and prepared in the lab.  The very best quality sperm are chosen for insemination.
  5.  Insemination. The chosen sperm are injected into your uterus via a special catheter (a very narrow tube).  This part of the procedure is a bit like a smear test – it might feel a little uncomfortable momentarily but it shouldn't be very painful and takes just minutes.  
  6. Pregnancy test. For many, the days counting down from insemination to official testing date are the hardest as there’s nothing to do but sit and hope. If your treatment has been successful, you’ll have your first pregnancy scan two weeks later.  If it hasn’t worked, you can discuss with your consultant whether to try another round of IUI or if it might be best to try another treatment such as IVF.

How much does it cost?

IUI treatment costs vary, depending on whether fertility drugs are required.  Per cycle you should expect to pay anywhere from £350-£1000.

Do bear in mind that since success rates per cycle tend to be lower than in IVF, you may need multiple rounds of IUI – six is not unusual – so costs can quickly escalate.

Depending on your age and circumstances you might want to consider the full range of treatment options, including IVF, in case there's a more suitable option for you.

Will it work?

According to the most recent data from the HFEA (Human Fertilisation & Embryology Authority), the percentage of cycles resulting in a healthy baby being born are:

  • 18% in women aged under 35
  • 14% in women aged 35-37
  • 12% in women aged 38-39
  • 5% in women aged 40-42
  • 1% in women aged over 42

As with all fertility treatments, success rates are higher among younger women.  Incorporating fertility drugs in your IUI cycle to boost egg production also has a positive impact on your chance of success.  For example, a recent study showed IUI with Clomid, a type of fertility drug, increased average success rates from 8% to 15% per cycle in women under 35.

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TTC Tips: how to choose a fertility clinic

TTC Tips: how to choose a fertility clinic

 

By Hannah Saunders, co-founder at The Fertility Circle.  Hannah underwent five rounds of IVF at three different hospitals/clinics (including one in Hong Kong).  You can read her story in her Path to Parenthood, here 

It might sound glaringly obvious, but choosing the right fertility clinic for you is really, really important.

You’re going to spend many hours with that clinic’s doctors and nurses – and most likely many thousands of pounds, too.

But how do you know if they’re the ‘right’ one?

If you’re just starting out, you might be feeling a little overwhelmed, especially if you’re having to pick a private clinic. [If you’ve been granted NHS funding, you’ll usually be given a more limited choice of hospitals based on your location, but even so, you should still compare hospitals so you can feel confident in your final choice]. With 100+ fertility clinics in the UK alone, it can feel a bit like finding an elusive needle in a haystack.

Rather than rushing to commit to a clinic, though, take your time and do your homework. Drawing up a shortlist of your preferred clinics and ‘interviewing’ them (see also our IVF Tips: 10 Questions to Ask a Fertility Clinic feature) will help put you back in the fertility driving seat and enable you to make an informed decision.

Here are some things to consider when choosing a fertility clinic:

1. Success rates

The data each clinic publishes on its annual live birth rates is a useful gauge, but provided they are performing at, or better still, above the national average then don’t use the data as your sole clinic selection criteria.

Success rates vary between age groups, can fluctuate year-on-year within clinics, and can also be skewed by clinics’ different patient eligibility criteria (for example if a clinic stipulates a preferred FSH level in female patients).

You’re broadly looking for consistent results including a strong live birth rate and completed cycle rate.

Success rates can be found on the HFEA website, on clinics’ own websites and on the clinic pages in the listings database here at The Fertility Circle.  Do question a clinic that is still quoting headline figures on their own site from several years ago, however, as it could imply a downward trend in recent years and you need to understand why this is.

It’s also advisable to understand your clinic’s policy on single vs multiple embryo transfer.  Some clinics favouring multiple embryo transfer may have marginally higher live birth rates as a result, but it’s important to be aware of the risks multiple transfers can present to mother and child if they develop into a multiple pregnancy, and it must always be your choice how many embryos you put back at transfer.

When you visit one of your shortlisted clinics for the first time, be sure to probe your consultant on their data and don’t be afraid to ask them to clarify any statistics you don’t understand or which seem out of step with comparable clinics.

2. Range of treatments offered

If you’ve been trying for some time and/or have had some basic diagnostic blood tests (to check hormone levels and other markers such as FSH, AMH etc), it’s possible you might start with fertility drugs or less invasive treatments like IUI.

If these don’t work, or you have a more complex diagnosis, you might need to progress to IVF or consider other paths to parenthood, such as donor IVF treatment. Finding a clinic that can not only offer you the highest standard of the treatment you need right now, but might potentially need in future, is an important consideration, depending on your age and/or medical history.

Think of it a bit like a job interview.  You’re the ‘employer’ with several applicants to consider.  Which CV has the skills and experience that best matches your needs, now and in future?

In addition to the range of treatments offered, ask about the clinic’s ethos.  For example, some clinics favour gentler treatments (some even specialise in ‘natural’ or ‘mild’ IVF, working with your own cycle, for example); at the other end of the spectrum are clinics which are highly forensic in their approach and will often prescribe multiple drugs, sometimes including steroids and immune treatments.  Ultimately, we are all different, and knowing where you are on the spectrum of treatment required – often affected by age; or whether your fertility issues are ‘unexplained’ or have been pinpointed – will help you to decide whether the clinic offers the right treatment type(s) for you. 

3. Cost (and cost transparency) 

Having to fund fertility treatment yourself can be a really expensive business and the need to keep going if it fails can become something of an addiction.

Agree your maximum budget with your partner at the start and do everything possible to stick to it. The physical and emotional stress of fertility treatment is tough enough without financial worries, too.

Budgeting - and also comparing clinics - can be complex, though, since clinics aren’t able to provide one fixed cost per treatment type: treatment plans will need to be tweaked and tailored to the individual.

So while some clinics may quote an IVF cost of £2,500, for example, this price can quickly escalate once you’ve added in multiple blood tests, scans and any other ‘add-ons’ you might need such as ICSI (intracytoplasmic sperm injection); PGS (pre-implantation genetic screening) etc.

Ask your shortlisted clinic to break down the total cost and walk you through their proposed treatment plan before you go ahead.

Fertility treatment often requires a degree  of trial and error and protocol tinkering, and some of the new elements your clinician might want to throw into the mix further down the line can be eye-wateringly expensive.  Whilst your consultant won’t have a crystal ball to foresee everything you might need, tell them budget is a concern and ask them to give you a worst-case picture so there are no nasty shocks if you do need more treatment later on.

Some clinics also offer packages such as ‘multi-cycle IVF’ or ‘Refund IVF’, which means you pay an upfront fixed fee for your treatment package for say, 3 cycles of IVF, and if you don’t get pregnant with that clinic after the three cycles, you are refunded part or even all of your initial cost.

The downside is you end up paying slightly over the odds if you’re lucky enough to get pregnant with your first cycle (but hey, at that point you won’t care about the money you spent – you’re pregnant).  But given some recent studies suggest the average couple take 2.7 IVF cycles before getting pregnant, it's worth considering, particularly if you’re the type of person who likes to have a plan in place and keep a tight rein on your finances.

4. Location/travel time

If you’re doing an IVF cycle, you’re likely to need to go into your clinic for blood tests and/or scans at least every couple of days during the stimulation phase, and a few clinics even ask you to come in as much as twice daily for blood work (so they can minutely tweak your treatment according to your daily response to the drugs).

Being reasonably close to your chosen clinic is therefore an important factor, particularly if you're working and need to minimise time away from the office.

Most clinics appreciate patients may need to travel for their appointments and will try to offer flexible appointment times, for example very early mornings or late evenings, and some are open at weekends, too.

While we’re talking location, it’s also worth checking whether the laboratory where your eggs will be developed following egg retrieval is on site at your clinic or somewhere else.  [Although my first round of IVF was at my local hospital, my embryo transfer took place at a lab in Central London. When we originally chose our clinic, it seemed like a minor detail, but when it came to embryo transfer day and we had to navigate our way to a new location, to undergo the final stage of our treatment with a new team, in a new environment, it definitely added to our (already heightened) anxiety levels].

5. Patient reviews

Although no two fertility journeys are identical, talking to someone who has had treatment at your prospective clinic is always useful.

What were the staff like? Was the clinic welcoming? Were the facilities good? How long were waiting lists? Did appointments run to schedule or were waiting rooms overflowing? Were treatment plans and costs clearly communicated?

You can also search forums for honest (sometimes brutally so!) patient reviews and ratings of most UK clinics.

 6. Rapport with your consultant

It’s extremely important you feel you can trust and communicate well with your consultant.

Do they put you at ease?

Do they explain things clearly and in terms you understand, rather than blinding you with science?

Again, back to the job interview analogy: if you were recruiting this person could you work well with them? Are they a good ‘fit’?

You want to be able to confidently answer ‘yes’.

Do remember though, clinics are businesses and they want you to choose their clinic, not their competitors. So keep a cool head and don’t be charmed into submission with promises of having ‘seen it all before and we’ll sort you out in no time’. If they don’t have the stats to back up their promises, or aren’t willing to clearly explain the treatment plan they have in mind for you – including ALL costs – then don’t feel pressured into going with them. It’s your body, your money, and your choice of consultant.

And a final piece of advice?

Try before you buy.

Most clinics host open days, evening talks and lab/site visits, enabling you to get a good feel for the people and the place well before you have to hand over your credit card.

Many clinics will also have someone who can answer your queries via email or phone and some will happily arrange a free initial consultation via Skype.

Clinics are competing for your business so it’s your prerogative to ask them any questions you might have – don’t worry that you’re wasting their time.

The right clinic is out there for you, so shop around and make an educated choice.  Having trust and confidence in your clinic and consultant will help you to embrace your fertility treatment with a much more positive mindset.

FURTHER INFORMATION:

Other good sources of clinic information include:

The HFEA www.hfea.gov.uk

Fertility Network UK www.fertilitynetworkuk.org

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TTC Tips: 10 questions to ask a fertility clinic

TTC Tips: 10 questions to ask a fertility clinic

 

By Hannah Saunders, co-founder at The Fertility Circle.  Hannah underwent five rounds of IVF at three different hospitals/clinics (including one in Hong Kong).  You can read her story in her Path to Parenthood, here 

Your first consultation with a fertility clinic can feel a little daunting.   All the unfamiliar terms, worries about whether they can fix you, if you can even afford it, and, well, just the pure medicalness of it all.

And whether you’ve a limited choice of clinic (e.g. if your treatment is going to be NHS-funded at a hospital near your home), or you’re working your way through a hefty shortlist of private clinics, there are some bits of info you’ll need before you commit.

But don’t worry, we’ve done some of the heavy-lifting for you.

Below is a handy checklist:  it’s the ten key questions to ask your consultant at your first meeting.

Q1: Am I eligible for treatment at your clinic?

Before you get too far down the line, double check the clinic is willing to treat you.  A few clinics have certain criteria you need to meet and won’t treat you if, for example:

-Your BMI (Body Mass Index) is above 30

-You are over 37

-Test results (such as your FSH score) aren't in line with the clinic's requirements

Many clinics have relaxed their criteria in recent years though and some now even trade on their open-arms approach (e.g. with an over-40s programme) but do ask the question up front to be sure.

Q2: Which treatment would you recommend, and why?

If you’ve been trying to get pregnant for some time, it's possible you may have already undergone some tests (usually via your GP or hospital referral), and might know what your particular fertility issue is.

However, according to recent HFEA data, up to 33% of patients undergoing fertility treatment are suffering from what is usually described as ‘unexplained infertility’, i.e. the root cause is unknown.

If this is the case, it’s possible your consultant might recommend a further course of tests, first, to see if they can pinpoint any specific issues (These tests might include things like sperm count and sperm motility testing; blood tests to check your hormone levels and other fertility markers; ultrasounds and genetic testing, among other things).

If you’ve been through most of the tests already and/or are just keen to crack on with treatment, then your doctor will map out a suggested treatment plan for you.

At your first meeting, ask them to explain exactly what they’re recommending, and why.

Use this opportunity to sense-check your understanding of the difference between many of the acronyms you’ll hear bandied about: IVF, ICSI, IUI... and what's involved in each.

For example, if you’re needing IVF, will you need ICSI too (if there’s potentially an issue with sperm count or motility)? Or should you start off with IUI and see how that goes before moving to IVF later, if required?

Doctors sometimes forget that all of this stuff is brand new to most of us – all the FSH, AMH, IUIs and ICSIs – and it can take a while to get your head around it.  Don’t let them rush through their explanation just because they’ve outlined the process to 1,000 other couples before you.  Ask them to walk you through, step-by-step, and use diagrams to explain things, especially if you’re more visual than verbal!

Also request a written summary of your treatment plan if possible, but if your consultant is pressed for time (and they usually are of course), make sure you take notes yourself.

TOP TIP: read your notes BACK to your consultant by way of summary before you leave to make sure you’ve not missed anything or have inadvertently invented new names for things…it’s a well-known phenomenon that fertility treatment plans are crystal clear when you’re with the consultant but everything they’ve said mysteriously evaporates into the ether as soon as you close the door behind you.

Finally, ask your consultant to sketch out the likely timings of your treatment.  For example, there are several steps in an IVF cycle, including the stimulation or injection phase, egg collection and embryo transfer. The length of time it takes to complete the cycle depends on whether you’re doing a long or short protocol so it’s good to understand the approximate number of days/weeks in each phase of your treatment.  And seeing the big picture before you start also helps remove some of that fear of the unknown.

Q3: What are my chances of success with this treatment at your clinic?

Success rates can vary significantly between clinics so you need to understand their figures.

Try to tease out:

-When were your figures reported?  Are they current or is the clinic still using stats from three years ago?

-What’s the live birth rate for my treatment at your clinic? (this is a more important marker than the number of pregnancies or embryos transferred)

-What’s the percentage of live births in my own age group?

This is the most helpful stat to get your head around.  While IVF has an average success rate across all age groups in the UK of 22% per embryo transfer (Source: HFEA Fertility Treatment 2017: Trends & Figures report), and 29% for women under 35, if you’re aged 40-42 that figure dips to 11% because of the natural decline in egg quantity and quality after the age of 35.

You need to ask your consultant to be totally open and honest about your chances with, say, IVF.  No one wants to leave the consulting room feeling dejected but you have to be pragmatic about success rates based on your age/medical issue. Treatment costs can quickly mount up so you need to be in full possession of the facts and spend your budget on the treatment which will offer the best chance of success for you. For example, if you're already over 40 is it better to go straight to IVF or try ICSI first and work up to IVF? Your consultant should help you work through these big and important decisions.

-Is there anything else I can do to help improve my chance of success?

For example, some clinics might suggest PGS (Pre-implantation Genetic Screening) to check the DNA of embryos created during IVF for genetic abnormalities (this might be recommended if you’ve suffered several miscarriages and your consultant thinks egg quality could be a factor).

Are there any lifestyle changes your clinic would recommend?

And given the rising number of studies showing the benefits of holistic treatments on fertility patients, are there any complementary therapies they would recommend (e.g. acupuncture), and does the clinic offer this, or work with a recommended provider?

Q4: Does your clinic favour single or multiple embryo transfers?

Medical best practice is now for elective single embryo transfer (eSET), as only 1-2% of eSETs result in multiple pregnancies, thereby reducing potential risks to mother and child (see below).

Generally, if you’ve two good quality embryos on embryo transfer day, and one is good enough to freeze, most clinics will suggest you put one back and freeze the other for a later frozen embryo transfer (if required).

However, the decision is not always clear-cut and there are certain circumstances when a clinic might advise putting two embryos back – for example if you only have a couple of embryos of below average quality and therefore nothing to freeze. The best advice is to be clear on the risks of multiple embryo transfers and to discuss the options carefully with your consultant.  Ultimately the decision is 100% yours though, and you have to be comfortable with the outcome, whatever it is.

Q5: What are the risks and side effects?

Once you are clear on the treatment plan your consultant is recommending, it’s important to ask about the drugs they’re proposing and any associated risks or side effects.  OHSS (Ovarian Hyperstimulation Syndrome) – where your ovaries react to the hormone injections and produce too many follicles – is a fairly rare condition but can be quite serious so it’s important to know what symptoms to look out for.

One of the biggest risks from fertility treatment is multiple pregnancy, which can have physical ramifications for both mother and baby, such as premature or preterm birth, or more rarely, birth defects.  Conditions during pregnancy are also more likely if you’re carrying multiple babies, such as high blood pressure and gestational diabetes.

Of course it’s easy to scare yourself silly so get the facts and try to keep perspective.  Risks and side effects do happen and you need to be aware but they are relatively rare.

Q6: Is all treatment done onsite?

In the long list of questions to ask, this one somehow seems like a minor detail when you’re facing up the fertility treatment mountain, but it’s definitely worth knowing upfront whether the laboratory is there onsite or not.

Some hospitals and smaller clinics will use other clinics’ laboratories for embryo culture and embryo transfer.  Which means while you might have been enjoying a short trip to and from the hospital for your blood tests, consultant appointments and ultrasounds during the initial phases of treatment, you could suddenly find yourself trekking halfway across the city for your embryo transfer.

While we’re talking laboratories, it’s also good to ask about embryo development and transfer: does the clinic do a 3 or a 5 day transfer?

Most clinics will tend to favour pushing to 5 days or blastocyst stage if they can, but there is then a risk that you could end up with only a few, or even no embryos to transfer. Talk to your consultant about their laboratory processes and the embryology team as an experienced team can really make all the difference.

 Q7: How much will my treatment cost?

There’s no escaping it:  fertility treatment can be extremely expensive if you’re having to pay for it yourself.

Clinics’ pricing information tends towards the ambiguous.  Many clinics quote a figure on their website, for IVF, say, but it will likely exclude many of the essentials you’ll need, such as medication, and sometimes blood tests and ultrasounds, too.

This can make it not only hard to set a clear upfront budget and know exactly what you’re in for financially, but also to compare clinics.

At your first clinic appointment, drill down into every aspect of your treatment plan and ask for itemised costs for each element.

Also ask whether your prospective clinic offers any kind of financial packages for your treatment.

Some offer ‘multi-cycle IVF’ or ‘Refund IVF’, which means you pay an upfront fixed fee for your treatment package for say, 3 cycles of IVF, and if you don’t get pregnant with that clinic after the three cycles, you are refunded part or even all of your initial payment.

The downside is you end up paying slightly over the odds if you’re lucky enough to get pregnant with your first cycle (but hey, at that point you won’t care about the money you spent – you’re pregnant). And given some recent studies suggest the average couple take 2.7 IVF cycles before getting pregnant, it could be worth considering, particularly if you’re the type of person who likes to have a plan in place and keep a tight rein on your finances.

Q8: Tell me about appointments and communication

Some clinics can get extremely busy, especially in cities, or if they have consistently high success rates.  The amount of contact time you’ll need, for blood tests and scans, will vary between clinics too. It’s useful to ask the following:

-How often will I need to come into the clinic?

-I’m working full-time – do you have flexible appointment times e.g early mornings/later evenings and weekends for blood tests?

-How often will I see a consultant?

-Will you be overseeing my treatment personally?

-How often will I be updated during treatment and how/by whom?

-When can I start treatment?

This last one is important. Your preferred clinic might not be able to treat you immediately and you might be put on a waiting list.  Ask how long the wait is going to be and if it’s several months and time is of the essence, you might want to consider going with one of your other shortlisted clinics, especially if their success rates are similar.

Q9: How long has the team been together?

This might seem an odd question to ask, but several studies have shown that teams – particularly in the medical, airline and military fields - who have worked together for a long time tend to get better results (it’s known as the ‘familiarity effect’. We’re going a bit off topic but this Harvard Business Review article explains things in case you’re interested https://hbr.org/2013/12/the-hidden-benefits-of-keeping-teams-intact).

As well as asking the question straight up at your first appointment, there’s usually a ‘meet the team’ section on clinics’ own sites; and you can find some candid feedback from past patients on a variety of fertility forums.  And here at The Fertility Circle, you can read other members’ reviews and ratings of each of the clinics listed in our database.

Q10: What happens if my treatment doesn’t work? What next?

It’s always good to have a back-up plan. You might start with IUI, but if you’ve not had success after a few rounds, move onto IVF (depending on your age and fertility issue).

So before choosing your clinic, it’s good to know:

-Does your clinic offer the full spectrum of fertility treatments?

-Do you offer counselling if my treatment fails and I need some support?

-Do you offer egg donor/sperm donor treatment, if I might need to consider it in future?

A few final tips:

Don’t forget the paperwork

Remember to take any paperwork you have with you to your appointment.  Blood test results; any investigative procedure results; relevant medical history for you and your partner.  This is all essential background info for your consultant to help them determine the best protocol (treatment type) for you.

Write it down

If, like me, you’ve a memory like a sieve, take as many notes as you can during your consultation. You’ll be unintentionally bombarded with rapid-fire stats and drug-names and you’ll probably leave the room with your head swimming, thinking ‘what is it we’re supposed to do next?’.  Better still, give this task to your partner or friend, if you've someone accompanying you on your appointment. It’ll not only make them feel a really useful part of the process (because let’s face it, there can be times along the fertility journey when they can feel like a casual bystander), but allow you to focus your full attention on your checklist.

Be a good listener

There’s an awful lot of info to digest at your first appointment and naturally you’ll be bursting to ask your questions.  Just make sure you give your consultant a chance to get a word in edgeways, too!

Good luck!

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Fertility 101: ICSI - how it works

Fertility 101: ICSI - how it works

What is ICSI?

Intracytoplasmic Sperm Injection (or ICSI, as it’s more memorably known), is a technique used during IVF – most commonly in couples experiencing male fertility problems.

In a standard IVF round, all the sperm in a sperm sample (around 50,000 of them!) will be put together with the egg and left to fertilise.

With ICSI, a single sperm is selected. 

Using a tiny needle, the sperm is injected directly into the egg in a laboratory dish.  This is to increase the chances of fertilisation between sperm and egg where the sperm may find it difficult to break through on its own – for example if the egg’s outer casing is too thick or the sperm is unable to swim well.

As with standard IVF, once fertilisation has taken place, the embryo is left in the laboratory to grow for between one and five days, before it is then transferred to the woman’s uterus.

Is ICSI for me? 

The majority of couples use ICSI during IVF to combat sperm-related issues, as it’s the most successful option for male infertility.

For example, if you or your partner have:

  • A very low sperm count
  • Abnormally shaped sperm
  • Sperm that don’t swim well
  • A blockage the prevents sperm being ejaculated normally (either through illness, injury or genetic issue) or you’ve had a vasectomy
  • Had unsuccessful IVF treatments previously and none, or very few of the eggs fertilised
  • Unexplained infertility, i.e. the majority of fertility markers have tested within normal ranges for you and your partner but you've been unable to fall pregnant naturally

What’s the process?

The process is exactly the same as with a standard IVF round (go to our What’s the Process section of IVF Fertility 101).

However, in ICSI, the embryologist will inject a single sperm into the egg, rather than leaving the sperm and egg to fertilise on their own.

How much does it cost?

ICSI costs are between £500-£1,000 per treatment cycle and are applied on top of your standard IVF treatment costs (which are usually £4,000-£10,000 depending on drugs and test required). 

Will it work?

ICSI results look impressive, resulting in the successful fertilisation of the egg with the injected sperm in up to 90% of couples, and the overall success rates for IVF with ICSI versus IVF without are about the same (go to our Fertility 101 Will it work? section).  So if your doctor has isolated male factor issues as the key cause of your inability to get pregnant then it’s a great option to try.

Do remember though that as with all fertility treatments, egg quality is key – and declines with age – so in spite of the high fertilisation rates there’s no guarantee that the embryo will continue to develop normally and some embryos may stop growing. 

And if your treatment cycle isn’t successful, you might want to wait a few months after treatment to give yourself a bit of space and time to recover before trying again, provided your doctor thinks ICSI is still the best option for you.

Alternatively, you can explore the many other options to start a family, including using donor sperm, donor embryos, or adoption.

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Fertility 101: overseas fertility treatment - is it right for you?

Fertility 101: overseas fertility treatment - is it right for you?

 

By Emma and Adam Haslam, founders of Your IVF abroad which facilitates safe and affordable assisted fertility treatment in a range of European clinics for patients who can’t or don’t want to have treatment within the UK system. Here Emma and Adam share their views on seeking IVF abroad based on their personal experiences and what led them to set up Your IVF Abroad.

 

“It just sounds like even more hassle…”

“Surely the language barrier will make things more complicated?”

“I can’t have that much time off work.”

“British fertility treatment is the best in the world…isn’t it?”

 

These are the concerns we hear day in, day out from prospective patients and believe it or not, until about five years ago myself and my husband Adam had the same worries and misconceptions about what fertility treatment outside of the UK would be like.

Let us start by saying that we are not here to badmouth or criticise the service provided by British clinics – to the contrary, we have lots of friends who have been lucky enough to have had successful treatment with both the NHS and private fertility centres.

But, if we give you a little detail into how we ended up having (successful!) IVF in the Czech Republic, it may shed some light as to why we feel SO passionately that there are real and tangible advantages to having treatment abroad.

Like many of you, I was 33 when I heard the words no newly married woman desperate to start a family with her husband, ever wants to hear: “We’re sorry Mrs Haslam but you’re perimenopausal with an inadequate (never good!) ovarian reserve and your BMI is too high for NHS treatment. Oh, and your husband’s sperm count is extremely low and has very poor motility.”

Not so much a double blow, more of a triple sucker punch.

Our limited funds meant we couldn’t afford the £6,500 to £10,000 plus that we were being quoted by some of the private clinics at home in the UK, particularly when we knew our odds were so poor and that multiple rounds could be on the cards. We were desolate.

Desperate Google hunts for alternatives led us to investigate a few clinics in the Czech Republic. Suddenly there was a chink of light – we quickly realised that even with flights, accommodation and medication, any potential treatment would be around 40% to 50% cheaper than those UK clinics. That slashed treatment costs by thousands of pounds.

You can read more about how our story ended here (clue – he’s about 2 ft tall with a penchant for Peppa Pig) but we want to address some of the most commonly asked issues that might help you decide whether you should dust off your passport in your quest to have a family.

 

1 – It is cheaper (and offers extremely impressive success rates and the very highest standards of care)

The old adage that you get what you pay for does absolutely not ring true in this case.

Assisted reproduction in the UK, without help from the NHS can be expensive. And when you’re already living through the purgatory hell that is infertility, the possibility of additional significant financial strain can cause extra stress for some people.

On average, and for clinics within the Your IVF abroad portfolio, we know that treatment INCLUDING flights, accommodation and medication, will be around 40% to 50% cheaper, on average, than in the UK.

In fact, our three rounds of IVF, cost the same as ONE in the UK, ‌thanks‌ ‌to‌ ‌low‌ ‌cost‌ ‌treatment‌ ‌and‌ ‌our‌ ‌clinic’s‌ ‌guarantee‌ ‌programme ‌that‌ ‌gave‌ ‌us‌ ‌our‌ ‌final‌ ‌cycle‌ ‌for‌ ‌free‌. That’s two extra rounds, and the last magic one, that gave us the most precious gift we could ever hope for. 

As with any clinic, of course you need to do your homework. But the good news is, that the EU has done some very solid legal work in regulating European clinics. And bodies such as the European Society of Human Reproduction and Embryology, like the HFEA in the UK, regularly publish guidelines on industry best practice. It also acts as a legal arbitrator of practices across the EU and clarifies the differing laws on IVF in each member state. So, you’re in safe hands.

Many European countries provide IVF and have excellent success rates.There are major players, like Spain, Greece and the Czech Republic. I can tell you that our clinic was uber modern, uber clean and a little like visiting a space-age hotel. Everyone spoke fluent English and the level of clinical and pastoral care was simply outstanding.

And bear in mind that compared to the rest of the world, Europe leads the way in assisted reproduction services. Figures from the European Society of Human Reproduction and Embryology show how flourishing European IVF is. Not including Asia, 71 per cent of worldwide fertility cycles were carried out in mainland Europe in 2009 – the last time the research was done.

In setting up Your IVF abroad we conducted three years of intense research to establish a bank of world-class clinics that each have their particular speciality – be it treating a woman with low ovarian reserve or with immune issues, or ICSI specialists for a man who has sperm quality issues. Because we are completely independent (in fact we are the only independent IVF ‘arranger’ in the UK that isn’t affiliated to a group of clinics) we can genuinely match clients to the right clinics – offering up to three after our initial free consultation.

 

2 – Having a change of scene or soaking up the sun during active treatment could be just what you need  

Many of my friends who had UK treatment said they had to skirt around the issue with their boss and feign multiple doctor’s appointments whilst nipping out for scans and the like. On the whole, they found it very stressful trying to maintain some semblance of normality.  

Personally, I found it hugely beneficial to my mental health to be out of the country, in a completely new place (Prague is SO beautiful!) and essentially ‘on holiday’ whilst being prodded and poked around with.

I felt I could switch off 100% safe in the knowledge that to everyone back home, my husband and I were just ‘on holiday’. There were no questions, no quizzical looks and we could relax (relatively speaking!) with our little secret. And we all know how important it is not to get overly stressed during stims/retrieval/implantation.  

In total we were away, each time, for three days each cycle (we had to have three) and we got to know our favourite places to eat, to walk to and to just generally chill out. It was also great to spend real quality time together, supporting each other one hundred percent rather than dealing with the mundanities of life at home. NEVER underestimate how something as simple as feeling the sun on your skin can really improve your wellbeing during times of great anxiety. 

As with UK treatment there are things that need to be organised before your European treatment can begin - such as blood work, tests, flights and accommodation - but therein is the reason we set up Your IVF abroad - to help get all the fiddly bits done so clients can focus on the important baby making part!

 

3 – Anonymity laws around treatment involving donors. 

Due to us both having health issues that would make using my own eggs and Adam’s sperm almost impossible, we ended up opting for treatment involving a donor embryo. 

In most (not all) European countries, there are strict anonymity laws around donor eggs, sperm and embryos, unlike here in the UK where donor-conceived children can, if they wish, find out identifying information and attempt to make contact with their donor once they reach 18.

Decisions around the anonymity of donors are extremely personal and people feel very differently about the best way to approach this. Anonymity was key for us in ensuring we could all move forward as a family. 

 

4 – It’s a whole lot quicker

Another crucial factor was speed – treatment‌ ‌with ‌donor‌ ‌embryo’s‌ ‌in‌ ‌the‌ ‌UK‌ ‌is‌ ‌even more expensive‌ ‌and‌ ‌the‌ ‌waiting‌ ‌lists‌ ‌can be lonnnnng….

So for those of you who might be looking at fertility treatment such as IVF with own egg and sperm, or donor egg and sperm or embryo adoption, it’s worth knowing that European clinics do not have the frustrating and unbearably long waiting lists that you’ll find in the UK and you can usually start treatment as quickly as your next cycle. 

Take Spain for example, which is now widely recognised as Europe’s egg donation epicentre accounting for around a third of all IVF cycles performed and around 50% of all European donation activity.

The reasons behind this lie in the fact that donors are paid and there is an active donor recruitment programme. Women aged between 18 – 25 years old are targeted by refer-a-friend schemes and stand to earn around €1,000 per donor cycle which takes around two to three weeks. Egg donation has therefore become an attractive and acceptable means of complementing your income and means that the donor supply/demand ratio is pretty balanced. ‌‌Donor’s‌ ‌are‌ ‌screened‌ ‌as‌ ‌are‌ ‌the‌ ‌embryo’s‌ ‌created‌ ‌and‌ ‌you‌ ‌can‌ ‌match‌ ‌your‌ ‌ethnicity,‌ ‌hair,‌ ‌eye‌ ‌colour,‌ ‌height‌ ‌and‌ ‌blood‌ ‌type.‌ ‌You‌ ‌even‌ ‌get‌ ‌to‌ ‌find‌ ‌out‌ ‌about‌ ‌the‌ ‌donor’s‌ ‌level‌ ‌of‌ ‌education‌ ‌and‌ ‌profession should you wish.‌ ‌

All of this can be a huge plus if you are a same-sex couple, single, over 40 or have a BMI over 35 (and are therefore turned down for NHS treatment like I was) and know that a donor, in some way, shape or form, is going to be a part of your story.  

So, there you have it – our reasons as to why stepping on a plane for your fertility treatment does not need to be as daunting as you think.

As in life, cost seems to be the overarching factor, which is why we are just so passionate (I want to shout it from the ROOFTOPS!) about telling people that European treatment can be MUCH cheaper and the standards are TREMENDOUS.

It’s impossible for us to talk about our IVF experience without becoming a little emotional.

We’ve been there, we understand how torturous it can feel and we wish you all so much luck.

Keep going. One day it will all be worth it.

Find out more information about Your IVF Abroad here.

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Fertility 101: egg donor IVF - how it works

Fertility 101: egg donor IVF - how it works

 

 

What is egg donor IVF?

In egg donor treatment, another woman’s eggs are used instead of your own in order to have a child. The eggs are collected from your donor via IVF and are fertilised – either with your partner’s sperm, or sperm from a donor - in the same way as in a regular IVF cycle i.e. in the laboratory [our Fertility 101: IVF – how it works will give you all the basics].

Eggs can be sourced via:

-an altruistic donor.  This refers to someone motivated by kindness to help others and in the UK is anonymous. A suitable match can be found via an egg donor agency or a licensed UK clinic. (See what’s the process?, below)

-an international clinic or egg bank

-an ‘egg share’ IVF cycle – where the eggs collected from your donor are split between the two of you for your own IVF treatment and also theirs

-a ‘known donor’ such as a close friend or relative

Whichever route you choose, you should work with a clinic with a good track record in donor treatment to ensure all the appropriate screening and paperwork is covered off.

Although egg donor IVF is becoming much more common, the decision to use an egg donor is quite a big one and you will need to think your way around some of the wider implications. Even if you’re coming to egg donor IVF having tried multiple other treatments, it can still take a little time to come to terms with the fact there’ll be no genetic link between mother and child; or the fact that your child will be legally entitled to contact your egg donor when they turn 18 (although it’s important to be aware that your donor will have no legal rights or responsibilities to any children born using their eggs). It’s natural to have lots of questions about the process and clinics will offer you counselling to help you work through everything.  There are some great organisations and forums to support you, too, such as the Donor Conception Network [https://www.dcnetwork.org].

When might I consider egg donor treatment?

There are a number of scenarios that might mean you'll want to consider using donated eggs to get pregnant.

If your eggs have been damaged by serious illness or during treatment (e.g. chemotherapy) you may not be able to use your own eggs to have a baby.

Early menopause or a high risk of passing on a genetic disease are other reasons you might need to use donated eggs.

Or you might be in a same sex couple.

Overall, women are increasingly turning to egg donation, particularly if other attempts to get pregnant using their own eggs have been unsuccessful. And the odds of getting pregnant if you're in the older age bracket are significantly improved compared to own-egg IVF, so for some the decision is largely based on the increased chance of success.

What’s the process?

In a fresh donor egg cycle, the process will broadly follow these steps.  Once a donor has been found and a date has been agreed to start the cycle with your donor, you can expect the process to take around 4-6 weeks. 

Step One: Egg donor matching

If you’re using an agency or clinic to source an egg donor, they’ll look through their donor list to see whether they’ve an appropriate match. If not, you’ll be put on a waiting list until someone suitable comes up.

In the UK, donors must be aged between 18 and 35 and have to go through rigorous screening before they are accepted by a clinic as a potential donor.

Step Two: Hormone treatment

If you’re doing a fresh egg donor cycle, both you and your donor will be given hormone treatment in order to suppress and synchronise your menstrual cycles.

Your donor will then enter the stimulation phase, where she will inject herself daily with gonadotrophin - a hormone which stimulate egg production – so she produces as many eggs as possible.

Step Three: Recipient preparation

Having an endometrial lining of at least 7mm gives your donor eggs the best chance of implantation, so while your donor is taking her injections, you will be given progesterone and oestrogen to develop your lining to the right thickness.

Step Four: Donor egg retrieval

When your donor’s eggs are fully developed, she will be given what’s known as a ‘trigger shot’ to trigger the final ripening of the eggs.

Two days later, your donor will be given a light anaesthetic and her eggs will be retrieved in a quick and simple procedure.

Step Five: Fertilisation

Your donor’s eggs are now ready to be fertilised with either your partner’s or donor sperm.

If you are using fresh (rather than previously frozen and thawed sperm), your partner or sperm donor will need to produce a sample at the same time as your donor’s eggs are collected.

The embryos which develop once the egg is put together with the sperm are monitored in the laboratory so your clinician can see which embryos are developing best.  Embryo transfers can be done on day 2, 3 or 5 and if possible, your clinic will usually push for a day 5 transfer when your embryos are becoming blastocysts.

Step 6: Embryo transfer

Once your clinic has graded your developed embryos and decided which ones look the best, you’ll be called in for the embryo transfer. The procedure takes around 30 minutes and is pretty painless: a tiny catheter is used to guide the chosen embryos into place and you can usually watch all the action happening on screen – it’s an incredibly exciting moment!

Any unused embryos from this cycle that are suitable for freezing can then be stored for future use - for example if this cycle does not result in pregnancy, or to create siblings with the same genetic link.

Step 7: Pregnancy test

Two weeks after your embryo transfer, you can take a home pregnancy test.  If it’s positive, you’ll need to book in with your clinic or GP for a blood test to confirm the pregnancy.

 

In a frozen donor egg cycle using frozen eggs from an egg bank, the process will be shorter since your donor has already gone through the stimulation and retrieval phase, so it’s only your cycle which will need to be managed and your lining prepared for transfer. You might also bypass lengthy waiting lists as you won’t need to wait until a suitable donor match comes through on your clinic’s books.

Do bear in mind there are pros and cons to weigh up when looking at fresh donor egg cycle vs frozen donor egg cycle.  For example, some studies show a slightly higher success rate in fresh donor egg cycles compared to frozen, so it’s best to do your research before going ahead.

You can find more information about egg donor IVF treatment on the HFEA’s website, www.hfea.org.ukand via the Donor Conception Network, www.dcnetwork.org.

Will I need to pay for donor eggs? 

Some individuals are able to get NHS funding for their treatment.  The best thing is to talk to your GP to find out about eligibility and funding criteria based on your age, situation and location.

If you do need to undergo private egg donor IVF (which most people do), it can be quite expensive, which is why it's important to choose your clinic and egg donor source carefully.

It is actually illegal to pay a donor for their eggs.  However, altruistic donors can be compensated up to £750 to cover their expenses.

Pricing varies significantly between clinics, who all have their own price lists, but an average egg donor IVF treatment cycle (once blood tests, scans and fees are included) can easily be upwards of £10,000 and can be as high as £15,000 in the UK.

Doing an egg share cycle (when your chosen donor shares half of her eggs with you and keeps the other half for her own use) can help reduce the costs quite significantly so it’s worth asking your clinic about this option.

Egg share donors will receive funding for either all or part of their own IVF treatment in return for donating half of their egg to the egg donor recipient.

Sourcing an overseas egg donor, either via a clinic abroad, or an international egg bank, can also be a cost-effective option, so you might want to consider this, too.
If you choose to use a donor agency they will charge a fee to find you an altruistic donor. Once a suitable match has been found you will then have to pay your chosen clinic for both your own and your donor's treatment. This can be comparatively more costly than egg sharing but the key benefit is you'll receive all of the eggs the donor produces.

Will it work?

The fantastic thing about egg donor IVF – in spite of the high costs – is that success rates are good. Couples using donated eggs have around a 10-15% higher chance of getting pregnant than with their own eggs, on average. And although stats vary between clinics, you can generally expect upwards of a 50% chance of success with donor egg IVF, with many clinics reporting success rates in the high 60s. As with any fertility treatment planning, it’s good to do your homework and compare success rates between your shortlisted clinics.  For more information on clinical success rates, visit the Human Fertilisation & Embryology Authority (HFEA) website:www.hfea.gov.uk

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Fertility 101: IVF - how it works

Fertility 101: IVF - how it works

What is IVF?

In IVF (in vitro fertilisation), an egg is removed from a woman’s ovaries and fertilised, in a laboratory, with sperm.  The ‘in vitro’ bit literally means ‘in glass’, so-named because the hoped-for fertilisation takes place outside the body, in a petri dish.

The goal is to cultivate a viable embryo that can then be placed back inside the woman’s uterus to develop into a healthy baby.

IVF can be carried out using:

  • Your own eggs and partner’s sperm; 
  • Donor eggs and your partner’s sperm;
  • Your own eggs and donor sperm;
  • Both donor eggs and sperm.    

Is IVF for me?

We are all different and some of us take longer than others to get pregnant.

If you’re experiencing difficulties conceiving and have been trying for some time – and the general rule of thumb is two years if you’re under 35 and six months if your over 35 - then the best first step is to see your GP.  

They can do some basic tests (including blood tests, ultrasounds to look at the condition of the womb) to help rule out any underlying, but often treatable, medical conditions which may be a factor.  They can also talk you through the various fertility treatment options (also see our guides for more) and might recommend IVF if:

  • You’re female, under 40, and have been struggling to conceive naturally after two years of regular sex
  • You’ve been diagnosed with a condition affecting your fertility such as blocked or damaged fallopian tubes, or you’ve had to have them removed
  • You suffer from endometriosis; polycystic ovarian syndrome (PCOS); fibroids etc
  • Your menstrual cycles are irregular
  • You’re no longer ovulating - if you’ve gone through early menopause for example
  • You or your partner have undergone cancer treatment which may have affected your fertility
  • Your partner is experiencing male factor infertility such as low sperm count 
  • Either you or your partner has a known genetic condition
  • You’re in a same-sex couple
  • You’re a single woman wanting to start a family
  • You’ve tried some other fertility treatments e.g. fertility drugs to regulate ovulation or you’ve tried artificial insemination without success
  • You’re experiencing ‘unexplained infertility’ ie there’s no apparent medical reason why you’re having difficulties conceiving

What’s the process?

The prospect of IVF can seem like a BIG THING and very ‘medical’ so understanding what happens at each stage of the process can help it feel a bit more approachable.  Here’s a quick breakdown so you know what to expect in a typical cycle: 

  1.  Cycle management. You might be put on the contraceptive pill for the month before you start your IVF cycle.  Although this sounds counter-intuitive, this is just so your doctor can control the timing of ovulation in preparation for your treatment. 
  2. Stimulation.  You’ll be given drugs which are usually self-injected daily and taken for around 10 to 14 days.  Usually, in a natural cycle, your body only releases one egg per month at ovulation time. The IVF medicine (usually known as Gonadotrophins) stimulates your ovaries into producing multiple eggs which can then be retrieved from your ovaries once they’ve had chance to ripen or ‘mature’. The average number of eggs retrieved is between 8-15 but you’re looking for quality not quantity so don’t be disheartened if you only produce a couple of eggs, especially in your first cycle. IVF is not a precise science and response to treatment can vary from one person to another.  Your doctor can tweak subsequent rounds of IVF based on your response to the drugs. Plus, remember it only takes one good embryo to get you pregnant. 
  3. Monitoring. You’ll be booked in for regular scans and blood tests during the stimulation phase – normally every few days.  The ultrasound scans are to check how many follicles you're producing in response to the medication, how quickly they are growing and how big they are.  Your doctor will use this information to estimate when the eggs are likely to be ‘ripe’ and therefore when ovulation might occur. Timing is key in IVF: the doctors don’t want you to ovulate too soon – they need to be able to remove the eggs when they are ready, during the egg collection procedure (see step 5, below).  
  4. Trigger shot. Two days before your eggs are due to be collected, you will be told to take another hormone injection, usually referred to as the ‘trigger shot’ as it triggers the final maturation of the eggs.  
  5. Egg collection. You’ll be given a light general anaesthetic so your doctor can retrieve the eggs that have been developing over the last couple of weeks.  It’s a short, straight-forward procedure using guided ultrasound and you’ll be able to go home the same day (though it’s important to have someone to collect you because you’ll be unfit to drive with the anaesthetic).  When you wake up you’ll be told how many eggs they collected. Your eggs will be taken straight to the lab where the embryologists will start put them with the sperm collected in a sperm sample from your partner that day (via masturbation) or using donor sperm.   
  6. Fertilisation and embryo development. Hopefully some of the eggs fertilise and the embryos begin to develop. Your eggs will be monitored daily in the lab and you’ll be kept updated on their progress, usually by phone. The embryologist will judge when it’s best to transfer the developing embryo or embryos back into your uterus.  If egg quantity and quality is good, the embryologist will usually try to let the eggs mature in the lab for as long as possible, ideally to blastocyst stage, but your eggs might be transferred any time from day 1 to day 6 after retrieval. 
  7. Embryo transfer. You’ll be fully awake for this quick, simple procedure and it’s fascinating to watch on the ultrasound screen as your embryo or embryos are guided into your uterus via a very thin catheter.  You’re able to get up off the bed straightaway (there’s no scientific evidence to suggest lying down has any effect on implantation whatsoever) and carry on your day. 
  8. Embryo freezing. If you have any embryos left over from your IVF cycle that are suitable for freezing, they can be stored for future transfers.
  9. The two week wait. You’ve made it through the injections and medical procedures, and now…nothing. Possibly the hardest part of any IVF cycle, this last 10-14 day phase sees you counting down the days until you can take a pregnancy test and/or have a blood test back at the hospital to determine whether or not the treatment has been successful.  If so, you’ll have your first pregnancy scan two weeks later. If it hasn’t worked, you can discuss next steps and options with your doctor. 

Will I need to pay for IVF?

The short answer? It depends.

Somewhat unfairly, the availability of NHS funding for your IVF and how many free ‘cycles’ or ‘rounds’ you’re entitled to largely comes down to where you live (you may have seen headlines in the press highlighting this unfortunate ‘postcode lottery’ affecting many UK IVF patients).

Guidelines have been set by NICE - the National Institute for Health and Care Excellence - recommending all women in England and Wales aged under 40 should be offered 3 free cycles of IVF treatment on the NHS.

They also say women aged 40-42 should be offered one free IVF cycle provided certain criteria are met. Go here to see the NICE Guidelines in full.

However, since funding is controlled at a local level (by Clinical Commissioning Groups, or CCGs) and not all CCGs provide the full 3 funded cycles, you might have to pay a private clinic if you are only offered one cycle on the NHS and need further treatment or if you are not eligible for any funded cycles at all.

You can find out how many cycles your local CCG currently offers by going to Fertility Fairness.

If you’re not eligible for NHS-funded IVF – so if you’re over 40 or need more cycles than those provided by your CCG – then you can opt to have treatment at one of the many private clinics in the UK and abroad (click here to search and book a clinic).

Costs vary but for a single cycle in the UK, once fertility drugs, blood tests and consultation fees have been included, you’ll need to budget £3,000-£5,000 and up.  

There are package discounts available from some clinics – often involving ‘money back guarantees’ for those willing to pre-book a series of IVF cycles – which could work out more cost-effective, particularly given a recent study put the average number of cycles required before success at 2.7, though of course some people do get lucky on the first round.  And it’s also worth remembering that if your initial IVF cycle (often referred to as a ‘fresh’ cycle) is unsuccessful but you have some embryos left over for freezing, it costs a lot less – usually around £1,500 – to do a subsequent cycle to transfer one of your frozen embryos (see our guide to Freezing your eggs).

Will it work?

The good news is that according to a recent report from the HFEA (Human Fertilisation & Embryology Authority), success rates are on the rise:

  • 22% average birth rate for women of all ages using their own eggs
  • 30% in women under 35 using their own eggs in a fresh embryo cycle

However there’s no avoiding the stark reality that success rates in women over 35 decrease quite significantly year-by-year.

To give you an idea, between 2014 and 2015, the percentage of IVF treatments resulting in a live birth was:

  • 23% for women aged 35 to 37 
  • 15% for women aged 38 to 39 
  • 9% for women aged 40 to 42 
  • 3% for women aged 43 to 44 
  • 2% for women aged over 44 

So if you’ve been struggling to get pregnant for some time or are over 35 you might want to get started on treatment sooner rather than later. You might also want to think about alternative ways to start a family, too, such as using donor eggs or sperm; surrogacy and adoption.  See our handy guides for more on these topics, too.

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