This treatment is undertaken when a couple is not successful in getting pregnant. It can be intrauterine insemination (IUI) or in vitro fertilisation (IVF).
If you have been trying to conceive for over a year but have been unsuccessful, it is recommended to have some tests to determine your fertility. These tests can then indicate whether assisted conception measures will help to achieve pregnancy. Fertility tests are carried out on both women and men.
Fertility tests will usually begin by confirming the following:
You will also have a thorough physical examination to rule out infections, fibroids or endometriosis. A physical examination of men will rule out any testicle lumps or other physical abnormalities.
Women will undergo the following tests:
Men will have the following tests:
Fertility tests are needed to determine why a couple who have tried for at least year to conceive have been unsuccessful.
Depending on the fertility test being carried out, the preparation varies. In each case, the specialist will indicate what care should be taken.
Abnormal results may indicate the following:
Egg freezing, or oocyte cryopreservation, is a method of preserving a woman’s eggs, enabling her to have the chance of having a baby in the future. As women get older, they typically produce fewer eggs, and often the viability of the eggs also falls, meaning that the chances of conceiving naturally also decrease. Freezing eggs at a younger age, and using them later can provide a better chance of conception.
Freezing your eggs is a good option for patients who have a medical condition or are taking medication which affects fertility, such as cancer. You might also choose to freeze your eggs (elective egg freezing) simply because you are concerned that your fertility is declining, but you have not found the right partner or are not currently ready to have a child, but think you may want one in the future.
Other possible candidates include members of the Armed Forces, or similar situations where severe injury or even death is a risk, and those planning to have a sex change operation.
Egg freezing begins the same way as IVF – this normally involves the patient taking fertility drugs to temporarily boost egg production and maturation. The eggs are then collected by doctors while the patient is sedated. Around 15 eggs are taken from most patients, but it may be less, depending on fertility.
Instead of mixing the eggs with sperm, they are mixed with a cryoprotectant (freezing solution). This will protect the eggs during the freezing process. The freezing itself is done either by fast freezing (vitrification) or slow cooling, after which they are stored in liquid nitrogen.
The maximum storage time is normally 10 years, but in certain situations the eggs can be stored for up to 55 years, or, if the patient wants, less than 10.
When the woman wants to use her eggs, they are thawed, and then fertilised. Standard IVF is not usually used, as eggs that have been frozen tend to have a tough outer coating, which sperm find more difficult to penetrate. Instead, a procedure called intracytoplasmic sperm injection (ICSI) is often used, which involves a skilled embryologist injecting a sperm directly into each egg, maximising the chance of fertilisation.
It is difficult to say how successful egg freezing is, as the number of women who do it is currently very low. Oocyte cryopreservation is a relatively new and quickly changing field, with new advances being made all the time, but with few studies into its reliability. If you are considering freezing your eggs, choose an experienced clinic with a high success rate with patients.
Recurrent or repeated miscarriages are when a woman has miscarried on three or more consecutive pregnancies.
Miscarriage (also referred to as pregnancy loss) can be devastating if it happens once; sadly some individuals miscarry on multiple occasions, and if three or more consecutive pregnancies are lost a diagnosis of recurrent miscarriage can be made. At this point, further tests are often conducted to find what is causing the pregnancies to be lost.
There are several factors that can lead to repeated miscarriages:
Most pregnancies are monitored to an extent, with most UK hospitals offering at least two ultrasound scans during a pregnancy, as well as regular prenatal check-ups. These measures often pick up irregularities in the pregnancy; however, if a woman suffers several miscarriages, a closer examination may be needed.
After recurrent miscarriages, certain tests and scans are usually offered to try to identify the problem. These tests include:
If a cause is discovered, the doctors and patient can work to counter it to try to prevent further miscarriages. For instance, some blood clotting disorders can be treated with medication, while a weakened cervix can be strengthened with a small stitch of strong thread (cervical cerclage) carried out once the patient is pregnant again.
Measures such as maintaining a healthy weight and avoiding harmful substances including alcohol and tobacco also lower the risk of miscarriage.
Preimplantation genetic diagnosis is a technique used in in vitro fertilisation treatments that allows the selection of embryos in order to avoid of genetic and chromosomal diseases. This technique is authorised for the detection of serious hereditary diseases which show early in embryonic development and for which there is still no cure. In these cases, the preimplantation diagnosis allows the selection of fertilised ovules where the embryo is exempt of genetic diseases before being transferred to the uterus. The diagnosis is made from the analysis of one of the cells of the embryo to determine if it is a carrier or not of a mutation of a particular gene; it can then be selected or discarded for implantation. In this way, the chances of success of in vitro fertilisation treatments are improved and the risk of abortion is reduced.
Egg donation is the procedure of giving eggs, anonymously and altruistically, to help women who wish to have a child and cannot for different reasons. The requirements to be able to donate are to be between 18 and 34 years old, be in good health, be free of sexually transmitted or hereditary disease and have legal capacity to grant authorization. Prior to performing this procedure, the patient must undergo a medical check-up to assess physical health status, with a medical examination that takes into account family history, and a gynaecological, and psychiatric examination.
Dr Benjamin Abramov is a leading fertility specialist and gynaecologist based in London, and is currently Medical Director of City Fertility Ltd. Specialising in pre-implantation genetic screening (PGS) and pre-implantation genetic diagnosis (PGD), IVF, and the management of recurrent miscarriages, Dr Abramov's ethos is a patient-centred approach, tailoring treatment to each individual case, and putting the needs of his patients first. With a wealth of experience in the fields of gynaecology and fertility treatment since earning his MD in 1994, Dr Abramov has held several senior positions in fertility treatment centres over the years. His current clinic (Gennet City Fertility) boasts impressive pregnancy success rates. He is known for using all methods available to help his patients to conceive, leaving no stone unturned, including using cutting edge technologies and thinking outside the box to find the answer.
This treatment is undertaken when a couple is not successful in getting pregnant. It can be intrauterine insemination (IUI) or in vitro fertilisation (IVF).
Assisted reproduction is a technique in which, through medical assistance, the egg is fertilized by the sperm. This technique is used when there is a medical problem that prevents the couple from getting pregnant.
Assisted reproductive technology aims to help women who want to become pregnant but may have had some difficulties in doing so. Some of these techniques include artificial insemination or in vitro fertilization (IVF).
Egg donation is the procedure of giving eggs, anonymously and altruistically, to help women who wish to have a child and cannot for different reasons. The requirements to be able to donate are to be between 18 and 34 years old, be in good health, be free of sexually transmitted or hereditary disease and have legal capacity to grant authorization. Prior to performing this procedure, the patient must undergo a medical check-up to assess physical health status, with a medical examination that takes into account family history, and a gynaecological, and psychiatric examination.
Egg freezing, or oocyte cryopreservation, is a method of preserving a woman’s eggs, enabling her to have the chance of having a baby in the future. As women get older, they typically produce fewer eggs, and often the viability of the eggs also falls, meaning that the chances of conceiving naturally also decrease. Freezing eggs at a younger age, and using them later can provide a better chance of conception.
Freezing your eggs is a good option for patients who have a medical condition or are taking medication which affects fertility, such as cancer. You might also choose to freeze your eggs (elective egg freezing) simply because you are concerned that your fertility is declining, but you have not found the right partner or are not currently ready to have a child, but think you may want one in the future.
Other possible candidates include members of the Armed Forces, or similar situations where severe injury or even death is a risk, and those planning to have a sex change operation.
Egg freezing begins the same way as IVF – this normally involves the patient taking fertility drugs to temporarily boost egg production and maturation. The eggs are then collected by doctors while the patient is sedated. Around 15 eggs are taken from most patients, but it may be less, depending on fertility.
Instead of mixing the eggs with sperm, they are mixed with a cryoprotectant (freezing solution). This will protect the eggs during the freezing process. The freezing itself is done either by fast freezing (vitrification) or slow cooling, after which they are stored in liquid nitrogen.
The maximum storage time is normally 10 years, but in certain situations the eggs can be stored for up to 55 years, or, if the patient wants, less than 10.
When the woman wants to use her eggs, they are thawed, and then fertilised. Standard IVF is not usually used, as eggs that have been frozen tend to have a tough outer coating, which sperm find more difficult to penetrate. Instead, a procedure called intracytoplasmic sperm injection (ICSI) is often used, which involves a skilled embryologist injecting a sperm directly into each egg, maximising the chance of fertilisation.
It is difficult to say how successful egg freezing is, as the number of women who do it is currently very low. Oocyte cryopreservation is a relatively new and quickly changing field, with new advances being made all the time, but with few studies into its reliability. If you are considering freezing your eggs, choose an experienced clinic with a high success rate with patients.
Family planning is a wide topic that involves taking steps to control when a pregnancy occurs. It can refer to both fertility treatments for couple trying to have children and contraceptive methods to prevent pregnancy.
The reason depends on the type of family planning.
Family planning is important to avoid unwanted pregnancy. There are different contraceptive methods available to achieve this end, and this kind of family planning is often done between the couple. However, a consultation with a doctor may be necessary to weigh up what kind of contraception is best for you. For example, some women may be unable to take contraceptive pills for medical reasons, or condoms may not be an option due to latex allergies, etc.
On the other hand, if a couple is trying to conceive, they may consult a fertility specialist to find out why they are having difficulties getting pregnant or to plan how to optimise their chances of having a baby. It may be that one or both partners are infertile and may need assistance in getting pregnant.
Family planning to conceive a child involves consulting a doctor, usually a fertility specialist or gynaecologist, who may run tests to find out why a couple is having trouble conceiving. This could involve:
Depending on the results of the tests, the doctor may advise different methods to maximise the chances of the couple having a baby, and will plan with the couple how they should proceed.
In some cases natural family planning will be advised. This simply involves having the woman monitor the signs of fertility in her menstrual cycle to know when she is ovulating, and therefore when is the optimal time to have sex.
In other cases, some sort of fertility treatment may be necessary or the couple may be advised to try options such as IVF.
Conversely, family planning to avoid unwanted pregnancy largely involves contraceptive methods, such as condoms or similar barrier devices, the contraceptive pill, or, again, using the natural family planning method to determine when the woman is ovulating and avoid having sex at that time.
Family planning carries several advantages:
If you have been trying to conceive for over a year but have been unsuccessful, it is recommended to have some tests to determine your fertility. These tests can then indicate whether assisted conception measures will help to achieve pregnancy. Fertility tests are carried out on both women and men.
Fertility tests will usually begin by confirming the following:
You will also have a thorough physical examination to rule out infections, fibroids or endometriosis. A physical examination of men will rule out any testicle lumps or other physical abnormalities.
Women will undergo the following tests:
Men will have the following tests:
Fertility tests are needed to determine why a couple who have tried for at least year to conceive have been unsuccessful.
Depending on the fertility test being carried out, the preparation varies. In each case, the specialist will indicate what care should be taken.
Abnormal results may indicate the following:
Fertility treatment is typically given by a fertility specialist or fertility doctor, often an obstetrician/gynaecologist specialising in the issues and treatment surrounding infertility. The sub-specialty is often referred to as 'reproductive medicine', dealing with the prevention, diagnosis and management of reproductive problems.
Fertility specialists consult for and are able to diagnose all manner of conditions surrounding infertility and related problems. These specialists may consult for both male and female infertility, making an initial assessment either for an individual or a couple. Fertility specialists typically use three main methods of treatment for fertility issues, being medication, surgical procedures, and assisted conception. Depending on the treatment, fertility specialists may refer to other specialists, such as surgeons or endocrinologists.
Surgical procedures may be used for conditions such as endometriosis (where the womb lining grows outside the womb), fibroids, and polycystic ovary syndrome (PCOS). In men, surgery may be used to correct epididymal blockages, and retrieve sperm.
Fertility medication is more commonly issued to women in order to help with ovulation issues. However, medication may be issued in some cases of male infertility or related problems.
Many people visit fertility specialists for assisted conception, typically through IVF (in vitro fertilisation), IUI (intrauterine insemination), or egg/sperm donation.
There are many reasons to visit a fertility specialist. For women under 35, visiting a fertility specialist is recommended when pregnancy has not been achieved after one year of unprotected intercourse. Women 35 and older are recommended to visit a fertility specialist after 6 months of trying.
Other reasons for visiting a fertility specialist include:
In those with a thyroid condition, or who are overweight, or have a known reproductive issue such as PCOS, visiting a fertility specialist is advised before trying to get pregnant. In addition, some may wish to visit a fertility specialist and consult for the following reasons:
Three weeks after the first day of your last period, your fertilised egg (ovum) moves slowly towards the uterus. From that moment on and for the following 35 weeks, the embryo develops and becomes a foetus. The baby will continue to grow inside the uterine cavity up until the delivery date. You’ll probably start to feel your baby moving about from weeks 15 to 22.
By week 4 the baby is about 2-5 millimetres long and going through the organogenesis phase - the formation of organs and of the nervous system. The baby already has a heart and stomach, but no mouth nor eyes; nor is it yet possible to distinguish any limbs. The embryo, attached to the placenta by the umbilical cord, floats in the amniotic cavity.
During this phase of the pregnancy the organs continue to develop. The baby, weighing about three grams and three centimetres long cannot see or hear well yet.
The baby’s brain, liver, stomach and pancreas are fully formed. The limbs keep on stretching and growing, the spinal column and the first muscles are developing, and the heart starts to grow. The nose and ears are now more obvious, and the tongue and optic nerve develop more and more.
During the third month, the foetus grows three times in size. The nerve cells start growing and the baby’s skeleton becomes clearer as well. The fingers start move and the baby may close them in a fist, although no movement is controlled by the brain yet. The eyes are now fully formed, the mouth can open and close, the lips become more distinct and the nostrils slowly begin to open up.
The baby starts making sucking motions with the mouth. By the end of the third month (week 13) the foetus will weigh about 65 grams and will be about 12 centimetres long.
During the fourth month the baby’s body will be covered in lanugo, a very fine, soft hair.
The appendix starts to grow The amniotic fluid flows in and out of the baby’s lungs, even though the lungs haven’t developed their final respiratory function yet.
The hearing system is now complete; the foetus can’t see yet, but the retinas are already light-sensitive.
During the fifth month, the baby’s muscles grow stronger, a thin, soft hair starts growing on the head and the baby now has his or her own fingerprints. It is now time for second ultrasound, the mid-pregnancy anomaly scan, which often allows to discover the sex of the baby.
Around week 21 the baby weighs about 300 grams and is roughly 24 centimetres long.
During this month the baby’s sexual organs start developing. Tooth buds and fingernails start to form. This is the beginning of one of the most exciting phases for parents – the baby starts hearing and will react to touch and sound.
This is the stage when the brain and the nervous system grow mature. The baby can open his or her eyes and respond to light. The baby weighs around 1.5 kilograms and is about 37 centimetres long.
During the eighth month the baby’s hearing system improves. The baby is feeding on amniotic fluid and the taste buds, digestive tract, kidneys and fingernails continue to develop. The baby is now able to feel pain.
During the last month of your pregnancy the baby grows plumper due to subcutaneous fat accumulation. The baby’s head should move down to your pelvis, getting ready for birth - this happens in 95% of the cases. However, the brain is not fully developed yet, even though it keeps growing rapidly.
A gynaecological examination is done to assess the overall health of the female reproductive system. During the exam, the gynaecologist will look at the external and internal reproductive organs, as well as at the breasts, to determine whether there are any problems or conditions present.
During a gynaecological examination, you will be lying down with your knees up and spread wide apart. The gynaecologist will inspect your vulva and vagina. With both a physical examination and a transvaginal ultrasound, the doctor will also check your uterus and ovaries.
It is very common to also do a smear test during the examination, to determine whether there are precancerous cells in your cervix. The sample taken is sent for examination in a laboratory with results shared, usually in a couple of weeks after the appointment.
The last part of the examination consists of a breast exam, where the gynaecologist checks for lumps or abnormalities. You will also be taught how to do a breast self-exam, so that you can do them at home periodically. The whole examination does not last more than 20-30 minutes.
A gynaecological examination is helpful to assess the general state of health of the female reproductive system, as well as to identify potential infections or problems. The very first examination should be done after the first menstrual cycle or after you become sexually active, even if there are no obvious problems or red flags. Should you have any itching, a burning sensation, abnormal vaginal discharge, as well as irregular menstrual periods or abnormalities or lumps on your breasts, you should go for a gynaecological examination as soon as possible. Even if you do not have any issues, you should go for a check-up at least once every three years (or more often if you have a family history of uterus or breast cancer).
You do not need to do anything before a gynaecological examination. However, you should schedule your examination away from your menstruations and remember to empty your bladder before the visit to avoid any potential discomfort.
A gynaecological examination is not painful at all. The feeling you will have during the internal examination is like that of using a tampon.
There are many potential anomalies that could be found during an examination. By going for your check-up, the gynaecologist can identify potential tumours, conditions, infections or even small irritations and determine the best treatment for you.
A high-risk pregnancy is one that involves complications or associated factors that pose a risk to the health of the mother and the foetus. Currently, around 10% of pregnancies are considered high risk.
The main factors that can identify a pregnancy as high-risk include:
Pregnancy proceeds differently in each woman, but there are some warning signs to go immediately to the doctor:
If a pregnancy is identified as being high risk, it should be monitored closely by the mother’s doctors, with regular prenatal check-ups.
The mother should try to avoid any factors within her control that could cause complications, such as avoiding alcohol and tobacco consumption and maintaining a healthy body weight.
In vitro fertilisation (IVF) is a procedure in which an egg is combined with sperm outside the body, in a laboratory. Once fertilised, the egg is transferred to the woman’s uterus, with the goal of successful pregnancy. It is a common fertility treatment.
This treatment is an option which can help a woman to become pregnant, in the case of infertility problems, such as:
IVF requires several steps to achieve ultimate success:
The first step when considering any fertility treatment is to visit your GP, who can refer you on to a specialist, or to visit a private fertility specialist or clinic. Once at the clinic, the specialist will speak to you about your fertility history and conduct an examination if necessary.
If IVF is deemed to be the best treatment, you will then be referred for assisted conception. At the clinic or assisted conception unit you and your partner will need to have blood tests, screening tests for sickle cell anaemia and thalassaemia, and your egg count will be investigated.
Once the embryo transfer has been made, you should rest for the remainder of the day.
Generally, you’re advised to wait for 2 weeks before a pregnancy test can be carried out. This time can be stressful and the clinic may offer counselling or support. If the treatment has been successful (and it is important to remember that IVF is not always so), you will be offered regular antenatal care and monitored throughout the pregnancy.
Infertility is the inability of a couple to become pregnant through natural means. Infertility affects the couple, both the man and the woman, who cannot have a child naturally. There are two types of infertility: primary infertility, affecting couples who have not become pregnant after at least one year of unprotected sexual intercourse, and secondary infertility, affecting couples who were able to become pregnant in the past but are now unable to.
There are various symptoms of infertility in men and women.
In women, symptoms may be related to the menstrual cycle and ovulation: abnormal menstruation, with more or less bleeding than usual; irregular menstruation, when the number of days between each menstruation is different each month; amenorrhoea, i.e., no menstruation; or dysmenorrhea, very painful menstruation. There may also be symptoms unrelated to menstruation, such as pain during sexual intercourse.
In men, the symptoms of sperm-related infertility include small amounts of ejaculate. There are also symptoms unrelated to semen, such as changes in hair growth, changes in sexual desire and erection problems. Men may also have a low sperm-count, making the chance of conceiving naturally more difficult.
Common causes of infertility among men and women are:
In women, infertility may be caused by:
In men, the causes of infertility may include:
Generally, if the origin of the infertility is genetic or caused by disease, then nothing can be done. However, you can avoid certain factors that may cause infertility:
Methods to treat infertility in men and women include taking hormones to resolve the hormonal imbalance, supplements to improve fertility, and antibiotics in the case of infection.
For women, having minor surgery to remove blockages or scar tissue from the fallopian tubes, uterus, or pelvic area is another option.
If these methods are unsuccessful, assisted reproduction techniques can be tried.
Miscarriage, or pregnancy loss, is when an embryo or foetus is naturally lost before being able to independently survive, in the first 23 weeks of the gestation period.
Sometimes the cause of miscarriage is unclear, and miscarriages can happen for many reasons. Most miscarriages are not affected by the woman herself, and most miscarriages are one-off events. Having a miscarriage does not necessarily mean you will not be able to have a successful pregnancy in the future.
Miscarriages which occur in the first trimester (i.e the first 3 months of the pregnancy) can be caused by abnormal chromosomes, which mean the baby does not develop properly. There may also be a problem with the development of the placenta, which can also lead to miscarriage.
After the first trimester, a miscarriage may occur because of health issues in the mother, or because of an infection which causes the waters to break. Food poisoning and certain medications can also increase the risk of miscarriage.
The commonest sign of miscarriage is vaginal bleeding. The bleeding may occur over several days, and can come in the form of spotting, heavy bleeding, or passing bright red clots. This bleeding can come and go, and because vaginal bleeding can occur lightly during the first trimester of pregnancy, it doesn’t necessarily indicate miscarriage. Speak to your healthcare provider or GP if you experience vaginal bleeding during pregnancy.
You may also feel:
Most miscarriages cannot be prevented, however there are certain activities or states which can increase the risk of miscarriage. Risk factor is increased if:
After a miscarriage, it is normal to feel an emotional impact. The miscarriage can affect not just you, but family and friends around you. Support is available for those who have lost a baby in miscarriage. Speak to your GP for advice, and you may be able to find a counselling group or counsellor who can help you and your family through what can be a difficult time. The NHS can help you to find bereavement support services in your area, or you may choose to visit a private qualified therapist or psychologist.
Preimplantation genetic diagnosis is a technique used in in vitro fertilisation treatments that allows the selection of embryos in order to avoid of genetic and chromosomal diseases. This technique is authorised for the detection of serious hereditary diseases which show early in embryonic development and for which there is still no cure. In these cases, the preimplantation diagnosis allows the selection of fertilised ovules where the embryo is exempt of genetic diseases before being transferred to the uterus. The diagnosis is made from the analysis of one of the cells of the embryo to determine if it is a carrier or not of a mutation of a particular gene; it can then be selected or discarded for implantation. In this way, the chances of success of in vitro fertilisation treatments are improved and the risk of abortion is reduced.
Prenatal diagnosis is a set of tests that are carried out during pregnancy and allow us to monitor the formation and development of the foetus.
There are different techniques, both invasive and non-invasive. Some of the tests are commonly performed on all women, while others are performed depending on the state and development of the mother and foetus.
In prenatal diagnosis, the gynaecologist will ask the mother several questions and review her medical history and family history, which may influence her health during pregnancy.
To control the health and development of the mother and the foetus, different clinical tests and diagnostic imaging tests will be performed. The main tests are:
The objective of prenatal diagnosis is to monitor the development of the foetus, as well as to detect and prevent possible diseases and deformities. Thanks to prenatal diagnosis tests and reviews, parents can anticipate what their baby's state of health will be like before birth.
Most tests to be performed during prenatal diagnosis are imaging tests such as ultrasound, which are painless. The tests are designed not to cause side effects or discomfort in the mother. In addition, it is a series of procedures that allow parents to know in depth the growth process of their future baby.
If any of the tests of the prenatal diagnosis provides abnormal results, it may be because the foetus is not developing correctly and may have some disease or deformity. In case any test indicates a risk of anomaly, more tests will be performed to rule out or confirm the problem and, if possible, prevent it.
The term “childbirth preparation” encompasses a range of tools that help parents-to-be prepare for the birth of their child from the start of pregnancy. They usually take the form of talks providing information about foetal development and medical check-ups; psychological aspects of pregnancy, birth and the postpartum period; what happens during childbirth; breastfeeding etc. In practical sessions, a specialised instructor shows pregnant women postures and exercises that will help make muscle structures more elastic in order to facilitate childbirth, as well as breathing and relaxation techniques to provide them with better self-control during labour contractions.
Pregnancy is a period of major adaptation for future parents, who should be aware that they are nurturing a new life and that they are responsible for their future child’s health and wellbeing, and they should be informed about the changes that the mother will experience and that pregnancy is ultimately an enriching experience. It also helps future mothers be better prepared during delivery, by working on elasticity, better postures for childbirth and control of contractions.
Childbirth preparation sessions are imparted by a specialist in obstetrics and gynaecology at hospitals, social and educational facilities or health centres. The pregnant woman can attend by herself or with their partner or companion. Sessions are usually between 1 and 2 hours. They are held over a period of 5 to 8 weeks, usually from the first trimester.
There are theoretical and practical sessions:
Pregnant women should obtain information about the various childbirth preparation courses available to them, as well as the techniques to be done in them. Childbirth preparation courses are based on several techniques, of which the most commonly used are:
Childbirth preparation is not compulsory. It is undertaken by future parents who want to be better informed and prepared for pregnancy and delivery. Alongside the childbirth preparation course, the pregnant woman must also be under the care of a specialist in obstetrics and gynaecology who will monitor her pregnancy and provide individualised care.
Recurrent or repeated miscarriages are when a woman has miscarried on three or more consecutive pregnancies.
Miscarriage (also referred to as pregnancy loss) can be devastating if it happens once; sadly some individuals miscarry on multiple occasions, and if three or more consecutive pregnancies are lost a diagnosis of recurrent miscarriage can be made. At this point, further tests are often conducted to find what is causing the pregnancies to be lost.
There are several factors that can lead to repeated miscarriages:
Most pregnancies are monitored to an extent, with most UK hospitals offering at least two ultrasound scans during a pregnancy, as well as regular prenatal check-ups. These measures often pick up irregularities in the pregnancy; however, if a woman suffers several miscarriages, a closer examination may be needed.
After recurrent miscarriages, certain tests and scans are usually offered to try to identify the problem. These tests include:
If a cause is discovered, the doctors and patient can work to counter it to try to prevent further miscarriages. For instance, some blood clotting disorders can be treated with medication, while a weakened cervix can be strengthened with a small stitch of strong thread (cervical cerclage) carried out once the patient is pregnant again.
Measures such as maintaining a healthy weight and avoiding harmful substances including alcohol and tobacco also lower the risk of miscarriage.
This is a procedure to mechanically extract sperm from the testicles in the case that a man does not release sperm in the semen. The procedure is used for IVF treatment and carried out under local anaesthetic in the surgery, in coordination with the egg retrieval from the patient's partner.
An ultrasound is a type of scan carried out by a sonographer which uses high-frequency sound waves to create a picture inside your body. A transvaginal ultrasound looks specifically at female productive organs including the uterus, cervix, and vagina, by passing the scanner through the vagina.
A transvaginal ultrasound is an internal examination. Many people are familiar with an ultrasound scan which involves passing a microphone over the stomach to see inside the womb. With a transvaginal ultrasound, the microphone is gently fed through the vagina.
You’ll be asked to lie on your side or on your back with your knees drawn up for the procedure, and you might need to wear a hospital gown. You’ll be able to see the images in real time on a monitor, but the sonographer will also take some still pictures to analyse later. The examination should take about 15-30 minutes.
Transvaginal ultrasound is a safe procedure and there are no side effects.
In pregnancy, a transvaginal ultrasound can be used to:
A transvaginal ultrasound might also be ordered if you have:
You don’t need to do any special preparations for a transvaginal ultrasound, other than emptying your bladder before the exam.
The examination is not painful but might be slightly uncomfortable as the microphone is moved around. The microphone is much slimmer than those used in external ultrasound examinations. It is about the size of a finger, and it is covered with a condom and lubricating gel. You will be able to put it in yourself if you prefer to. After the exam you will be free to go home straight away.
If an abnormal growth is found within the ovaries or uterus, there are a number of things that this could be. Fibroids, a type of benign tumour that can cause abdominal pain, are extremely common. Ovarian cysts are also common, and most go away without treatment. In some cases, however, a tumour might indicate ovarian cancer.
Other issues that can be detected with a transvaginal ultrasound include ectopic pregnancy (see above) and a low-lying placenta, which may or may not need to be treated. The results of the scan should be available within 1 or 2 weeks, and you will be able to discuss them with the doctor who ordered the scan. If a tumour is found inside your ovaries, the doctor is likely to order a biopsy to find out what kind of tumour it is.
Ultrasound is a diagnostic imaging procedure that allows you to see organs and soft structures inside the body. At present, they can be 2D, 3D or four-dimensional images. Ultrasound is a non-invasive technique, in which radiation is not used and thanks to this, it is used to visualise developing foetuses.
It is carried out using high frequency sound waves emitted through a transducer that captures the echo of different amplitudes which occurs when they ‘bounce’ off the organs. These signals, once processed by a computer, give a series of images.
With this procedure you can clearly differentiate the shape and size of each structure inside the body. In medicine it is used to see the heart, kidneys, liver and blood vessels, among other organs. In addition, ultrasounds are also carried out on patients who are pregnant. Another function is the study of different tissues of the body such as the blood flow of arteries and veins to detect arteriosclerosis and blood clots. Ultrasounds also allow the analysis of the thyroid gland and other soft structures of the neck as well as tendons, ligaments, muscles and joint structures, and mammary glands.
Usually, you do not need any type of preparation for having an ultrasound. In cases where the area to be examined is the abdomen, the specialist may tell you to drink three glasses of water approximately one hour before the test.
During the ultrasound, the patient will lie on a table or stretcher with the area to be analysed exposed. The specialist will apply a transparent gel that will allow the movement of the roller built into the transducer. During the scan the expert will interpret the images and determine which shots are correct according to each case. The only slight discomfort that can be felt is the gentle pressure that the specialist applies when passing the transducer over the body area. The gel applied can also feel quite cold when applied.
The types of images that are considered abnormal are:
e-Consultation is a private messaging and video conference service that allows contact with leading specialists at the time you choose, from any place.
Embarking on your fertility journey can be daunting. That's why you deserve peace of mind from being in the hands of fertility experts who really care about your individual personalised fertility plan. Medical Director of City Fertility Ltd. clinic Dr Benjamin Abramov explains why you should choose his clinic for successful fertility results.
Read more
In vitro fertilisation is a form of fertility treatment that can help women to get pregnant. Dr Benjamin Abramov, a leading fertility specialist, answers some more frequently asked questions about IVF, following on from part one.
Read more
In vitro fertilisation is a form of fertility treatment that can help women to get pregnant. Dr Benjamin Abramov, a leading fertility specialist, answers some frequently asked questions about IVF.
Read more
Having a baby is not always straightforward. Genetics and infertility can conspire to make starting a family seem like an impossibility. However, options such as IVF can help to maximise your chances. One such option is pre-implantation genetic screening (PGS), which can help to streamline the IVF process. Fertility specialist Dr Benjamin Abramov explains.
Read more
For couples struggling to have a baby due to infertility, in vitro fertilisation (IVF) is an option many look to. What exactly are the chances of IVF working first time, and why do treatment cycles fail? Leading fertility specialist Dr Benjamin Abramov is here to explain.
Read more
Everything you need to know about in vitro fertilisation (IVF)
Does IVF lead to twins and multiple births?
What should we do if we experience multiple miscarriages?
When is preimplantation genetic diagnosis used?
City Fertility Ltd: the most requested procedures in clinic
City Fertility Ltd: what treatments are offered?
Welcome to City Fertility Ltd.
City Fertility Ltd: why choose us?