Category: Fertility Treatments & Options

Is it harder to conceive with your second child? It can be but it’s different for everyone. Unfortunately, infertility affects 1 in 6 people, so if you are struggling, you’re not alone. This article will share everything you need to know about what secondary fertility is, what causes it, and the treatment options available to you. Quick facts: What is secondary infertility? Secondary infertility is when you are having difficulty conceiving after previously conceiving and giving birth. To be defined as secondary infertility, the previous birth must have occurred without help from fertility treatments or medications like IVF (in-vitro fertilisation). The definition of primary infertility, in comparison, is when someone who’s never conceived a child has difficulty conceiving. So, how common is secondary infertility? Struggling to conceive might come as a shock if you’ve already had a baby. Secondary infertility, however, is a challenge faced by lots of individuals and couples who are trying for more children.  A World Health Organization (WHO) report suggests that around 1 in 6 (17.5%) people are affected by infertility (primary and secondary infertility) worldwide. Secondary infertility: definition and signs You can be diagnosed with secondary infertility by a healthcare professional when: The main sign of secondary infertility is being unable to get pregnant when you’re having regular, unprotected sex for up to six months or a year depending on your age. It could also include several failed artificial insemination (IUI) attempts.  If you’re worried about your fertility, discuss it with your GP or a healthcare professional. Common causes of secondary infertility The causes of secondary infertility are the same as the causes of primary infertility. For women and those assigned female-at-birth (AFAB), these include age-related fertility decline, hormonal imbalances, blockages in your reproductive environment (uterus, fallopian tubes or ovaries) and lifestyle choices such as your weight, nutrition, sleep, stress, and smoking and alcohol. For males and those assigned male-at-birth (AMAB), the causes of secondary infertility are similar. These include age-related fertility decline, lifestyle choices, and hormone imbalances. However, specific concerns for males and those AMAB are testicular damage, genital infections, or problems with ejaculation or sperm. Age-related causes of secondary infertility Age-related fertility decline could be a cause of secondary fertility. For women and those AFAB, it’s natural for the quantity (ovarian reserve) and quality of eggs to diminish, leading to a decline in fertility. In your 20s, your fertility peaks. Then, fertility gradually declines in your 30s, particularly after age 35.he chances of getting pregnant each month during your 30s are about 20%. That means that for every 100 fertile 30-year-old women trying to get pregnant in one cycle, 20 will be successful and the other 80 will have to try again.  By age 40, the chance is less than 5% per cycle, so fewer than five out of every 100 women are expected to be successful each month. Advanced maternal age is associated with increased risks of infertility and complications during pregnancy. Factors like decreased ovarian reserve and higher rates of chromosomal abnormalities can contribute to challenges in conception. Hormonal imbalances affecting secondary infertility Hormonal imbalances are a leading cause of primary and secondary infertility. Hormones regulate your menstrual cycle—consider them the orchestrators of your fertility. Hormonal imbalances can indicate conditions like Polyendocrine Metabolic Ovary Syndrome (PMOS, formerly known as PCOS) or thyroid issues and can affect ovulation, meaning you might not release an egg every month or the release may be delayed. If an egg isn’t released, pregnancy can’t occur. Hormonal changes can also negatively affect male fertility, reducing sperm production, mobility and motility.  Infections and STIs affecting secondary infertility Infections, both viral and bacterial, can affect your fertility. Some infections, particularly Sexually transmitted infections (STIs), can have lasting negative effects on your fertility if left untreated so it’s important to get regular checkups. Other viral and bacterial infections might temporarily affect fertility. For male secondary infertility, the testis are particularly susceptible to viral infection. Evidence is also emerging that Covid-19 might impact the testis. A common cause of secondary infertility in males or those AMAB, is poor semen quality, including a low sperm count, and low motility. This means sperm that isn’t moving properly or abnormally-shaped sperm which makes it harder for them to move and fertilise an egg. There’s a male fertility misconception that the type of underwear someone wears can affect fertility. Although there seems to be a link between increased temperature of the scrotum and reduced semen quality, there’s no evidence to suggest that the type of underwear worn by men and those AMAB can affect infertility. If you’ve had any infections, surgeries or medical diagnoses in the last 12 months, it might be worth mentioning to your GP if you’re having trouble conceiving or with secondary infertility. Medical diagnoses and treatments affecting secondary infertility Unfortunately, cancer treatments like radiation and chemotherapy, surgery, or a medical diagnosis can affect secondary infertility. If you’ve recently undergone cancer treatment or are about to, you might want to check your fertility with a advanced hormone and fertility test and consider fertility preservation treatments like egg freezing, IVF (in-vitro fertilisation), and donor eggs or embryos. Lifestyle considerations for secondary infertility Lifestyle choices can affect secondary infertility. Things like being underweight or overweight, smoking, using drugs and drinking alcohol. These can all increase the risk of secondary infertility by disrupting your hormone balance and impacting your overall health and well-being. Poor nutrition can negatively impact fertility Poor nutrition like eating lots of trans fats and saturated fats found in ultra-processed foods, and having a high-sugar diet have been shown to negatively impact fertility. Regular exercise to support fertility Although regular physical exercise is considered healthy and will support weight management and optimise fertility, excessive exercise can negatively affect ovulation and fertility in women and those AFAB. Getting enough sleep to support fertility Studies suggest that sleep disturbances correlate with adverse reproductive health outcomes like menstrual irregularities, increased time to and reduced rates of conception, and increased miscarriages. Women with diminished ovarian […]

Premature Ovarian Insufficiency (POI) is when the ovaries stop working normally before the age of 40. Getting a diagnosis can be worrying at first, but there are options available. Let’s take a look at what you need to know about POI including symptoms and treatments.  Quick facts: What is Premature Ovarian Insufficiency? In short, Premature Ovarian Insufficiency (POI) is when the ovaries stop functioning properly before the age of 40. It can significantly reduce your fertility.  This doesn’t always mean that you don’t have any eggs left in your ovaries or that you couldn’t carry a baby. It means your body is failing to mature eggs or to ovulate each month.You may have heard of Premature Ovarian Insufficiency (POI) being referred to as premature ovarian failure. It is also referred to as Primary Ovarian Insufficiency, gonadal dysgenesis, and hypergonadotropic hypogonadism. Premature Menopause Premature Menopause is when someone before the age of 40 experiences menopause. This means they will not have any more periods and are permanently no longer able to become pregnant.  This is different to POI, where although fertility becomes significantly reduced, there is a chance of spontaneous ovulation, and hence a period might still occur. Some people are still able to conceive spontaneously after their diagnosis. However, POI and Premature Menopause do share many of the same symptoms. What are the symptoms of POI ? POI symptoms are similar to menopause and low oestrogen. You’re likely to experience: Other than menopausal symptoms, loss of skin pigmentation caused by vitiligo or hyperpigmentation can accompany POI. As can hair loss caused by alopecia.  Fatigue, anxiety, and depression can also be common symptoms as a result of other symptoms or a diagnosis (3). If you’re missing your period for three or more months, it’s important to get your hormones tested to try and decipher what’s going on.  You can miss your periods for a number of reasons, including increased stress, changes to your diet or exercise routine. Some people might even like the idea of not getting a period every month, but sudden changes should always be investigated to check the cause of the change and rule out POI or something more serious. What causes POI ? Roughly 1 in 100 people will experience POI and it can affect people up to the age of 40, with some affected as early as their teens (4). But despite its prevalence, the causes, like for many female-reproductive health conditions, are still relatively unknown (2).  POI can happen spontaneously. However, there are a few known risk factors that may increase your risk of developing POI. These include: How is POI diagnosed? To receive a POI diagnosis, you’ll need to get a hormone test. High FSH (greater than 25) and low oestrogen levels, also seen at the onset of menopause, are indicators of POI. This is accompanied by absent, unpredictable or irregular periods for at least two consecutive months.  If POI is suspected, you might also be sent for an internal ultrasound to check your antral follicle count (AFC). Antral follicles are small fluid-filled sacs in your ovaries containing immature eggs. An AFC count is an indicator of the number of eggs you have left in your ovaries, also known as your ovarian reserve. What does POI mean for my overall health? POI can increase the risk of other illnesses or health problems if left untreated. People with untreated POI have an increased risk of developing heart disease and stroke.  Also, because oestrogen plays such an important role in bone health, low oestrogen seen in POI is known to lead to lower bone density, increased risk of bone fractures, and osteoporosis.  There is also evidence that lower oestrogen levels earlier in life can increase the risk of developing Alzheimer’s disease or dementia (3,4). If you have received a POI diagnosis, your doctor will likely recommend hormone therapy to you. This could be in the form of HRT or taking some form of hormonal contraception.  Hormone therapy can help to alleviate symptoms and reduce the risk of developing the associated conditions mentioned above. Does POI affect fertility? Often, yes, POI can reduce your fertility significantly. This can mean getting a diagnosis can be stressful and upsetting, particularly if you want to start or grow your family.  Although POI means your ovaries aren’t functioning properly, as many as 25% of people with POI do spontaneously ovulate. Another 10% do conceive and deliver after their diagnosis (5). If you are looking to get pregnant, there are treatment options available if you have POI—including In Vitro Fertilisation (IVF).  Egg donation is also an option for some people. POI is a condition that affects the ovaries, not the uterus. This means egg implantation and your ability to carry a pregnancy are not greatly affected by a POI. Think you might be experiencing POI symptoms? If you suspect POI symptoms, like irregular or absent periods, it’s important to get checked. Our at-home advanced hormone and fertility test can give you a better insight into your hormones and any symptoms you might be experiencing.  Our team of experts will help you understand whether your symptoms are related to POI or other underlying health conditions. We can also support you with follow-up fertility treatments and fast-track you to specialists for tailored care plans. References:

IVF can be a highly effective fertility treatment for some people, but it doesn’t guarantee a successful pregnancy. Here we cover what the IVF process entails, who could benefit from it and things to consider if you’re thinking about undergoing a cycle.  Quick facts: What is IVF? In-vitro fertilisation (IVF) is a fertility treatment for those who can’t or don’t wish to conceive naturally. It’s one of the most common fertility treatments in the UK, with as many as 50,000 people undergoing IVF in the UK each year.  IVF involves removing eggs from the ovaries, attempting to fertilise them with sperm in a lab and then transplanting any successfully fertilised eggs (embryos) into the uterus. This is called an IVF cycle. It’s an invasive procedure and doesn’t guarantee a successful pregnancy.  Whether or not it’s right for you will depend on a range of personal and medical factors, as well as carefully considering the IVF cycle process. Fresh cycle vs frozen cycle IVF cycles can be fresh or frozen. Once an egg has been successfully fertilised by a sperm in the lab, it creates an embryo. This embryo is then typically incubated in the lab for 3-5 days.  In a fresh cycle, it will then be transferred to the uterus. In a frozen cycle, the embryo will be frozen at this point and transferred to the uterus at another time. This might be done if your uterus isn’t prepared to receive an embryo, or if you had several embryos that were successfully fertilised, they will be frozen, rather than transferring more than 1 at time, which is associated with multiple pregnancies (expecting two or more babies from a pregnancy). Who is IVF for? IVF can benefit lots of different types of people. Some instances where IVF may be explored could be: What happens in an IVF cycle? There are four key stages involved in an IVF cycle—ovulation stimulation, egg retrieval, egg fertilisation and embryo transfer. The entire process may take between 4 to 6 weeks but will vary and depend on you. Ovulation stimulation Firstly, you’ll take a course of fertility medication to stimulate your ovaries to mature multiple eggs. Usually in one menstrual cycle, you’ll only release one egg for ovulation. But this medication stimulates many eggs to mature.  During this time you’ll need to go to the clinic regularly for ultrasounds and blood tests to analyse your progress. The simulation period generally lasts for around 10 days.  Egg retrieval and sperm collection Once your eggs are mature, you’ll undergo a retrieval procedure. Egg retrieval is carried out under ultrasound guidance, where a small transvaginal needle is used to suck follicular fluid  that contains your mature eggs, out of your ovaries. You’ll have the option to have the procedure done under general anaesthetic or mild sedation. Whilst your eggs are being retrieved, your partner or sperm donor will be required to go into the clinic and produce sperm cells which will be used to fertilise your eggs, unless your partner or donor sperm has previously been frozen. Egg fertilisation During the fertilisation step, your eggs and the sperm will be combined in a lab. The goal is for the sperm cells to break into and enter your egg cells where an embryo will be formed.  There are multiple techniques in which your eggs can be fertilised. One technique is called conventional IVF which involves placing the mature eggs in a petri dish full of sperm. Another technique is called intracytoplasmic sperm injection (ICSI), where one sperm cell is selected based on morphology and injected directly into your egg cell. The technique used depends on the sperm, clinic and whether or not you have attempted conventional IVF successfully or not before.   Embryo transfer If you undergo a fresh cycle, any successful embryos will be transferred 2-5 days later. If you have a frozen cycle, you will be given medication to prepare the uterus lining and depending on your progress, your doctor will determine a transfer date.  However, this doesn’t guarantee a pregnancy. The embryo will still need to successfully implant to your uterus. You will be given a pregnancy test roughly 2 weeks later, which can confirm whether or not the IVF process has been successful.  The process for an embryo to grow into a healthy baby and undergo live birth is a very complicated and precise journey. A certain number of chromosomes, which is our genetic information in the form of our DNA, is required for an embryo to develop into a baby.  The test that is used to understand and analyse the number of chromosomes in the embryo before implantation is called Pre-implantation Genetic Screening. However, many other screening techniques can be used too depending on your clinic. Is only one embryo transferred? If more than one egg is fertilised, your doctor will choose one to transfer, based on trying to assure the maximum possibility of a pregnancy. There are multiple criteria that the clinics use to determine this, including:  Sometimes you will be given the option to transfer more than one embryo. This may increase your chances of developing multiple pregnancies but again, doesn’t guarantee a pregnancy. Can you get IVF on the NHS? The NHS provides full funding for IVF for those who: Whether or not you are eligible for IVF under the NHS also depends on where you live as different trusts have different requirements and funding availability. You must discuss thoroughly with your gynaecologist or GP and if you are not eligible, there are many private clinics available for IVF treatments.  The cost for 1 cycle of treatment is roughly £5,000. This depends on the clinic you choose and the treatment protocol you follow.  How effective is IVF? Yes, IVF can be an effective fertility treatment and many women can successfully become pregnant and give birth to healthy babies via IVF. The success rate depends on a range of factors, including age, medical history, sperm quality and success rates of your clinic.  As younger women […]

In this article, we’ll explore how fertility treatments can affect your mental health. We’ll discuss the ups and downs and tips for taking care of your emotional wellbeing. Quick facts: Understanding the emotional side of fertility treatment  Sometimes, the road to parenthood is not as straightforward as we may initially think. If you’ve struggled to conceive naturally, don’t want to, or can’t, fertility treatments can be a great option.  But they can come with a huge range of emotional challenges, that are often lost in the conversation centring around all of the physical aspects of the procedures.  According to recent studies, up to 30% of people seeking fertility assistance report symptoms of anxiety and depression, while nearly 40% grapple with elevated stress levels. Fertility treatments like egg freezing and IVF are often described as ‘emotional rollercoasters’, with moments of joy and love, and moments of sadness, uncertainty and fear.  The anticipation of each treatment cycle, uncertainty of outcome and the financial burdens can all take a toll on mental health. Many individuals and couples going through fertility treatments may feel isolated or like they’re carrying the burden alone, which can exacerbate feelings of loneliness. Some individuals may also feel pressure to conceive within a certain timeframe, adding to the stress. This pressure can come from societal expectations, family, or personal goals. Here we lay out some tips for looking after your mental health during treatment as well as some proactive ways to deal with the prospect of failed treatment. Tips for looking after your mental health during fertility treatment Everyone deals with stress differently and it’s important to find a method that works for you, as well as understanding your triggers. Some of these methods may work for you.  Get as much information as possible about your treatment  Understanding the fertility treatment process can significantly reduce anxiety. Research the steps involved and make sure you know exactly what will happen at each stage. Prepare a list of questions for consultations with your doctor or specialist to clarify any doubts or worries. Knowing what to expect can make the process feel less daunting, allowing you to feel more in control of your journey. Don’t make it the only topic of conversation  While sharing your feelings and concerns with your partner is crucial, it’s essential not to let fertility worries or discussions about your treatment dominate every conversation. Taking breaks to discuss non-fertility-related topics, especially if you’re going through this process with a partner can provide relief and maintain emotional connections with your loved ones.  Lean into your family and friends Your support network is invaluable during fertility treatment. Lean on family and friends who are empathetic and understanding. Share your experiences, but also make time for enjoyable activities together that can take your mind off things. These connections can offer emotional support and a sense of normalcy. Consider fertility counselling Fertility counselling can offer a safe space to explore your emotions and concerns with a mental health professional. These experts can guide you through the emotional challenges of fertility treatment, providing valuable coping strategies and emotional support. You can book an online appointment with one of our fertility counsellors at any time.  Identify your triggers Take time to understand how stress affects you personally. Recognise your personal triggers and signs of stress, such as irritability, sleep disturbances, or physical tension. Once identified, develop a toolbox of coping strategies that work for you. This may include relaxation techniques, journaling, exercise or talking to a friend. Practice mindfulness Mindfulness techniques, like deep breathing, meditation, or progressive muscle relaxation, can help you stay grounded during the emotional turbulence of fertility treatment. Regular practice can reduce anxiety and increase your overall sense of well-being. Keep active and don’t isolate  Maintaining physical activity and staying engaged in enjoyable activities can positively impact your mood. Exercise releases endorphins, which can help alleviate stress. Additionally, avoid isolating yourself during treatment. Maintain social connections to provide emotional support and prevent feelings of loneliness. Avoid any other big life changes The fertility treatment journey itself is a significant life event that can be emotionally taxing. Avoid introducing additional stressors, like moving to a new home or starting a new job, during this period if possible. Staying in a familiar environment and maintaining your established routine can provide stability and reduce anxiety. Join a support group Support from friends and family can also be vital, but it’s important to remember that not everyone will understand the emotional complexity of fertility struggles. Joining a support group can allow you to connect with other people going through the same struggles. There are lots of online groups available or in-person group counselling-based sessions. Waiting for your pregnancy test result The two-week wait, that agonising period between embryo transfer and the pregnancy test, is often one of the most emotionally challenging phases of fertility treatment. It’s a time marked by heightened uncertainty and anxiety, as the long-anticipated results of your efforts hang in the balance.  Try to plan ahead for activities and distractions that can help take your mind off the uncertainty. Having a plan in place can provide a sense of control over your time and emotions during this period. Keep a schedule of daily activities, work commitments, or outings with friends and family. Consider engaging in hobbies you enjoy, reading a good book, or taking up mindfulness and relaxation techniques. It can be beneficial to focus on tasks and experiences that bring you joy and fulfilment. Remember that a busy mind has less space for worries. Lean on your support network during this challenging time. Share your feelings and concerns with loved ones, as they can provide invaluable emotional support. Whether it’s a shoulder to lean on, a listening ear, or a comforting presence, friends and family can help alleviate some of the anxiety and loneliness you may be feeling. Don’t hesitate to communicate your needs to them. Facing the prospect of a failed fertility treatment Experiencing a failed fertility treatment can be emotionally devastating. It’s a moment […]

Fertility preservation methods can be a great way for people to put having kids on hold, or preserve their fertility if they need to for medical reasons. Here we go through the main procedures available to women and those assigned female-at-birth. Quick facts: What is fertility preservation? Fertility preservation involves freezing your eggs, embryos, reproductive tissues or sperm, so they can be used in the future and you can hopefully have a biological family. For women or those assigned female-at-birth, there are a few different fertility preservation methods available. Which one is right for you will depend on your age, medical history and personal fertility goals.  Each method involves removing either eggs or tissues, freezing and storing them in liquid nitrogen—a process called cryopreservation. When you are ready to use them, they can be thawed and used to help you conceive.  These processes are all designed to help those at risk of potential infertility or to assist those who can’t conceive naturally. Who might use fertility preservation? There are lots of different reasons why someone may undergo fertility preservation. Generally, the reasons can be categorised as either medical or social preservation.  In the UK as of July 2022, you can store your eggs for 55 years for both medical and social reasons, as long as you renew your consent every 10 years. Medical fertility preservation Medical fertility preservation is for anyone undergoing fertility preservation for medical reasons. This could include possibly losing their ability to conceive naturally because of impending medical treatment. Reproductive health conditions Some reproductive health conditions such as Premature Ovarian Insufficiency (POI) and early menopause can affect fertility. Additionally, conditions such as endometriosis or fibroids might require surgery around the pelvic organs to manage it, your doctor may suggest fertility preservation before this in case there is a risk of damage to the ovary. Cancer Certain cancers and cancer treatment, including chemotherapy and radiotherapy (especially targeting the pelvic organs), or surgeries impacting the ovaries, can impact our fertility. Egg freezing may be suggested on a case-by-case basis for those who are looking to have children post-cancer treatment. Gender-affirming care If you’re undergoing gender-affirming care, you might want to preserve your fertility before starting hormone therapy or having reconstructive surgery. Although anyone with or undergoing the above may still be able to get pregnant naturally, there might be a risk of impacting their ovarian reserve, which may make it difficult to conceive. This is why considering fertility preservation is recommended before starting therapy.  Social fertility preservation Social fertility preservation is when you freeze your eggs or embryos for ‘social’ reasons. This can include if we are worried about our natural fertility decline with age, but we aren’t quite ready to have children yet. Or if we aren’t sure if we want children at all, but would like to keep our options open for the future.  As we age, our egg quantity and quality decline. This can make getting (and sometimes, staying) pregnant more difficult. Age, also increases the risk of pregnancy-related complications, like miscarriage, genetic disorders in the baby and gestational diabetes, especially after our mid to late 30s. In our early to mid-20s, we are at our most fertile—but there’s still only a 25–30% chance of us getting pregnant each cycle. This gradually reduces during our 30s to around 5% by age 40.  What are the different types of fertility preservation? Fertility-preservation options for women and AFAB people include egg freezing, embryo freezing, ovarian tissue cryopreservation, ovarian transposition and gonadal shielding. Egg freezing (Oocyte cryopreservation):  Egg freezing is a medical procedure which can help us to plan for our future fertility. It’s what’s known as a ‘fertility preservation method’, or scientifically speaking, ‘oocyte cryopreservation’. Egg freezing involves taking medicine to encourage the growth of the eggs in our ovaries, which will then be collected during a short surgical procedure. Viable eggs will be frozen and stored in liquid nitrogen (-196°C). They do not decline in quality—like they would do if they remained in your ovaries as you age.  These eggs can be thawed at a later date whenever you are ready to start a family through fertility treatment. This whole process is what’s called an ‘egg freezing cycle’.  Technically, you can freeze your eggs at any age before menopause, but eggs retrieved in your 20s and early 30s usually result in better outcomes than those in your late 30s and 40s. This is largely to do with the quality of the eggs at the time they are retrieved, as generally, our eggs begin to decline more rapidly from 35 onwards. Embryo cryopreservation (embryo freezing) This is a procedure that involves removing eggs from the ovaries, fertilising them with either a partner or donor sperm to create embryos and then freezing the resulting embryos for future use. Embryo cryopreservation would usually require an in-vitro fertilisation (IVF) cycle.  The egg retrieval process is similar to the one used in egg freezing. Once retrieved the eggs will be analysed in the lab by an embryologist and then fertilised with sperm from your partner or donor once. They are then placed into an incubator to allow the resulting fertilised egg (embryo) to develop.  The embryos are then frozen and stored in liquid nitrogen. Once you are ready to conceive, the embryo will be thawed, cultured and will be transferred to the uterus.  The number of embryos transferred is dependent on your age, the quality of the embryo(s) and if you have had failed IVF cycles in the past. It’s generally preferred to transfer just one embryo because this reduces the chances of complications associated with multiple pregnancies.  If you have good-quality embryos left over at this stage, you can opt to freeze them for future cycles, discard them or donate them to someone else. Sometimes, if a sufficient number of embryos are not collected in one cycle, your doctor will recommend another cycle. Ovarian tissue cryopreservation Ovarian tissue cryopreservation is the only fertility preservation option to help younger people who have not gone […]