MAKE INFORMED DECISIONS WHEN SEEKING TREATMENT

Dr. Abayomi Ajayi

When you’re exploring fertility treatment, it’s difficult to know where to start. There’s so much information out there and it’s hard to know which sources you can trust. If you are having trouble becoming pregnant, first thing to admit is that you’re not alone.

About one in four couples have difficulty conceiving naturally, so if you have been trying for a baby for a while you should see your personal doctor, especially if you’re 36 or above and you have been diagnosed with a cause of infertility or you have a history of problems which may affect your fertility.

If you have not been able to get pregnant after about one year of regular, unprotected sexual intercourse, either you or your spouse may have a fertility problem. Concerns about being pregnant should not be ignored. Don’t wait. Consult a qualified medical doctor who will refer you to a specialist that will investigate the reason why pregnancy is not occurring.

It begins with a medical history, physical examination and recommended tests or lifestyle changes.

A woman that has been trying to get pregnant for over a year should generally be offered a test to check that she is ovulating. If these tests don’t reveal a problem, further tests are done to check that the fallopian tubes are not blocked.

Generally, fertility tests for women include a cervical smear test if she hasn’t had one recently, and blood test to see if she is ovulating. This is done by measuring progesterone in a blood sample taken seven days before her period is due. Other tests include a blood test to check for hormone imbalances, such as measurement of follicle stimulating hormone (FSH), luteinising hormone (LH). This test can also identify possible early menopause as a cause of subfertility.

The man should also have sperm test checks for abnormalities as well as urine test for chlamydia, which, in addition to being a known cause of infertility in women, can also affect sperm function and male fertility. If one or both of the couple have a condition that affects fertility, more tests could be necessary, but if the test results are normal and you have been trying for a baby for less than 18 months, you may need to make lifestyle changes and continue trying to conceive naturally.

Lifestyle can affect chances of conceiving significantly, particularly if you are a heavy smoker or overweight or underweight. In 10-15 per cent of cases, despite investigations, a clear cause of infertility is never established (unexplained infertility). Whatever the diagnosis, the clinician will explain the best treatment options that are available to you.

But if the tests reveal a possible fertility issue, especially if you are in your 30s or older, you may need to see a specialist for further tests. These tests will be discussed in detail in the next article. For now, we are focusing on choosing a fertility clinic or fertility treatment provider.

Before taking the next step in your journey to become pregnant, it’s worth seeking out a good fertility clinic. Couples challenged by infertility need to be meticulous in choosing their preferred treatment clinic as their choice goes a long way in determining their chances of achieving pregnancies.

Do some homework first. When it comes to choosing a clinic, do thorough research ahead of time.

Look out for clinics that have high pregnancy and birth rates, high quality management system, as well as strong ethics, good experience and cutting edge technology and infrastructural setup to boost your chances of getting pregnant.

Assess your eligibility for treatment. How much will your treatments cost? How convenient is the location? What are the waiting lists like for treatment? If you are using donor sperm, eggs or embryos in your treatment, it is worth contacting a few clinics to research how waiting lists compare for donor treatments.

Appearances matter and the first cut is often the deepest. When you contact or visit the clinic, how do you feel there and what about the way the staff treats you? Ask a lot of questions of every fertility clinic you’re considering. How long has the fertility clinic’s medical director or embryologist and other key staff been there? How long have the doctors and technicians been there? What are their antecedents? High staff turnover can be a sign of bad management and can contribute to mistakes.

Be sure the clinic has a wide range of infertility remedies available and is familiar with the latest technology. How concerned is the clinic about ethical issues? If you call the clinic and they’re too busy to answer your questions, try elsewhere. They may not have time for your questions once you’re a patient, either.

Ask lots of questions so you feel fully informed about the treatment they are recommending. If possible, talk to other patients to hear their personal experiences of the clinic. Find out how many cycles (rounds of treatment) are attempted before trying another approach or stopping treatment altogether.

Is there a support group and are there qualified counsellors? Having emotional support is very important when going through fertility treatment.

A good clinic must offer you an opportunity to talk to a counsellor about the implications of your suggested treatment before you consent to it. When researching clinics, you may want to ask about this and whether they have any support groups you can join. What are the success rates? It’s only natural for you to want to know your chances of success.

Ask about the number of treatments carried out in a particular year and the number of pregnancies and births that resulted. These success rates should be used only as a general guide and not as a personal prediction of your own chance of success.

Directly comparing the success rates of clinics is not useful because all clinics treat patients with different diagnoses, which affects the average success rates. Also, most clinics carry out too few cycles each year to reliably predict a patient’s future chance of success.

Choose a clinic that shows the type of patients each clinic treats, including their age and diagnosis and how long they have been infertile. This may help identify clinics that treat patients with similar needs to you and also puts the success rates for that clinic in context. Success rates are broken down by treatment.

Before you step into the fertility clinic, find out what kind of invasive tests or procedures might lie in wait for you. Keep in mind that some fertility centres that looked great several years ago may have had high staff turnover and declined in quality.

In a nutshell, the most important thing you can do when making decisions about fertility treatment is to ensure you are well informed. Read all you can, don’t be afraid to ask questions, talk to other people, including considering joining a patient-led support group. When you’re choosing a clinic, success rates are important but they aren’t the only thing that matters – location, cost, funding, what treatments are offered and even the atmosphere can all make a difference.