Conception: assess your options and chances

Facts and figures

Becoming pregnant requires a complex combination of factors and events. With patience, a positive attitude and the appropriate treatment, most couples will eventually achieve their dream.¹ The knowledge from this research may help you plan your treatment course.

The overall success rate for Assisted Reproduction Technologies (ART) is high
A Danish study from 2009 found that within five years of starting ART treatment, almost 70% of couples had succeeded in having at least one child.² It’s important to remember however that the success rate for fertility treatment is not absolute. The outcome will be different for every individual couple and clinic.
Achieving success often takes time and multiple attempts
In the same study, the number of couples who had a child after following ART treatments doubled from about 30% after a year to more than 60%, after three years of treatment. More than 40% went through four or more cycles during the length of the study.²
Your commitment and ability to cope with stress may affect the outcome
Fertility treatment is strenuous – physically as well as emotionally. Couples who abandon treatment, without any apparent medical reason to give up hope, often attribute their decision to psychological stress. Between 25-54% of couples drop out of ART before they complete three cycles.^3-6 They give psychological stress as the key reason for their decision.^6-9

A specialised clinic will be able to offer a complete diagnosis and advanced treatment options. Take a look at the fertility pathway.

Maximizing your chances

Here are some steps you and your partner can take to give yourself the best chance of success:

Deciding whether you need a break

Knowing that overall success rates of ART are high may help you psychologically. But at some point, you and your partner may question whether you’re in need of a break. It’s a personal decision that only you and your partner can make. Reflecting on four key questions together may help make up your mind.

^{1. Oakley L et al. Lifetime prevalence of infertility and infertility treatment in the UK: results from a population-based survey of reproduction. Hum Reprod 2008;23(2):447-450. 2. Pinbourg A et al, Prospective longitudinal cohort study on cumulative 5-year delivery and adoption rates among 1338 couples initiating infertility treatment. Hum Reprod.2009;24; 991-999. 3. Land JA, et al. Patient dropout in an assisted reproductive technology program: implications for pregnancy rates. Fertil Steril. 1997;68(2):278-281. 4. Schroder AK, et al. Patient dropout in an assisted reproductive technology program: implications for pregnancy rates. RBM Online 2004;5(5):600-606. 5. Osmanangaoglu K, et al. Patient dropout in an assisted reproductive technology program: implications for pregnancy rates. Hum Reprod. 2002;17(4):2651-2655. 6. Rajkhowa M, et al. Reasons for discontinuation of IVF treatment: a questionnaire study. Hum Reprod. 2006;21(2):358–363. 7. Olivius K, et al. Why do couples discontinue in vitro fertilization treatment? A cohort study. Fertil. & Steril. 2004;81(2):258-261. 8. Hammerberg K, et al. Women’s experience of IVF: a follow-up study. Hum Reprod. 2001;16(2):374-383. 9. Domar A, et al. Impact of psychological factors on dropout rates in insured infertility patients. Fertil Steril. 2004;81(2):271-273.}

Cervical mucus

A natural lubricant produced by the female body that aids the transportation of sperm and helps protect against infection.

Cervix

The cervix or neck of the uterus is the lower, narrow portion of the uterus where it joins with the top end of the vagina.

Chlamydia

A sexually-transmitted infection, which may be asymptomatic or cause genital inflammation and discharge, pelvic pain and fever. Untreated, chlamydia can lead to Pelvic Inflammatory Disease (PID) and fertility problems.

Chromosomes

Structures found in the nucleus of cells that contain genes and carry heredity information, such as eye colour, blood type and vulnerability to disease. Humans have 23 pairs of chromosomes. One set of 23 chromosomes is inherited from the biological mother via her egg and the other from the biological father, via his sperm. Each sperm cell contains either male or female sex chromosomes. As such, it determines the gender of the foetus. Genetic abnormalities occur when an individual is born missing a chromosome or has more copies of a chromosomal pair.

Clomiphene citrate

A prescription drug used to bring on ovulation. It comes as a tablet and is often used as an initial treatment for women with ovulation problems. Clomiphene citrate induces ovulation in 80% of women who have trouble ovulating on their own.

Conception

The moment of fertilization when the sperm meets and penetrates the egg.

Congenital abnormalities

Physical abnormalities present at birth.

Corpus luteum

A hormone-secreting mass within the ovary that forms from the remains of a follicle each time an egg is released. The hormones it produces prepare the uterus for embryo implantation. If pregnancy does not occur, the mass is shed during menstruation.

Cryopreservation

A technique used to store human tissue at very low temperatures. Embryos that are not used in an ART cycle may be preserved in this way for future use. Also known as “Freezing”.

Cryptorchidism

A condition usually detected at birth or childhood whereby the testicles fail to descend. When a male foetus develops in the uterus, his testicles normally form inside his abdomen and descend into the scrotum shortly before birth. Undescended testicles usually descend themselves by the sixth month of life, but are unlikely to descend after this period of their own accord.

Idiopathic infertility

Unexplained infertility.

Infertility or primary infertility

The inability of a couple to achieve conception after a year of unprotected intercourse – six months if the woman is over 35 – or the inability to carry a pregnancy to live birth. Also see Subfertility.

Intracytoplasmic Sperm Injection (ICSI)

A single sperm is injected directly into an egg cell with microscopic guidance. If fusion takes place, the embryo is transferred into the uterus for implantation. This clinical procedure is often used in conjunction with In Vitro Fertilisation if the male partner has a very low sperm count, low sperm motility or poor-quality sperm.

Intrauterine device

(IUD): A contraceptive device consisting of a small piece of bent plastic, which prevents pregnancy by changing the environment of the uterus.

Intrauterine Insemination (IUI)

A procedure whereby sperm are deposited directly into the uterus via the cervix using a catheter.

Irregular ovulation

Menstrual cycles that vary more than a few days in length from month to month are considered irregular. Most menstrual cycles occur about every four weeks, with the normal range lasting between 24 and 35 days.

In Vivo

A process that occurs inside the body.

In Vitro Fertilization (IVF)

Eggs produced with the assistance of fertility drugs are retrieved from the woman’s body and fertilized by sperm in a laboratory environment. The resulting embryos are transferred via catheter to the uterus.

Immune system disorders

On rare occasions, an impaired immune system may regard the egg or sperm as a ‘foreign body,’ and attack it as an ‘intruder.’

Implantation

The process whereby the embryo embeds itself into the lining of the uterus. The cells from the embryo eventually connect with the mother’s blood vessels to form the placenta. See also ectopic pregnancy.

Fallopian tube

A funnel-shaped passage through which sperm are guided towards the egg, and fertilized eggs are conveyed to the uterine cavity.

Fertilization

The moment of conception when the genetic material contained in the sperm and egg combine to create an embryo. Fertilization usually occurs inside the fallopian tube. It may also occur in vitro during a clinical process. See also In Vitro Fertilization.

Fertility treatment

Any procedure used to enhance fertility or to help couples achieve pregnancy.

Fertility psychologist

A health specialist with professional qualifications in psychology and counselling relating to fertility issues.

Fibroid tumour

A benign (that is, not malignant or life-threatening) tumour made up of fibrous tissue that may form in the uterine wall. Fibroid tumours may be present without any symptoms, or may cause abnormal menstrual patterns or infertility.

Follicle

A fluid-filled sac in the ovary, which contains the egg released during ovulation. Each month a new egg matures and travels to the fallopian tube.

Follicle Stimulating Hormone

A hormone released by the pituitary gland in both sexes. In women, FSH stimulates the growth of the ovarian follicle necessary for egg production. In men, FSH stimulates and supports sperm production. Elevated FSH levels are associated with gonadotrophin failure in both men and women.

Freezing

(See Cryopreservation)

Amenorrhoea

The absence of a menstrual period in a woman of reproductive age. Physiological states of amenorrhoea are seen during pregnancy and breastfeeding. Outside the reproductive years, there is an absence of menses during childhood and after menopause. See also premature menopause.

Andrologist

A medical specialist who deals with male health, particularly relating to the problems of the male reproductive system and urological problems unique to men.

Artificial Insemination (AI)

Procedure whereby sperm are deposited via the vagina into the cervix or uterus using a catheter. The technique is used to transfer donor sperm or to overcome problems with sexual performance, the interaction between sperm and mucus, or the quality of sperm.

Assisted hatching

A procedure whereby a small hole is drilled in the protective membrane of the embryo using a laser device or a dilute acidic solution to assist hatching and aid implantation.

Assisted Reproductive Technologies (ART)

A variety of procedures used to bring about conception without sexual intercourse, including In Vitro Fertilisation (IVF), Gamete Intra-Fallopian Transfer (GIFT) or Zygote Intra-Fallopian Transfer (ZIFT), Intracyto-plasmic Sperm Injection (ICSI), Microsurgical Epididymal Sperm Aspiration (MESA) and Testicular Sperm Extraction (TESE).

Autoimmune disease

A disease where the body attacks its own cells due to an overactive immune response.

Azoospermia

A complete absence of sperm in the semen. See also Oligospermia.

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