Fertility at forty – or even thirty

• Smoking is probably the single most significant factor — women who are life-time smokers will undergo their menopause approximately 5 years ahead of schedule and will become sub-fertile sooner and have a higher risk of miscarriage.
• Women who are significantly below or above their ideal weight are also at a higher risk of fertility problems and/or pregnancy complications.
• Women who have had pelvic surgery, endometriosis or recurrent pelvic infections also seem to have a lower chance of successful pregnancy, probably because their store of viable eggs is reduced.

Fertility treatments

Intra-Uterine Insemination

Some women trying to conceive later in life may be helped by fertility treatments such as Intra-uterine Insemination (IUI) in conjunction with ovarian stimulation. Stimulated IUI is a treatment designed to enhance a couple's natural fertility without resorting to 'high-tech' treatments.

The woman undergoes stimulation with gonadotrophins (hormone injections) to encourage 2 or 3 eggs to mature. Throughout the drug phase, treatment is monitored by ultrasound and when the follicles are ready, a final injection of hCG is given to provoke ovulation.

Approximately 30 – 40 hrs later, specially prepared sperm (ideally 5 million, highly active sperm) are inserted through the cervix in a fine plastic tube and deposited high up in the uterus, near to the opening of the Fallopian tubes. Putting very good sperm in exactly the right place at the right time boosts natural fertility. Success rates with stimulated IUI are typically 10 – 15% per cycle.