Smoking

There is now a good deal of evidence that suggests that smoking is harmful to both male and female fertility. Put into real terms if a woman smokes 20 cigarettes per day she reduces her natural fertility by over 20% and brings forward the age of menopause by 5 years. Smoking is also harmful to the developing foetus.

Body mass index

It is important to be normal weight for your height for best chance of pregnancy. Obese men also experience sub fertility. Normal BMI is 20‐25 kg/m2. There is good evidence that BMI of over 30 reduces the chances of pregnancy by 20%. Overweight women also have increased risk of miscarriages, developmental abnormalities in the baby and serious complication in pregnancy or child birth.

We advise that fertility treatment should be only performed when the BMI is 35 or less. Ideally it should be over 20 and less than 30.  It is also important to know that NHS funding is currently only available to women with a BMI of 30 or less.

Prevention of spina bifida

There is evidence that a small dose of folic acid (400mcg daily) is helpful in lowering the incidence of fetal abnormalities such as spina bifida. All women going through the IVF programme should consider taking this small daily dose of folic acid. Women who suffer from epilepsy should take 5mgs daily.

Rubella (German Measles)

Although most women were vaccinated while at school, the vaccine occasionally is not effective. If you are not immune to rubella and you contract the condition in pregnancy, it can have disastrous effects on the fetus. A simple blood test will show whether or not you are immune. This could be organised either through the hospital clinic or through your GP.

Treatments available

Unfortunately at least 1 in 6 couples will need to consult a doctor for assistance with conception. The Leeds Centre of Reproductive Medicine offers the following investigations and treatments to assist with conception:

REFERRAL

Referral process and outpatients

INVESTIGATIONS

Woman

  • Examination
  • Blood tests
  • Ultrasound scan
  • Sonohysterography
  • Tubal patency tests (hysterosalpingogram & laparoscopy)

Man

  • Examination
  • Blood tests
  • Ultrasound scan
  • Semen analysis

Treatments

  • Ovulation Induction
  • Intra Uterine Insemination
  • Donor Sperm Insemination
  • In Vitro Fertilisation (IVF)
  • Frozen Embryo Transfer
  • Intra Cytoplasmic Sperm Injection (ICSI)
  • Micro Epididymal Sperm Aspiration (MESA)
  • Percutaneous Epididymal Sperm Aspiration (PESA)
  • Egg donation
  • Embryo donation
  • Surrogacy
  • Pre‐implantation Genetic Diagnosis (PGD)

Cervical smear

Regular cervical smears lowers the incidence of cervical cancer. In the United Kingdom women routinely have smears performed every 3 years. You should have a smear within this period before you start treatment. It is not advisable to have treatment or become pregnant if you have an abnormal smear until treatment is complete.