Frequently
Asked
Questions (FAQs)
Frequently Asked Questions (FAQs)
What is infertility?
Infertility is clinically defined as an inability to conceive naturally after 12 months of regular, unprotected intercourse.
This is shortened to 6 months when the prospective mother is over 35, has irregular menstrual cycles, tubal problems or there is a sperm related issue. It is also important both men and women are checked because problems with sperm cause approximately 4 out of 10 cases of infertility.
Why does Body Mass Index (BMI) matter?
Weight and BMI can have a significant impact on a woman’s ability to conceive, even with fertility treatment, and can also affect a pregnancy. We are able to be a little more flexible in treating women whose BMI is around 35 – for example, we can offer general fertility treatment where a woman’s BMI is 36 or 37 – but advanced treatments such as IVF cannot be carried out unless the BMI is 35 or under.
This can be very difficult for patients, and it can add another dimension of emotional upset to an already difficult situation. We believe it is important to understand why this is the case. For example:
Where a woman’s BMI is above 35 it can be difficult to conduct an ultrasound, which is both an essential part of pre-treatment testing and an integral tool during treatment. Without the ability to clearly see the uterus, ovaries and surrounding structures, treatment cannot take place and factors contributing to infertility can go undetected.
There is evidence to suggest that a high BMI negatively affects the success of fertility treatment. It is not unusual for a woman to stop ovulating while she is carrying excess weight and for ovulation to start again when she brings her BMI down. Similarly, there can be an increased risk with the egg collection procedure and sometimes a decline in the number of eggs that could be collected.
There is an increased risk to both mother and foetus during pregnancy if the woman’s BMI is above 35, and so restricting treatment to support conception also safeguards against some of these issues.
The effect of BMI on fertility treatment is a complex topic and research continues to be carried out in this area.
Is there an age limit for treatment?
Different treatments have different age limits, but it is important to know that age is one of many factors that will be considered in each person’s case; there may be reasons treatment is not recommended for an individual despite being before the age limit. As a rough guide, IUI can be an option until age 38, IVF before 45 and using donors eggs before 50, but each of these specific scenarios will be discussed on a case by case basis by the clinical team, so if you are outside of these age guidelines please get in touch to discuss your own situation.
Do I need to have a General Practitioner (GP) referral to have a consultation?
We do not need a referral from a GP in order to see you, but we would prefer to keep them updated on any consultations or treatment you have once you have self-referred.
Can I attend the consultation on my own?
If you are undergoing treatment as a couple, then it is important that you are both involved and fully informed about any investigations and treatment options throughout your time as patients. If you are undergoing fertility testing you are welcome to come to appointments for scans, blood tests and semen analyses alone but when you have a consultation to discuss the results of these, it is important that both partners are there.
If you are a single woman looking to undergo treatment you are welcome to attend appointments on your own or with a friend or relative if you would find it useful to have their support.
Where are consultations held?
We aim to hold the majority of our consultations online to ensure they are as accessible as possible, with any appointments where we need to conduct tests or examinations held face to face at Litfield House Medical Centre.
Weight loss medications and fertility: What you need to know?
In recent years, medications like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro) have become widely used to help people lose weight and lower their body mass index (BMI). For some individuals trying to conceive, especially those with obesity or weight-related hormonal issues, these medications can support healthier weight and improve chances of conception.
However, it’s important to understand the potential risks and limitations of these treatments if you’re planning a pregnancy or currently undergoing fertility treatment:
- Not recommended during pregnancy: These medications are not considered safe to use during pregnancy.
- Possible delays in treatment: Experts recommend stopping these medications at least two months before trying to conceive. This pause helps ensure the medication is fully cleared from the body, reducing any risk to a developing baby.
- Effect on menstrual cycles and ovulation: Some people notice changes in their periods or ovulation patterns while using these medications. While weight loss can improve fertility overall, these hormonal changes may temporarily affect your cycle.
- Individual response varies: Not everyone responds the same way to weight loss medication. For those with underlying fertility issues, medication alone may not be enough, and a more comprehensive approach may be needed.
At our clinic, we support a holistic and personalised approach to fertility. If you’re considering weight loss medications as part of your journey, it’s essential you keep us informed of this. We are here to help you make informed decisions every step of the way.
Will I need to have tests done?
We cannot start treatment until we have some key information about each patient. The male partner must have a recent advanced semen analysis and the female undergoing treatment will need relevant blood tests as well as a transvaginal ultrasound scan. The blood tests can be conducted by your GP and the results shared with us, or we can do them ourselves in our clinic. The transvaginal scan needs to be under our care as it will be a specialist fertility scan. You will be advised which tests are needed, including any additional tests once the course of treatment has been decided.
How much will treatment cost?
We have a very simple pricing structure for treatment, but we find it is useful to speak to patients about their circumstances before discussing costs. This is not to hide the costs involved in treatment, but rather to make sure that the information you receive is relevant to you specifically. For example, you may be interested in the cost of IUI treatment, but then discover that this is not a viable treatment option for you.
We also find it helps patients who approach us to be able to ask questions about the prices, as comparisons between clinics can be tricky without being able to ask for clarification on some points. Simply put each patient cannot realistically expect their treatment to cost the same as another’s, whose circumstances maybe very different.
When and how do I pay for treatment?
Payment for treatment is made in advance and can be made by Bankers’ Automated Clearing System (BACS) or card. We also have experience with a range of health insurance providers, however many of our patients pay first for the treatments themselves in advance and later settle this with their insurance provider.
What are your treatment success rates?
Success rates are massively dependent on a wide range of factors. At the very least, the age of the women and her egg reserve has a huge bearing on the likely success of treatment, but even this ignores significant nuances that will affect the chances of success. For example, to compare two women of the same age doesn’t allow for the fact that the quantity and /or quality of their eggs may vary, they may or may not have other underlying health conditions, all factors that affect outcomes of fertility treatment.
We believe it is more representative to present these to you on an individual basis once you speak to the doctor and they have an understanding of your own circumstances.
How long would I be a patient for?
We see some patients for one-off fertility testing or pre-conception advice, and others for longer times while they undergo fertility treatment. If you are prescribed medication to stimulate ovulation (e.g. Clomid or Letrozole) then we will often give several months of medication to maximise the chances of success.
In other cases, we may see a couple or individual for IVF treatment and they become pregnant during their first treatment cycle, meaning they are with us for a very short time. Whatever the treatment course followed, we see patients until they have had an early pregnancy scan (at around 7 weeks gestation) to ensure that all is well with pregnancies we have helped to support, and at this point they move from our care into that of their local maternity services.
Of course, the greatest joy for us is meeting the babies born to our patients and we are always eager to book in for patients to return to us with their beautiful babies once they are born.
What happens if I conceive naturally whilst waiting for my appointment?
We would be delighted to hear the news and will be happy to give you a full refund if you conceive naturally whilst waiting for your first appointment with us.
Understanding AMH Levels while on the contraceptive pill?
Anti-Müllerian Hormone (AMH) is a hormone produced by small follicles in the ovaries and is commonly used to estimate ovarian reserve—the pool of eggs remaining. It’s a useful tool for women who are curious about their fertility, even if they are not trying to conceive right now.
However, if you are taking the combined oral contraceptive pill, it’s important to understand how this might affect your AMH levels and what that means for interpreting the results.
- Some studies suggest that taking the pill may slightly lower AMH levels—though not in all women. This reduction is usually temporaryand does not reflect a true decline in ovarian reserve, but you may worry unnecessarily due to the falsely low result.
- Best time for testing: AMH can be tested at any time in your cycle, even while on the pill, but if a low result is found, your specialist may recommend repeating the test three months after stopping the pill to get a more accurate reading.
- Age and fertility: After age 23, a gradual decline in ovarian reserve is expected over time. An AMH test provides only one piece of the fertility picture—it doesn’t predict your chance of natural pregnancy or egg quality, both of which are influenced by age.
- AMH is not a fertility test: A “normal” AMH does not guarantee future fertility, just as a “low” AMH does not mean pregnancy is impossible. It’s a guide, especially useful when planning for egg freezing or assisted fertility treatments.
What a fertility specialist might advise:
- Discuss your goals: Whether you’re just curious, thinking about future fertility, or considering egg freezing. Your fertility specialist can help interpret your AMH in context.
- Look at the full picture: AMH is often combined with other assessments such as an antral follicle count (AFC) via ultrasound and follicle-stimulating hormone (FSH) levels to better understand your ovarian reserve.
