If you’ve been trying for a baby for a while, are in a same-sex partnership, or are single and just aware that time is ticking on, you may be wondering what fertility clinics do and whether it’s worth heading to one. We spoke to Dr Gorgy, one of the UK’s finest specialists in reproductive medicine and a consultant at The Fertility and Gynaecology Academy, for more information.

What Does A Fertility Clinic Do?

“There are a number of services fertility clinics usually offer,” says Dr Gorgy, “before we get into any possible specialisms.” The services usually offered are:

Fertility Testing

This is when a series of tests are run to get a picture of how fertile you (and possibly your partner) are. Dr Gorgy explains: “‘If you are a woman with a male partner, we certainly recommend fertility testing for your partner too.” This is called semen analysis, where a sample is taken and then analysed in the lab to ascertain sperm count, motility and other characteristics that can affect fertility. It’s a common assumption that any fertility issues are almost always problems with the woman but in fact, male factor infertility accounts for around 30% of all fertility problems.

Dr Gorgy says: “Fertility testing for women usually involves blood tests to determine your level of anti-mullerian hormone (an indicator of how many eggs you may have left) and a transvaginal ultrasound to assess your ovaries, uterus and fallopian tubes. If you are attending a private fertility clinic, there will be different treatment packages available and I would certainly recommend a comprehensive testing package. This is because fertility roadblocks come in many forms and to rule out certain problems you need very sophisticated scanning.

“Here at The Fertility and Gynaecology Academy we sometimes see couples come to us bewildered after getting basic screening somewhere and they say ‘my levels of anti-Mullerian hormone were good, I thought everything was fine’ but actually there were issues with the structure of their womb cavity or fallopian tubes – things that require sophisticated techniques, like an aqua scan, to identify. An aqua scan is used to check the integrity of the womb cavity to exclude the possibility of scarring, polyp, and uterine septum. The procedure also includes injecting air into the fallopian tubes to ensure they are open and unobstructed.”

Egg Freezing

Egg freezing is when a woman elects to have a number of her eggs removed and frozen, to be stored for use in future fertility treatment if she requires. It is becoming increasingly popular, as awareness grows of how much female fertility declines after the mid-30s but women often still need a bit more time – time to find the right partner and/or to achieve financial and career stability before the pressures of motherhood.

The process has seen tremendous technological advances in recent years. We are now at the point where a woman aged 40 or over has a significantly better chance of having a healthy pregnancy with eggs that were frozen in her mid-30s than using her fresh eggs over 40 years old.

Egg freezing can reduce the risk of complications that come with pregnancy over 40 – such as chromosomal abnormalities and miscarriage.

In order to aim for the best chance of a future pregnancy, egg freezing involves ovarian stimulation with fertility drugs to encourage your ovaries to produce more eggs. Then, the eggs are removed under sedation and the mature eggs are frozen.

Some fertility clinics use an older slow-freezing method but here at The Fertility and Gynaecology Academy we use state of the art vitrification ‘flash freezing’ technology. This is because freezing them within 5-10 minutes in this way drastically reduces the risk of cell damage to the eggs that can happen when eggs are frozen over hours. To use the eggs later in life, they are thawed and injected with sperm (in a technique known as ICSI). The fertilised eggs are then put back into the woman’s womb.

Sperm Freezing

It’s seldom talked about, but male fertility is subject to decline too, with advancing age linked to declining sperm quality and testicular function, not to mention a higher risk of genetic diseases and chromosomal abnormalities in the baby. Bearing that in mind, some men choose to freeze their sperm for use later in life.

Fertility Medicines

There are a number of fertility drugs that can work to trigger ovulation in women with issues such as Polycystic Ovarian Syndrome (PCOS), in addition to medicines that may help to stimulate male fertility as well. Fertility medicines on their own are much less effective than assisted conception techniques like IVF but they are fairly inexpensive and non-invasive so some people opt to try them first.

Intrauterine Insemination (IUI)

Also known as artificial insemination, Intrauterine Insemination (IUI) is a process whereby washed sperm is put into a woman’s uterus when she is ovulating, to help her conceive. You can have IUI either with or without the aid of fertility medicines. Using fertility drugs will make a pregnancy more likely but it also increases the chance of multiple births. A good fertility clinic will assess and consult with you thoroughly, to help you determine which is best for you.

In-Vitro Fertilisation (IVF)

In-vitro fertilisation (IVF) is a technique in which a woman’s eggs are fertilised with (either her partner’s or a donor’s) sperm in a laboratory, before being placed back in the womb to grow and develop. In order to achieve the best chance of conception success, usually that process follows controlled ovarian stimulation, which is the administering of fertility drugs to stimulate the ovaries to produce more eggs. Dr Gorgy says: “We want to harvest 8-12 eggs to offer you the best chance of a live birth. The eggs are then removed under sedation and fertilised in the lab, with one or two of the embryos selected for insertion into the uterus. Fertility clinics want to select only the best embryo(s) for implantation. Here at The Fertility and Gynaecology Academy we use a state of the art close monitoring time lapse imaging technique with embryoscope technology, to enable us to pinpoint only the strongest embryo(s) for implantation.”

Intra-Cytoplasmic Sperm Injection (ICSI)

The process for ICSI is the same as for IVF, except that in the laboratory the sperm is injected directly into the egg for fertilisation. It is recommended for couples in which the male partner has poor sperm quality or a previous IVF cycle had poor egg fertilisation rates.

Surgical Fertility Interventions

There is more to fertility medicine treatment than what is outlined above, but not every clinic will offer it. For example, some women with PCOS may benefit from ovarian drilling, a surgical procedure to induce ovulation. Women with endometriosis may choose surgery to remove cysts, and blocked fallopian tubes may warrant a procedure. When a man’s semen has no sperm in it or when there is a blockage obstructing the sperm’s passage, extraction of sperm via a procedure can help.

All of these procedures we can carry out at The Fertility and Gynaecology Academy, but the truth is that surgery is not always the right choice, and sometimes it is a better use of your time and resources to go straight to IVF. A good fertility clinic will leave no stone unturned in assessing and consulting with you, so you are fully informed to make the right choice for you.

Reproductive Immunology For Recurrent Miscarriage/Repeated IVF Failure

Some fertility clinics will specialise in complex cases, as we do here at The Fertility and Gynaecology Academy. In fact many patients come to us after a series of miscarriages and failed IVF cycles elsewhere. Some women have problems with the way that their immune cells interact with their reproductive system. We practice reproductive immunology, studying and responding to the immune system’s role in pregnancy to offer couples with recurrent miscarriage or IVF failure a better chance of success. While there are no guarantees, through sophisticated immune testing and individually tailored treatments, we’ve helped countless couples who’d all but given up hope of achieving their dream of a baby.

What Happens When You Go To A Fertility Clinic For The First Time?

It can depend. Some patients will go to a fertility clinic convinced they want to go straight into examinations, and others will want a thorough consultation first. We think it is always best to have a consultation in the first instance because it gives your consultant a good breadth and depth of information about you, and together you can find the best way forward to bring you that much closer to your goal of a baby.

What Is The First Step Of Fertility Treatments?

Treatment should always be led by a patient’s own fertility profile, so exacting testing must lead the way. Different fertility treatments, and sometimes a mix of them, may be better indicated depending on the specific problems that are keeping you from conception. At a good fertility clinic there is no generic ‘first line fertility treatment’ because every patient’s journey is different – not just biologically but in terms of preferences, time of life, and so on.

Have you been trying to conceive for a while? Want to check if everything is alright? The sooner any problem is discovered, the better. Here at The Fertility and Gynaecology Academy our technology and expertise are second to none. To find out more or book a consultation, call The Fertility and Gynaecology Academy now on 020 7224 1880 or email info@fertility-academy.co.uk.