76 ask the Fertility Expert
Q
Q
Age and fertility
Donor sperm
I am a 38-year-old woman and have found a partner late in life. We would like to start trying for a family and, because of my age, we don’t want to leave it too late before seeking assistance. Any advice?
We are a lesbian couple in a civil partnership. We want to access donor sperm to start our own family. Can we access this service in Ireland?
Try to conceive naturally by having regular intercourse each month for at least six months. Ensure you stack the odds in your favour by keeping a healthy lifestyle. Cut out smoking and reduce alcohol intake to one or two glasses of wine (or equivalent) per week – or, even better, abstain totally from alcohol. Your partner should also adhere to the same lifestyle advice and watch his BMI. Physical exercise and nutrition is equally important for male general health and fertility. Due to your age, I would suggest some simple blood tests if you have not been successful conceiving after six months. Blood tests should be carried out around day two to four of your menstrual cycle. An ultrasound scan of the ovaries can also lend a lot of valuable information about your fertility profile. Your partner should have a sperm assessment (seminal fluid analysis) at a recognised specialised lab. Often, the information gives us something to treat simply or to circumnavigate with some more complicated medical or interventional therapies like intra-uterine insemination (IUI) or in-vitro fertilisation (IVF). But remember that the majority of couples get pregnant themselves and with little or no intervention. Try to relax and achieve pregnancy yourselves.
Q
Sperm test results I recently had a sperm test carried out because my partner and I have been trying to get pregnant for the last nine months with no success. The results are confusing; can you explain what the average should be for a man?
Yes, absolutely. It amazes me that still some couples – both hetero and gay – will leave Ireland to access donor sperm. It must be either for privacy or embarrassment reasons, or because there is a lack of public awareness that we have donor sperm banks in Ireland. All fertility clinics that provide artificial insemination by donor sperm are duty bound to confidentiality and privacy. Donor sperm clinics will assign a donor more often than not. At our ReproMed clinics we do give an option to the couple to review all available donor profiles and help them to make the decision of donor selection for the insemination treatment. It is a very natural process of sperm and egg fertilising in your body as normal. We do employ clinical protocols, which sometimes entail simple fertility enhancing medications and, more often than not, we track the egg follicle growing to maturity and time ovulation and insemination to best maximise your pregnancy success rates. Artificial insemination success rates are no less than your natural rate of conception.
Quick Guide
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How to ... find a fertility clinic ✹ Ask your GP for recommendations
This is not a straightforward question to answer. There are several factors that are measured in a standard semen analysis: volume, count, motility, morphology and the presence of anti-sperm antibodies. A good count, motility and morphology of sperm cells instinctively makes sense; after all, it would be difficult to achieve a spontaneous pregnancy if there are no sperm cells present, if they are not swimming or if they are grossly abnormally shaped. However, the significance of anti-sperm antibodies is not completely understood. Anti-sperm antibodies are generated when the immune system comes in contact with sperm cells in the body. These antibodies bind to the sperm cells and can prevent them from reaching or fertilising the egg; however, many men with anti-sperm antibodies achieve spontaneous pregnancies. Most semen analysis results vary a lot between individuals and can even vary from day to day in one individual. Although these tests can be useful, a man’s fertility or infertility does not solely depend on the semen analysis results and the couple’s clinical history should be taken into account. Therefore, it would be best to discuss the semen analysis results with a fertility expert if you’re worried.
MI June-Jul 2014_Ask the experts.indd 76
✹ Do research on the internet, looking for reviews from people who have used the clinic ✹ Get a personal recommendation ✹ Call the clinic and ask any questions you may have (if a clinic doesn’t answer your questions satisfactorily, then maybe it’s not the right clinic for you) ✹ Look for a clinic that suits you in terms of location, success rate for your particular treatment, price, and general ethics
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Tip .... IUI vs IVF: what’s the difference? ✹ IUI is much less
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Tip… The importance of zinc One of the most
invasive. The sperm
important minerals
sample is ‘washed’,
for fertility in both
with the more mobile
sexes is zinc, but
sperm inserted into
many of our foods
the woman’s cervix.
are stripped of this
Often the woman
essential nutrient
is given a low dose
thanks to processing
of fertility drugs to
and refining. Foods
enhance ovulation
particularly high in
as well.
zinc include mangoes,
✹ IVF is when the egg
pumpkin seeds and
is extracted from the
fish, especially oysters.
woman and fertilised
Look for organic, fresh
with sperm from the
food if possible.
man. The embryo is then inserted into the woman.
and procedure.
23/05/2014 12:37:34