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Polycystic ovarian syndrome affects almost 25-30% of women who are experiencing fertility problems. This is the commonest cause of female infertility and it is also the one with the best chance of successful treatment. The symptoms may vary from extremely irregular cycles to almost completely absent cycles (Amenorrhoea). Some women have an excess of body hair, and although this is sighted as one of the most common symptoms of PCOS, it actually only occurs in 40% of cases. In addition to this, an excess of body weight and acne may also be attributed, but again not in all cases. I highlight all of these symptoms and stress that they are not always presents as this was not my experience.

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Endometriosis is thought to affect approximately between 1 and 15% of women. Of the women affected, many go undiagnosed as there are no symptoms present. Of the women unfortunate enough to suffer badly from the disease, most experience fertility related problems. This may be secondary infertility, in that they may have already had a child and experienced difficulty at a second conception, at which time the condition is diagnosed.

The endometrium is otherwise known as the lining of the womb and the disease manifests itself as the same cells are established outside the womb e.g. on the ligament supporting the uterus. in the ovaries, tubes, pelvis, bowels, bladder, etc. In patients with endometriosis, these cells, like the endometrium, respond to the monthly hormonal changes. When a woman with endometriosis menstruates, the endometrium is shed in the form of a period, the endometriosis breaks down in the same way but because these cells are trapped inside, and cannot escape, they form swellings filled with dark blood (known as chocolate cysts) and adhesions which may damage the tubes.

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ICSI is a relatively new procedure which has been successfully perfomed throughout the world since the late 1980’s. For many couples, particularly those where the male partner has fertility problems, ICSI may be the only option.

The ICSI process is identical to that of IVF, with one additional step: a single egg is injected with a single sperm. This is a micro-manipulation technique which overcomes the problems of low sperm count, poor motility or abnormal sperm.

If no sperm are present in a semen sample, procedures are available that can allow sperm to be collected from different parts of the male reproductive tract, depending on the nature of the problem.

IVF is the process by which a woman’s (or donor’s) eggs are fertilised with either her partner’s (or donor’s) sperm inside a glass dish, In-vitro (Latin for ‘in glass’). In order for this procedure to be carried out, the woman’s normal fertility cycle must first be suppressed, clinically referred to as ‘down regulation’. This is done using fertility drugs known as gonadatrophins, which are normally administered either as a nasal spray or injection. Down regulation can take anything between 7 to 28 days to occur with an average of 15 days. During down regulation you may have a period but this is not always the case; blood samples and scans may be used to check that you have down regulated satisfactorily. Once the normal hormonal cycle is suppressed, doctors now have control over your cycle, which enables them to stimulate your ovaries using gonadotrphins in the form of daily hormone injections. The hormone injections usualy last between 7 to 14 days, with an average of 10 or 11 days.

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