It is estimated that one in seven British couples trying for a baby will experience delays in conceiving and seek help with their fertility. Some are treated on the NHS, others have to pay tens of thousands for the chance of a baby through techniques such as IVF, ICSI, and GIFT (see below). Here's our guide to the assisted conception minefield.
If you are having trouble conceiving talk to your GP first. You and your partner may then be referred for tests, and possible treatment. It's frustrating, but different health authorities have different policies about fertility treatments and IVF in particular. Generally, the NHS aims to offer women between the ages of 23 and 39 one cycle of IVF, assuming you meet your local authority's eligibility criteria. Your GP can give you information about the criteria and policies for fertility treatment operating in your region.
One of the other problems is that waiting lists for NHS-funded fertility treatment can be extremely long, so if you have been trying to get pregnant for a while - particularly if you are over 30 - it's important to see your GP as soon as possible to get tests underway and, hopefully, a referral.
Assuming you are eligible for NHS-funded treatment, it's important to know that you will still have to pay normal prescription charges for your fertility drugs - unless you are exempt from paying prescription charges.
Costs depend on the type of treatment you need. A single attempt at IUI for example, is significantly cheaper than a more complex cycle of IVF. Always check exactly what the quoted price for your treatment includes before you decide on a clinic. Some clinics include consultation fees, counselling and tests in their overall price, but others don't. Fertility drugs are usually extra, and can be very expensive.
Fertility drugs from around 瞿800* per cycle - It is usually the woman who will take fertility drugs - such as 'ovulation inducers', which can trigger egg production if you are not ovulating each month. Sometimes, that's all that's needed to get you pregnant. These drugs are also often used as part of another treatment, such as IVF or IUI (see below).
Surgery from 瞿2,500* - Some cases of infertility can be helped with surgery. Fallopian tubes can be unblocked with keyhole surgery, and sperm can be retrieved surgically for use in fertility treatment.
IUI (Intrauterine insemination) from 瞿450* - Sperm - which has been 'sorted' to ensure that only the healthiest is used - is placed into the womb at the woman's most fertile time. This is a particularly suitable treatment if your partner has a low sperm count or if his sperm is struggling to survive the journey to the womb.
VF (in vitro fertilisation) - from 瞿2,500* - A woman's eggs are collected and fertilised with her partner's sperm (or donated sperm) in a laboratory. The fertilised embryos are then put into her womb to implant. This treatment is especially suitable for women with unexplained infertility, blocked fallopian tubes, or where other types of fertility treatment have been unsuccessful. Women over 40 can be recommended to use donor eggs.
At some clinics it is possible to get cheaper IVF if you are able to 'egg share', which means donating some of your eggs (providing you are between 18 and 34 and fit a series of other, strict criteria) to other couples or for research.
GIFT (gamete intra-fallopian transfer) from 瞿2,500* - Eggs and sperm are collected as for IVF, and screened to find the healthiest. The sperm and eggs are then mixed in a dish and placed in one of the woman's fallopian tubes to fertilise naturally.
Using donor sperm (from 瞿1, 500*), eggs and embryos (from 瞿6,000*) - If you need to use donated eggs or sperm, waiting lists can be long (the average is three to five years) and treatment expensive (it's not widely available on the NHS). Ask your GP if you are eligible, or if you can go to a slightly cheaper patient-funded clinic.
One of the reasons donated eggs and sperm are becoming more scarce is because, since April 2005, anyone who registers to donate eggs, embryos or sperm has to provide information about their identity. A child who is born as a result of a donation, is legally entitled to find out the identity of the donor when he or she reaches 18.
ICSI (intra-cytoplasmic sperm injection) from 瞿1,000* - Used in conjunction with IVF, a single sperm is injected into the centre of a harvested egg, to give it the best chance of fertilising. It is often recommended if the male partner has a very low sperm count or if other problems with the sperm have been identified.
*All prices are for private treatment and will vary according to case, clinic and area.
Choosing the best clinic
Your GP should be able to give advice and recommendations on the best clinics in your area, but for more information log on to the Human Fertilisation and Embryology Authority (HFEA) website. The HFEA regulates and inspects all UK clinics. To choose the best clinic for you and your partner, look at the treatments each clinic offers, the criteria they have about who they will and won't treat, the length of the waiting list, and costs (which can vary). Don't travel too far afield, as some treatments require regular, sometimes daily check-ups. When you look at a clinic's success rate remember some are more inclined to take on difficult cases (so lowering their average). Visit the clinic before you commit and listen to your instincts. Fertility treatment can be very stressful. You need to feel nurtured and looked after.