FAQS

People thinking about fertility treatment often ask “Why are we having problems conceiving?” There are a number of reasons why people experience problems when trying to conceive. Around 30% of fertility issues are caused by female factors, around 30% to male, 20% combined male and female and 20% is unexplained.

The most common reason for female fertility issues is age, fertility begins to decrease after the age of 35, and by the age of 40 is in significant decline. Other reasons include:

• Problems with ovulation
• Issues with the womb or fallopian tubes including scar tissue or endometriosis
• Overall health, being overweight our underweight can impact fertility

The most common cause of fertility challenges for men involves poor quality or insufficient sperm. Problems can arise when either not enough sperm is being produced, or the sperm is of poor quality.

You can read in more detail about the causes of fertility issues in our Where to Start section.

In general, if you are unable to conceive after a year of regular unprotected intercourse then you should seek medical advice. If you’re struggling to conceive, you’re not alone. Infertility is a fairly common issue that can affect one in 7 people in the UK. Fertility challenges occur more often than most people realise.

According to the World Health Organization (WHO), about 15% of people globally, struggle with fertility problems, so you’re not alone if you face these challenges.

https://www.who.int/health-topics/infertility#tab=tab_1

Around 30% of infertility is caused by female factors, around 30% to male, 20% combined male and female and 20% is unexplained.

We have a wide range of test and treatments at Care, and treatment is always designed around the needs of each individual.Your doctor will discuss test results in detail with you and advise you clearly on the most suitable treatment.

You will find information on all of our tests, treatments and techniques on our website.

View our Treatments and Services to get started

Costs depend on which treatment you need but the treatment journey can be broken down in to stages, with costs involved at each stage.

You will need to pay for your initial consultation, any pre-treatment tests or scans, and then for the treatment itself with any necessary medication.

You can access a full breakdown of costs on each Care clinic page on our website. View here for all clinics, here for understanding IVF costs and here for funding IVF treatment.

We offer a range of funding packages (Carepay) including a multi-cycle option.

Carepay includes the following range of funding options:

IVF Multi-Cycle Programme

• This funding option can help pay for IVF treatment by offering a fixed, discounted fee for people who pre-pay for two cycles of IVF, rather than paying for each cycle individually.

IVF Refund Programme

• The IVF Refund programme offers up to 100% refund if you do not have a baby following 3 fresh cycles of IVF treatment. 

Donor Egg IVF Refund Programme

• If you need IVF using donor eggs, our Carepay Donor Egg IVF Refund programme provides up to two cycles of IVF or ICSI using donor eggs, if the cycle(s) are successful, 50% of the upfront cost will be refunded to you, reducing the cost of your IVF Treatment

A number of key factors can impact IVF success including: Embryo selection - choosing the best embryo for transfer can have a significant impact on

treatment success.  We have techniques which we can use including Care-maps AI and PGT-A

Sperm quality and quantity - For men considering fertility treatment, in addition to ICSI, where we inject the sperm directly into the egg, we have a number of ways we can support and optimise treatment including:

• Zymot sperm preparation

• MERC

• Surgical Sperm retrieval

Diagnosis of fertility issue. It’s important that we have a full understanding of the potential cause of the fertility issue. We have a range of tests which can help diagnose most fertility issues. This enables us to design a Personalised Treatment Plan for each patient.

Lifestyle

There are a number of different things you can do to optimise your lifestyle when you’re thinking about fertility treatment.

• Diet - Eating a healthy and balanced diet is crucial for both men and women when preparing to conceive.

• Smoking - it’s best to stop smoking. Cigarette smoke contains toxic substances that can impact both male and female fertility. Men who smoke have been shown to have abnormalities in sperm production. Both sperm quality and quantity are affected. For women, smoking causes hormonal changes that can lead to menstrual irregularities.

• Cut out alcohol - Alcohol disrupts the hormonal balance of the female reproductive system and this can impact fertility. Excessive alcohol intake is also detrimental to sperm quality

• Weight - Another aspect of your lifestyle to consider is maintaining a healthy weight as your weight, whether too high or too low, can affect your chance of getting pregnant. Being overweight or underweight can also reduce the effectiveness of fertility treatments and can increase the risk of pregnancy complications.

Wellbeing

Going through fertility treatment definitely falls under the heading of ‘a stressful experience’ and you are likely to feel a range of emotions before, during and after treatment. At Care, we know how important support is, and there are some things we advise to try to help reduce your stress levels including Counselling and joining our Forum. Our Carepals teams are also available to answer your questions and give you guidance on your treatment journey.

We have a number of treatment options available depending on your needs. These include:

• IVF with donor sperm
• Shared Motherhood
• IUI with donor sperm
• Surrogacy
• IVF with donor eggs
• We offer transgender men and women the option of preserving their fertility prior to transitioning through egg, sperm or embryo freezing.

Every couple is different and we will be guided by you to tell us how you would like to have treatment. You may:

• Know from the beginning who will provide eggs and who will have the transfer – if you do, we will carry out investigations to make sure it is safe for the egg provider to undergo ovarian stimulation and check that they are likely to respond well. The person planning to carry the pregnancy will have investigations so that we are sure it is safe and suitable for them to carry the pregnancy;

• Be flexible about each partner’s role. In this case, you may both want to have both types of pre-treatment investigations before deciding the best option for your treatment plan

Our teams will offer guidance and support at each stage of your treatment journey.With Shared Motherhood, both individuals in the couple can take part in the IVF journey to family has a shared experience, right from conception. One partner donates eggs to her partner in IVF treatment, and is the ‘biological mother’. The other partner carries your baby and experiences the pregnancy as the ‘gestational or birth mother’. Shared motherhood follows the same general treatment pathway as IVF treatment, using donated sperm with the egg provider’s partner having the embryo transfer and carrying the pregnancy.

An easy way to get started is to make a call to our new patient enquiry team on 0800 564 2270. They can answer all your questions including costs, funding, how does IVF work, how long does treatment take. When you’re ready, they can book a consultation for you and give you the guidance and support you need about what to do at each stage of your journey, so hopefully nothing ever feels overwhelming.

You also might want to join one of our fertility information events, we hold these regularly and details are available on our website.

Before your first consultation with us, we’ll ask you to complete a short medical questionnaire about your fertility history and any health issues.

On the day of your consultation your clinic team will carry out some checks and tests including:

• Body Mass Index (BMI) - this is a measure of body fat based on height and weight

• Blood pressure

• A pelvic ultrasound scan

• Semen analysis (if necessary)

• Blood tests (checking for anti-mullerian hormone (AMH) and follicle stimulating hormone (FSH levels)

During your consultation your consultant will review your medical questionnaire and any notes from previous treatments. They will explain the results from your ultrasound scan and the semen analysis. You will have the opportunity to talk through your individualised treatment options and ask any questions you have.

Your clinic team will provide you with written information and costings for your different treatment options.

Our Carepals teams are available to answer your questions and guide you on what your next steps are when you’re starting treatment and beyond. They can advise on consent forms, making payment and answer questions you might have about your treatment process.

They are all knowledgeable and caring, and will offer you the support you need.

PGT-A is used to screen embryos for imbalances in chromosome numbers.

Following fertilisation, an embryo divides into 2 cells, then four, eight, sixteen and so on, until 5 or 6 days after fertilisation there are over 100 cells. At this stage the embryo is known as a blastocyst embryo and it has an outer layer of cells called the trophoblast which surround the outside of the embryo. These are the cells that develop into the placenta. There is also a ball of cells inside the trophoblast called the inner cell mass and it is these cells that develop into the foetus and then baby.

In PGT-A, approximately 5 cells are removed from the outer layer of the blastocyst. This biopsy procedure is performed by a highly skilled senior embryologist. Biopsied embryos are then frozen and the biopsied cells are sent to a specialist laboratory for PGT-A analysis. The results of the test are available within a few weeks. If the biopsied cells have 46 chromosomes, the embryo they came from is suitable for transfer, and embryo transfer can take place in a frozen embryo replacement cycle.

Studies have shown that removal of cells from the blastocyst doesn’t harm the embryo’s development and thousands of babies have been born after transfer of embryos that were biopsied.

Caremaps, our time-lapse imaging technique, has been designed to help us choose the best embryo without genetic testing. It allows us to predict which embryos have the most potential, which can increase your chances of successful IVF treatment.We have now collated almost half a billion images, from 63,000 embryos, from our very own time lapse incubators and trained a machine learning model to assess them accurately and automatically. The Machine Learning analyses embryo development from fertilisation right up to the point of embryo transfer to the patient.

With Caremaps-Al we can select embryos with improved accuracy as we know which has the greatest chance to become a baby. We have confidence in our technology because we have built and tested it ourselves and because we only use our information collected from our very own laboratories.

Generally yes, and your doctor can give you advice on this. There are a few important points to be aware of:

When you’re having a semen analysis

• We recommend that you abstain from any form of ejaculation for the two to five days before your semen analysis to ensure a robust sample.

During your IVF treatment

• Sex during the early stimulation phase of an IVF cycle is fine as long as you are using a form of barrier contraceptive eg. condom. If you were to ovulate unexpectedly, we want to avoid the possibility of multiple pregnancy.

After embryo transfer

• On returning home, we generally advise that you take things easy, avoiding lifting and strenuous activity including sexual intercourse.

The embryo

We do know from scientific evidence that genetic abnormalities in embryos increase with the age of the egg provider. It is also possible for a perfectly healthy person to have rearrangements in their chromosomes that don’t cause any problems for them, but cause genetic imbalances in embryos created with their eggs or sperm. Genetic abnormalities can lead to failed implantation and miscarriage.

The endometrium

The conditions in the uterus have to be just right for an embryo to implant as there is a carefully coordinated interaction between an embryo and the endometrium at the time of embryo attachment. There is very limited time when the embryo is able to attach called the “window of implantation”. The embryo transfer procedure is carefully timed to make sure the embryo is in the uterus at the right time to implant but there are studies that suggest the window of implantation can be slightly earlier or later in some women. This asynchrony might be a factor in repeated implantation failure.

While it’s normal to have bacteria in the vagina and uterus, occasionally the levels and type of bacteria can change. Although this change doesn’t cause any outward signs of infection it can be associated with changes in the conditions inside the uterus (the uterine environment can become more acidic for example) and this can affect fertility.

Immune system issues

Our bodies are usually protected from bacteria and viruses by our immune system which works by killing and removing cells that it recognises as invaders because of their different genetic code - our immune system releases chemical signals called cytokines that cause inflammation.

It is believed that the immune response in the uterus is usually moderated to allow an embryo to implant and grow without being attacked by the immune system or triggering inflammation. Some scientists believe that in some cases of miscarriage, the mother’s immune system may fail to accept an embryo because it has a different genetic code and that having an illness caused by a more vigorous immune system than usual (known as an autoimmune illness) could be a risk factor in implantation failure or miscarriage.

Blood clotting issues

The preparation of the uterus for implantation and support of the growing embryo is dependent on a good blood supply. Some studies have suggested that there is an increased risk of miscarriage where the woman carrying the pregnancy has a higher than usual risk of their blood clotting as small blood clots can restrict vital blood flow.

We have a range of testing options that we use to investigate possible causes of implantation failure or miscarriage in relation to all of the potential issues outlined above.

Yes, we offer a range of testing and treatment options. It’s important to understand the reason for the miscarriage, and there are a number of potential reasons why an embryo doesn’t attach in the uterus or miscarries in early pregnancy. Medical science has yet to help us fully understand all the possible reasons but in general terms miscarriage or implantation failure can arise either because the embryo is not viable or the environment of the uterus isn’t as it should be.

Care proactively recruit egg donors, and you can access a wide choice of donors through our frozen egg bank.

We also offer fresh donor egg IVF treatment.

Endometriosis affects 1 in 10 women in the UK, and around 1.5 million people in the UK are currently living with the condition. Endometriosis can affect anyone of childbearing age.Whilst endometriosis may make it harder to conceive on your own, your chances of getting pregnant with endometriosis can be high, depending on the severity of your condition, age, overall health, and fertility treatment options.

Since endometriosis can take many forms, and the success rates of treatments vary, your doctor will outline your best treatment options with an individual plan for you. Our teams are very experienced in identifying the causes and symptoms of endometriosis and the fertility treatment options available to help you conceive.

With the right treatment, the chances of getting pregnant with endometriosis are high for most people.

Is luteal phase defect a real issue? I read a lot about it when I was TTC but when I saw a specialist he pretty much said it wasn't a real issue and as I was ovulating that was enough. I'm very fortunate that I did get pregnant after 18 months of trying, but always wondered if having a luteal phase of 10 days was the reason it took so long.

There is a lot of controversy on the issue of luteal phase defect. Many doctors think it is a real issue; however, there are no definite tests for it, and there is no effective treatment. There is much ongoing research that should give some answers for the future.