Patients
need a referral for fertility testing at the reproductive units. Fertility examinations
is recommended after about one year of trying to conceive. If you or your
partner suffer from a known condition that will complicate conception, it is
advisable to start fertility testing and treatment sooner. The first basic
tests are performed at your health centre or in another outpatient facility.
After these, you will be referred to a specialist, if necessary.
Male-female
couples will have their first appointment together, during which you will be
asked questions about your health in general to plan the appropriate tests: a
semen sample, a menstrual cycle assessment, and a test to check that the
fallopian tubes are open. In the case of female couples or single women hoping
to conceive, we will perform a menstrual cycle assessment and a test to check
that the fallopian tubes are open, if necessary.
Once
the basic tests have been completed and the results are available, the patient
or the couple will see a specialist. The doctor will tell them their test
results and suggest individual treatment depending on the causes of the
infertility. For male-female couples, the cause may be a condition affecting
the man, the woman, or both. Sometimes the cause of infertility is not
identified. Female couples and single women need donated sperm in order to
become pregnant.
Fertility
treatment options depend on the causes of infertility and the couple’s wishes.
For some couples, adoption or no treatment may be the best option. It is
important to eliminate factors that have a negative effect on fertility, such
as weight issues and smoking.
Infertility
treatment includes:
- Ovarian follicle growth
stimulation (e.g. letrozole pills and gonadotropin injections) to induce or
stimulate ovulation
- Surgery when the cause of
infertility is endometriosis, myoma or a damaged fallopian tube
- Insemination, which involves
injecting washed sperm cells into the woman’s womb when the egg is released
from the ovary
- In-vitro fertilisation (IVF),
which involves fertilising the egg in a laboratory dish and placing the embryo
in the woman's womb
- Intra-cytoplasmic sperm
injection (ICSI); a method used if the sperm count or motility is very low.
ICSI involves injecting a single sperm directly into an egg with a thin glass
needle.
- Insemination or in-vitro
fertilisation with donated reproductive cells if the patient does not have
reproductive cells or the cells are abnormal.
In
public health care, the upper age limit for women seeking fertility treatment
is around 40 years. Women who receive treatment with donated reproductive cells
must be under 40 years old when the treatment decision is made. As a rule,
treatment options do not include post-sterilisation treatment, or treatment to
couples who have already had two children together. According to the Finnish
Act on Assisted Fertility Treatments, infertility treatment with donated cells
cannot be provided if the couple requires a surrogate, or if it is apparent that
the child's balanced development cannot be guaranteed.
Basic
infertility tests are carried out at HUS’s Reproductive Medicine Unit, and at
Hyvinkää, Lohja and Porvoo Hospitals. HUS's Reproductive Medicine Unit is the
central provider of in-vitro fertilisation, treatment with donated reproductive
cells, and ovulation induction treatment as well as the planning and provision
of more complex fertility treatment.
HUS begins to provide fertility treatments with donor cells in
November 2019. We are looking for egg and sperm donors to be able to offer
treatments with donated gametes.
Visit the HUS Sperm and Egg Bank’s website: www.sukusolupankki.fi