By Neus Ferrando Gilabert BSc, MSc (embryologist) and Dr. Ana Mª Villaquirán Villalba MD, MSc (gynecologist).
Last Update: 05/15/2014

The discontinuation rate of assisted reproduction treatments (ARTs) on the part of the couples who want to have children is very high, after one or several failures couples decide to give up. Reasons are not only the high costs of the treatments, but also emotional exhaustion is very high and some couples cannot bear the pressure. For this reason it is important that the couple considers how many attempts will make and how far they intend to go.

The fact is that almost 50% of couples turning to fertility centres desist after the first attempt. Sometimes the reason is purely economical, however the most of the time other circumstances come into play such as the stress and the anxiety these treatments cause to the couple.

Definitions

We understand as attempts of assisted reproduction the times that a couple undergoes any techniques aimed to help them to achieve pregnancy. The techniques may range from the easiest that would be Artificial Insemination (CAI / DAI), to In Vitro Fertilisation (IVF) or Intracytoplasmic Sperm Injection (ICSI) which is considered the most sophisticated technique.

Artificial Insemination basically consists in depositing a small amount of partner’s semen in the uterus which has been previously capacitated. This method selects the sperm cells with best motility which will be introduced in the body of the woman at the same time of ovulation. Artificial insemination may be either performed with partner’s semen (CAI) or with donor semen (DAI) in the case of homosexual couples, single women or when partner’s semen does not fulfil the necessary requirements.

In Vitro Fertilisation happens, as its name suggests, in the laboratory. The purpose is to induce ovulation in the woman by means of medicines to achieve a reasonale number of mature oocytes, which are removed from the ovaries by follicular puncture in the operating room and are placed in a culture with the partner’s semen in search of fertilisation.

Intracytoplasmic Sperm Injection goes beyond as regards fertilisation, because instead of waiting it happens in the culture, a sperm cell is directly inserted inside of each mature oocyte. In both cases it may be performed with the partner’s or a donor’s semen, as well as with own or donated oocytes.

The Human Fertilisation and Embryology Act 2008 is about the use and storage of sperm, eggs and embryos for its application in humans, it also regulates assisted conception services in the UK. The law specifies which type of women can be provided with a fertility treatment. The woman must be in good health and the pregnancy should not carry a risk of harm to the child.

Public Health funds techniques to women aged between 23-39, depending on the country. If you are eligible for NHS funded treatment, you will still have to pay normal prescription charges for your fertility drugs (unless you are exempt from paying prescription charges). It depends on the age, the cause of infertility, the number of total performed cycles and since when has the woman been attempting to get pregnant etc.

Hope in cases of infertility

Hope in cases of infertility

About over 60,000 fertility treatments are performed each year in the UK by couples who suffer from infertility. As we mentioned before, many of these couples abandon the treatment after the first attempt.

It has been proved that near 30% of couples suffer significant stress that sometimes lead them to leave it. Despite the likelihood of success is cumulative and increases with the second and the third attempt, they lose heart with the first failure.

In addition to the stress, the economic factor must been obviously taken into account, for which the crisis has only aggravated the situation. The cost of artificial insemination fluctuate between £651.76 and £977.64 while an in vitro fertilisation technique means at least £3.258.79. If we go on to donated gametes, the price increases significantly.

Couples make a great economic effort that sometimes does not bear fruits, they then have to save again for a second attempt that will mean a higher sacrifice because of the time we live.

FAQs from users

As regards the number of IVF attempts before giving up, does it vary if it is conventional IVF or ICSI?

By Dr. Ana Mª Villaquirán Villalba MD, MSc (gynecologist).

Unless fertilization failure has occurred with IVF, we usually take into account all cycles done with both techniques before deciding to move on to another treatment such as egg donation. Even though each patient is different, the average number of IVF attempts recommended is 3 or 4 at our clinic.

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Authors and contributors

 Neus Ferrando Gilabert
BSc, MSc
Embryologist
Bachelor's Degree in Biology from the University of Valencia (UV). Postgraduate Course in Biotechnology of Human Assisted Reproduction from the Miguel Hernández University of Elche (UMH). Experience managing Embryology and Andrology Labs at Centro Médico Manzanera (Logroño, Spain). More information
Dr. Ana Mª Villaquirán Villalba
Bachelor's Degree in Medicine from the University of Valle, Colombia. Specialist in Obstetrics & Gynecology. Master's Degree in Human Reproduction from the University of Valencia and IVI. Currently, she is the medical director of Tahe Fertilidad. More information
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