My husband states that I have a “degree in infertility from the university of Google” and any person who has done IUI/IVF/ICSI will agree that the Web is a wonderful place for answers on questions that constantly pop up. The idea of this article is for those questions that you do not find on Google and unless you do have the support of a fellow patient; is difficult to get answers too!
When do we start looking at IUI / IVF / ICSI?
Every one of us try not to get pregnant until we decide that the “time is right” and we stop using contraceptives. And then nothing happens. In reality; should you have been using contraceptives for a while; changes is that your body will require time to adapt to the clock Mother Nature intended for our cycles. So don’t start stressing should you not be pregnant after the first month or two.
The most important thing to remember is that the older you get; the quicker you must look for medical assistance. Where a 25-year old lady can wait for a couple of months; a 35-year or older old lady should seek help much quicker and as soon as possible.
The good news: It can be something as simple as an infection. So do not say – we cannot afford extensive medical procedures before checking out what is causing you not to fall pregnant. And do remember that stress does play a part; it is not just an old wives tale. Dream about your planned miracle; but do not obsess – the getting pregnant game is hard enough without additional factors!
Finance and affordability
Also remember; FHF does give loans for infertility treatments although terms and conditions apply. You have to use one of the approved clinics on their list and the money goes directly to the clinic. Also; some banks do give small personal loans for people with good financial records. Without having to give them the full description on your required treatment; you only declare the money as required for “medical reasons.”
This will completely depend on your history with your bank and also which bank you are banking with. The catch is that here you have control over the money as it is deposited into your bank account and you need to make sure that the budget is spent wisely.
Most important is that you must only get the loan once you are 100% sure of what treatment you will be going on. When starting the rocky road of infertility; know that there are finance options available; but please do not exhaust them too early!
What clinic/doctor do I go to?
There is more than one option available for infertility treatment. The general trap is that we go for the most obvious or the ones that we know from advertisement and the information we find on Google.
Many people do not know that infertility treatment does not come with a fixed pricetag. Each clinic has their own set of prices for different procedures and each clinic defines the treatment differently. Know that in Sandton you will get the Sandton service; but do expect the Sandton price tag as well.
There is an extensive list of clinics all over South Africa on http://www.getpregnant.co.za/clinics.asp. But also remember that many Life and Netcare hospitals now have fertility clinics which might be more affordable and accessible for you and your partner; just check on the groups webpages. The catch lies in shopping around with phoning and asking:-
- Price of various IVF procedures (IUI/IVF/ICSI)
- What this prices includes (E.g. some clinics assign a nurse to your specific case which is reasonably available; but make sure you are clear on how much this will cost additionally)
- What you need to pay additionally to the hospital / clinic for the use of the theater etc.
- The waiting period for you too see the doctor for a first consult.
- Operating hours for general and required consultations
What is the difference between IUI/IVF/ICSI?
IUI is when the male gives a sperm sample, then the sample is 'washed', the good sperm are taken out and inserted into the woman's cervix through a catheter. IUIs are useful when there is male factor infertility because the weaker sperm don't have as far to travel. IUI is the least invasive.
IVF is when the egg is taken out of the female's body and the sperm is taken from the male and they are joined together outside the body and then inserted back into the female. In conventional IVF, the eggs and sperm are mixed together in a dish and the sperm fertilises the egg ‘naturally’. However to have a chance that this will occur, large numbers of actively swimming normal sperm are required.
ICSI refers to the laboratory procedure where a single sperm is picked up with a fine glass needle and is injected directly into each egg. Very few sperm are required and the ability of the sperm to penetrate the egg is no longer important as this has been assisted by the ICSI technique. ICSI does not guarantee that fertilisation will occur as the normal cellular events of fertilisation still need to occur once the sperm has been placed in the egg.
What do I expect on my first visit?
You will not start your first fertility cycle on your first visit. Your practitioner will first need to determine why you are not conceiving before any treatment comments.
So for starters be ready for a long list of bloodtest and even a papsmear should yours be older than required by that specific clinic. Your blood tests can include HIV / AIDS; full blood count, infections and even syphilis. Each doctor to his own and be ready for the first battery of needles.
More advance tests as laparoscopies or historoscopies might be required; but your doctor will discuss this with you and make sure you understand the reason for these tests.
What is the difference between the long protocol and the short protocol?
With the long protocol: you start on day 20 of your cycle into the next (so the treatment falls over 2 cycles) With the short protocol; you start only on day 1 and do the whole protocol within one cycle.
Does my BMI really make a difference?
Unfortunately yes. Should you decide that you are trying to conceive, eat healthy and try to get your BMI as close as possible to the “good side” Please don’t do crash diets or fads as this is only going to make your situation worse. The word is Healthy!
I am pregnant; what now?
Congratulations! The dreaded needles and wait for the test is over and it almost feels unreal.
Remember the following:
You are one of the few lucky ones that know of 4 weeks that you are pregnant. The downside is that you will have long waiting periods between scans, consults and tests. Be careful, behave healthy and pregnant (no bungee-jumping!). If you are scared about something; speak to the receptionist or nurse at the clinic and ask Doctor to get back to you. If there is blood or severe pain – phone your emergency number immediately and lie down (that includes not driving unless instructed so by your docter)
You will be scared. We all are, promise you that. Miscarriages happen even to “normal” pregnancies and not only to bad people.
- Have a support structure
- Avoid negative people
- Take you medication(which you will probably receive until week 10 – 12 of your pregnancy).
- Eat healthy
- Stay away from people who smoke and smoked filled rooms
- Exercise responsibly
- And enjoy being pregnant! You worked hard enough for this miracle to happen for you and your partner.