Contents 

Introduction 

• What is infertility?
• Getting pregnant
• Why can't we conceive?
• Investigating infertility
• Treating infertility
• Assisted conception
• Case studies
• Egg or sperm donation
• Adoption and surrogacy
• Will we get a baby?
• Preparing for pregnancy
• Coping with infertility

Important: "This book is intended not as a substitute for personal medical advice but as a supplement to that advice for the patient who wishes to understand more about his or her condition.

Before taking any form of treatment you should always consult a medical practitioner.

Introduction

Most adults intend to have children. If you have picked up this book, it is likely that you, a member of your family or a close friend is having difficulties in achieving this aim. You are not alone. Fertility problems are probably the most common reason (other than pregnancy) for anyone between the ages of 20 and 45 seeking medical advice in this country. About a quarter of all couples will experience an unexpected delay in achieving the size of family they want, and most of these will consult their GP. About a sixth of all couples will be seen at a hospital fertility clinic.

The aim of this book is to help you to understand more about getting pregnant, why you may not have been successful so far, the investigations and tests that may be needed to establish the cause, and the infertility treatments available.

Infertility is more than just a medical or physical problem. It can also lead to intense emotional and psychological distress. This can disrupt a couple's relationship with each other and with friends, family and work colleagues who may seem to be achieving parenthood very easily. The world around such couples seems a fertile place from which they are excluded, and they may even withdraw from social situations where they may meet pregnant women or young children. Most clinics recognise the emotional aspects of infertility, and include specially trained counsellors among their staff. However, some couples are reluctant to seek this type of professional support. This book therefore includes a chapter on coping with infertility.

Infertility and its various treatments raise moral concerns and ethical dilemmas for many couples. This is particularly the case for new assisted conception treatments, egg and sperm donation, and surrogacy. These are important issues but beyond the scope of a small book like this, and we deal with them only briefly.

Doctors, nurses and scientists often use technical medical terms. You may be unfamiliar with a number of these words, so there is an explanatory glossary at the end of the book. The glossary also includes explanations of acronyms (such as IUI and ICSI) and abbreviations that are commonly used in infertility tests and treatments.

A small book of this type has to be concise. We have included a list of information sources for couples who would like more detail on pages 88—91.

Key Points

• Fertility problems are a very frequent reason for people to seek medical advice
• About a quarter of all couples will experience an unexpected delay in achieving the size of family that they want
• Approximately a sixth of all couples will visit a hospital fertility clinic for advice
• Infertility is more than just a medical or physical problem; it can also lead to intense emotional and psychological distress

About the authors
Dr David Cahill is a Consultant Senior Lecturer in Obstetrics and Gynaecology in Bristol, specialising in reproductive medicine and infertility, from investigation through IVF treatment. A graduate of Cork University, he trained in Ireland and moved to Bristol to complete his specialist training.

Mr Peter Wardle is a consultant Gynaecologist at Southmead Hospital, Bristol. He has over 15 years' experience as a specialist in reproductive medicine and infertility. He is an inspector for the Human Fertilisation and Embryology Authority and a former Honorary Secretary of the British Fertility Society.

Dr Tony Smith Family Doctor Publications' Medical Editor-in- Chief was for many years Deputy Editor of the British Medical Journal and continues to work as an Associate Editor. He is the Medical Editor of both the Complete Family Health Encyclopaedia and the Family Doctor Home Adviser.