Fertility FAQs

‘Water’ in the Fallopian tube is the medical term to describe a reaction of the tube to severe inflammation. This can happen after sexually transmitted infections like chlamydia but this is not the only cause. Swollen tubes can be detected by ultrasound scan and have an important impact on the success of IVF treatment: they can diminish your chances of success by up to 50%. It is common to discuss an operation (key-hole laparoscopy) to confirm the suspicion and then remove the tube which can no longer serve any useful purpose. 

Fibroids are like lumps of gristle in the ‘meat’ of the muscle of the womb. The can be tiny like a grain of rice or large like a melon and anything in between. They are very common and often do not cause problems or any difficulties with getting pregnant. Sometimes they can form just under the surface of the womb lining where a pregnancy will try to implant. These fibroids usually need to be removed (surgically) to improve fertility. Large fibroids (eg the size of an orange or more) can cause heavy periods, distortion of the womb and discomfort such as pressure on the bladder. This is worse if there are several of them. Surgery may be advised before fertility treatment. More information about fibroids.

A cyst is a pocket of fluid. Every monthly cycle involves the development of a cyst containing the egg for that month’s ovulation. This type of cyst is called a follicle. So, ovarian cysts can be quite normal and a sign of the normal monthly pattern of egg turnover. Sometimes the cycle goes off-track and a cyst will remain visible on ultrasound scanning for longer than usual. It is common for these cysts to disappear with patience and a bit of time (a few weeks).

Endometriotic cysts are not normal- they contain endometrial (womb lining) cells that have migrated into the wrong place. They can enlarge and cause pain as the cells inside them bleed regularly in time with your period. They do not usually go away with patience and observation. Sometimes surgery may be advised (keyhole / laparoscopy).

Dermoid cysts are quite common. They can be present with absolutely no symptoms and found by chance on ultrasound scan. They are benign (not cancer) but can get bigger over time. They can contain all types of body tissues: skin cells, hair, teeth, glands. It is common to recommend the removal of dermoids because they can get in the way of the egg-containing area of the ovary and can make the whole ovary twist on its stalk. This is painful and dangerous if it is not managed quickly and properly (surgical operation).

Malignant or cancerous cysts are very rare in women in the fertile age group.

It is sensible to dye your hair before treatment starts (if that is your normal hair care) and wait until you know the outcome (pregnancy test) before doing so again. You may decide to wait a bit longer if you become pregnant. For more information please see: Is it safe to use hair dye when I’m pregnant

Going far away for a holiday / work during the treatment program is not advised. You should wait until you have had your pregnancy scan before you leave so that you are not in an unfamiliar place / country if you were to develop any problems e.g. bleeding, pain, ectopic pregnancy risk. 

If you want to be seen in the clinic on the NHS you must see your GPs (both partners in a couple) to request a referral and to get your basic tests done. Your GP can find guidance on the tests required through ‘Leeds Health Pathways’.

If you would like to be seen privately, it is still best to get a referral from your GP, and to have the initial tests done. You will get more out of your first appointment with this preliminary information. You can tell your GP which consultant you would like to see and which hospital you would prefer to attend.

Yes you can but we cannot always guarantee it for every step of your treatment. Please ask if this is important to you and we will do our very best to accommodate you. All intimate examinations are chaperoned (supervised by a female member of staff), and all practitioners are fully and professionally trained to support you and maintain privacy and dignity at all times.

NHS-funded fertility treatment is allocated according to local criteria based upon the Integrated Care Board (ICB) that pays for the services your GP uses in their area. Your GP is the best person to ask if you are ‘eligible’.

Sometimes your partner’s situation may influence your eligibility. For example, many ICBs will not fund treatment if one partner has had a child with a previous partner.

In general:

• Fertility treatment is not NHS-funded over the female age of 43
• Fertility treatment may be NHS-funded in women aged 40 to 42 years dependent upon your fertility assessment
• Fertility treatment is not NHS-funded for women who are significantly overweight (Body Mass Index higher than 30 kg/m2)
• Fertility treatment is not NHS-funded for single women
• Fertility treatment may be NHS-funded in same sex partnerships where neither partner has a child and all criteria are met
• Fertility treatment is not funded where either partner is a smoker
• Fertility treatment is funded when couples have been in a stable relationship for two years and are currently living together

Most ICBs fund one attempt of IVF. If either partner has had NHS funded treatment in the past, there is no NHS funding.

See Commissioning policies: West Yorkshire Health & Care Partnership ICB for more information.

Yes, through are partners at Care Fertility Leeds

Care Fertility Leeds at Seacroft Hospital, York Road, Leeds, LS14 6UH.

See Care Fertility | AccessAble for directions.

For an NHS consultation, please make an appointment to see your GP.

For a private consultation, please contact Care Fertility Leeds: 0808 304 7739 or Book a Consultation

The chances of successful IVF treatment are more closely related to the age of the woman than any other factor. This is because the eggs a woman has have been in her ovaries since before she was born. They reduce in number and quality over time. By the age of 35, the average woman has already lost about 80% of all her eggs.

By the menopause (average age 51) they have all virtually disappeared.

At 43, about 90% of the eggs that are left are abnormal and not capable of producing a healthy baby. Usually they do not fertilise, of, if they do, they do not continue (late period, fleeting positive pregnancy test, early miscarriage).

IVF is not NHS-funded over the age of 43 because the chances of success are so slim (less than 5%). Most women who conceive in their mid-forties will do so with the help of donated eggs from younger women.

The age of the male partner is less important. Men continue to make new sperm through their life and the quality is much ‘fresher’ than eggs of similar age.

IVF in a nutshell:

• take hormone injections to make the ovary produce multiple eggs at once, instead of just 1
• take a second hormone injection to prevent the body from releasing those eggs until they are all ready
• take a third hormone to synchronise the release of the eggs
• collect the eggs (through a needle inside the vagina guided by ultrasound scanning) with sedative and pain-relieving medicines (egg collection)
• fertilise the eggs with a fresh sperm sample in the laboratory: allow the embryos to grow
• select the leading embryo for transfer and insert it into the womb
• two week wait to pregnancy test
• three week wait to pregnancy scan (looking for a heartbeat in the baby)

Women will need to have the day of their egg collection procedure off work, and the day after to recover fully from the sedation medication. You will need to take a half day off on the day of your embryo transfer as the timing can vary.

An IVF treatment cycle takes from four to six weeks (depending on the specific tailor-made program) until the pregnancy test result.

All treatment is followed up with a clinic appointment to discuss the details, what has been learned, whether there is anything that can be changed next time and whether it is sensible to try again.

Care Fertility Leeds counsellors are here to support you if needed. They can be very helpful to talk through options as well as coming to terms with disappointment.

Care Fertility Leeds freezes embryos in about 60% of treatments. About 90% of these will survive the freezing and thawing process and have a very good chance of producing a pregnancy.

IVF has been done for 40 years. ICSI has been done for nearly 30 years. There have been many studies following the physical and mental health and well-being of IVF / ICSI conceived children. There have been no major concerns that the process of these treatments is doing harm. More than 5 million children have been born form these techniques to date. 

In the UK, every treatment is registered with the Human Fertilisation and Embryology Authority which gives clinics their license to offer these treatments. The Register permits on-going research as the first IVF / ICSI generation is starting to have their own children. It will take another generation to understand whether some infertility is inherited.

No it is not. However, because IVF pregnancies are so closely monitored, very early losses are identified when they may not have been noticed under normal circumstances.

Miscarriage is actually very common (1 in 4 of all pregnancies end in miscarriage) and is usually the natural consequence of an abnormal or unhealthy pregnancy being ‘let go’

Endometriosis is a common gynaecological condition which affects an estimated 10% of the women of reproductive age and is associated with infertility, menstrual pain, pelvic pain, and ovarian cysts (endometriomas). Between up to 50% of the women presenting with infertility have underlying endometriosis. The exact reason as to how the endometriosis develops is unknown.

Endometriosis can only be diagnosed with a laparoscopy (keyhole surgery) although it may be suspected from symptoms and on an ultrasound scan if a cyst is identified.

Studies suggest that laparoscopic surgery on mild to moderate endometriosis, or removal of uncomplicated endometriomas may be beneficial in improving endometriosis-associated pain and in increasing spontaneous pregnancy. IVF/ICSI will provide you with the best chance of conceiving if you have endometriosis-associated infertility.

If you have symptoms suggestive of endometriosis and are trying for a baby, please speak to your GP and get a referral to see a specialist. For more information please see: Endometriosis

There are several ways of testing to see whether your fallopian tubes are open and able to work normally. The doctor will talk through your options and may advise you that one method is more suitable for you than another.

Hysterosalpingography (HSG)

Having a healthy lifestyle is important for general health but it is becoming clearer with advances in scientific and medical understanding that it is even more important before and during the very early stages of pregnancy. Preparing for pregnancy to give your baby the best chances in life is an area we have reinforced for many years, for both women and men. Sometimes, a lifestyle adjustment is all that is needed for couples to conceive naturally after months or years of trying without success.

• Stop smoking completely
• Reduce alcohol intake to a minimum for both men and women. No safe limit has been identified so no alcohol consumption is advised.
• Women should have been vaccinated against German measles (rubella) or have confirmed immunity.
• Women should have an up to date, normal cervical screening smear test.
• Women should be taking folic acid (vitamin B) supplement at 400 micrograms daily before and during treatment, and for at least the first three months of pregnancy (buy over-the-counter ‘folic acid for pregnancy’ or ‘multivitamins for pregnancy’).
• Both partners should aim for normal body weight for their height. Women, in particular, should aim for a body mass index (BMI) ideally under 25kg/m2, and absolutely under 30kg/m2 to access NHS-funding. Treatment is less successful and riskier at heavier weights. Pregnancy is also less healthy with a higher risk of blood pressure problems and diabetes in heavier mothers.
• A healthy, varied diet and regular physical exercise are helpful for overall health, weight management and stress reduction.
• Discuss any other medication you take with your GP and specialist(s) to ensure any risks to yourself (from other medical conditions) and to your up-coming pregnancy / baby are minimised.
• Consider carefully the use of complementary therapies, and please inform us what you are using / doing. Acupuncture is not known to be harmful and many patients find it helps with managing stress.
• If you wish to discuss your lifestyle and diet in more detail, you may wish to consult a nutritionist who can focus on specific micronutrients and recommend changes accordingly

There are different reasons for wanting or needing to store sperm.

Sperm storage for fertility preservation

This may be offered as a consideration before treatment that could affect an individual’s long-term fertility for example:

1. Before treatment for cancer involving chemotherapy and / or radiotherapy
2. Before treatment for any condition that requires medication or surgery that could affect sperm creation or release in the normal way, including gender transitioning sperm storage for back-up during IVF/ICSI treatment.
3. Occasionally sperm is also stored if there are concerns about the quality of the sperm before fertility treatment or if you are worried you may not be able to produce a sample at the time of treatment. Please do not be embarrassed to ask about this.

When the sperm count is very low and there is a concern that there could be no sperm in the ejaculate, it is sensible to produce at least one sample in advance of the day when the sperm is required to fertilise the eggs, and freeze it.

The laboratory will always request a fresh sample as the quality is usually better, but the frozen sample is there as a back-up. It is important that the correct preparation takes place before a sperm sample is produced and frozen. The man must have up-to-date screening blood tests for:

• Hepatitis B core antigen
• Hepatitis B surface antigen
• Hepatitis C antibody
• HIV antibody
• Syphilis antibody

These must be taken less than 3 months before the sample is frozen. You should also abstain from ejaculation for 3 to 5 days before producing the sample to be frozen.

Sperm storage for donation between known individuals

This situation may arise between a female same-sex couple who have chosen a friend as their sperm donor. It may arise between brothers, one of whom is infertile. It also happens in surrogacy arrangements where the woman carrying the baby is not the partner of the sperm provider. In these situations, the sperm ‘donor’ needs to have various screening tests before he puts sperm into the freezer, and then again after six months to make sure that no illnesses have developed in the meantime, that might affect the safe use of the stored sperm in the recipient woman  (Hepatitis B, C, HIV and Syphilis, Chlamydia, Gonorrhoea, CMV, HTLV 1&2 ). The sperm cannot be used until the 6 month quarantine period has passed and the sperm is released as safe to use. (Sperm used from unknown donors from a sperm bank is screened in exactly the same way.)

Surrogacy is when a woman carries and gives birth to a baby for another individual who wishes to have a child but cannot do so naturally or with the help of other fertility treatment.

Surrogacy may be needed by women with medical conditions that make it impossible or dangerous for them to get pregnant and give birth. These include:

• Women who were born without a womb, or have a malformation of the womb.
• Women who have had a hysterectomy (removal of the womb) e.g. for treatment of cancer from which they have fully recovered.
• Women who have a damaged womb lining e.g. following severe scraping of the womb causing extensive scarring
• Women who have had many miscarriages
• Women who have had many unsuccessful attempts at fertility treatment e.g. in vitro fertilization (IVF)
• Women with severe medical conditions for whom a pregnancy could be dangerous e.g. cystic fibrosis
• Surrogacy is also an option for male same-sex couples who wish to have a family.

More information on surrogacy will be provided by Care Fertility, if this is a potential option for you. You can also learn more at: Surrogacy | HFEA, SurrogacyUK and Brilliant Beginnings