Getting pregnant: a glossary

You’ve probably heard of these terms, but here’s how they actually work – and what they mean for your wallet

IVF

One of the most invasive and expensive options, in vitro fertilisation has a good success rate (29% for those under 35, reducing steadily to 9% for women aged 40 to 42). It takes four to six weeks and involves three weeks of daily injections to suppress reproductive hormones, then a shot of follicle-stimulating hormone (FSH) to increase the number of eggs your ovaries produce and then finally another to mature them. Eggs are collected (under sedation), combined with the sperm in a lab, and you’re given more hormones to prepare your womb to receive the embryo. After six days, the best one or two embryos are transferred into your womb using a catheter and, two weeks later, you can take a pregnancy test. Funding for NHS provision varies depending on where in the UK you live. Some NHS trusts only fund IVF up to the age of 35, while doctors can refuse to treat people who are clinically obese. If you pay privately, IVF costs up to £5,000 for one cycle, plus additional costs for tests, medications and consultations. Go to nhs.uk/conditions/ ivf/availability

EGG FREEZING

Contrary to its image as a simple fertility insurance policy, egg freezing is a pretty invasive procedure with a success rate of around 19%, according to the Human Fertilisation and Embryology Authority. For two or three weeks, you’ll have daily injections to boost egg production and help eggs mature; when they’re ready, a healthcare professional will collect them (as with IVF), before they’re stored in liquid nitrogen. When you want to use them in an IVF cycle, they’re thawed and those that have survived are injected with your partner’s or a donor’s sperm. You can combine the private egg freezing process with Nhs-funded IVF cycles (provided you fit the criteria for NHS IVF). The cost of egg freezing alone is between £3,000 and £3,500, with additional costs for storage and medication. The whole process done privately costs between £7,000 and £8,000. Both Dr Morton and Dr Corda caution that the success rate from freezing non-fertilised eggs alone is poorer than with embryos. They encourage women to think about creating embryos – with their partner’s or a donor’s sperm – instead. Go to hfea.gov.uk/ treatments/fertilitypreservation/egg-freezing

IUI

This fertility treatment works by injecting sperm (either from a partner or a donor) directly into a woman’s womb. After fertility tests, the doctor will work out when you ovulate and may give you medicines to stimulate ovulation. As soon as an egg is mature (confirmed by a vaginal ultrasound), you’ll be given a hormone injection to stimulate its release. The semen is washed and filtered of any chemicals to produce a concentrated sample of healthy sperm before being inserted into you, via a catheter. It’s mostly painless and takes around 10 minutes, and the success rate depends on your individual circumstances, with everything from your age to the quality of the sperm playing a role. You may be offered IUI on the NHS if you’re unable to have vaginal sex (due to a physical disability or psychosexual problem) or if you’re in a same-sex relationship, but the criteria vary from trust to trust, and waiting lists can be long. If you decide to go private, a cycle costs between £700 to £1,600. Go to nhs.uk/conditions/ artificial-insemination

EGG DONATION

Women choose to donate their eggs for many reasons, whether as an altruistic act or as part of an egg-sharing scheme; the latter takes place when a patient who’s already having IVF donates some of their eggs to the clinic where they’re having treatment, usually in return for discounted treatment. You’ll need to be between 18 and 35 to donate your eggs, and you’ll have tests to ensure you won’t pass on any health problems. It’s exactly the same as the early stages of IVF, so you have daily injections to suppress your cycle, then start hormone treatment to boost egg production. A day or two before collection, you’re given a hormone injection to help them mature and they’re collected while you’re sedated. Donors can receive compensation of up to £750 per cycle. Go to hfea.gov.uk/ donation/donors/ donating-your-eggs

UNEXPLAINED INFERTILITY

This is the diagnosis given by the NHS when no cause can be identified in either partner, and it accounts for around one in four cases of infertility. It can be a great source of upset and frustration for couples who have been investigated and appear to have all the necessary parts to make a baby: healthy eggs, sperm, uterus and fallopian tubes. ‘There will always be a small proportion of couples with whom doctors can’t identify a problem; yet they don’t get pregnant,’ explains Dr Morton – adding that, after the most common causes of infertility are ruled out, these couples will be offered assisted reproduction techniques, such as IUI or IVF. Go to fertilitynetworkuk.org