If you have been trying to start a family for over a year without success then talk to your GP. For those that need fertility treatment in Norfolk there is a consistent pathway for all NHS patients and your GP can refer you directly to a specialist at Bourn Hall for fertility testing, diagnosis and ovulation induction as appropriate.
This joined-up service enables couples to gain a good assessment of their fertility at one clinic, without the need to visit a hospital, and to have a diagnosis in six weeks. Fertility declines with age so a rapid diagnosis gives more options for achieving your dream of having a baby.
Infertility also impacts mental wellbeing and puts stress on relationships; Bourn Hall also provides fertility counselling to help individuals and couples to cope with the fertility journey.
Kirstie and George’s story: unexplained infertility
“It just didn’t occur to me when we first started trying for a baby that we would struggle to conceive,” says Kirstie, aged 32. “My periods had always been regular as clockwork and I was in my twenties so I just assumed that I would get pregnant. I now realise that was a bit naïve of me.
“As time went on and I couldn’t get pregnant I started to wonder if we were doing something wrong. We didn’t drink or smoke and we were not overweight so what could the issue be?”
After three years, the couple decided to go and see their GP to ask for help. The GP referred the couple for fertility testing at Bourn Hall. Kirstie and George live in Norfolk, where Bourn Hall is commissioned by the NHS to undertake all of the ‘Level 2’ fertility diagnostic testing.
Bourn Hall did a number of tests and told the couple that they had ‘unexplained infertility’, which is when no cause can be found in either partner. Around one in four cases of infertility are classed as unexplained. The National Institute for Health and Care Excellence (NICE) recommends that people with unexplained infertility who have not conceived for over two years of having regular unprotected sex should be offered NHS-funded IVF treatment subject to NHS eligibility criteria.
Fortunately Kirstie and George were eligible for NHS funding for IVF treatment and were able to continue their fertility journey with Bourn Hall – one of the providers selected by the Norfolk CCG to provide IVF treatment to patients in the county.
Advice for others
The couple now have a baby son, Owen, and Kirstie has the following advice for other couples struggling to conceive.
“Don’t be frightened about asking for help or about fertility treatment,” she says. “Everyone was so lovely and helpful at Bourn Hall and whenever we rang up with a query they always got back to us really quickly.
“We are just so happy that Owen is here, he is a dream for us.”
Tasha and Adam’s story: sub-fertility on both sides
“When I turned 21 my mum pointed out that she, my aunt and my Nan had all fallen pregnant at that age and she jokingly warned me to be extra careful,” says Tasha from near Norwich. “I naturally assumed that we must all be really fertile in our family and that I would fall pregnant just as easily as they had done.”
Tasha met her husband Adam when they were both teenagers and they got married when Tasha was 24. A few months after their wedding she came off the pill and thought that it would just be a matter of time before she got pregnant.
“Four years later nothing had happened,” says Tasha, now aged 31. “I have always wanted to be a mum. I work as a veterinary nurse and am naturally a nurturing person. Everyone around me had started to have children and in the end I had to come off social media because of the constant reminders that someone else I knew was pregnant.”
Tasha went to see her GP, who arranged for her to have some blood tests – which didn’t identify any issues. “I then frogmarched Adam down to the GP so that he could be tested as well,” she says. “Adam’s tests showed that his sperm had slightly low motility and we were told that we could be referred for further, more specialist diagnostic testing.”
HyCoSy to check tubes
At Bourn Hall Tasha had a HyCoSy test to check that her fallopian tubes were clear. Tasha’s periods had always been painful and heavy, which can be a sign of conditions such as endometriosis which can cause scarring to the tubes, but the HyCoSy test revealed that her tubes were clear.
Semen analysis to check sperm quality
Adam had a semen (sperm) analysis, which involves a series of measurements including the concentration of sperm and how many are motile (moving as they should), progressive, and normal in shape. If one or more of these measurements is below the normal range it could impair fertility. Adam’s tests revealed that he still had slow sperm motility and Bourn Hall advised that, although it still might be possible for the couple to conceive naturally, IVF would be their best option as they had already been actively trying for more than four years.
Healthy BMI to maximise chances
However, there was still one hurdle to overcome: Tasha needed a BMI of 30 or less to be eligible for NHS funding as having a BMI of 19 – 30 increases the chances of success.
“The problem is that when I get stressed I eat,” says Tasha. “Bourn Hall told me that I needed to lose some weight.”
Losing weight and eating the right nutrients can be a challenge for many people, so Bourn Hall’s fertility nurses can advise patients on steps to take to adopt a healthier lifestyle.
“I was really focused on what needed to be done and whenever I felt like comfort eating I stopped myself because I knew I was doing it for the greater good.” Tasha lost a stone and the couple were ready to embark on their IVF treatment at Bourn Hall.
IVF with ICSI
The couple had IVF with ICSI (Intracytoplasmic Sperm Injection). ICSI involves an embryologist carefully selecting an individual sperm and capturing it with a very fine pipette before injecting it directly into the egg. The couple were successful on their third attempt and are now proud parents of Matthew.
Tasha used complementary therapy to help her cope with the journey.
“I was quite sceptical about it but it was just such a relaxing experience; I found it so helpful. My acupuncturist was a really lovely lady and she saw me at various stages of our IVF journey and it really calmed me down and relaxed me.”
NHS fertility testing and diagnosis for Norfolk patients
GPs in Norfolk are able to refer patients directly to Bourn Hall for fertility testing after they have been trying for a year to conceive.
The NHS fertility diagnosis and treatment service includes:
A review with a fertility specialist – this includes a discussion of lifestyle factors and medical history, and advice will be given on ways to improve chances of natural conception or of successful treatment if this is required.
- female tests – this includes: a number of blood tests to confirm that hormone levels are normal and that eggs are being produced and released regularly; a scan to check that the fallopian tubes (that transfer the eggs from the ovaries to the womb) are clear; and a scan of the pelvic area to ensure it is healthy and clear of obstructions caused by conditions such as endometriosis, which can cause scarring and adhesions.
- male tests – these include semen analysis to check quality and quantity of sperm and their movement.
A fertility diagnosis in 6 weeks – the results from both sets of tests are reviewed by a fertility consultant and advice given. With a diagnosis it is possible to make recommendations for the next step, which might include:
- Ovulation induction with fertility medication, such as Clomid, to boost egg production. If this is advised it would be started immediately. The ovaries are closely monitored to determine the best time for natural conception to occur.
- Referral for surgery
- Referral for fertility treatment such as IVF
- Counselling to support mental wellbeing and fertility health
NICE advises that referral for Level 2 fertility services is appropriate for couples who have had regular unprotected sexual intercourse for 12 months and have failed to conceive, unless earlier investigation is indicated.