General Fertility Questions
- What is Anti-Müllerian hormone (AMH)?
AMH or Anti-Müllerian hormone is a natural hormone produced in women’s ovaries by the follicles (the structures that contain the eggs).
The AMH test is used to assess a woman’s ovarian reserve (“OR”), which indicates how many viable eggs a woman has left in her ovaries. The AMH test can be done at any time during the menstrual cycle. The reference value (or the level considered “normal”) varies from lab to lab so it can be difficult to compare results from one lab to another.
AMH declines with age. However, a high AMH could suggest Polycystic Ovarian Syndrome (PCOS) in some patients.
- What is a normal follicle-stimulating hormone (FSH) level for IVF?
Follicle-stimulating hormone (FSH) is an important hormone made in your pituitary gland. The FSH test checks if your pituitary gland produces too much or too little FSH, or if you have any potential issues with your ovaries or testicles.
For women, FSH levels naturally fluctuate throughout the menstrual cycle, so the test is normally undertaken around day 3 of the cycle.
In general, the normal result for women between the first day of the period and ovulation is between 1.4 and 9.9 IU/mL. For men, the normal results are between 1.4 and 15.5 IU/mL.
The FSH test is usually done in combination with anti-müllerian hormone (AMH) and antral follicle count (AFC) tests because normal FSH on its own cannot accurately predict whether your ovaries will produce suitable eggs in response to stimulation.
- Can you increase your AMH levels?
AMH levels reflect a woman’s ovarian reserve (egg supply), which decreases with age. This means a low AMH level is reflective of low ovarian reserve.
Some studies suggest that vitamin D and dehydroepiandrosterone (DHEA) supplementation may increase AMH levels. However, there is not enough evidence to show that these are effective at increasing chances of conceiving, as ovarian reserve will still naturally decrease with age regardless of whether a woman has a high AMH level. It is important to note that while a high ovarian reserve may indicate a higher chance of pregnancy, a low AMH level does not always mean that a woman will not be able to conceive naturally.
Women should discuss with their doctor before taking any supplementation to address any fertility issues.
Egg and Sperm Donation Questions
- Can using donor eggs in fertility treatment increase the chances of success?
Birth rates decline with age when patients use their own eggs. This is because both the ovarian reserve (egg supply) and the quality of the eggs decrease with age.
Egg donors are on average 5 years younger (30.2 years) than IVF patients (35.6 years). Therefore, using donor eggs from younger women can help improve your chances of successful fertility treatment. This is particularly true for patients who are over 40 years of age.
- What are the risks of using a sperm or egg donor?
The risks associated with an egg or sperm donor are generally minimal when choosing a donor from a licensed fertility clinic. Your donor’s medical and family history is thoroughly evaluated to rule out any potential hereditary disorders, including chromosomal abnormalities or genetic diseases. Additionally, your donor will have undergone several blood tests and other screening procedures to ensure no sexually transmitted diseases (STDs), or blood-borne viruses are presented upon donation. In order to become a donor, they must present a negative test result for human immunodeficiency virus (HIV), Hepatitis B and C, and human T-cell lymphotropic, which is associated with cancer.
- How much do donor sperm and eggs cost?
Sperm collection is generally a less invasive and time-consuming donation process compared with egg donation. In the UK, the cost of donor sperm is between £800 and
£1,500 depending on the clinic or sperm bank you are using. If you are buying from a sperm bank and the sperm needs to be shipped to your treatment clinic, there will be a fee for transport and fees from the clinic for handling the sperm.
The costs of using donor eggs are between £3,000 to £5,000 for up to 8 eggs.
If you are going through IVF using either donor sperm or donor eggs, we suggest that you speak with your treatment clinic first to check which sperm banks or egg banks they work with.
Preparing for IVF Treatment
- What vitamins and supplements should I take before IVF?
Eating a healthy and balanced diet will help you get most of the vitamins and minerals that you need for a healthy pregnancy. However, women are recommended to take 400mcg folic acid tablets every day for 3 months before pregnancy and until 12 weeks of pregnancy. Folic acid is important for the healthy development of a foetus, as it can help reduce the risk of birth defects.
Vitamin D supplements are also recommended for women who have low levels on their blood test. All adults need 10mcg vitamin D each day, and this can be obtained through sun exposure. Vitamin D can also be found in food such as oily fish, eggs and red meat. Women who are not getting enough vitamin D through sun exposure and a healthy diet are recommended to take vitamin D supplements.
- How can I prepare for semen analysis?
You will need to refrain from any sexual activity for at least three days, but not more than five to seven days before your sample is collected. This means no sexual intercourse or no ejaculation of any kind, including masturbation. Longer or shorter periods of abstinence may result in a lower sperm count or decreased sperm motility.
- Am I eligible for NHS IVF funding if I already have a child?
Whether the NHS will fund your IVF treatment depends on the local eligibility criteria in your area.
You may have heard the term “postcode lottery” when it comes to accessing IVF in the UK, as the eligibility criteria will depend on your location. Scotland and Northern Ireland make their own decisions regarding who is eligible for NHS-funded fertility treatment, whilst in England and Wales, the National Institute for Health and Care Excellence (NICE) sets out guidelines for individual NHS clinical commissioning groups (CCGs) who then set the criteria for their local catchment area.
Fertility Treatment Questions
- What are short and long protocols in IVF?
A number of methods (also called “protocols”) can be used to stimulate a woman’s ovaries to produce eggs. The most common are long protocol IVF and short protocol IVF. Each approach involves scans to monitor how the follicles are developing. The aim is to collect as many healthy eggs, ready for fertilisation.
- What is the difference between a natural and medicated frozen embryo transfer (FET) cycle?
There are two main embryo transfer protocols: the natural frozen embryo transfer (FET) cycle and a medicated FET cycle.
- Is egg collection painful?
Our research shows that most women did not find egg collection painful, as a sedative is administered during the procedure. However, common side-effects you may experience following the procedure include bloating, constipation, abdominal cramps and/or light vaginal bleeding. Over-the-counter painkillers can be taken to ease any discomfort you experience after egg collection.
Read our guide on egg collection (click here)
Fertility Medication Questions
- How should I store Meriofert?
Meriofert is a hormonal drug used in fertility treatments, such as IVF, to stimulate ovaries to produce more follicles, and therefore more eggs. It contains purified Follicle Stimulating Hormone (FSH), Luteinising Hormone (LH) and Human Chorionic Gonadotrophin (hCG), which are naturally occurring hormones in women.
Meriofert should be stored between 3°C and 25°C, so depending on where you live, it can be stored at room temperature or in the refrigerator. Keep Meriofert in its packet so it is protected from light, and avoid storing it where it may be exposed to heat or moisture.
- What are the side-effects of Buserelin medication?
Buserelin medication is used to suppress your natural ovulation cycle prior to starting stimulation medication so that your clinic can better control your ovaries’ follicle production. Buserelin will put you in a temporary menopausal state to prevent early ovulation (and therefore the loss of your eggs). Not everyone will experience side-effects of Buserelin and if you do, you are unlikely to get all of them.
Common side-effects of Buserelin include menopausal symptoms such as hot flushes, vaginal dryness and increased sweating. You may also experience dizziness, tiredness, nausea, abdominal pain, diarrhoea, constipation, headaches, stiffness and mood swings as well as changes in your period.
You should contact your doctor/local emergency department immediately if you develop a red skin rash or have breathing difficulties, as these could be signs of an allergic reaction.