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Last Updated: Sunday, 14 January 2007, 23:11 GMT
IVF Q&A
Below are the answers to your questions about IVF following the Panorama programme, IVF Undercover.

Geeta Nargund is the Consultant and Head of Reproductive Medicine at St George's Hospital. She's also a senior lecturer at St George's Hospital Medical School, London and medical director of Create Health Clinic in London.

She has published extensively on the use of advanced ultrasound technology in reproductive medicine. She pioneered the use of follicular Doppler for assessment of egg quality in infertile women and One-Stop Fertility Diagnosis using advanced ultrasound technology.

She has also published the first scientific paper of cumulative live birth rates with Natural Cycle IVF (IVF without ovarian stimulation).

She is the President of the International Society of Minimally Assisted Reproduction. She is passionate about No/Low stimulation IVF and making Assisted Conception Treatments (ART) more natural, safer and affordable globally.

She is also the chief executive of the UK national women's health charity, Health Education Research Trust and is committed to raising public awareness about women's health and funds for scientific research.

Frequently Asked Questions

What is IVF?
IVF is a technique where fertilisation of the egg and sperm will take place outside the body, in a laboratory Petri dish. In conventional IVF, lots of sperm are added to the Petri dish next to an egg. ICSI (Intra-Cytoplasmic Sperm Injection) is a form of IVF where single sperm is injected inside an egg to facilitate fertilisation if there is a severe sperm problem.

Can anyone get IVF treatment?
Not everyone can get IVF on the NHS. You need to check with your GP regarding your local NHS criteria for provision of IVF. However, if you are not eligible to have IVF on the NHS or if the waiting list is too long, you may consider having self-funded IVF.

How do I know if we need IVF treatment?
Your consultant will give you that advice. Women with damaged or blocked Fallopian tubes and couples where there is a serious sperm problem will need IVF/ICSI.

Where do I go to get IVF treatment?
You can ask your GP for advice or enquire with the Human Fertilisation and Embryology Authority (HEFA).You may want to do your own research by checking with individual clinics with your questions or attending patient open sessions.

How much does it cost?
The cost of an IVF cycles varies significantly in different clinics. Please make sure that there are no extra or hidden costs. It could cost anywhere between 2, 000 to 7,000 per cycles depending on which clinic you go to.

What are the options available to me?
IVF is not necessary for every couple. There are several simple options like boosting your ovulation with tablets only, Intra-Uterine Insemination (IUI- injection of sperm into the womb at ovulation) in a natural cycle.

I've heard IVF can be very invasive, what are the processes we will have to go though?
IVF treatment involves several steps. Before you start IVF cycle, you will need an ultrasound scan, blood test and sperm analysis. You and your GP need to sign consent forms and you would have a detailed consultation about the procedure, drugs, side effects, success rates, costs and risks associated with it. The actual treatment cycle may involve ovarian stimulation with daily injections and you will have an egg collection and embryo transfer procedure. All procedures and are out-patient and there is generally no need for general anaesthetic or hospital admission.

What are the drugs that are used in IVF?
Generally the drugs (FSH & LH) are given to stimulate your ovaries to produce more eggs, to ripen eggs and time the egg collection and the hormone (progesterone) to help implantation after the embryo transfer.

What are the side effects and health risks of drugs given in IVF treatment?
Ovarian suppression drugs can give you occasional headaches and hot flushes. Stimulation injections can make you feel bloated and premenstrual. Please read about Ovarian Hyperstimulation Syndrome (OHSS) and ask if you are at risk of developing this complication. Its severe form is very rare but can be life threatening. If you are advised to take steroids, viagra, intravenous injections, please check with the consultant regarding safety of such drugs. They are not necessary and can be associated with risks. There are concerns about long-term effects of repeated ovarian stimulation but further studies are necessary. Please ask your consultant about this.

How long does the IVF process take?
It depends on the type of cycle recommended to you by your consultant. If you are having natural cycle or soft stimulation in a natural cycle it will be fitted in your natural cycle. Your egg collection will take place around your ovulation time and you will know whether you are pregnant or not by the time you are due to have your period. If you are having a cycle where your ovaries are suppressed before stimulation, your cycle could last up to six weeks before you know the result.

Are there any alternative therapies that work, I've heard acupuncture and reflexology can help?
Please ask your consultant whether you are likely to benefit from alternative therapies because there is no clear scientific information.

Should we make any life style changes to increase our success rates?
Yes. Please stop smoking and reduce your alcohol intake to less than 10 units per week. Optimise your weight and BMI. Reduce your stress levels if possible. Exercise regularly.

Are there any vitamins or pills that will help our success rate?
Women need to take folic acid. Sometimes men with mild/moderate sperm problems are advised to take antioxidants, zinc and selenium. Please check with your consultant.

How successful is IVF treatment?
Average IVF live birth rates are around 25 to 30% per cycle in younger women. Please check with the HFEA and individual clinics. Woman's age has a major impact on success rates.

Are the IVF clinics regulated?
Yes. IVF clinics are regulated by the HFEA. You are free to enquire with authority or clinics at any stage about any information you may need.

Where can we get additional information about the clinic we have been referred to?
You can ask the HFEA or directly from the clinic. Satellite or transport clinics currently do not appear on the HFEA list but appear under the clinic where egg collection and embryo transfer are carried out.

What difference has the change in law meant to egg or sperm donations?
Unfortunately, there is an acute shortage of egg and sperm donors in the UK at the moment following the change in law recently.

Are there any risks with IVF treatment?
There are risks associated with drugs and procedures. Please ask the consultant to explain these risks to you before you start treatment.

What is natural cycle IVF and does it work?
In natural cycle IVF, your naturally produced and ripened egg is collected for fertilisation and the resulting embryo is put back into your womb. It is only suitable for those who ovulate regularly. Success rates of natural cycle IVF are lower than stimulated IVF per cycle and you may need up to three or four cycles of treatment. But the cost is low and there are no stimulating drugs involved.

What is soft stimulation IVF and how does it work?
This involves low dose hormones given in a natural cycle without suppression of ovaries. It is aimed at producing more the one egg and embryo without the risk of ovarian hyperstimulation and compromising success rates. It is a good option if IVF is needed.

Is there anything we can do to increase our chances of success?
Try to improve your life style and diet.

If I don't get pregnant after our first attempt, can I try again?
Yes. If it is stimulated IVF, you are normally advised to wait for a couple of months before trying again. If you have natural cycle IVF you can try in subsequent cycles.

Are the chances of having birth defects higher with IVF?
Please ask your consultant for details before you start treatment. There is an increased risk of having premature and low birth weight babies with IVF. You also need to check about risks with ICSI at consultation.

What kind of changes will we have to make to our lives if we undergo IVF?
You will be attending the clinic three to four times for ultrasound scans and blood tests over a period of two to three weeks. Each visit might last up to 30 to 40 minutes. Please make sure you are able to do this without the need to take the day off. You need the day off on the day of egg collection. You can go back to work on the day of embryo transfer which does not involve any analgesia or sedation. You can carry on with your work and normal life after embryo transfer while you are waiting to do a pregnancy test.

We've have tried a number of IVF processes that have failed, when should we stop trying?
It is very important that you do not continue with IVF after three to four cycles unless your consultant advises you. It is unlikely to work unless a different approach is taken for future treatment. Several couples conceive naturally after failed IVF treatments. It is really important that you continue trying naturally. If you cannot conceive naturally because of blocked fallopian tubes or having no sperm, your clinic should help you to make a decision to come to terms with infertility and move on after reasonable number of attempts.

What's the best age to have IVF?
Women under the age of 35 have the best success rates. But you should consider IVF only if it is your only or the best option.

How do I know that the cost of my treatment is reasonable and I am not being exploited or my health put at risk?
Please check with the HFEA and do some research with many clinics. Most clinics will respond to your questions by e mail or on telephone. As regards to drugs given in IVF cycles, please check for dosage and safety information with clinics before you agree to take them. Always ask for information about minimum dosages required, side effects, complications and long-term effects.

Can I go to other countries for IVF?
Yes. But please check regarding clinic's practice, safety, success rates and costs involved. Ensure that the clinics are regulated.

Can I have IVF if I am unmarried?
Yes. In the UK, the regulatory authority expects all clinics to take "the welfare of child" into account before treatment.

Can single people or lesbian couples have IVF?
Yes. But the NHS provision of IVF is currently being discussed.



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