Infertility: ten questions you were afraid to ask with answers

Every fifth couple in the Czech Republic has infertility issues. Although this is a fairly common issue, there are many myths and a lack of clarity surrounding this topic. When is the best time to get pregnant, what is the best time to try for a baby and which risk factors threaten fertility? We know the answers to these questions and more!

1. Is there a perfect age for pregnancy?

Although the average age of first-time mothers is increasing every year, the best time for a woman to conceive her first child is between 20 and 29 years of age. While men’s fertility begins to decline after the age of forty, the decline in women’s fertility begins after they turn thirty.

2. What are the most common causes of infertility?

‘in 25% of cases, it is the woman who experiences infertility issues. This is both due to the higher age of women and the aging of their eggs, as well as other health complications associated with untreated inflammation, polycystic ovary syndrome or endometriosis. In 33% of cases, the issue lies with the man, particularly due to a lack of sperm or low sperm count. One-fifth of cases are a combination of issues on both partners’ sides, and the rest remain a mystery to doctors,’ explains  MUDr. Milada Brandejská from the Europe IVF reproductive medicine clinic. 

3. How does an unhealthy lifestyle affect fertility?

In addition to health issues, stress, lack of sleep, smoking, alcohol and obesity can also significantly contribute to poor fertility or infertility. For example, obese pregnant women have up to a third higher risk of preterm delivery.

4. What is the best time to try for a baby and when should you visit a specialist?

Age is an important factor in the treatment of infertility. Women under 35 who are unable to conceive can wait a year before visiting a clinic, but women over 35 should not delay visiting a reproductive centre for more than half a year. It is best to seek out a specialist as soon as possible, because a visit to a specialised workplace is often the best help you can get.

5. What can I expect from a first examination at a reproductive medicine clinic?

The couple usually comes together. ‘During the first examination, we always try to listen to our clients as much as we can to get an understanding of their situation and individual needs to convince them they are in the right hands. Women will generally undergo a detailed gynaecological examination and hormone profile test, while men are sent for semen analysis. We are not only interested in a detailed medical history, but also in the sperm count, whether the woman’s fallopian tubes are open and how she is ovulating. We use these results to decide whether further tests are necessary. In the most extreme cases, we resort to the IVF method, i.e. in vitro fertilisation, which refers to the fertilisation of an egg outside the woman’s body,‘ describes MUDr. Milada Brandejská from the Europe IVF reproductive medicine clinic.

6. What does IVF entail? Is it a painful procedure?

IVF consists in the fertilisation of an egg outside the woman’s body ‘in vitro’. Although you may experience more intense menstrual pain during IVF stimulation, the egg retrieval itself is performed under general anaesthesia, so it is not painful. The whole process takes 10 to 15 minutes, after which the woman is allowed to rest at the clinic for two hours, and then she is released with the person accompanying her. Clients who undergo the treatment with donated eggs do not receive hormone stimulation and therefore do not experience any pain.

7. What is the difference between IVF and IUI? 

While the egg and sperm are placed in a test tube for fertilisation in IVF and the embryos are cultivated in a laboratory environment, in intrauterine insemination, or IUI, the sperm’s path to the uterus is simply facilitated with its insertion through a thin catheter. This allows the sperm to bypass the environment of the vagina and cervix and reach the egg much sooner. For this reason, insemination is usually the method of first choice when the cause of infertility is poor sperm quality or irregular ovulation. This simplest type of treatment is completely painless; it is performed during ovulation and can either be performed during a woman’s natural cycle or with hormone stimulation.

8. Is IVF covered by health insurance? 

For clients under the age of 40, health insurance companies cover the first three IVF cycles. If only one embryo was transferred in the first two cycles, then they also cover a fourth cycle. In terms of age, if you are diagnosed with bilateral ovarian blockage, health insurance companies will pay for this procedure from 18 to 40 years of age. Women without this disorder can receive IVF treatment from 22 years of age to 40 years of age with full coverage. 

9. Who can undergo IVF treatment?

By law, a woman under the age of 49 can undergo treatment at an assisted reproduction clinic, i.e. she must not be older than 48 years and 364 days on the day of the embryo transfer. There is no age limit for men. But you can’t do it without a partner – IVF is considered a couple’s treatment, to which the partner of the opposite sex must always give his/her consent. 

10. What is the success rate of IVF treatment?

The effectiveness of IVF significantly depends on the woman’s age, namely the age of her eggs. ‘In the long term, we consistently achieve a high success rate of up to 68%, which ranks us among the world’s leading assisted reproduction centres. The success rate of IVF is affected by the clients’ age and the laboratory methods used. Our doctors are always happy to give you advice and recommend the best methods for your particular case,‘ adds MUDr. Milada Brandejská from the Europe IVF reproductive medicine clinic.