General fertility questions

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.

Yes, adenomyosis can affect fertility chances. If it is just one or two miscarriages, then it may be just bad luck as you put it, but if it is more than 3 miscarriages, then I would recommend investigations to see if there is a cause for the miscarriages. An ordinary UTI is unlikely to affect implantation, although if you were very unwell with it, then it may have contributed to a poor pregnany outcome.

No. There is no clear evidence to suggest retroverted uterus is a problem. Position of uterus is determined by the ligaments holding it in place . Going through a childbirth does changes the strength of liagment so it is not uncommon to have a retroverted uterus. It has no bearing on your fertility.

I would recommend against all fertility treatment (including frozen transfer) while you are breast feeding. The hormone called prolactin released from pituitary gland during suckling could interfere with your cycle and could interfere with lining of the womb. So we would not recommend any treatment during lactation. Ideally you would need to stop 3 month prior to seeking fertility treatment. Another factor to consider is that the medicines we give as part of your fertility treatment can affect breast milk production.

I am so sorry to hear this. Unfortunately there is still a very small risk that there can be an ectopic pregnancy in the tubal stump or the bit of the tube that is running in the womb muscle. There is no way of eliminating this risk. Regardless of where embryos are placed they can migrate to the tube.

Intramural fibroids are associated with a reduction in fertility outcomes, and this may be due to the fibroid affecting the blood flow to the lining of the womb. Having said this, the size, the exact location of the fibroid and the clinical history will need to be considered when thinking about the prognosis and what (if anything) needs to be done about the fibroid. At same time a fibroid does not cause subfertility in all cases.

Termination of pregnancy (expectant, medical ) is generally not associated with infertility. But surgical procedure could increase risk of having intra uterine adhesions which in turn could cause infertility in few occassions.

We’re experts in time-lapse imaging, and so far we’ve had more than two thousand births using this technology. As a result, we’re now able to compare the timelines of embryo development in embryos that have resulted in the birth of a baby, to those that haven’t. From this we’ve learnt that, even if embryos look similar, there will be subtle differences in their development that can help us to see which are most likely to lead to successful treatment.

CAREmaps was created using this information. CAREmaps is a form of time-lapse imaging that incorporates a unique algorithm based on the ideal times that an embryo should reach certain key stages of development. With CAREmaps all of your embryos will be compared to this timeline, and this information will be used to select the embryos for transfer that have the highest chance of becoming a baby.

Using CAREmaps we’ve had a clear uplift in pregnancy and birth rates compared with standard methods in all age groups. You can find out more about CAREmaps here

An ectopic pregnancy increases the risk of a future ectopic pregnancy (either on the same tube, if it was not removed, or in the other tube). As long as at least one tube is present, there is a chance of natural pregnancy. If both tubes are diseased or absent, IVF will be necessary for you to get pregnant in the future.

Yes it can. Although it depends on the type of cyst. For example an endometriotic cyst can affect your fertility.

We're not aware of any proof these lubricants etc are effective in assisting fertility. The best natural things you can are such as cutting out alcohol, smoking, taking exercise and eating well. We've created a page on our website with more details about this here https://www.carefertility.com/where-to-start/top-tips-for-improving-fertility/. If however there are issues affecting fertility the sooner you can get treatment the better your chance of a positive result.

Bleeding does not usually occur with ovulation. Spotting can occur but unusual at ovulation, it is not uncommon when the embryo is implanting in the womb.

No there is no science to back this up! The womb is situated in the pelvic cavity, where it benefits from the normal core temperature of the body. Basal body temperature measurements are sometimes used to assess for ovulation, but there are now much better tests available for checking for ovulation.

Unfortunately egg quality has very little to do with lifestyle. The main factor affecting egg quality is age. Whilst 31 isn't old, in terms of fertility, egg quality declines from mid 20's onwards. It's very unfortunate to have this diagnosis and we can understand it's disappointing for you however we treat many successful parents with donor eggs every year. However, if you're unsure about this diagnosis, we're always happy to provide a second opinion and welcome you to visit your local CARE clinic for a consultation.

We are not aware of any scientific proof that these lubricants assist conception.

There is no clear evidence. Some believe a pregnancy (natural or with fertility treatment) 'resets' reproductive function - but there is no clear evidence that this is true.

Apart from severe male factor infertility, such as very low sperm count, which may (not always) be caused by a genetic condition, then yes this could be passed on to a male child. But in almost all other cases there is no good evidence of passing on infertility. There are some rare genetic conditions - for example is egg donation is required due to failure of the ovaries, this could be genetic - and several rare circumstances such as this; but in general the answer would be no. Many of the early cases of IVF have had children who have gone on to conceive naturally.

No, we aren't aware that this affects a woman's ability to conceive.

Yes whilst a high FSH means the chances are you have a low ovarian egg reserve, whether or not you enter into early menopause is entirely down to the individual. Find out more about low ovarian reserves with our female IVF diagnostic tests.

It is recommended that you have a consultation to discuss your options. Some fertility treatments are non invasive. Whilst we offer treatments into early 50s the sooner you can receive treatment, the higher your chances of success.

No, not in general - whether it is fertility drug treatment or IVF. There may be some very specific genetic conditions that can be inherited, but general patters of concern from fertility treatment so that it ought not to be recommended - no. All specific conditions

Absolutely as soon as possible is always better. As fertility rates don't improve with age the sooner you can get treatment for any fertility issues the better your chance of a successful outcome.

Whatever is best for you! Provided everything is OK you can try for another baby as soon as you like.

If you have had the standard fertility investigations, and have been trying for more than 2 years, then most clinicians will suggest moving forward to IVF.

Being overweight affects fertility from both male and female perspectives, but particulalry from female perspective. From your husband's point of view I will suggest a sperm test to see if there is any problem, and trying to maintain good glucose control.

The word 'massively' is subjective, but it is always advised to keep alcohol at most no more than recommended government limits - we must not forget, alcohol is still to a small extent toxic; larger doses may cause problems with fertility and/or the foetus

There's no guarantee that any amount of alcohol won't affect your fertility. If you're trying to conceive we'd recommend you cut out all alcohol if possible.

We'd recommend anyone trying to conceive follow a normal healthy diet. Having the right nutrients in your diet is essential in creating and maintaining healthy eggs and sperm. We recommend our patients incorporate a range of fruit and vegetables into their diet as well as proteins, fats and carbohydrates. The changes made to your diet will take around 3 months to take effect on your fertility. So, if you’d like to make a difference to your chances of becoming pregnant, it might be beneficial to you to begin your preparation sooner rather than later.

We're sorry to hear of your IVF journey and that you've been unsuccessful so far. Although there is no definitive research evidence to show stress affects the outcome, many clinicians believe it can have an impact and ask their patients to consider adopting strategies to manage stress, including acupuncture, yoga, music, exercise and seeking professional psychological help.

Excessive and intense weight training can affect fertility if it stops you from having periods. If you are concerned about exercise or drugs affecting your ovulation, then you can test for ovulation to rule out this as the cause of infertility.

Acupuncture is the only holistic treatment for which there is published data in the scientific literature that demonstrates benefit - but not all studies agree, not least because of patient variablility

There is evidence to show that acupuncture can be beneficial when trying to conceive. Whilst there may not be the same evidence with reflexology it can be helpful simply to help you relax during your treatment. We would always recommend you advise your doctor if you are undergoing an alternative therapy such as these during your fertility treatment.

We're not aware of evidence to suggest they help fertility and we'd not recommend you take any supplements during fertility treatment without consultating your doctor.

If you have endometriosis and are having trouble starting or growing your family, then we might be able to help. For more advice, arrange an appointment with one of our consultants – they’ll be happy to talk more about any problems you’re having.

If you’re looking for treatment for endometriosis but you aren’t hoping to conceive, you’ll need to ask your GP for a referral to a gynaecologist specialising in endometriosis.

Congratulations on your pregnancy. Endometriosis is a condition that affects all women differently, and it would be impossible to tell without a full consultation whether or not your condition has improved and the impact on your fertility. We'd strongly recommend you speak to your GP first to understand what's going on first before seeking further treatment.

Endometriosis can affect the fallopian tubes, egg quality, fertilization prospects, and embryo quality. However, many women with endometriosis have no problem conceiving a pregnancy. As endometriosis is different for every woman, some women will benefit from surgery, others from assisted conception. A consultation can be helpful if you are considering trying to get pregnant to fully understand your options.

As you proved it yourself, endometriosis and polycystic ovarieas are not absolute reasons for infertility. Whilst both can reduce your chances, they do not leave you completely infertile. The exact chances for you to conceive again in the future do depend on your clinical history and any medical conditions. If you do wish to conceive again, we'd strongly recommend you speak to a CARE fertility expert. We are able to offer genetic screening for a specific abnormality that can cause miscarriage, C4M2, and possibly increase your chances of success. However what we would strongly recommend is you visit for a consultation just so you're fully aware of your options.

It's really difficult to say what could be causing you to feel sick and dizzy without undergoing investigations i'm afraid. Some people do report feeling a little nausea after taking folic acid, which we assume will be included within your pre-natal vitamins. However it does sound like something you would need to speak to your GP about first, just to rule out anything more serious.

Unfortunately yes, it is likely you will have issues conceiving naturally as PCOS stops the body from ovulating, fortunately however, IVF can be is extremely effective for patients with PCOS, particularly under 40 we can highly recommend it if you are trying to conceive.

No, not necessarily. The lining can just be absorbed back into the body so a light period isn't indicative of a thin lining.

You'll need to undergo several tests, all at different parts of your cycle so as long as you can determine when day 1 is there's no reason why you can't start now.

Without tests we couldn't diagnose whether or not you were ovulating. However, at 39 we'd agree that the sooner you can receive treatment the better. If you're looking to book a private consultation you should investigate clinics, research success rates, costs and treatment offered. We'd also recommend visiting a clinic before you decide whether or not to go with them for treatment. All CARE clinics offer a free 1-2-1 as well as patient information evenings to help you to decide if this is the right choice for you.

We would recommend you see your GP to discuss the possible reasons you can't gain weight. As you know, it can impact your fertililty and your ability to get pregnant, however until the cause is determined it is impossible to say whether or not it would cause permanent infertility or not.

Yes, long cycles can be a sign of not releasing eggs from your ovaries (anovulation). Polycyctic ovaries is the most common reason for long cycles, and your doctor can easily check for this with hormone screening tests and ultrasound scan.

There is no number that can be given as a definite answer. Luteal phase is normally 14 days, and if your luteal phase is less than 10 days, it will be useful to have a consultation.

There is no clear evidence that a short luteal phase is a definite problem, and there is no clear guidance on how to test for luteal phase defect and on how to treat it. However, if the luteal phase is consistenlty less than 10 days, then I think it is worthwhile having a consultation.

Not necessarily. Many women have spotting and still have a normal pregnancy.

Fairly quickly, usually within 2 months

It sounds as if you would be best to speak to your doctor first about your periods. Everyone is uniquely different and it would be impossible to say whether or not this would affect your fertility with this information. Once you've got the all clear from your doctor, using donor sperm won't lower your chance of getting pregnant at all, so you've the same chance as any 38 year old undergoing treatment (assuming no undiagnosed fertility issues)

Of course, and we’d be glad to help. If you and your partner are UK residents, we’ll just need you to go through a few screenings to check that you’re eligible, after which we can put you in touch with non-profit surrogate agencies to help you search for the right person. Once you have your surrogate, you can then have treatment at CARE.