According to a recent study presented at the Royal College of Obstetricians & Gynaecologists (RCOG) Virtual World Congress many women are not aware that their fertility may improve after IVF for their first child. The study investigated 21 women who had experienced post-IVF natural pregnancy.
Dr. Annette Thwaites, Lead Researcher, Kings College Hospital, London, said, “There is scope to follow-up with women after IVF but information about the chances of spontaneous births and need for contraception isn’t given. Fertility services, maternity services and community services could all do more to give women information on contraception postnatally. Even if a woman has had IVF previously, a woman shouldn’t lose the right to plan the rest of her family. We need to stop shielding these women from the information they really do need.”
Many women don’t use contraception after IVF
As a result, many women do not bother with contraception after IVF. Not only that, but they are rarely told about this issue. Women who are successfully treated with IVF often have persistent views concerning their infertility status and the reasons for this may be rooted in previous failed treatment.
Even where treatment has been ultimately successful the need for repeat cycles or intracytoplasmic sperm injection (ICSI), low numbers of eggs collected, poor quality embryos and pregnancy complications can all reinforce the subjective view that infertility is a permanent affliction.
Improved fertility for PCOS patients
However, this is not always the case. For instance, when polycystic ovary syndrome (PCOS) is cited as a cause of infertility there can often be an improvement in fertility after IVF.
Dr .Melanie Davies, Obstetrician & Gynaecologist, University College Hospital, London said, “I think many women genuinely think that contraception after IVF just doesn’t apply, but lots of women do have natural pregnancies after IVF. Infertility due to PCOS can improve after a spontaneous pregnancy or after IVF, even if the IVF is not a success and this is possibly due to ‘needling’ the ovary.” ‘Needling’ is a procedure, which stimulates dormant eggs within the ovary.
Women not routinely informed about spontaneous pregnancy
The study found that women report not being routinely informed about the chance of spontaneous pregnancy after IVF.
Dr. Davies agreed. She believes that, after IVF, the chance of pregnancy will depend on the reason for the couple’s subfertility.
Dr. Davies said, “Given that a huge number of patients these days have unexplained subfertility. This is when there is no absolute cause of infertility identified and it might not prevent a pregnancy but slows it down. Such couples still have a chance of natural pregnancy.”
Patients need advice
The problem here is that the women also reported that spontaneous pregnancy was shocking and not universally welcomed and inter pregnancy intervals were often much shorter than they would have liked. Fertility struggles and going through fertility treatment can put an enormous strain on both physical and mental health and can have a long-lasting impact, so it seems reasonable that patients should receive the right support, guidance and advice following treatment. This includes advice on when natural conception may be possible.
The number of such pregnancies is unknown in the UK, because it is not tracked within the NHS maternity dataset. However, previous studies have shown natural conception taking place in 17% of women who received IVF up to 7 years after the IVF birth. However, given the increasing use of IVF in recent years, Dr. Thwaites thinks the importance of understanding and meeting the contraceptive needs of women post-IVF is increasingly important.
Dr. Thwaites concluded, “During the recruitment process for the current study, I came across women who said since their IVF pregnancies they had no idea what they should do about contraception.”
