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Bridge Opening HoursQuestions and Answers
What is Infertility?
Infertility is the inability to conceive after one year of unprotected intercourse or the inability to carry a pregnancy to term. This definition is reduced to six months for women over 35, those with a history of painful periods, irregular cycles, pelvic inflammatory disease and miscarriages, and couples who know that the male partner has a low sperm count.
How can we determine if we have a fertility problem?
If you've been trying to conceive for over 6 months, you may have a fertility problem.
How long should we try before we see a doctor?
In most cases you should see a doctor if you have been trying to conceive (having unprotected sex) for at least one year. If you have been trying ovulation predictor kits and other methods, you should see a doctor if you have not conceived in 3-6 months. If you are over 30, we recommend that you see a doctor for a check-up as soon as you decide to start trying to conceive.
Is infertility primarily a woman’s health issue?
Not at all. For almost half of infertile couples, the cause is related to the male partner (either alone or in addition to a female factor). When a couple have fertility concerns, we recommend that both the male and female partner have full consultations in order to determine the most effective treatment approach.
What kinds of tests can I expect if I come in for a consultation?
We typically perform three tests when a couple schedules an initial consultation. For the female partner a blood test can determine whether hormones are in the correct balance and a pelvic cavity can help us to identify any physical impediments to fertility. For the male partner, a semen analysis can show whether there are issues with sperm. We will also review each partner’s medical, surgical and family history and answer any questions you may have.
What treatments are available?
There are a wide range of treatments available for infertility, depending on the cause or causes. These include medication, surgery to correct physical blockages and treatments such as IVF and IUI.
What is a cycle?
Your menstrual cycle is the number of days from day one of one menstrual period until day one of your next period. This is generally about a month. Your treatment cycle will normally last about the same time.
What is day one of my cycle?
Day one is calculated as the first full day of your period, with heavy bleeding that starts before midday; so for timing purposes, you should ignore spotting or light premenstrual bleeding.
Will stress affect my chance of pregnancy?
The more stressed you are, the more difficult the experience of IVF is likely to be. Remember our nurses and counsellors are here to help you during this time and our Mind/Body courses have helped many couples along the way, with impressive results – see www.bridgemind-body.co.uk.
How long will a stimulated cycle take?
This will depend on the type of treatment you are having and your individual response to the medication. On average it takes between 10–16 days of FSH injections before the egg collection procedure takes place. There’s then about 12–16 days before your period is expected.
Can I continue to have acupuncture while on a treatment cycle?
Yes, You can continue to have acupuncture during your treatment cycle.
Is there anything I need to avoid during my treatment?
Smoking - has been shown to be toxic to eggs and can cause damage to the DNA of sperm. We strongly recommend that you stop smoking prior to commencing a treatment cycle.
Chinese herbs – we recommend that you do not take herbal preparations whilst on a treatment cycle (if they are strong enough to have an effect, then there’s a risk of harm).
Medication – if you are taking any medication, whether prescription or over-the-counter, please inform your nurse or doctor.
Alcohol – can be taken in moderation. If you have any concerns please discuss with your doctor.
I have a headache; what can I take?
It is safe to take Panadol or Panadiene (or generics) at any stage through the cycle. Likewise, with any other pain or discomfort you can take these first but, if the pain is not relieved, contact a Fertility Nurse. All NSAIDs (eg. aspirin, iboprofen, Nurofen, Naprogesic) should be avoided throughout treatment.
Can I still exercise during my treatment cycle?
We ask that you avoid strenuous exercise. This elevates your core body temperature and, especially following your egg collection, it shakes up your ovaries and could lead to more swelling or bleeding than usual. Likewise, avoid saunas and very hot baths.
Can I have intercourse during my treatment cycle?
We advise all patients on a stimulated cycle to abstain from intercourse after starting FSH injections for two days after egg collection. The reason is that a stray sperm and a stray egg left over from your egg collection could lead to a multiple or ectopic pregnancy. If you are commencing a natural or frozen cycle we advise that you speak with a Fertility Nurse about this. If you are having PGD then intercourse is even more dangerous, as pregnancy could result from an untested embryo.
This is all a bit of a dilemma, because it’s still best for your partner to have an ejaculation or ejaculations around the time of your trigger to make sure the sperm is fresh for your egg collection.
I’m feeling constipated. What should I do?
Firstly, drink plenty of water or try prune juice. Stone fruits and high fibre cereals can help. Failing that, pharmacy products that are not absorbed, such as Senocot, are also fine.
Do I need to keep the medication refrigerated?
All injectable medications and the progesterone pessaries need to be kept refrigerated whenever possible during the course of your treatment. Any unused medications and used syringes must be returned at the completion of your cycle for safe disposal. Alas, we cannot refund the cost of any unused items.
I am using progesterone pessaries and there’s some bleeding. Is it okay?
It is not unusual to experience some spotting whilst using the pessaries. This can be as a result of some irritation to the cervix or vagina and is not indicative of a failed cycle. If you experience bleeding do not stop taking any of your medications until you have spoken with you’re a Fertility Nurse.
Is it normal to have cramps after the egg collection?
Yes, this can vary from mild discomfort to ‘period like’ cramps. It is also common to have bloating and tenderness in the breasts. If these symptoms concern you, please contact a Fertility Nurse.
Do you have any suggestions for coping with the two week wait between embryo transfer and pregnancy test?
We appreciate that this is can be the hardest time of all. After a couple of weeks of daily attention you tend to be left alone. So we advise that you stay in touch with the nursing team and remember that the counsellors are available to help if you are finding the waiting time difficult.
Don’t forget to pamper yourself during this stage and try not to read too much into your symptoms. Everyone responds differently and there’s almost no symptom that unequivocally means the treatment hasn’t worked.
How long can embryos be frozen for?
Theoretically forever, but the HFEA states that the maximum period of time that embryos should normally be stored is 10 years.
Do I need to have a break between cycles?
We recommend that you have at least one month’s break following a stimulated cycle, but you can go “back-to-back” if you’re doing a natural or frozen embryo transfer cycle.