Tick tock – fertility clock

Women in their forties are acutely aware that their biological clocks are running down fast, and they can’t risk waiting (or wasting!) six months to ‘give Mother Nature another chance’. It’s wise to get help sooner rather than later and, given the limited amount of fertility treatment available on the NHS and the long waiting lists, you may have to consider going private if you can afford it. See – fertility treatment - the postcode lottery.

Intra-uterine Insemination (IUI) in conjunction with ovarian stimulation can help some women who want to conceive later in life. Intra-uterine insemination with ovarian stimulation boosts the chances of getting pregnant by increasing the number of eggs released each month and ensuring that high quality sperm are in exactly the right place at the right time. The woman has daily hormone injections to stimulate her ovaries which are monitored by ultrasound. When two or three good follicles have developed, ovulation is triggered with an injection of HCG (human chorionic gonadotrophin) - a hormone used to stimulate ovulation which helps the egg mature within the follicle and promotes its release). Two days later her partner produces a sperm sample from which the most active sperm are selected. They are then passed into the cavity of the womb through a fine plastic tube and deposited high up near the opening of the fallopian tubes. Success rates with stimulated IUI are typically 10-15% per cycle. The relatively aged egg seems to prefer the gentle stimulation and the in vivo rather than in vitro environment of IUI.

Many women in their late thirties or early forties choose to have IVF treatment even if there’s no explanation for why they haven’t conceived. The success rates for IVF (approximately 25% per cycle for women under 40 and 10-15% per cycle for 40+ plus) depend on a woman having good ‘ovarian reserve’, - that is, being able to produce a good number of follicles containing eggs in response to the stimulating drugs used in IVF. If several eggs can be collected (ideally up to six) then there is an increased chance of a pregnancy occurring. We can predict a success rate for IVF – taking into account age, past medical history, FSH (follicle stimulating hormone) levels and ovarian scan results.