Assisted conception is
dreams come true for many in Greece. According to the Human
Fertilization and Embryology Authority (HFEA), about one in eight couples in the
Greece have difficulty conceiving.
Having sex every two to three days is the best way to conceive. Trying to time
intercourse with when you produce eggs (ovulation) can put you both under stress
and this is unlikely to improve the chance of successful
conception.
A woman's fertility gets
lower as she gets older, so older couples are more likely to have difficulty
conceiving children. With regular unprotected sex, 94 percent of fertile women
aged 35 will get pregnant after three years of trying. This drops to 77 percent
for women who are 38. Women who smoke and who are underweight or overweight (BMI
less than 18.5 or over 25kg/m2 are also more likely to have trouble conceiving.
Around one in 20 men may be
sub fertile. The main problem is usually to do with the structure of the sperm.
Lifestyle can have an effect on sperm quality - smoking, drinking too much and
wearing tight-fitting pants (which keep the testicles too warm) can reduce male
fertility.
If you have been trying for
a baby for a year without success, you may be experiencing subfertility and your
GP should consider referring you to a specialist. If you are a woman over 35 or
have had problems in the past such as an entopic pregnancy or pelvic infection,
it may be worth being referred earlier than this.
The most common reasons for
people needing help with conception are:
The woman's ovaries aren't
producing eggs or there aren't enough of the man's sperm, or the sperm are not
active enough.
The fallopian tubes that
carry eggs from the ovaries to the womb are damaged other gynaecological
problems, such as endometriosis or fibroids
However, in up to a quarter
of people attending a fertility clinic, the causes of subfertility or
infertility are unexplained because current testing methods are unable to
determine what is causing the subfertility. Tests and treatments are available
for both male and female fertility problems. Both partners will need to be
tested and it's usually best if you attend appointments together - but follow
the advice of your specialist.
Initial tests of your
fertility can be started by your GP, who can give support and lifestyle advice.
It's best to have treatment for fertility problems under the care of a
specialist team. This team will include a doctor - usually a specialist in
women's health (obstetrics and gynaecology), and a counsellor. Seeing a
counsellor can help you to cope with the stresses and strains that come with
fertility problems and having fertility treatment.
If you have a regular cycle,
you will have a test for your levels of the hormone progesterone seven days
before your period is due. These checks that you are producing eggs (ovulating).
Your blood will also be tested for the other hormones involved in getting
pregnant.
You will have an ultrasound
scan of your womb, fallopian tubes and ovaries. The best quality pictures are
seen when the scanning probe is placed in the vagina (a transvaginal
ultrasound). Your specialist may also suggest you have a laparoscopy, which is a
keyhole operation to look directly at your ovaries and fallopian tubes. An
alternative to a laparoscopy to check your fallopian tubes is a test called a
hysterosalpingogram (HSG). This is a test where your doctor will inject a dye
through your cervix while you have an X-ray. If your fallopian tubes are open,
the dye can be seen to flow through them. HSG is an outpatient test, which means
that you won't need to stay overnight in hospital.
For
Men
You will need to take a
sample of your semen to the clinic for testing. This will look at the numbers of
sperm, how they move and whether they have a normal
structure.
Treatment
The treatment that is best
for you will depend on the cause of subfertility.
Helping you to
ovulate
If all or part of the
subfertility is to do with not ovulating (eg if you have polycystic ovary
syndrome), treatments can stimulate your inactive ovaries to produce eggs. This
is called ovulation induction. At its simplest, this involves taking a medicine
called clomiphene (e.g. Clomid) or tamoxifen for six days each month. Your
doctor may also prescribe a medicine called metformin if you have polycystic
ovary syndrome and clomiphene wasn't effective on its own.
Controlling ovulation and
collecting eggs
A more complex form of
ovulation induction is used if you are preparing for the fertility treatments
called in-vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI).
The aim is to control the timing of your monthly cycle accurately so that your
eggs can be removed and fertilized on a specific day. A normal monthly cycle
will produce only one egg, but with this method, which uses three hormones given
at different times, you produce several ripe eggs at once. This is called
superovulation and it increases your chances of a pregnancy.
Usually, the eggs are
collected while you have an ultrasound scan. A thin needle is passed through
your vagina and into your ovary. This is done as an outpatient procedure, so you
won't need to stay overnight in hospital and you usually won't need a general
anesthetic.
Assisted
conception
There are many different
technologies that can help you to conceive. All of these aim to bring the sperm
and an egg, or eggs, close together.
The three main methods are
as follows.
Intra-uterine insemination
(IUI for short)
Sperm that have been washed
and specially prepared are put inside your womb just before ovulation is due.
This is usually the first method offered to couples who have unexplained
infertility. It's also useful if there are ejaculation problems or mild problems
with the quality of the sperm. IUI can be combined with ovulation induction (see
Helping you to ovulate).
In vitro fertilization
(IVF)
IVF can be carried out with
donor sperm or donor eggs. The sperm and embryos can also be frozen for future
use, although there are strict legal rules, supervised by the HFEA, to regulate
these procedures. You will need to discuss these methods with your specialist.
In the
UK, the Human Fertilisation
and Embryology Authority (HFEA) licenses clinics offering advanced fertility
treatments such as IVF.
Eggs and sperm are mixed in
a test tube in a laboratory - this is where the phrase "test-tube baby" comes
from. Successful fertilization can be seen with a microscope after about 12 to
20 hours. One or two embryos are transferred into your womb using a soft plastic
tube passed through your vagina. IVF is useful if your fallopian tubes are
damaged or have been removed. It can also work well if your subfertility is
caused by endometriosis (for women) and for mild sperm problems (for
men).
Intracytoplasmic sperm
injection (ICSI)
A single sperm is injected
into an egg in the laboratory and the resulting embryo is transferred to the
womb, as with IVF. The cytoplasm is just the scientific name for the insides of
the egg cell. This type of fertility treatment is used when there are more
serious problems with the sperm or when problems between the egg and sperm are
preventing fertilization.
Complications
Complications are when
problems occur during or after the treatment.
Ovulation induction
increases the chances of having a multiple pregnancy (such as twins). This
raises the risk of problems for the mother and baby. Ovulation induction can
also produce a rare condition called ovarian hyperstimulation syndrome, in which
the ovary is overstimulated and produces too much of the hormone oestrogen. As a
result, the woman is at an increased risk of getting blood clots and chest
problems, and may need to go into hospital for monitoring and treatment.
Pregnancies that result from
IVF can still be ectopic (the embryo starts to develop outside the womb, usually
in a fallopian tube). Also, any technique that involves putting instruments into
your body can cause infection or damage to internal organs.
Success
rates
The success of assisted
conception is very variable and depends on the reason for subfertility and, for
women, your age. The success rate goes down sharply over the age of 40. If you
are having IVF or ICSI, your clinic should tell you its live birth rate - the
so-called "take home baby" rate. Each year the figures for the
UK are published by the HFEA
(see Further information).
Embryoland IVF Center Athens
is a new center of excellence in Athens,
Greece, dedicated to the needs of
women and their partners. They offer expert fertility, early pregnancy and
female health care within a unique caring and supportive environment. Their
medical and scientific consultants are all internationally renowned experts and
pioneers in the field of reproductive medicine with extensive experience in
assisted conception.
Embryoland IVF Center Athens
provides a complete program of assisted conception including ovulation
induction, intrauterine insemination (IUI), in vitro fertilisation (IVF) and
intracytoplasmic injection (ICSI) with treatments tailored to individual
patients.
They are sensitive to the
complex issues facing couples with infertility and provide, at every stage, the
necessary emotional support and professional guidance. The clinic also offers a
comprehensive gynaecological and early pregnancy service, with consultant
experts in Sperm
Storage (PCOS),
pre-menstrual tension (PMS), endometriosis and pelvic pain, oncology, the
menopause and adolescent gynaecology. Their consultants can also provide “Well
Woman” screening.
To appreciate how Embryoland
IVF Center Athens can help you conceive, it's important to understand exactly
what has to go right for conception to occur. That's why we've put this Article
together - to provide you with the best possible information on fertility,
infertility, and assisted conception treatments.
If you have particular
questions that we don't cover here, contact us and we'll try to get back to you
as soon as possible.
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