The fertility post code lottery: what to do while you’re waiting for IVF

There is no equal accessibility to fertility treatment in the UK. The system is a postcode lottery that leaves many patients frustrated and unable to grow their families. On the 30th of June 2020, HFEA released their latest report around fertility trends and it reveals that NHS funds 60% of fertility treatment in Scotland but less than 30% in parts of England. This is because funding is allocated locally, with some CCGs not providing fertility treatment at all, or providing one or two cycles, well below NICE recommendations of 3 cycles for women under 40 and 1 cycle for women 40 to 42.

What are the key facts around IVF funding?

• Around 2000 fewer patients had their first-round funded by the NHS
• England has seen the percentage of NHS funded IVF cycles has gone down
• The East of England has been hit the hardest, with NHS supported cycles going down from 55% to 26%
• In contrast, Scotland and Wales have increased the percentage of NHS cycles

These findings are devastating, especially as new evidence has been shared at ESHRE this week about the global problem of infertility, where almost every country in Europe has fertility rates below replacement rates. According to Health Matters, 78% of women of childbearing are either wanting to prevent or achieve a pregnancy. And according to Dr Alice Domar, associate professor at Harvard Medical School, couples are waiting longer than needed to access initial GP consultations and when they do, they are not offered the support they need to go ahead with the treatment. Couples wait on average 3.2 years for a diagnosis, a further 2 years until treatment starts and a further 1.6 years until conception.

In a journey that causes significant emotional distress and where every year that goes by reduces the likelihood of success, patients need more information about their fertility health, more emotional support and easier access to treatment.

What you can do while you’re waiting for IVF

Most couples (84%) will get pregnant within a year of having sex during their fertile window and after 2 years, 90% of couples will get pregnant. However, for some, it may take longer. If you have taken the first step to attend a GP appointment and are waiting to access fertility services, there are a few things you can do to improve your chances of pregnancy.

1. Get to know your cycle 

The more you know about your body, cycle and ovulation, the easier it will be for healthcare professionals to give you the support you need to get pregnant. A lot of women have a cycle of around 28 days. However, every woman is different, and some have cycles ranging from 20 to 45 days. Start counting on the first day of your period and stop counting on the first day of your next period.

2. Track your ovulation

There are around 6 days each month when you can get pregnant: the day of ovulation and the 5 days before (fertile window). Ovulation tests help you identify when ovulation is about to happen. They measures the amount of LH (luteinising hormone) in your urine so you can pinpoint the best time to have sex to conceive. This hormone increases between 12 – 48 hours before ovulation, sending a message to the ovaries that ovulation can occur. 

3. Have sex during your fertile window

Once you have identified your LH surge, you know ovulation is about to happen. It means you are in your fertile window and having sex during this time increases the chances of the sperm fertilising the egg.

4. Take folic acid and vitamin D supplements

Take 400 micrograms of folic acid every day before you're pregnant and until you're 12 weeks pregnant. Folic acid can help prevent birth defects known as neural tube defects. You should also eat foods that contain folate, such as green leafy vegetables. Take 10 micrograms of vitamin D each day to regulate the amount of calcium and phosphate in the body, which are needed to keep bones, teeth and muscles healthy. 

5. Combine a healthy balanced diet with moderate exercise 

Eat a healthy balanced diet, with vegetables, fruits, slowly absorbing carbs, healthy fats and drink plenty of water. Avoid refined sugars and trans fats. Being overweight or underweight can affect your chances of conceiving. However, a balanced diet, alongside moderate-intensity physical activity can help you move closer to the fertility zone for weight.

6. Adjust your environment and habits

Preconception care is a good opportunity to adjust your lifestyle and give yourself and your baby the best possible start in life. Reduce alcohol consumption and give up smoking. Minimise your exposure to environmental factors like pesticides, solvents, metals and endocrine disruptors.

7. Keep the relationship alive

The focus of trying to conceive can affect couples. Be mindful that your partner may have different ways of coping with the circumstances, different views about what treatments to consider or how long to try them for. Make sure your relationship is not only about trying to conceive and you are still engaging in activities that give you both a sense of connection, pleasure and accomplishment.

8. Look after your mental health

This journey can be isolating, and feelings of emotional distress, anxiety and depression are common. Make your mental health a priority and seek support from others who are going through similar journeys, family and friends who are understanding or professionals who can guide you.

In conclusion…

The waiting time can be challenging, but it is also an opportunity for you to look after your fertility health and give yourself and your baby the best possible start in life. Tracking your ovulation whilst you’re waiting and having sex during your fertile window will give you more information about your body and may help you get pregnant.