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  • Writer's pictureHannah Horne-Robinson

10 things I wish I knew about fertility treatment before I started

By: Hannah Horne-Robinson, an MSc Education in Digital and Social Change student at the University of Oxford. All views expressed are her own.

My partner and I have been dealing with infertility for 4 years. Looking back there is so much I didn’t know. If you have been trying to conceive for a while and are wondering about fertility treatment, here are 10 important things to know!

  1. Conception is so much more difficult than we were taught! My school taught us that unprotected sex always led to pregnancy but the reality is very different. Usually, a woman ovulates once per menstrual cycle and, on average, the probability of conception is 10% per cycle! At this rate, trying each cycle - if they are close to a month-long - means a 72% chance couples will conceive after a year of trying and 92% after two years.

  2. If you have been trying to conceive for close to a year, do not stress but start a conversation with your doctor! A diagnosis of infertility will only be made after one year of trying, but you can start the discussion beforehand so that if you hit the year mark, you can begin investigations right away. I dragged my heels and I regret it!

  3. You will need to advocate for yourselves along this journey. Perhaps even starting with getting investigated! If your doctor does not want to order the tests, ask for a second opinion or seek out other testing options. Get comfortable with being a little pushy and asking for what you need.

  4. A diagnosis is just a label. A diagnosis of infertility simply means you have not conceived after a year of trying - it does not mean you will never have children! I delayed investigations partly for fear of getting the response of "infertility". A diagnosis is not to be feared and it is not the last word. It is only a label to help you receive useful information and hopefully treatment.

  5. Infertility is full of unknowns, even about cause! There are a few direct causes and effects. For example, certain cancers can specifically damage reproductive parts. However, it is possible for a man to have a low sperm count or a woman to have blocked tubes and doctors will not be able to determine what caused those things to happen. Frustratingly, there is also a diagnosis called "unexplained infertility"!

  6. IVF may be the most well-known fertility treatment but there are many options. These could be arranged on a spectrum from cheap and simple to expensive and involved. On one end are lifestyle changes, such as stopping smoking or drinking. A more intense option is taking medication and supplements, this could be to improve your overall health or for specific goals, for example, helping ovulation be more consistent, or increasing sperm production. In the middle of the spectrum may be Intrauterine insemination (IUI) which involves both medications and going to a clinic. IVF is more involved and additional treatments like Intracytoplasmic sperm injection (ICSI) could be added, particularly if you are navigating low sperm count. Then at the other end are donation and surrogacy.

  7. Your diagnosis and age will determine the treatment your doctor recommends. For example, if both members of a couple are under 30, with unexplained infertility, doctors may recommend IUI. If that doesn't work, the couple might eventually move to IVF. Whereas other diagnoses, for example, if a woman's tubes are blocked, a doctor would likely recommend IVF first.

  8. Everyone's "journey" will look different. I knew that patients seeking different treatment options would have different experiences but I assumed these treatments were standardised procedures. I started my first round of IVF at the same time as a friend, and we thought we would have all our procedures at the same time and be pregnant together. Our paths diverged within a week! Everyone will have a different treatment plan set with their doctor. Every individual reacts differently to the treatments and will have different results at every step along the way.

  9. Expect your emotions and decisions to change over time. If you go through multiple rounds of treatment, your feelings toward different treatment options will likely change as you learn more. Do not feel like you need to learn everything up front or make up your mind now about complicated topics. You also do not need to stick to your decisions a year from now!

  10. Fertility clinics can do great things BUT treatment does NOT guarantee conception. Pursuing fertility treatment requires a careful balance of hope and realism. You need hope to push you forward but it is important to have realistic expectations. I wish I had been better informed of our chances before starting so I could mentally prepare myself for what was to come.

There you have it! If you are wondering about your fertility, it is never too early to start exploring your options. If you are trying to conceive (#ttc) know that you are not alone. Many social media communities, charities, and clinics are there to support you, as are we at Jack.


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