If you’ve been trying for a year or more to get pregnant (or six months if you are 35 or over), you may be starting to think about fertility treatment. Here’s a quick run-down of what’s available.

Fertility drugs

Commonly prescribed drugs include:

• Clomid (clomifene) – stimulates the ovaries to produce eggs. Your doctor may prescribe it if you are not ovulating or you are ovulating irregularly – this will have been diagnosed if you have tests following a long period of not being able to get pregnant.
• Metformin – often used to trigger ovulation in women who have polycystic ovary syndrome (PCOS).
• Pulsed gonadotrophin-releasing hormone (GnRH) – this is used to stimulate egg production when a woman isn’t producing this hormone herself.

Fertility drugs also play a role in other fertility treatments, such as IVF.

IUI (intrauterine insemination)

You may be offered IUI if you have unexplained infertility or ovulation problems. IUI can also help couples where the man has poor sperm quality. In this case, doctors will separate fast-moving sperm out from the slower ones then use IUI to place them in your womb close to ovulation. They may recommend you take a fertility drug to boost the amount of eggs you produce beforehand.
IUI is also used as part of other fertility treatments, such as sperm donation or surrogacy.

IVF (in vitro fertilisation)

• You may be offered IVF if:
• you have unexplained infertility
• your fallopian tubes are blocked
• other fertility treatments, such as Clomid or intrauterine insemination (IUI) haven’t worked.

For women, the first step in IVF involves taking a drug to suppress your natural menstrual cycle. You’ll then be given a hormone injection to boost the number of eggs you produce followed by an injection to help the eggs mature.
Your eggs will be gathered during a simple procedure (with a local anaesthetic and sedation) and fertilised in a laboratory using your partner’s (or a donor’s) sperm. Finally, a single fertilised embryo will be transferred back to your womb and the rest frozen for possible future attempts.
IVF can be a long, demanding process so you will need plenty of support as you go through it.

ICSI (intra-cytoplasmic sperm injection)

ICSI involves a similar process to IVF. However, instead of simply mixing the egg and sperm together in the laboratory, doctors choose a single sperm and inject it directly into the egg.
This technique is becoming more common and is particularly helpful for couples where the male partner has poor sperm quality or doesn’t ejaculate any sperm.
If necessary, sperm can be collected directly from the testes or epididymis (a small tube near the testes where sperm are stored and matured).