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Doina Ionescu

General Manager, Merck Healthcare UK & Ireland

Struggling to conceive? Make sure you are fully informed about the issues around fertility treatment before you start.


Starting a family requires serious thought, but even if you decide to go ahead, getting pregnant is not always as simple as you might hope.

Around one in seven UK couples may have difficulty conceiving, according to the NHS. While 84% of couples will conceive naturally within a year if they have regular unprotected sex, this falls to one in four or less once they have been trying for more than three years without success.

Fertility issues do not just affect heterosexual couples – same-sex couples, couples where one or both are trans and single people, may also face hurdles when wanting a baby.

Considering fertility treatment

If you have been trying to conceive (TTC) and have had no success, you may begin to consider fertility treatment. But before you do, it’s important to ensure you know what your options are and the challenges that you could face on your fertility journey. Merck UK has created Bloom, an educational website designed to give individuals the information and resources they need to begin their fertility or IVF journey – whatever path that may take. 

Doina Ionescu, General Manager for Merck Healthcare UK & Ireland, explains some of the treatment challenges for people struggling to conceive and how these can be navigated. The company wants to support better conversations between fertility patients and their clinicians to support shared decision making.

“Patients should have all the facts and know what to expect during their fertility journey,” says Ionescu. “This includes feeling empowered and equipped with the right knowledge about their clinic partner and treatment choices.”

Moving the narrative to patient ‘expectations’

Ionescu explains: “In 2021, the Competition and Markets Authority (CMA) published guidance for people at the different stages of considering and undergoing fertility treatment with private providers, to ensure they are aware of their consumer rights in law.

“This is all very well but we want to shift the focus from ‘rights’ to ‘expectations’, by increasing patient education and encouraging individuals to feel involved, consulted and listened to in their decisions around fertility treatment.”

Ionescu points out that Merck works closely with fertility clinics to understand the patient journey and clinic processes, in order to develop the right information and tools that will support patients during their fertility journey and allow clinics to improve efficiency in their clinical practice.

NHS fertility treatment varies across the country, with location determining access criteria and the number of IVF cycles received.

A need for personalised treatment

No-one likes to feel they are just a routine case when they access any type of medical treatment, but this is even more the case with something as personal and emotionally charged as fertility treatment.

IVF and other fertility treatments are increasing in popularity and the science is evolving all the time. Ionescu says: “This means there is a greater need to personalise treatment and not accept a ‘one-size-fits-all’ approach. Treatment protocols will often need to be adapted based on evidence-based interventions and patient preferences.”

Access problems lead to pressures

Not everyone gets the access to fertility treatment they want. NHS fertility treatment varies across the country, with location determining access criteria and the number of IVF cycles received.

“This has meant that patients can feel a heightened sense of urgency to create the family they desire and are accessing private clinics in increasing numbers,” says Ionescu.

Merck supports the fight for equitable access to fertility treatment but recognises that while a “postcode lottery” to NHS treatment exists, there is a risk that people will make decisions under pressure – sometimes without fully understanding all the facts.

Help to make an informed decision

Fully informed, unpressured decision-making about your fertility journey can help you make better decisions. Ionescu says: “It is essential that people undergoing fertility treatment are well informed and that they are involved and consulted in decisions around their treatment and care.”

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