18 Oct

imageAs a GP I regularly see young women who are anxious about not getting pregnant and if they have been trying for 12-18 months or sooner if over the age of 36yrs, despite having regular unprotected sex we consider that they may be infertile and need further investigation.
Around one in seven couples may have difficulty conceiving. This is approximately 3.5 million people in the UK.
About 84% of couples will conceive naturally within one year if they have regular unprotected sex.
For every 100 couples trying to conceive naturally:
84 will conceive within one year
92 will conceive within two years
93 will conceive within three years
For couples who have been trying to conceive for more than three years without success, the likelihood of pregnancy occurring within the next year is 25% or less.

There may be physical problems or often they are not conceiving due to a stressful, unhealthy lifestyle or for no apparent reason, which infact amounts to 15% of women. Hence, my first bit of advice is to advise a couple to have some quality time together and forget about babies and not infrequently within a couple of months they report back with a positive pregnancy test! One couple having been trying to conceive for several years and were due to go to India I suggested they forgot babies but to make sure they visited the Taj Mahal and looked into each other’s eyes. Needless to say 9 months later they were blessed with a beautiful son. I have watched some of these babies grow up and I couldn’t help but smile to myself when several of these, now grown up babies have approached me to do a work experience or help with their application to university or even medical school!  (recruiting preconception- has Jeremy Hunt heard about that!)

Moreover, over the decades, the availability of treatment and the type of women receiving it has changed dramatically. Dr Robert Forman worked with the British doctors who “created” Louise Brown, and is now medical director of the CRM Care London clinic, part of the country’s biggest fertility company, with seven “branches” in the UK and Ireland. Care now performs more than 7,000 cycles of treatment a year and boasts success rates of up to 50 per cent. When IVF started, it was purely for women with blocked fallopian tubes,” says Dr Forman. “One of the biggest changes over the years is that we are now increasingly treating people who are not technically infertile. It is single women who are opting for egg freezing or donor insemination, gay couples coming for treatment, as well as those who can conceive but have genetic testing of embryos, for instance, to screen out cystic fibrosis if they know they are carriers of that gene.” Recently we were delighted to facilitate a referral of a gay couple for successful IVF and for this family to be part of our practice and there are others in different situations who now feel confident to ask for support in preparing to conceive and then have their antenatal care within the practice.


However, infertility has become an industry and very costly to couples who take the route of IVF when in some cases a simple alternative could solve the problem. The NHS alone doesn’t carry all this demand: it only funds 41% of the IVF cycles in England and Wales, with more than half of people paying to sort out the problem for themselves – or at least trying to sort it out. We as GPs try to do as much before referral to avoid unnecessary IVF. As I read in one article about infertility,  “If you’re having sex three times a week, you have a much greater chance of success, rather than just waiting for that ovulation window. We need to talk about these things as well as IVF.” It would be useful to read the article on infertility in NHS choices website prior to consulting your GP before rushing off to ask for IVF independently.

Age-based infertility (rather than infertility that would exist regardless of age) is on the increase because it’s more socially acceptable, and indeed more possible, to delay motherhood than it was 30 years ago. This isn’t scaremongering, it is fact. Now they have recourse to a solution; but IVF is expensive and requires an average of four cycles to work – at roughly £5,000 a cycle, if it’s on the NHS – and the more that women “delay” their childbearing years (whether by design, accident or life circumstance), the heavier the demand for IVF. It was recently written in the press that schools are advising girls not to leave it ‘too late’ to have a baby.

Having conceived pregnancy is not always straight forward and employers are not always sympathetic  and women are expected to continue and cope with all that comes their way. There are many questions to be asked as women prepare to enter this new world of motherhood.

Eventually, the precious baby arrives but more and more mothers are isolated with no grandmother or extended family nearby to advise them how to deal with the numerous problems of caring for a baby ensue. We frequently see mothers in surgery coming to ask us for advice, which we are happy to help but attending a surgery or urgent care centre alongside ill patients is not ideal for a new mother and baby let alone being inconvenient for both. Hence, when Diana Hill an award-winning BBC science documentary film-maker.attended one of our Multi-Disciplinary Group meetings to talk about her company, “The Essential Parent Company” which she created with  Dr Rebecca Chicot a Cambridge PhD in Child Development and Parenting I felt it was an excellent resource to share with patients especially new mothers.

For a limited period of time there will be free access and if those viewing the videos give favourable comments there is a chance this may continue.


Professor Robert Winston, a pioneer of fertility and reproductive health pioneer has been a key advisor and provides expert information in maximising the chances of getting pregnant

With expert team of obstetricians, midwives, antenatal dietitiants and antenatal health experts The Essential Parent Company brings the most trusted advice to help you have a healthy and happy pregnancy, labour and birth.


With expert partners The Royal College of Paediatrics and Child Health, UNICEF UK Baby Friendly as well as midwives, paediatricians, sleep experts, paediatric dietitians, development psychologists and The Essential Parent Company present trusted video demos and advice to help have a safe, happy and healthy baby. With advice on feeding, sleeping, crying and everyday care and health they aspire to give a one stop hub for warm, expert advice.




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Posted by on October 18, 2015 in Training and Advice


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