Starting a family and parenthood is a sacred right to every individual, a principle we deeply believe in at LUNA and strive to deliver consistently to our patients.
We believe in adopting a natural and minimally invasive approach to help our patients to start their family life. As such, we prioritise working collaboratively with our patients to understand their priorities, their desired outcomes, and specific health needs to help them get pregnant.
Over-reliance on assisted conception exposed many patients to the ‘’conveyor belt’’ method of IVF with fragmented and suboptimal care. At LUNA we strongly oppose this approach and endeavour to deliver consistent, individualised, evidence-based fertility care.
Our team is highly experienced in reproductive endocrinology and have delivered leading academic outputs in the field of reproductive medicine (Link). They run high quality specialised clinic in the NHS with advanced expertise in managing ovulatory disorders, recurrent miscarriage, male fertility, and donor egg IVF.
Choosing the right pathway to parenthood is often complex. Our fertility experts are dedicated to help you explore all available avenues in a transparent, unbiased, and evidence-based approach to identify the treatment that most suit your needs.
We provide flexible virtual consultations to help patients explore their preferred treatment options, gain a specialist opinion, and offer continious support.
Although there is no standardised definition, most experts would define infertility as the inability to achieve or conceive a successful pregnancy in couples, after regular unprotected intercourse for six months for those who are over 35 or for those under the age of 35, is termed as ‘Infertility.’ This emotionally challenging and complex condition impacts the ability of couples to build and grow their families as they desire.
Infertility can occur in both males and females. Various factors contribute to female infertility, including issues with the fallopian tubes, ovulatory disorders, age-related declines in fertility, and abnormalities in the uterus.
Sperm-related problems, hormonal imbalances, lifestyle factors, environmental influences, and anatomical issues may contribute to male infertility. Thorough evaluation and treatment are essential to effectively address the main causative factors.
Ovulatory Disorders: Ovulatory disorders mostly cause female infertility. These conditions affect the normal pattern of egg release from the ovaries. Disorders like hypothalamic dysfunction and Polycystic Ovary Syndrome (PCOS) can destroy the ovulation process, ultimately making it problematic to conceive.
Tubal Factors: Fertilization can be hindered by issues related to fallopian tubes. Scarring or blockages in the fallopian tubes prevent the egg and sperm from meeting, conditions such as endometriosis, and pelvic inflammatory disease (PID) can contribute to these challenges.
Uterine and Cervical Factors: Implantation can be affected by the interference of polyps, uterine fibroids, and abnormalities. The health of the cervix and uterus is considered essential for fertility. Cervical factors, including mucus abnormalities and narrowing of cervix (cervical stenosis), can influence fertility as cervical mucus plays an essential role in sperm transport.
Age-related Factors: As women age, there is a natural decline in fertility. Conceiving becomes more challenging due to a reduction in the quality and quantity of eggs. Advanced maternal age increases the likelihood of chromosomal abnormalities, raising the risk of birth defects or miscarriage.
Other factors include semen abnormalities, male or female hormonal imbalances, lifestyle factors, environmental influences, and anatomical issues may contribute to male infertility. Thorough evaluation and treatment are essential to effectively address the main causative factors.
A comprehensive medical history and thorough evaluation are crucial steps in diagnosing infertility. Healthcare providers gather information about medical conditions, previous pregnancies, menstrual cycles, and lifestyle factors through a detailed history of both partners. This evaluation helps identify potential causes, paving the way for the next steps in the diagnosis process.
Ovulation Monitoring: The regulation of ovulation and menstrual cycles can be monitored by ovulation predictor kits, basal body temperature charting, and blood tests that determine the levels of hormones like FSH and LH.
Hystero-salpingo contrast sonography (HyCoSy): An ultrasound scan based test to detects any blockages or abnormalities in the Fallopian tubes. This procedure involves the injection of a particular contrast dye into the fallopian tubes and uterus while performing a Transvaginal Ultrasound to also assess the follicles, uterus, ovaries an other female pelvic organs.
Laparoscopy: Laparoscopy is a minimally invasive surgical procedure. It involves the use of a laparoscope, a thin, flexible tube equipped with a light and camera. During laparoscopy, the laparoscope is inserted through small incisions in the abdominal wall, allowing surgeons to view and examine the organs in the abdominal and pelvic cavities. It allows the identification of problems, including adhesions, ovarian cysts, and endometriosis.
Hormone Testing: Hormonal imbalances can be uncovered with the help of blood tests. These tests assess thyroid levels, prolactin, and sex hormones like progesterone and oestrogen.
Ovarian Reserve Testing: The quantity of remaining eggs in women can be identified by antral follicle count and anti-Mullerian hormone (AHM) tests.
Endometrial Biopsy and endometrial receptivity testing: The lining of the uterus may affect implantation. In certain cases, evaluation of any potential issues of the lining of the uterus can be made possible by an endometrial biopsy.
Genetic Testing: Some genetic disorders affect fertility. Genetic testing is recommended if repeated miscarriages are occurring.
Semen analysis: key test to assess the sperm quality and male fertility. This is sometime combined with other tests such as a Sperm DNA Fragmentation and testicular biopsy to explore male infertility causes.
These procedures and tests enable the healthcare providers to suggest appropriate recommendations and treatment plans for every individual or couple.
Several treatment options are offered to address the causes of infertility. It is important to tailor each treatment to the patient current health condition, fertility aspiration, and future plans. Some of these treatments include:
Ovulation Induction: Medications like gonadotrophins and clomiphene are used for ovulation induction. These medications encourage the release of eggs by stimulating the ovaries. Women with ovulatory disorders should opt for these medicines as they increase the chances of conception.
Intrauterine Insemination (IUI): Intrauterine insemination is mainly used in cases where problems in cervical mucus quality or sperm motility are reported. This procedure involves the processing of sperm and its direct placement into the uterus.
Surgical Interventions: Some females may benefit from surgical interventions. Laparoscopy is one of the surgical interventions that improves fertility in conditions like blocked fallopian tubes, ovarian cysts, or endometriosis.
Assisted Reproductive Technology (ART): To overcome infertility, some advanced procedures like Assisted reproductive technology (ART) are employed. These procedures are primarily used in cases where other treatments have shown no success. Some of the primary ART procedures include:
In Vitro Fertilization (IVF): IVF is used for several causes of infertility, like endometriosis, blocked fallopian tubes, or unexplained infertility. It is a very effective treatment option, involving the retrieval of women’s eggs, fertilisation with sperm in the laboratory, and implantation of resulting embryos into the uterus.
Intra-Cytoplasmic Sperm Injection (ICSI): ICSI is a technique in which a single sperm is injected directly into an egg. This facilitates fertilisation. ICSI is used when previous IVF efforts or in cases of severe male infertility.
Gamete Intrafallopian Transfer (GIFT): GIFT allows fertilisation to occur within the body. It involves the transfer of eggs and sperm into the fallopian tubes. It is not used commonly but may be recommended for special cases. This option is rarely used in current practice.
Zygote Intrafallopian Transfer (ZIFT): ZIFT involves the transfer of fertilised embryos into the fallopian tubes. It is considered a variation in GIFT and is used in cases when multiple IVF cycles do not result in pregnancy or when IVF is not suitable. This option is rarely used in current practice.
Psychological and Emotional Support: It is emotionally challenging to deal with infertility. Access to mental health professionals, support groups, and supportive counselling can help to provide emotional support throughout the fertility treatment. It helps couples and individuals navigate the psychological features of infertility, helping to maintain the well-being of the patients.
Infertility affects couples and individuals worldwide, presenting as an emotionally challenging and complex condition. It’s crucial to remember that infertility can result from various factors, ranging from ovulatory problems to age-related issues, impacting both females and males
Seeking proper guidance from healthcare providers and fertility specialists is crucial when facing infertility. They can perform essential tests, offer expert advice, and recommend treatment plans tailored to address specific infertility cases. This ensures that individuals and couples receive appropriate guidance and care on their journey to parenthood.
There is no doubt in the fact that infertility is a challenging journey. Hope and courage are essential throughout the treatment of infertility. Advances in technology, medical science, and proper counselling are essential to remain optimistic. By using and following healthcare providers’ recommendations, many individuals and couples achieve their dream of becoming parents. Always remember that you are not alone in this journey, your healthcare team and many resources are available to support you to achieve parenthood.