tfp logo

FAQs

Find answers to the most frequently asked questions of our patients here.

General information

We are struggling to conceive. What do we do first?

If you have been trying to concieve for a year and have been unable to conceive naturally, don’t delay any longer and book an appointment for a fertility assement with your GP or private fertility clinic. These tests help you to get to the bottom of why you might be struggling to conceive, as there could be an underlying issue.

What changes to my lifestyle can I make to increase my chances?

Your lifestyle can impact your fertility, some small changes that can make a difference to your fertility are:

·        Maintaining a balanced diet and a healthy weight

·        Regularly Exercising

·        Taking supplements e.g.  ‘well man’, ‘well woman’ and vitamin D

·        Not smoking or taking recreational drugs

·        Minimising alcohol consumption

·        Getting plenty of sleep

·        Reducing and managing your stress levels

Will a donor be able to trace my child?

A donor is not issued with any personal information that could be used to identify a child born as a result of their donation. A donor can request to know the number of babies who were produced as a result of their donation, the year of birth and the child’s gender.

We need fertility treatment, why do I need counselling?

We strongly advise all of our TFP IVF patients seek counselling during their IVF treatment. Sessions are confidential and are available before, during and after treatment. These counselling sessions offer patients additional emotional support, during what might be an incredibly important and emotional journey. 

What treatments exist for male infertility?

Treatment for male infertility are always tailored to an individual but treatments that may be required include:

· Intracytoplasmic sperm injection (ICSI): As part of the IVF process, sperm is injected straight into the egg to help overcome low sperm motility or count.

· Surgical Sperm Retrieval (SSR): If suitable, prior to Intracytoplasmic sperm injection (ICSI) men can have sperm surgically retrieved if no sperm is present in the ejaculate.

· Donor sperm: Altruistic donations can be used to achieve a pregnancy. Special counselling sessions are available At TFP, all of our fertility clinics offer counselling for individuals and couples to discuss their feelings and the implications of using donor sperm.

How are fibromyalgia and endometriosis related?

As endometriosis is a painful condition and can lasts many years, women with endometriosis may develop fibromyalgia over time as it may trigger it.

How can we improve the quality of our sperm and eggs?

A number of factors have been shown to reduce the quality of eggs and sperm, so there are a number of things you can do to minimise this risk, and provide the best conditions possible for the development of your reproductive cells. These types of cells are created over a prolonged period of time, so the modification of lifestyle must be considered as a long term investment. You can find out more in our Lifestyle Advice section.

What causes infertility?

You need four things to get pregnant:

  • you need to produce an egg (ovulation),

  • you need good quality sperm,

  • then the egg and the sperm need meet and fuse (fertilisation).

  • the resulting embryo must then implant in the womb.


It sounds relatively simple, but in fact hundreds of synchronised hormonal and physical events must take place and there are many steps where things can go wrong.


“Infertility” is defined as the failure to get pregnant after one year of having regular, unprotected intercourse.


Around 1 in 6 couples have difficulty in conceiving, and this proportion is increasing, largely because women are starting their families later in life and because sperm counts are falling. However, with the appropriate help, the vast majority of couples can realise their dream.


There are many reasons why you might be having difficulty getting pregnant but broadly they are due to problems of ovulation and egg quality, problems of sperm quality, problems with the fallopian tubes, or a combination of these.


Common egg problems:

  • Polycystic ovary syndrome.

  • Being over- or underweight

  • Medications that affect ovulation

  • Increasing age. Unfortunately, as a woman gets older, the quality of her eggs decreases.


Common sperm problems:

It is thought that environmental pollutants are resulting in increasing sperm problems. As a result, we are seeing more men with:

  • Too few sperm

  • Not enough motile (active) sperm

  • Minor genetic problems that affect sperm counts and quality

  • Genetic problems or past infection.


Common fallopian tube problems:

  • Past pelvic infection

  • Past pelvic surgery


Endometriosis:

Endometriosis is a common condition where the cells that line the womb (and bleed each month with a menstrual period) occur outside the womb. Even mild endometriosis can have a negative effect on a couple’s fertility.


Unexplained infertility

In a proportion of couples we can’t find an obvious cause and this is termed “unexplained infertility”. It doesn’t mean that there is nothing wrong, it just reflects our current state of knowledge and it might be due to a subtle problem with one of the hundreds of things that are required for successful conception and implantation

I have a low anti-mullerian-hormone (AMH) level. How might this affect my cyle?

Your level of AMH helps to predict how well your ovaries will respond to stimulation during an IVF cycle. It can be used to tailor the stimulation drugs to an individual patient and can predict which patients may expect low or high egg numbers and which patients are at a higher risk of ovarian hyperstimulation syndrome (OHSS). Patients with a low AMH  do have lower pregnancy rates but the degree of this reduction is more age-related, with patients 39 years old and older having lower chance of pregnancy than patients with the same AMH who are less than 39 years old. Pregnancies have been reported in patients with very low, or barely detectable AMH levels but patients with a low AMH (less than 3.1 pmol/l) also have an increased risk of failed fertilisation across all age groups.

How is sperm produced?

Sperm is produced in the testes. Sperm develop inside very small tubules in testicular tissue (seminiferous tubules) and then move along a network of tubes to a holding place (the epididymis) before ejaculation. In the average man with a normal sperm count, the testes produce thousands of sperm every second, but it takes three months for these to become mature and be ready to be ejaculated.

What fertility tests are there for men?

There are several ways to test male fertility, but these depend on the outcome of the initial semen analysis. For men with normal numbers of sperm with good motility we don’t typically offer further tests, as their results don’t influence treatment or treatment outcomes. For men with abnormal sperm results, we will advise on the options on a case by case basis. The semen analysis is the most important test, and the place to start.

I have been told I need a Surgical Sperm Retrieval (SSR). What is the chance of obtaining sperm?

This will depend on the reason you need the procedure. Men who have no sperm in their ejaculate due to a blockage have a higher chance of retrieving sperm than men who have testicular failure. Retrieval rates range between 25-75% but please speak to your doctor at your consultation for a more accurate estimation based on your own diagnosis.

You can find out more on the SSR treatment page.

What happens if my sample is poorer quality than it had been previously?

We will speak to every couple on the day of treatment about their sperm quality and discuss the best treatment option. If the sample is poorer than expected, we may need to use a procedure called ICSI. This is where we inject a single sperm into each egg to help maximise fertilisation rates, and can be done with very small numbers of sperm. If numbers are extremely low or we fail to find sperm on the day of treatment, we may be able to do a surgical procedure (SSR) to recover sperm for treatment.

What happens if I can’t produce a sperm sample on the day of treatment?

If you are concerned that you may struggle to produce a sample on the day of treatment please speak to an embryologist about freezing (vitrifying) a sample prior to treatment which can be used as a back-up: this can help to alleviate stress on the day. If we do not have a semen sample on the day of treatment, we may be able to extract sperm surgically, or vitrify the eggs to commence treatment at a later date.

What preparation do I need?

For the best result, you must abstain from ejaculation for a minimum of 3 and a maximum of 5 days (See: Can we have sex during treatment or before a sperm sample?). Wash your hands and genitals before you produce the semen sample. You must tell the clinic about any illness or medication taken in the last three months, as these things can affect your semen quality, and the advice you’re given after the analysis.

Can I produce a sperm sample at home?

If producing a sample at the clinic is unsuitable or unsuccessful, or if you are concerned that you may have difficulties, please speak to a member of staff about alternative arrangements. It may be possible to produce a sample at home. You will be provided with an appropriately labelled sterile pot and a sealable plastic specimen bag for transport. You must ensure that the sample can be transported at a temperature between 20C – 37C (we suggest close to your body/ inside jacket pocket) and within 1 hour of production. You will also need a form to state that the sample is your own. You must inform a member of staff if the whole sample was not collected. Spillage of the sample can affect the results and subsequent treatment plans.

Where and how do I produce the sperm sample?

It is best to produce the semen sample on-site at the clinic. A discreet and quiet room is provided. We will do our best to make you comfortable and relaxed; you may wish to have your partner with you, but please be aware that this isn’t always possible. You must inform a member of staff if the whole sample was not collected. Spillage of the sample can affect the results and subsequent treatment plans.

We have been advised to use donor sperm, what is the process?

We have our own donor sperm bank and you can purchase what we have available at any one time. You can also obtain donor sperm from our preferred European sperm back. There is no waiting list for purchasing donor sperm, for more information about donor sperm, click here. The embryology team will advise as to how many straws or vials of sperm will be required for your treatment cycle.

Can we have sex during treatment?

Many couples remain intimate during treatment and this is perfectly fine in most cases. There are times when unprotected intercourse is best avoided and this will be clarified during treatment as it is different for different couples.


One occasion when we can give general advice is before a sperm sample is provided for analysis or treatment. It is important to avoid ejaculation for a few days as this affects the result and both the number of sperm and their motility. The highest number of sperm and best motility are typically seen after a man has abstained for between 3 to 5 days. Abstaining for longer than this may increase the number of sperm but the proportion of sperm still ‘swimming’ falls. In contrast, ejaculating every day may increase sperm motility but the numbers will be lower. The 3 to 5 rule is the best compromise therefore between concentration and motility.

How long will the whole IVF process take?

The standard course of drugs for an antagonist cycle is 14 days. If it is necessary to have a long cycle, the drug course lasts around 4 weeks. After this you will have your egg collection procedure. 3 or 5 days after your egg collection you will generally have your embryo transfer. This is the standard time taken for IVF cycles but individual circumstances may alter these timings slightly.


One occasion when we can give general advice is before a sperm sample is provided for analysis or treatment. It is important to avoid ejaculation for a few days as this affects the result and both the number of sperm and their motility. The highest number of sperm and best motility are typically seen after a man has abstained for between 3 to 5 days. Abstaining for longer than this may increase the number of sperm but the proportion of sperm still ‘swimming’ falls. In contrast, ejaculating every day may increase sperm motility but the numbers will be lower. The 3 to 5 rule is the best compromise therefore between concentration and motility.

What is the difference between IVF and ICSI?

IVF (In Vitro Fertilisation) is where a high number of (prepared) sperm are added to a dish containing the eggs and the sperm are left to swim to the eggs on their own. The sperm & eggs are left together overnight and checked for fertilisation the following morning.
ICSI (Intra Cytoplasmic Sperm Injection) is where a single sperm in injected into an egg by an embryologist. This technique may be used if the sperm concentration or motility are low or if poor fertilisation had been achieved previously with IVF.

Is there a chance that none of my embryos will form blastocysts?

Approximately 40% of embryos will reach the blastocyst stage. Those at a compacting or cavitating stage (the stage before the blastocyst stage) can still be transferred but do have a lower chance of achieving a pregnancy. There is a small chance that all of patients’ embryos may stop developing at the embryo stage, this happens in approximately 2% of blastocyst cycles and results in the embryo transfer been cancelled.

What is blastocyst culture?

‘Blastocyst culture’ is the term commonly used to describe the culture of embryos until they are five days old. A blastocyst has a large number of cells and consists of two distinct cell types. Around 40% of embryos will reach the blastocyst stage and those that do have a higher chance of implanting once transferred.

What is my chance of success?

Success in IVF treatment is determined by a large range of factors. Your doctor is the best person to advise you about your chances of success, as they have all the information about your treatment programme.

Will I be able to freeze my spare embryos?

Embryos which are not transferred can be frozen if they are of a suitable quality. At the time of embryo transfer the Embryologist will discuss with you the quality of the embryos for transfer and any remaining embryos and will advise you if these meet the criteria for freezing.

I have been advised to consider a single embryo transfer (SET), why is this beneficial to me?

If you have been recommended for SET you are a patient with a high chance of achieving a pregnancy from IVF treatment. A high chance of pregnancy is accompanied by a higher risk of twins, and a higher risk of complications, if we replace two embryos.

Do frozen embryos deteriorate over time in storage?

Frozen embryos are stored in liquid nitrogen at a temperature of -196°C. This means they are held in a suspended state and do not deteriorate with time in storage.

What proportion of embryos survive the freezing/thawing process?

We find approximately 90% of frozen embryos survive the freezing/thawing process. This can vary depending on the stage of development that the embryos were frozen and an individual patients’ embryos susceptibility to the process.

What happens after my sperm test (semen analysis)?

After your semen analysis your sperm will be frozen and thawed. This will show the survival rate of the sperm once thawed. You will then be contacted and informed whether you are initially suitable to be considered as a donor

Will any donor-conceived children ever know who I am?

If a child is born as a result of your donation, they are able to find out information about you once they reach 18 years of age and this information could lead to them identifying you.

Do you have an egg/embryo donation programme?

Yes, we receive donations from women who are prepared to do something amazing by donating some of their own eggs for use in our fertility programme (altruistic egg donors), donations from someone known to the recipient patient (known egg donors) and donations from patients going through their own fertility treatment with no female fertility issues (egg sharers).

Will I be accepted as a patient?

Apart from adhering to HFEA guidelines the clinic has few restrictions on who it will accept, the main one being an upper age limit of under 44 with your own eggs or under 55 using donor eggs. If after the initial consultation we do not feel that it would be in the best interests of your own health to proceed with IVF we will talk this through and provide full counselling and support to help you decide on the next step. For some unusual circumstances we may hold a case conference to discuss the ethics of proceeding to treatment. You will be advised if this applies to you.

How much will it cost?

There is no standard fee for fertility treatment as there are a number of complex factors that will vary for everyone, such as the amount of medication needed. For a detailed breakdown of the pricing structure for the different stages of the process and the services available, as well as a list of price examples, please visit our clinic pages.

Do I have any parental responsibility for donor-conceived children?

No, the recipient couple are the parents of any resultant child; you have no financial or legal obligation or responsibility.

Pre-footer

Ready to start your fertility journey? We're here for you

Schedule an appointment to start your fertility journey with us.