Clinical update
In vitro fertilisation Essential facts
Find out more
Infertility affects around one in seven couples in the UK. In vitro fertilisation (IVF) is one of several interventions available to help those with fertility problems conceive. According to the Human Fertilisation and Embryology Authority (HFEA) the number of IVF cycles performed each year has increased steadily since 1991. In 2011 more than 2 per cent of all babies born in the UK had been conceived through IVF treatment.
What’s new The National Institute for Health and Care Excellence (NICE) has published a new quality standard on IVF, which calls for an end to the postcode lottery of treatment. This recommends that the NHS should provide women aged below 40, who have failed to become pregnant after two years of trying, with three full cycles of IVF treatment. In addition, some women aged 40 to 42 should have one full cycle of NHS treatment, says NICE.
Causes/risk factors A variety of risks are associated with IVF treatment. These include the side effects of drugs, for example hot flushes, feeling down or irritable, headaches, nausea and vomiting, shortness of breath and abdominal bloating. Ovarian hyperstimulation syndrome is a rare complication, more common in women aged under 30 and those with polycystic ovary syndrome. IVF also carries a slightly higher risk of an ectopic pregnancy. The risks of miscarriage and birth defects increase with the age of the woman having treatment. If more than one embryo is
Expert comment Rebecca Goulding is a fertility nurse specialist at Nuffield Health in Woking, Surrey
ISTOCK
NICE quality standard on fertility (October 2014) www.nice.org.uk/ guidance/qs73
placed in the womb as part of IVF, there is an increased chance of a multiple birth, which in turn significantly increases the risk of complications, including high blood pressure, gestational diabetes and pre-eclampsia.
Treatment The success rate for a treatment cycle of IVF is about 32 per cent for women aged under 35, decreasing as the woman’s age increases. A woman aged between 40 and 42 has a 13.6 per cent chance of success. According to the HFEA’s latest report, two thirds of women having treatment are aged 37 and below. A cycle of IVF costs the NHS about £3,000.
How you can help your patient Undergoing IVF can be emotionally and physically demanding. NICE recommends that couples should be offered counselling before, during and after treatment. Nurses can help people to prepare for treatment, understand its implications as well as provide support at critical times, for example when a cycle has been unsuccessful. ‘This is a sensitive area and as nurses we play a vital role in supporting patients, with counselling a major aspect of that role. We can help patients to manage their expectations, making a plan for their treatment options. Before treatment, we can advise on lifestyle changes, such as reducing stress, having a balanced diet, taking folic
NICE guidance on fertility assessment and treatment (February 2013) www.nice.org.uk/ guidance/CG156 Human Fertilisation and Embryology Authority www.hfea.gov.uk Infertility Network UK www.infertility networkuk.com Fertility Friends www.fertilityfriends.co.uk Fertility Fairness www.fertilityfairness.co.uk The Senior Infertility Nurses Group singuk.co.uk British Infertility Counselling Association www.bica.net British Fertility Society www.britishfertilitysociety. org.uk
acid, reducing caffeine and alcohol, and maintaining a healthy weight. ‘It is also important that we help patients to not feel overwhelmed by their treatment, but take it step by step. Referring them to support networks – including those online – where they can share their experiences with others who are having treatment, can be helpful too.’
NURSING STANDARD december :: voluses 29without no 14 ::permission. 2014 19 Downloaded from RCNi.com by ${individualUser.displayName} on Jul 20, 2016. For personal use only. No 3other Copyright © 2016 RCNi Ltd. All rights reserved.
In vitro fertilisation Essential facts
Find out more
Infertility affects around one in seven couples in the UK. In vitro fertilisation (IVF) is one of several interventions available to help those with fertility problems conceive. According to the Human Fertilisation and Embryology Authority (HFEA) the number of IVF cycles performed each year has increased steadily since 1991. In 2011 more than 2 per cent of all babies born in the UK had been conceived through IVF treatment.
What’s new The National Institute for Health and Care Excellence (NICE) has published a new quality standard on IVF, which calls for an end to the postcode lottery of treatment. This recommends that the NHS should provide women aged below 40, who have failed to become pregnant after two years of trying, with three full cycles of IVF treatment. In addition, some women aged 40 to 42 should have one full cycle of NHS treatment, says NICE.
Causes/risk factors A variety of risks are associated with IVF treatment. These include the side effects of drugs, for example hot flushes, feeling down or irritable, headaches, nausea and vomiting, shortness of breath and abdominal bloating. Ovarian hyperstimulation syndrome is a rare complication, more common in women aged under 30 and those with polycystic ovary syndrome. IVF also carries a slightly higher risk of an ectopic pregnancy. The risks of miscarriage and birth defects increase with the age of the woman having treatment. If more than one embryo is
Expert comment Rebecca Goulding is a fertility nurse specialist at Nuffield Health in Woking, Surrey
ISTOCK
NICE quality standard on fertility (October 2014) www.nice.org.uk/ guidance/qs73
placed in the womb as part of IVF, there is an increased chance of a multiple birth, which in turn significantly increases the risk of complications, including high blood pressure, gestational diabetes and pre-eclampsia.
Treatment The success rate for a treatment cycle of IVF is about 32 per cent for women aged under 35, decreasing as the woman’s age increases. A woman aged between 40 and 42 has a 13.6 per cent chance of success. According to the HFEA’s latest report, two thirds of women having treatment are aged 37 and below. A cycle of IVF costs the NHS about £3,000.
How you can help your patient Undergoing IVF can be emotionally and physically demanding. NICE recommends that couples should be offered counselling before, during and after treatment. Nurses can help people to prepare for treatment, understand its implications as well as provide support at critical times, for example when a cycle has been unsuccessful. ‘This is a sensitive area and as nurses we play a vital role in supporting patients, with counselling a major aspect of that role. We can help patients to manage their expectations, making a plan for their treatment options. Before treatment, we can advise on lifestyle changes, such as reducing stress, having a balanced diet, taking folic
NICE guidance on fertility assessment and treatment (February 2013) www.nice.org.uk/ guidance/CG156 Human Fertilisation and Embryology Authority www.hfea.gov.uk Infertility Network UK www.infertility networkuk.com Fertility Friends www.fertilityfriends.co.uk Fertility Fairness www.fertilityfairness.co.uk The Senior Infertility Nurses Group singuk.co.uk British Infertility Counselling Association www.bica.net British Fertility Society www.britishfertilitysociety. org.uk
acid, reducing caffeine and alcohol, and maintaining a healthy weight. ‘It is also important that we help patients to not feel overwhelmed by their treatment, but take it step by step. Referring them to support networks – including those online – where they can share their experiences with others who are having treatment, can be helpful too.’
NURSING STANDARD december :: voluses 29without no 14 ::permission. 2014 19 Downloaded from RCNi.com by ${individualUser.displayName} on Jul 20, 2016. For personal use only. No 3other Copyright © 2016 RCNi Ltd. All rights reserved.
