Fertility experts answer your Qs

Fertility experts Prof and Dr Lieberman, joined us for a webchat

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Here are some of the questions posted by our babyexpert.com users along with Professor and Dr Lieberman’s informative advice.

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Q: I am currently pregnant with our first child, which was conceived by ICSI (we were lucky and it worked first go). I’m 38, and so we want to try for our second child fairly quickly. Our baby is due at the end of Jan, and ideally I’d like to be having our next round of ICSI by Sept. Is that too soon? Are there guidelines about how long I should leave it before going through IVF again?

A: Very pleased to hear you good news and we hope the rest of the pregnancy goes well. Life will be very different with a new baby in the house, and you may not be so keen to start so quickly. If you are going to breast feed, we advise you wait till the baby has stopped before starting again. If you are not planning to breast feed then the soonest is when you are feeling up to it. Six months is probably a good time There is no strict time to wait

Q: I have just had IVF I am now on the 2 week wait, the clinic have said to wait 18 days until testing. Why would I need to wait this long shouldn’t it be less than this? I had my egg transfer 48 hours after my egg collection. I have also had acupuncture weekly during IVF should I carry on with this during the 2week wait and hopefully pregnancy. During the 2week wait is rest best or is it ok to be out and about I was thinking of going to work on the 2nd week?

A: The 2 week wait is always a very stressful time. We normally advice waiting for 14 days after the embryo transfer to perform a urinary pregnancy test as long as you are not using BHCG injections to help support the lining of the womb (most clinics would not use BHCG injections). The evidence for acupuncture is to have it on the day of egg transfer and possibly a few hours later. The evidence is not very strong, and is less so for its use in the 2 week wait. Unfortunately there is no clear answer to work or not work…whatever you feel happiest doing.

Q: My husband and I have been trying for a baby for nearly 3 years now. We’ve had all the tests and have been told its unexplained fertility. We’re both 27 and feel as though we’re the lowest priority with the NHS because of our age. 
It’s so frustrating because we both wanted to have children in our mid twenties and the disappointment I feel every month. when I get my period is really getting me down. I think it’s particularly bad because no one can tell us there’s anything wrong so there’s always that hope in the back of my mind. We’ve been told we could have to wait years for IVF and even then I believe the chances of it working are quite low. We can’t afford to fund extra cycles on our own. Is this normal and do you think we still have a chance of conceiving naturally?

A: Unexplained sub-fertility (where all tests results are “normal”) is given to about 30% of all couples that are trying for a baby. You are certainly not alone. There is certainly a good chance that you will conceive in the next few years (about 50% of couples in your situation will conceive in the next 2 years). Although difficult you need to try and keep a positive outlook. Without going through your complete medical history it is important to maintain good general health (stop drinking/ smoking) aim for a healthy weight ( BMI as close to 20-25 as possible) and take folic acid. There is wide variation in local funding for assisted conception.

Q: I have just turned 36 and my husband and I have been trying for a baby for 18 months. We’ve had all of the blood tests and sperm analysis and I had an HSG earlier in the year and none of the tests have revealed any problems. We’re due to return to the consultants in February having been told to go away and keep trying for the last 8 months with no luck. We’re due to have 2 rounds of IUI (intrauterine insemination) and then 1 round of IVF if that doesn’t work. Please can you tell me what to expect with IUI, what sort of likelihood there is that it will work since there seem to be no obvious things wrong with us?

A: The advice that you have been given seems very sensible. Female age is the most important predictor of fertility outcome. The success rate is clinic dependant; here at Manchester Fertiltiy Services it is 11% per cycle started (live birth rate) for IUI combined with ovarian stimulation. Stimulated IUI involves being given a course of tablets (clomid) or injections to increase the number of eggs that your ovaries produce. Women are normally monitored by ultrasound and blood tests. The IUI process involves your husband giving a fresh sperm sample, which is washed and prepared. This prepared sample is then put inside your womb (a bit like a smear).

Q: Please  could explain the criteria for being prescribed Clomid? Does this vary according to the trust you are in?

A: We believe that clomid (a tablet that stimulates egg production) is very useful in women who have infrequent, irregular or absent periods. The most common cause for such problems is polycystic ovarian syndrome, but other causes need to be ruled out before prescribing. A recent large study has shown that Clomid is no better than nature alone in couples with unexplained sub-fertility.

Q: I conceived in August but in September found out it was Ectopic so I had to have my right tube removed. I wondered if you could give me any information on how many people in my situation have had to go onto have fertility treatment of some kind? I realise it is not long since my operation so right now I’m not too worried but I just want more of an idea really?

A: You are asking about successful pregnancy chances following a single Ectopic pregnancy. The simple answer is that most women who have had a single Ectopic pregnancy go on to have a subsequently normal pregnancy. Your fertility is not halved but decreased by about 25%. You are more at risk of a further Ectopic than a woman who has never had one. The next time you conceive you need to have a pregnancy scan early on about 6- 7 weeks.

The North West’s leading provider of IVF, Manchester Fertility Services, was established by Professor Brian Lieberman in 1986 and continues to be the region’s leading provider of IVF.  It houses a dedicated IVF theatre and state-of-the-art laboratory.  

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