Frequently Asked Questions
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Q. Is it still ok to have sex during fertility treatment?
If you are having fertility treatment we would encourage you to continue your normal sexual relations, as it is very important emotionally for most couples at this vulnerable time. Couples having IVF or ICSI treatment may find that sex is too uncomfortable in the few days approaching the day of egg collection, because the ovaries at this stage are very swollen and tend to be somewhat tender. The chance of natural conception, and the success of assisted conception, is reduced when the man does not ejaculate for more than one week. Optimum semen quality is normally associated with ejaculation every 2-4 days.
Q. How long will I have to wait for an appointment?
At Isis, we should be able to arrange your first appointment with the nurses within 2 weeks. If the nurses are not available within that time, it may be possible for you to see the consultant directly in the first instance, and arrange the second nurse appointment afterwards, although this may necessitate an extra visit to review results before a final decision can be made about treatment.
Q. Does Isis provide fertility treatment for patients over 40 years of age?
At Isis we recognise that an increasing number of women now delay childbearing until their late thirties and in some cases their early forties. We do provide treatment for women of any age up until their natural menopause, or for women who have gone through an early menopause until 50 years of age, but every case must be considered individually.As women advance into their forties, their ovaries become more resistant to the hormones that we use to stimulate them for IVF treatment. A hormone check during your period will tell us whether you fall into this category. If your natural ‘FSH' level is above 15, there is little chance that eggs would be produced in a routine IVF cycle, and in these situations we often recommend egg donation. In addition, the risk of miscarriage and fetal abnormality should you conceive using your own eggs rises dramatically with age. This should also be taken into account before a decision is made regarding treatment. The specialist will address all these issues with you at the time of the first medical consultation.
Q. What are FSH and LH?
Follicle stimulating hormone (FSH) and luteinising hormone (LH) are chemical messengers produced by a small gland called the pituitary gland at the base of the brain. These ‘hormones' send signals to the ovaries to enable an egg to be produced every month. During a period the levels are lowest in the body, but the blood level of FSH rises gradually as an egg is prepared for release after approximately 14 days.
The level of LH produced by the body is fairly low in comparison, until the egg is almost ripe. Then the pituitary sends a huge surge of LH into the blood stream, to help the ovary finish the maturation process, and to ensure that the egg is released 36 hours later. The surge of LH may be detected using a daily urine testing kit. The levels return to a low level again once ovulation has occurred.
The level of FSH in the blood stream during a period helps us determine ‘how old your ovaries are compared with your biological age'. As a woman gets older, the natural level of FSH that must be secreted by the pituitary gland in order for the ovary to be stimulated to ‘grow' an egg, gets higher. The hormone injection that we use to stimulate your ovaries to grow multiple eggs during IVF treatment is also FSH, so if your natural level is high, we need to give you a higher daily dose to ensure that eggs will develop (you become resistant to the hormone).
Q. Do you treat single women?
Yes we treat single women, and also women in same sex relationships. In these cases, we encourage the women involved to speak to our counsellors prior to treatment, and of course we must be assured that the facilities for childcare and support in the pregnancy satisfy the HFEA welfare of the child requirements.
Q. How long do I have to wait before a semen analysis?
A routine semen analysis can usually be arranged within 2 days at
Isis from Monday to Friday and your doctor will give you the results. A men's room is set aside at the centre for this and privacy is always assured. The sample should be produced by masturbation into the pot provided by the embryologist, who will give further instructions at the time. We recommend that you should abstain from ejaculation for 3-4 days prior to attending for the analysis. A longer or shorter abstinence will result in a suboptimal semen sample. The embryologist will examine the sample directly and can usually give you with the result within an hour.
Q. Does Isis have an egg share programme?
Isis offers the option of egg sharing to suitable couples at their request.
Q. Does my partner need to attend all the appointments during a treatment cycle?
Many couples like to come together to the clinic, but we appreciate that people also have busy lives and work commitments. We do like to see the male partner at the initial doctor consultation to go through the medical history in detail. It also helps to have two people to help remember the information that is given. It can be quite a lot to take in all at once! The only time we need the man to be present otherwise is the day of egg collection, when a semen sample is produced. In exceptional circumstances we can freeze sperm beforehand and use a thawed sample, but a fresh sample is always preferable.
Q. Are the embryos replaced one at a time or both together?
The total number of embryos that are being replaced (usually 2) are placed in the catheter together.
Q. Are there any special precautions I should take after my embryo transfer?
Well life should go on as normally as possible after your embryos are replaced, but it makes sense to take things a little easier if you can, and try to de-stress during what can be a very tense time. Healthy regular meals and a good nights' sleep are recommended. We also recommend that baths are avoided for a week, and that swimming pools, jacuzzis and saunas should be avoided until the pregnancy test result. Most couples choose not to have intercourse during the 2 week wait for the pregnancy test, but there are no medical contraindications to sex after the first week has passed.
Q. Will my embryos fall out if I go to the toilet or have a bumpy car journey after the embryo transfer?
Embryos are normally deposited towards the top end of the womb cavity, where they float down into one of the deep folds of the soft womb lining, and settle there. The entrance passage to the womb is up to 3cm long, and has an inner and an outer gate, and contains a mucus plug that helps to seal things. We normally ask you to have a full bladder at the time of the embryo transfer to make the procedure a little easier, so it would be normal to pass urine immediately afterwards. When the bladder is emptied the womb curves over, thus ensuring that the exit route is further protected. Having a bumpy car or train journey immediately or at any time before the pregnancy test will not produce any untoward effects. The embryos will not move if you have diarrhoea or constipation, and are completely unaffected by the frequency of passing urine.