Intrauterine insemination or IVF with intracytoplasmic sperm injection (ICSI), or the use of donor sperm or eggs may also be offered.
IVF involves the removal of an egg from the ovaries and its subsequent fertilisation in a laboratory. The natural cycle is suppressed, before the egg supply is boosted through the use of medication. An ultrasound scan is then used to monitor the maturation of the eggs, which are removed when ready and fertilised in vitro. Finally, one or two fertilised embryos are replaced in the womb.
IUI is offered if the patient is unable to have vaginal sex (due to disability or a pyschosexual problem), if you have a specific condition that makes it impossible to conceive (like HIV preventing safe unprotected sex) or if you are in a same sex relationship and have failed to become pregnant after 6 cycles of IUI using donor sperm.
ICSI (essentially injecting a sperm into an egg) may be offered on the NHS if necessary – normally if the male sperm is generally of low quality (e.g. low motility), if the sperm sample that has been collected is of low quality (due to normal variation in sperm quality) or if previous IVF attempts have failed.
​The success rate of IVF changes significantly based on the age of the patient – it is around 29% for women under 35, but only 9% for women aged 40-42.
The risks of IVF include multiple births, premature delivery and low birth weight, ovarian hyperstimulation syndrome (giving swollen and painful ovaries), along with the higher rate of miscarriage that is present for older women that become pregnant.