Fertility treatments - an overview

When to see your GP

If you’ve been trying to conceive for a year or more, it’s time to have a chat with your GP. Or if you're over 35, or you’re concerned you or your partner may have a fertility problem, your GP may be able to help after six months. Your GP will probably refer you to a fertility clinic and staff there will chat to you about the best fertility treatment for you.

Fertility drugs

These are often used first , before the treatments outlined below. Doctors tend to use these three drugs:

• Clomid (clomifene) – this stimulates the ovaries to produce eggs. Your doctor may prescribe it if tests have shown you are not ovulating or you are ovulating irregularly
• Tamoxifen - an alternative to clomifene
• Metformin – often used to trigger ovulation in women who have polycystic ovary syndrome (PCOS)
• Pulsed gonadotrophin-releasing hormone (GnRH) – this is used to stimulate egg production if you’re not producing this hormone naturally

These fertility drugs may also help the fertility treatments below, like IVF.

Assisted conception

IVF (in vitro fertilisation)

The best known fertility treatment, IVF involves an egg being removed from the woman's ovaries, then fertilised with sperm in a laboratory. The fertilised egg, now called an embryo, is then popped back in the woman's womb to hopefully grow and develop.

ICSI (intra-cytoplasmic sperm injection)

ICSI involves a similar process to IVF. However, instead of simply mixing the egg and sperm together in the laboratory, doctors choose a single sperm and inject it directly into the egg.

This technique is becoming more common and is particularly helpful for couples where the male partner has poor sperm quality or doesn’t ejaculate any sperm.

IUI (intrauterine insemination)

You might be offered IUI if you have infertility or ovulation problems that can’t be explained. It’s also helpful for couples where the man has poor sperm quality.

With IUI, doctors separate fast-moving sperm from the slower ones, then use IUI to pop them in your womb, around the time you ovulate. You might also be asked to take a fertility drug to boost the amount of eggs you produce beforehand. IUI is also used as part of other fertility treatments, such as sperm donation or surrogacy.

Where to get treatment

Fertility treatment funded by the NHS varies across the UK, and waiting lists can be sometimes be quite long. The best way to get started is having a chat with your GP about treatment in your area.

Going private

You may also decide to consider private treatment. “It will cost a few thousand and there’s unfortunately no guarantee of success,” says Richard Smith, consultant obstetrician. “But it does mean you can choose from a wider range of treatments and be treated sooner. If you decide to go private, ask your GP for advice, and make sure you choose a clinic licensed by the Human Fertilisation and Embryology Authority (HFEA).”