Infertility has many different causes. They include, blocked or damaged Fallopian tubes, endometriosis, failure of ovulation, fibroids and hostile cervical mucus for women and failure of sperm production, low motility, abnormalities and antibodies for men.
Natural conception is dependent upon several factors and processes. Firstly, the woman needs to produce an egg from one of her ovaries which must be able to travel freely down into the Fallopian tube.
The man has to produce a high number of good quality sperm which are capable of making the journey from the vagina, through the cervix and into a Fallopian tube where fertilization takes place. The timing of sexual intercourse is also crucial as conception can only occur during ovulation (ie, when the female produces an egg). Once fertilization has occurred, a normal uterus is required in order for the embryo to implant and develop.
If any of the above requirements are not met, the chance of conception occurring naturally is reduced or impossible.
Today, one in six couples require referral for investigation and treatment for infertility and there are many reasons for this.
Natural human fertility is low compared with most other species and peak human fertility (defined as the chance of pregnancy per menstrual cycle in the most fertile couples) is no higher than 33%.
Most fertile couples - around 90%, should achieve pregnancy within a year of regular intercourse. This rises to 95% over a two year period.
For some couples therefore, a long delay in conceiving reflects low fertility rather than infertility. Even so, the usual criterion to define infertility and initiate investigations, is a delay of more than one year. This is especially true for patients over 30 when the natural decline in fertility begins to accelerate.
Widespread media coverage of the subject of infertility have raised overall public awareness to the fact that a large group of the population may find they suffer from one or more conditions which will affect their chances of starting a family.
Seeing your GP is one most likely course of action if you are concerned about failure to conceive after several months of unprotected intercourse and Bridge at Holly House welcomes both referred patients and self-referrals.
Female Infertility
In the past 25 years, the percentage of births to women aged 30 or over has doubled. This very evident trend of delaying childbirth until career or other lifestyle objectives have been achieved has consequences which many women are fully prepared to risk, although a proportion may be insufficiently aware of the steep decline in fertility which begins in the early 30s and certainly by the age of 35-36.
In addition to the age factor, the two main causes of female infertility are ovulation disorder and fallopian tube damage. Endometriosis, fibroids and hostile cervical mucus are additional causes. Some of these conditions may respond to gynaecological surgery and we have outstanding facilities and a team of specialists ready and waiting to treat you.
About 15% of couples will have more than one cause for their infertility. It is therefore important to make complete investigations from the outset rather than focusing treatment on the first cause identified. In about 25% of couples no definite cause will be found, even after complete investigation. These couples are said to have ‘unexplained infertility’ but can, of course, still be treated.
Male Infertility
A great proportion of our infertility cases involve male problems and we find a high number are not what they first seem to be.
If you or your partner have been told that the male partner is not producing sperm (a condition known as azoospermia) and advised to take the donor route, come to us first - we may be able to find what others have missed. The reason for this is simple.
The basic sperm analysis on which many consultants and clinics base their diagnosis is indicative, but not conclusive.
At Bridge at Holly House, we go one vital step further by offering a complete programme for Male Factor Optimisation. This second step is RCS (Rapid Centrifugal Spinning) a follow-up and more revealing investigation.
RCS detects very minute quantities of sperm, too small to register in conventional analysis, and isolates these for harvesting. As few as 10-20 means that IVF or ICSI can commence immediately. The RCS procedure also confirms a zero sperm count which, in most cases, removes any need to consider the cost of surgical extraction for genuine azoospermia sufferers.
If the sperm count is even lower, there is still hope that you can avoid the donor option as we have two surgical procedures, PESA and TESE, which can extract viable sperm if even the tiniest amount is present. (But note that successful surgical extraction can never be 100% guaranteed).
We have made Male Factor Optimisation at Bridge as affordable as possible and the result is, we think, the best-value success-orientated approach available.
Sometimes, donor sperm is the only option but, for many supposedly infertile males, Male Factor Optimisation (MFO) treatment at The Bridge Centre may be the solution and offer a whole new world of opportunity.
Further information and appointments are available by calling 020 8936 1288.
or email us at bridge@hollyhouse-hospital.co.uk
