Next Steps

Social networking

Service Navigation

last step

ART: how long should we try?

Adjusting expectations to your treatment programme

Giving yourself time

If your initial experience of fertility treatment hasn’t ended in success it’s natural to feel discouraged. But be reassured. Improvements in medication, microsurgery and Assisted Reproductive Technologies (ART) make pregnancy possible for the majority of couples.

You’re in the hands of a group of medical professionals dedicated to identifying the source of your fertility problems. Often that takes time. It may be just too early to expect a positive result. In most cases multiple cycles are necessary.

Talk to your doctor about your specific case. Every journey is different depending on the results of tests and the kind of treatment you decide to pursue. In the meantime, take encouragement from these statistics:

A high success rate

A Danish study from 2009 shows that within five years of starting ART treatment, almost 70% of couples succeed in having at least one child.¹

Reaching success often takes time and multiple attempts

Most couples who succeed undergo multiple treatment cycles. In the same study 28% conceived within a year, but it took three years for 62% to conceive. More than 40% of couples went through four or more cycles during the length of the study.¹

Look beyond averages

Success rates depend on multiple factors including diagnosis, clinic expertise and the age of the women treated. In the Danish study success rates over the 5 year period varied from around 52% for women aged 35 or older to almost 75% for the ones younger than 35.¹ Speak with your specialist. It’s important to be sure that your diagnosis is complete and that you’re following the best treatment strategy.¹

Often, the most stressful stage of the treatment cycle is the waiting time – the 14-day period between the embryo transfer and the pregnancy test. Discover how to maintain a positive outlook throughout your treatment cycle.

How to give yourself the best chance

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.^2-5

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

Deciding how long to continue

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 may help make up your mind.

^{1. 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 2. Rajkhowa M, et al. Reasons for discontinuation of IVF treatment: a questionnaire study. Human Reprod. 2006; Vol. 21(2): 358–363. 3. Olivius K, et al. Why do couples discontinue in vitro fertilization treatment? A cohort study. Fertil Steril. 2004; Vol. 81(2):258-261. 4. Hammerberg K, et al. Why do couples discontinue in vitro fertilization treatment? A cohort study. Human Reprod. 2001; Vol. 16(2):374-383. 5. Domar A, et al. Impact of psychological factors on dropout rates in insured infertility patients. Fertil Steril. 2004; Vol. 81(2):271-273}

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)

Ectopic pregnancy

A pregnancy in which the embryo implants outside the uterus and cannot be sustained.

Ejaculate

The seminal fluid discharged upon male orgasm, which helps transport sperm.

Egg retrieval

A procedure used to obtain eggs from ovarian follicles for use in In Vitro Fertilization. Retrieval may be performed during a laparoscopy procedure or via the vagina using a blunt syringe and with the aid of an ultrasound to locate the follicle in the ovary.

Embryo

The early stages of foetal growth from conception to the eighth week of pregnancy.

Embryo transfer

The process whereby an embryo is transferred into the uterus after the egg has been fertilized outside the body during a laboratory procedure.

Embryologist

A specialist involved in the various aspects of assisted reproduction laboratory procedures related to sperm, oocytes and embryos.

Endocrinologist

A medical specialist concerned with the study of hormones and infertility, having first trained as an obstetrician/gynaecologist.

Endometrial biopsy

The removal of a sample of the lining of the uterus for examination.

Endometriosis

A condition whereby cells that normally line the uterine cavity grow outside the womb, for example in the fallopian tubes, ovaries, or even the bladder or intestines. The cause is largely unknown. Scarring from endometriosis may cause conception difficulties.

Endometrium

The lining of the uterus, which is shed during the menstrual cycle. If conception takes place, the embryo implants itself into the rich vascular membrane, which nourishes the developing foetus.

Epididymis

A tightly coiled tube located above the testicles or testes, where sperm mature for fertilization.

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.