If you would like a copy of this information on tape, in large print, in Braille or in another language, please contact the Service Equality Manager on 0116 258 4382.

Haddaad rabto warqadan oo turjuman oo ku duuban cajalad ama qoraal ah fadlan la xiriir, Maamulaha Adeegga Sinaanta 0116 258 4382.

Eĝer bu broşürün (kitapçıĝın) yazılı veya kasetli açıklamasını isterseniz lütfen servis müdürüne

0116 258 4382 telefonundann ulaşabilirsiniz.


December 2006. Due for review December 2009.

Directorate of Women’s, Perinatal & Sexual Health Services

Information leaflet

Please write down any questions or worries you may have and your doctor will be happy to answer them:

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What is this leaflet about and who is it for?

This leaflet is produced for couples looking for advice for possible fertility problems, and to help you understand the investigations and treatments you may need.

Fertility problems affect one in seven couples in the UK. Most couples (about 84 out of every 100) who have regular sexual intercourse (that is every two to three days) and do not use contraception will get pregnant within a year. About 92 out of 100 who are trying to get pregnant do so within two years.

Women become less fertile as they get older. In women aged 35 about 94 out of 100 who have regular unprotected sexual intercourse will get pregnant after three years; however in women aged 38 only 77 out of every 100 will do so.

The effect of age upon men’s fertility is less clear. If you have not been able to get pregnant after two years of regular unprotected sexual intercourse either one or both of you may have a fertility problem.

In men a fertility problem is usually because of low numbers or poor quality sperm.

A woman may have fertility problems because she does not produce eggs regularly or because her fallopian tubes are damaged or blocked and the sperm cannot reach her eggs.

Unexplained - for nearly one third of people, no reason can be found for their problem. This is known as having unexplained fertility problems by healthcare professionals.

What will happen when we get to the unit?

You will meet the members of the team. You will both be asked questions about yourselves to help us to understand if you are having fertility problems.

Initial assessment will include:

Female partner

·  Weight, height, blood pressure, body mass index. You may require a general examination.

·  Pelvic examination - collection of swabs to rule out any pelvic inflammatory disease.

·  Cervical smear test if required.

·  Ultrasound to check your womb and ovaries.

Male partner

·  You may require a general or lower abdominal examination.

Why am I having these investigations?

Body weight / Female partner

Women who have a BMI of more than 29 can take longer to conceive. If you are overweight and you have irregular periods, or no periods at all, losing weight may increase your chances of getting pregnant.

Evidence shows that women who take part in group exercise and diet programmes have a better chance of getting pregnant than those who try to lose weight on their own.

If you are underweight - BMI less than 19 and have experienced irregular periods you may find that if you

Useful addresses:

NICE guidelines: www.nice.org.uk

NHS - Response line: 0870 1555 455

NHS - Smoking Helpline: 00800 1690 169

www.givingupsmoking.co.uk

Do you feel that you are at risk of verbal or physical abuse? If so, you may find the following numbers useful:

Domestic Violence Helpline: 0116 255 0004

Women’s Aid: 0116 285 8079

Refuge (24 hour crisis line): 0870 599 5443

Smoking

May reduce fertility in women. For men there is a link between smoking and poorer quality sperm. The effect that smoking has on a man’s fertility is not certain.

Passive smoking may affect a woman’s chances of falling pregnant. Stopping smoking will improve your general health.

Caffeine

Is a stimulant found in drinks such as tea, coffee, cola, and chocolate. There has been little research into the effects of caffeine on fertility problems.

Medicines & Drugs

The number of prescribed and over the counter medicines you are taking, including recreational drugs such as cannabis, cocaine and anabolic steroids may interfere with your fertility.

Folic Acid

Taking a tablet called folic acid in women when you are trying for a baby and for the first twelve weeks of pregnancy reduces the risk of having a baby with a condition such as spinal bifida..

Complementary Therapies

Not enough studies looking at complementary therapy treatments have been completed, further research is needed.

increase your weight up to a normal range your ovaries will start working again, and so improve your chances of getting pregnant.

Body weight / Male partner

If your BMI is above 29 your fertility is likely to be lower than normal and any weight loss would therefore be helpful to increase the chances of conception.

Blood Tests / Female Partner

You may be advised to have the following hormonal blood tests. Hormones are chemical messengers secreted by glands into the blood stream; they are assigned to a specific organ.

Follicle Stimulating Hormone (FSH)

This is a hormone produced by the pituitary gland. It stimulates the follicles in the ovary to develop.

Luteinising Hormone (LH)

Is a hormone produced by the pituitary gland. When LH rises it completes the maturation of the egg, and then instigates the rupturing of its follicle.

Progesterone

A female hormone produced after ovulation has occurred. It is responsible for preparing and maintaining the womb lining after ovulation.

Oestradiol

Causes the lining of the womb to become progressively thicker during the first half of the menstrual cycle before ovulation.

Prolactin

A hormone produced by the pituitary gland. If present in excessive amounts it causes milk secretion and cessation of menstrual periods in women.

Thyroid Stimulating Hormone (TSH)

It controls the rate of the body metabolism, growth and development.

Rubella

Is to check your immunity to German measles. Infection with the rubella virus can affect a baby in early pregnancy.

Diagnostic procedures

Hysterosalpingogram

Is an X-ray test, which involves the injection of a small amount of dye through the cervix into the womb. It informs us about the uterine cavity as well as the fallopian tubes. It is commonly used to check if the tubes are blocked.

Laparoscopy and Dye Test

Is an examination to test the function of your tubes, we will bring you into hospital and give you an anaesthetic and put a small telescope into your abdomen to examine your abdomen and tubes, we will then put dye through your fallopian tubes to see if they are blocked or damaged.

Male Partner

You may need to have a sperm analysed. If there is a problem we may refer you to another doctor with a special interest in male fertility for further investigations.

Both partners blood tests

Hepatitis B&C

These viruses can affect the liver. The viruses may also be passed from mother to baby during delivery. If we are aware that you have Hepatitis B your baby can be immunised against the virus after birth. At present there is no vaccine to protect against Hepatitis C.

Human Immunodeficiency Virus (HIV)

This virus infects the immune system, which is important for fighting infection. HIV can also be passed from mother to baby during pregnancy. If a woman is found to be infected, she can reduce the risk of passing the virus to her baby through drug treatment during pregnancy, having a caesarean section, and avoiding breastfeeding.

HIV and Hepatitis B & C can be contracted through unprotected sexual intercourse with an infected partner or sharing needles with an infected person.

Unless you are at high risk the chances of the test being positive are very small.

Trying for a baby

There may be some things you can do as a couple to improve your chances of getting pregnant. Please consult your doctor who should tell you more about the following points.

Alcohol

A unit of alcohol is a small glass 125mls of wine or half a pint of beer/lager.

Your fertility is unlikely to be affected if a woman does not drink more than 1 or 2 units of alcohol once or twice a week. If a man does not drink more than 3 or 4 units of alcohol a day, drinking excessive amounts of alcohol can affect the quality of a mans sperm.