Fertility issues are more common than you think – around 15% of couples worldwide struggle to conceive naturally. There are a multitude of treatments available, however this also means it can be difficult for couples to evaluate the options and make decisions about the next steps.
According to Dr Michael Eisenberg from twoplus Fertility, “Assisted reproductive technology (ART) refers to fertility treatments that involve manipulating eggs or embryos. Eggs are removed from the ovaries and then combined with sperm in a lab to make an embryo which can then be put back in to the woman’s reproductive system. One of the most well known types of ART is in vitro fertilization (IVF), however there are other options depending on the circumstances, including gamete intrafallopian tube transfer (GIFT) and intracytoplasmic sperm injection (ICSI)”.
IVF
IVF is usually used to treat infertility due to insufficient sperm production, endometriosis, or problems in the tubes. It involves giving medication to induce ovulation. After that, a doctor uses a needle to remove the eggs with the help of an ultrasound device. In the lab, technicians put the eggs and sperm together to generate embryos. The doctor selects one or a few embryos and transfers them to the uterine cavity.
GIFT
GIFT is used to treat infertility due to unknown causes or when the woman has endometriosis and a healthy Fallopian tube. The doctor transfers the eggs to the fallopian tubes, where fertilisation occurs.
ICSI
This technique can be helpful when others have failed or when there’s a severe sperm disorder. It involves obtaining eggs through IVF and injecting a single sperm into each egg to avoid fertilisation by abnormal sperm. The resulting embryo is transferred to the woman’s uterus.
IUI is another fertility treatment option (non ART). IUI involves inserting sperm directly into a woman’s uterus. This technique is indicated when the couple cannot have sex due to physical or psychological problems or when other fertilisation treatments fail. The sperm donor can be a partner or a donor. The sperm is washed and filtered, then the doctor places a thin and flexible tube that guides the sperm through the vagina and into the uterus.
Dr Eisenberg says, “Whilst ART and other in-clinic fertility treatments have their place, some couples prefer to try less invasive, more affordable, at-home options first, before considering medical intervention”.
A new wave of fertility-tech companies has meant that a sophisticated array of fertility treatments, devices and diagnostics is now available to support natural conception in the privacy of your own home. One device worth considering is the twoplus Sperm Guide – a small, comfortable device which helps increase the chances of natural conception by aiding more sperm cells to reach the egg.
Even though an average ejaculation produces 20 to 150 million sperm per milliliter, only a fraction of this reaches the cervical mucus so that fertilisation can happen in the fallopian tubes. Factor in the fact that the average sperm count of men from western countries has dropped more than 50% in less than 40 years and it is clear that maximising effective sperm count is more important than ever in ensuring natural conception.
By preventing sperm loss and allowing a greater amount of sperm to reach the cervix, the Sperm Guide could be compared to intracervical insemination (ICI). ICI involves placing the sperm directly inside the cervix using a needless syringe. The main difference being the Sperm Guide can be used at home without any medical involvement.
Cost can be a big factor when looking at fertility options – what couples are entitled to can vary from postcode to postcode and personal circumstances can also play a part. There is also no ‘one-size-fits-all’ solution to fertility and couples should always seek medical advice, however the following comparison of the most common treatments sets out the key differences when it comes to cost, success rate and other medical considerations:
| Treatment Name | Type | Invasive | Cost (GBP) | Success rate (%) | Other considerations |
| IVF | Surgical | Yes | £18,390 per cycle* | 20-35% per cycle. | The medication used can cause adverse events. IVF is associated with an increased risk of multiple gestations.
|
| GIFT | Surgical | Yes | £15,000 per cycle | 29.3% per cycle. | Possible Adverse events due to the medication used and increased risk of multiple gestations.
|
| ICIS | Surgical | Yes | £1471 | 56% following four cycles. | Possible Adverse events due to the medication used. |
| IUI | Non-surgical | Minimally | £1790 per cycle | ~15% per cycle. | Possible adverse events due to the medication used. Increased risk of multiple pregnancies.
|
| ICI | At-home or doctor´s office
|
Minimally | £1029 per cycle | ~15% per cycle | Medication may be required or not. |
| Sperm Guide | At-home | Non-surgical minimally | £49 (reusable, four to six times) | Not provided but may be similar to ICI. | No medication is required. No increased risk of multiple pregnancies. |
*An IVF cycle is defined as one egg retrieval and all the embryo transfers that result from it.
Deciding on a fertility treatment can be overwhelming, especially when so many emotional and financial factors are involved. Take time to evaluate the options, talk to your GP and consider lifestyle changes, alongside any treatments, to maximise your chances of success either at-home or in clinic.
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