Infertility - How Important is IVF?

Basic Fertility Facts

All fertility, human or otherwise, is dependent on three determinants - science, the environment and fate. If we consider our own very being we would not exist if our parents had not made love at ovulation time in one particular menstrual cycle. This was a result of pure science - a particular egg fertilized by a particular sperm to generate an embryo, which implanted and went to full term. Our number would not just come up on another occasion. Our brothers or sisters are the result of other acts of love.

If the embryo tries to implant in the lining of a womb diseased by tuberculosis, or with fibroids actually in the cavity it is likely to fail, even if the embryo is of good quality.

Fate may decree that the male partner may have been born without sperm germ cells in the testes, something that even now IVF cannot overcome although cloning, may later circumvent.

So it's the generation of excellent quality embryos which are able to implant and go to term which results in the miracle of pregnancy and childbirth. Something so easily achieved without thinking by so many and yet so hard to achieve by others. Often the problem is beyond a couple's control so they seem in the dark and unsure when and where to turn for help.

Some GPs consider infertility a real health problem and others do not. It is important to ask a number of questions relating to mumps, which can damage the testes, sexually transmitted diseases like Chlamydia doing the same to the man and blocking the Fallopian tubes in women, or painful endometriosis reaping havoc in the pelvis when the lining of the womb implants outside the womb.

What perhaps the general public fails to realize is how crucial age is in determining fertility-outcome. Starting to try at 40 may mean that your best fertility years have already past. Pursuing an occupation, or paying off a mortgage, may put off the day when one even thinks about having a family.

At the same time we helped women have children who were born without a womb, or who had this removed when they were young because of cancer or hemorrhage, with a surrogate host carrying the child for them. Most still have active ovaries but no prospect themselves of being pregnant - normal in every respect except for one quirk of fate.

 

So IVF in one form or another is very important and has brought much happiness to couples previously saddened by their plight. Where to seek advice and what to expect poses one of the greatest problems since IVF may not be necessary at all. It is not the answer to everything. Unfortunately the Human Fertilization & Embryology Authority (HFEA) cannot tell you where you can get comprehensive investigation and the whole range of treatment options, which is what you deserve. Why do IVF when something simple like intrauterine sperm insemination (IUI) with your partner's sperm will work? Certainly not if you are 43 because it is very unlikely to succeed.

Unfortunately the general public cannot rely on the "league tables" of success taken from each year HFEA results to tell you how good, or comprehensive, any centre is. Results can be influenced by who is treated - omit the older women, or those with declining ovarian function or a poor response to the drugs used to promote eggs, and the higher up the table you will go. However you may not get any egg donation or surrogacy and that is highly relevant if you need it. What couples require to know is where to find a centre that has a sustained track record offering a whole range of services, not just IVF, where the outcome of treatment using donor eggs is good since these are the favorable patients and all clinics should have a 25-35% live birth rate with this method. If they don't offer an egg donor service, or more complex treatments like surrogacy or advanced laser surgery for severe pelvic problems, are they really doing the best for the infertile? I question so.

All infertile couples deserve at least that, even though we all know there is no certainty they will succeed - nature doesn't guarantee that. At least they should be able to be treated as effectively as possible to secure life's precious gift - a child.