So you want to get pregnant?
Heterosexual Couple Edition
You and your partner have made the decision to start a family. Here are some things you may want to know. Healthcare professionals recommend having intercourse every 2-3 days around ovulation. If you’ve been trying for a few months, you may even want to consider tracking your cycles to ensure you’re having sex during your fertile window. The fertile window is the day of ovulation and the five days prior to ovulation (that’s the length of time sperm could survive in the female reproductive system). You can calculate your fertile window through determining the length of your cycle, using OPKs (ovulation predictor kits), observing changes to your cervical mucus and even testing your BBT (basal body temperature). Having intercourse during your fertile window can increase chances of conceiving.
When should I seek help?
If you’re heterosexual couple trying to conceive for one year, it could be time to book an appointment with your GP for some initial investigations. 84% of couples will conceive within that first year of trying if they have regular unprotected sex, but problems with fertility can affect nearly 1 in 7 couples in the UK. Your GP will perform an assessment and run some tests in order to see if there are any fertility problems you may be experiencing.
What can I expect from my GP?
Your GP will ask specific questions relating to your reproductive health. These will involve things like when your latest menstrual period was, how long your menstrual cycles are and if you have any known medical conditions that may have an impact on your fertility. The tests may include a blood test during your cycle to check if you are ovulating, an ultrasound scan to assess your ovaries, fallopian tubes and uterus and a semen analysis.
What could the results be?
Some fertility tests may take time but when they are all completed, you should get your results from your GP. You may find out if there are any underlying issues causing fertility problems. You could get a diagnosis of:
Female factor infertility, this is commonly caused by problems with ovulation.
Male factor infertility, this is often caused by a low number of sperm or sperm that aren’t moving properly.
Unexplained infertility, where a cause of infertility is not identified.
What treatment options are available?
Depending on the results of your investigations, your GP may be able to refer you for treatment on the NHS. This is subject to the guidelines set out by the CCG (clinical commissioning group) in your area, as there are different allowances depending on where you live. The different treatment types may include medicines, surgical procedures or assisted conception. If you have unexplained infertility, you may be recommended to keep trying naturally for another year.
If there are ovulatory problems, you could be eligible for medicines that encourage ovulation, a treatment known as Ovulation Induction. This treatment would be organised through your GP or at a fertility clinic. The response of the medicine would be monitored by ultrasound scans and intercourse would be advised when ovulation is predicted.
You can read more about Ovulation Induction on the NHS website.
Some surgical procedures are used to assist with fertility. If you have blocked fallopian tubes, you could have surgery to repair them, read more about the procedure here. A laparoscopic procedure could help remove endometriosis and could improve chances of conceiving naturally, you can read more here.
IUI - intrauterine insemination. IUI is a treatment that takes place within a fertility clinic. It could be performed in your natural cycle or in a medicated cycle. A medicated cycle would involve stimulating ovulation before the procedure. The procedure includes producing a sperm sample, the sample would be washed and prepared in the clinic and the sample would be inserted into the uterus with the help of a thin catheter going through the vagina and cervix.
You can read more on IUI on the NHS website.
IVF - in-vitro fertilisation. IVF is a treatment that takes place within a fertility clinic. It requires a hormone stimulation to produce multiple eggs in the ovaries. The eggs would be removed through a surgical procedure and fertilised with a sperm sample that is produced on the same day. The fertilised eggs are called embryos, these are cultured in a laboratory until a suitable day for embryo transfer, where an embryo is placed in the uterus with the help of a catheter that goes through the vagina and cervix.
You can find more details about IVF on the NHS website.