Do you have questions about conceiving or fertility? Ask The Fertility Partnership - £200 voucher to be won

[BellaMumsnet]

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Whether you’ve experienced problems conceiving in the past or you’re exploring IVF options for the first time, finding the right fertility treatment for you or your partner can seem like a confusing and difficult process. With this in mind, the Fertility Partnership’s expert, Professor Tim Child, is on hand to help answer your questions.

Meet Professor Tim Child:
Tim Child is Medical Director of Oxford Fertility and Group Medical Director of The Fertility Partnership, Associate Professor at the University of Oxford, and Honorary Consultant Gynaecologist at the Oxford University Hospitals NHS Foundation Trust. As of 2021, he was appointed to the board of the Human Fertilisation and Embryology Authority (HFEA) - the Government regulator responsible for making sure fertility clinics and research centres comply with the law.

Here’s what The Fertility Partnership has to say:
“Thinking about fertility treatment can be daunting at the best of times and it's natural to have lots of questions. While there are plenty of small changes you can make to help you conceive, if you need advice about fertility treatment, we’re here to offer understanding and expertise.”

So whatever your question about conceiving or understanding the fertility treatments available to you, please post your questions on this thread for Tim to answer. Tim will be back on the 20th April to answer your questions.

All who share a question on the thread below will be entered into a prize draw where one Mumsnet user will win a £200 voucher for a store of their choice (from a list).

Thanks and good luck!

MNHQ

Insight Terms and Conditions apply

*Please note this thread does not constitute personal medical advice, and please do not disclose personal health information on this forum. You should always speak to a GP/healthcare professional in person for advice specific to your situation.

What would be your key things to look for when looking for a private ivf clinic?

Hi, Im new on here. Been TTC for 6 years and have started the process with an IVF clinic. Sadly I found out my amh levels are low at 1.98 so my success rate has dropped from 60% to 15-20%. Is there anything I can do to increase my chances? Can you still get pregnant with low Amh or am I better of exploring other options?

Question: For complex medical backgrounds, following a year of trying to conceive naturally, and a couple in their 30s; would you recommend ‘sperm washing’ and IUI, or would you suggest IVF straight away.

Background to why I’m asking my question: my husband was diagnosed as HIV positive after we’d been trying to conceive for about 12 months. He’s been undetectable for 6 months now. So we believe we can recommence unprotected sex. I have PCOS, endometriosis and adenomyosis, age 33, he’s 34.

How big an impact can lifestyle choices have on fertility?

If I was told that my chance of success for my first ivf cycle is 20%, does it follow that 2 cycles would give a 40% chance, and 3 cycles a 60% chance...? Or does it not work like that?

At 44, with an AMH of 14, is there a chance that I could conceive naturally or is egg quality likely to be low? Is IVF my best chance of success and even then is there much chance?

Im 39 and have been trying for over 9 years naturally have been diagnosed with secondary infertility by nhs and have been advised to "just keep trying". How much longer is it worth trying?

Why do some clinics tell you not to wear deodorant on transfer day?

Do special lubricants such as Sasmar Plus really improve the chance of conception by a significant amount?

Does a low AMH level mean I’ll go through menopause early ?

Do you think the postcode lottery of IVF funding will ever be rectified, or are we looking at it being reduced further?
I'm waiting to see if my one and only NHS funded round of IVF has been successful. I'm 35 and NICE guidelines state I should be offered 3 rounds. My CCG (and all of the other CCGs in this county) will only fund 1 round.

I am 39 and have mild pcos. What would be the chances of me falling pregnant naturally now?

What do you think about dhea for low ovarian reserve?

hi, i m 41 with an AMH of 7.9. i retrieved 14 eggs and 7 fertilised.
i am told that i have a 20% of IVF to work at first retrieval.
And 40% by the 3rd retrieval.
my question is: do women without an issue have more chance trying to conceive by IVF than naturally after 40?
As IVF seems to being more effective as i m ageing but i can retrieve more eggs in one month.
Is IVF the future for women in their 40ies who dont have any other issues to prevent pregnancy?
thanks!

Hello, my question is why is there such discrepancy between the UK regarding IVF funding and waiting lists? I understand in Scotland you are entitled to 3 cycles on the NHS and England is basically a postcode lottery. I am Northern Irish where only one cycle was offered up until recently, now 2 but due to the backlog, we're told the waiting list was approx 4 years. At 36 this is no good to us so we were forced to go privately. (Good decision as we have been on the NHS list for years already) One failed cycle at 9k and another 10.5k spent via Access fertility for 3 cycles of ICSI (not including the meds!) Is this something that is going to be addressed by the NHS going forwards? Ps we got our first and long awaited BFP last week after a 5dt 😊

If you ovulate later than you usually do e.g cycle day 20 instead of day 14, will your period be that many days late too? Ie does your luteal phase stay consistent?

Hello everyone - thanks so much for all of your questions. Finding the right fertility treatment for you or your partner can raise so many questions, so never feel alone in your journey. TC

@BristolMum96

How common is secondary infertility?

Hi @BristolMum96. 1 in 7 couples suffer from the disease of infertility. Secondary infertility, in which the woman has conceived beforehand, can appear for many reasons. It could be because the woman is now older than she was when she conceived beforehand and so less fertile. It could also be that the couple have always had a low monthly chance of natural conception (for whatever reason). Therefore, sometimes conception will happen very early during the first months of trying, leading to the first pregnancy but then later on the very low monthly chance of conception (mixed with bad luck) means that there is a delay, even though nothing has changed. It is also important to assess whether there have been any changes to lifestyle factors (such as BMI, diet, smoking, medical illnesses requiring investigation or treatment) as these can impact primary as well as secondary infertility. I would also advise undergoing the same investigations and treatment for secondary infertility as primary infertility.

@DoctorBambino

Hi Prof Tim! I'm awaiting the start of my next cycle to begin my first round of IVF at OFU. What are your tips to improve chances of a good IVF cycle (lifestyle, diet, exercise, supplements etc)?

Thank you for the question @DoctorBambino. Delighted that you have chosen TFP Oxford Fertility to look after you. The lifestyle factors which have been shown to affect the chance of IVF success include; female BMI (aim to be as normal as possible, certainly less than 30), smoking/vaping, a diet low in processed foods (a Mediterranean diet can also help maximise egg and sperm quality) and if you enjoy exercise then there is no reason to avoid it… do however avoid high impact exercise during IVF stimulation and around or after embryo transfer. For supplements, I often suggest a range such as Pregnacare Conception which has good amounts of Vitamin D plus Folic Acid, as well as other useful vitamins and minerals that are helpful for conception (for both men and women). Best of luck!

@Dyra

How likely is it that someone who needed Clomid to conceive their first child will need it to conceive subsequent children?

@Dyra thank you for your question. Usually Clomid is required to help women with a lack of ovulation due to conditions such as polycystic ovarian syndrome. If Clomid was previously required because of PCOS and it resulted in the birth of a child and you still have irregular periods due to lack of ovulation, then it is likely that the further course of Clomid will be needed to conceive another child.

@Hopezibah

I would love to know more about potential impact of autoimmune conditions on fertility and also treatments like MTX and biologic drugs affecting future fertility. My daughter has been on MTX for sometime due to JIA and I want to understand whether she will need to perhaps consider whether this could have affected her fertility once she is older and ready to start a family so that she can factor this into timescales when planning a family once she is grown-up. We have never been told of this as a risk but I have started to hear anecdotally of people who have low ovarian reserves and they believe it is because of the medications and treatments they have had for their JIA when they were younger.

Hi @Hopezibah, it is important to remember that women can have a very low ovarian reserve but if they continue to have regular periods then the number of eggs in the ovaries doesn't affect the natural chance of conception. However, a lower ovarian reserve can reduce the chance of IVF working. People with a severe autoimmune disorder may have low ovarian reserve due to their condition, rather than any of the drugs, such as methotrexate, that are being used to treat an underlying disease. For your daughter, I suspect her juvenile arthritis will not have a major effect on her fertility but it is always a good idea to assess the situation earlier on in her reproductive journey as an adult. At that time she could arrange a discussion with a fertility expert. In general, it is more important to have an inflammatory autoimmune disease under control by using drugs than it is to avoid the drugs, leading to worsening of the inflammatory condition.

@2mumlife

I've previously been treated for CIN3 cervical changes and cervical erosion. Consultant at my clinic has said I do seem to have a shorter cervix and may need s cervical stitch if I become pregnant. Could this be affecting my ability to conceive? Struggling despite otherwise having no known issues (normal AMH, under 35, hycosy normal, using donor sperm of high quality). Thanks

Hi @2mumlife. A cervical erosion (more properly called an ectropion) will not affect fertility. Having treatment for CIN3 or cervical changes usually does not affect fertility unless a significant amount of cervical tissue has to be removed. As you are having donor sperm treatment then the clinic performing the procedure would normally inject the sperm inside the uterus, beyond the cervix. The treatment on the cervix would therefore not be affecting the chance of the sperm fertilising an egg.

@TechnoDino

Should all women who are diagnosed with PCOS assume that their fertility will e affected, or only of their cycles are very erratic?

Hi @TechnoDino, PCOS will only affect fertility if the cycles are irregular due to lack of frequent ovulation. If the woman has a BMI greater than 30, as is sometimes seen with PCOS, then this separately can affect the chance of conception and increase the risk of miscarriage.

@Dalooah

To what extent does an embryos quality before cryopreservation affect outcomes of successful pregnancy?

Thank you for the question @Dalooah. When IVF Laboratories describe embryo quality they are describing how the embryo looks on the outside. This certainly does affect the chance of the embryo implanting, regardless of whether it is fresh or frozen. It can also affect the chance of the embryo surviving the freezing and thawing procedures. However, the external quality assessment does not tell the embryologist the genetic quality of the embryo within. Embryos having the wrong number of chromosomes is the commonest cause of a failed implantation or early pregnancy loss. This is why embryos that can appear of reduced quality externally can still lead to the birth of a healthy child and why top-quality embryos do not necessarily lead to success.