If you’re a single female and trying to conceive
You have made the decision to start a family. Here are some things you may want to know. One of the first steps you can take is to visit your GP. They can give you advice on what services are available in your area. The NICE guidelines (National Institute for Health and Care Excellence) state that single females have to try to conceive six times using artificial insemination before being considered for NHS-funded treatment. Your GP should discuss options for treatment and should give you an idea of what the NHS allowance is in your area, as set out by the CCG (clinical commissioning group).
What can I expect from my GP?
As well as discussing treatment options, your GP may also ask questions related to your reproductive health, like when your last menstrual period was, how long your menstrual cycles are and if you have any known medical conditions that may have an impact on your fertility. You may be able to access some initial investigations, which could include a blood test during your cycle to check if you are ovulating and an ultrasound scan to assess your ovaries, fallopian tubes and uterus.
What could the allowance be?
In order to access funded treatment on the NHS, you would need to complete six cycles of self-funded artificial insemination (also known as IUI – intrauterine insemination). Single women who have not become pregnant after 6 cycles of IUI undertaken in a clinical setting should be referred for further assessment and possible treatment, if eligible in your area. Some CCGs fund up to 6 cycles of artificial insemination. However, some areas require 12 cycles of self-funded IUI before any access to fertility treatment on the NHS. This can be a large financial expense – so it’s very important to know the requirements and eligibility criteria in your area. If you’ve completed 12 cycles of IUI without achieving a pregnancy, IVF (in vitro fertilisation) could be considered the next treatment option. CCGs will not routinely fund the cost of donor sperm, but can fund the associated treatment at the providing unit. Unfortunately, there are a few CCGs that stipulate that the funding for assisted reproductive treatments are limited to couples only.
What treatment options are available?
The different treatment types may include IUI or IVF, both of which would take place within a fertility clinic. You’d need to attend an initial consultation and have investigations performed to determine which treatment type would be suitable. You would also need to attend a counselling session, as it’s a requirement when using donor sperm.
IUI can be performed in your natural cycle or in a medicated cycle. The procedure takes place around the time of ovulation. A medicated cycle would involve stimulating ovulation with daily medication. The process includes thawing the donor sperm sample, washing and preparing it in the clinic and the sample would be inserted into the uterus with the help of a thin catheter going through the vagina and cervix.
IVF requires a hormone stimulation to produce multiple eggs in the ovaries. The eggs would be removed through a surgical procedure and fertilised with the donor sperm sample. The fertilised eggs are called embryos and these are cultured in a laboratory until a suitable day for embryo transfer, where an embryo is placed in the uterus with the help of a catheter that goes through the vagina and cervix.
When going down the route of either of the above fertility treatment types, you would need to purchase your own donor sperm. Some fertility clinics have their own donor banks that you can use, there are independent UK donor banks where you can purchase samples and there are international donor banks that can ship samples to you from overseas. You can read the Béa guide to Donor sperm to find out more.