Dear Professor Winston,
I listened to you on Woman’s Hour and was inspired and grateful to have someone speak so frankly about the subject of infertility. I have a 5 and half year old boy, and have been trying for another baby since he was about 1years. That’s 4.5 years. I am now 37. I’ve had all the tests I can have done on the NHS and they have found nothing abnormal. My husband has also had his sperm count tested a few times, and they are normal. We were seriously concidering IVF a few months ago but I was put off by the invastive nature of the treatment, added to which we would be paying for it and couldn’t afford more that one round.
You mentioned that the success rate of those falling pregnant through IVF and natural means for those with infertility are basically the same. Which is great for me, as it takes IVF off the table once and for all for me. But you did mention there may be hormone treatments that might help. I wondered what those were.
Thanks and I look forward to hearing from you,
Kind regards. O


Dear O,

If the infertility is genuinely unexplained, then presumably there is no problem with ovulation and therefore no hormonal problem. Presumably tests for ovarian reserve were normal? So I am unconvinced that any hormonal treatments would be helpful. Obviously it is difficult to give definitive advice when I do not know the results of your tests – nor even what tests have been done – but if these have been reasonably exhaustive, the figures do show that natural sex is as likely to produce a pregnancy as IVF. The one real justification for IVF is, I think, that occasionally an IVF cycle throws up results itself which indicate why you are having such difficulty in conception. For example, sometimes subtle hormonal issues surface, sometimes there are problems with fertilisation.

If you want to read more about treatments for unexplained infertility, there is a wonderful book ‘Unexplained Infertility’ by Patrick Taylor and John Collins published by Oxford University Press. Although it is now very out of date and there are new treatments, it shows that most of the so-called treatments for unexplained infertility are no better than doing nothing. Most recent research still indicates that much of what they say is still true. I had difficulty finding my copy of the book because it is out-of-print, but got it eventually on line from Amazon. It might be worth looking through their various remedies – some of which may be worth revisiting – but essentially, the real issue is that the success rate of IVF has not greatly increased since this book was published. My own book just published by Quadrille this week (proceeds to Genesis Research Trust) The Essential Fertility Guide is listed on Amazon at £7.00 and may be helpful.

Best wishes
Robert Winston

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