Having a baby for many is a fundamental part of life, yet one in every seven couples in the UK struggle to conceive.

There are many different reasons for this, and numerous treatments to improve their chances of having a baby. However, many people assume the best way of overcoming fertility problems is through IVF (in-vitro fertilisation) - but that's often not the case, insists fertility expert Professor Robert Winston.

Although one of the founding fathers of IVF himself, Professor Winston believes the technique, where an egg and sperm are mixed in a dish, creating an embryo which is then implanted in a woman's uterus, is used far too often before other, usually cheaper and less stressful options, are fully explored.

DON'T RUSH IN

In his new book, The Essential Fertility Guide, Professor Winston outlines fertility treatment options and suggests that more than half of those referred to IVF clinics may be treated by alternatives. He says some doctors in the NHS don't take infertility seriously enough, too swiftly shunting patients into the private sector where expensive IVF, which only has a 25% success rate, is a highly profitable industry.

"There are numerous causes of infertility," says Professor Winston, "and the best treatment may be different in each circumstance. Unfortunately, the massive publicity given to IVF has led to most people believing that it is almost the only treatment and the most successful. This is utterly wrong.

"Couples rush into IVF far too frequently."

OTHER OPTIONS

So what are the alternatives to IVF? Depending on the cause, these include:

:: Drug treatments to encourage ovulation

:: Artificial insemination (AI)

:: Microsurgery

:: Laparoscopic (minimally invasive) surgery

:: Treatment for endometriosis

PROFIT OVER PATIENT

Prof Winston points out that many of the 47,000 women treated with IVF every year are referred to clinics "without the competence or interest in offering anything other than IVF". The National Institute for Health and Care Excellence (NICE), recommends three treatment cycles for those needing IVF, but the NHS frequently limits each patient to just one.

Prof Winston says: "Regrettably, in the commercial sector, where most IVF is done because NHS provision is so inadequate, the pressure for the clinic to offer profitable IVF rather than another treatment is strong."

He says that while there are of course ethical private practitioners, it's often easier to immediately put couples on the IVF treadmill rather than spend sufficient time investigating the underlying cause of infertility.

WHOSE PROBLEM IS IT?

Failure to conceive is caused by a female problem in just over a third of cases, says Prof Winston. The most common cause of female infertility is failure to ovulate (around 30%), damage to the fallopian tubes causes around 25% of female infertility cases, while endometriosis is found in about 20% of infertile women.

In another third of infertility cases, the problem is that the man is sub-fertile and may have a low sperm count, for example, and in the remainder, both partners are responsible.

In addition, a substantial number of couples have what is referred to as 'unexplained infertility' - although more detailed testing sometimes reveals a possible cause.

Many couples have two, or occasionally more, infertility causes.

"Do not go for IVF treatment without a clear idea about why you need it. Most infertile couples do not require this complex treatment," says Professor Winston, who stresses that couples need to ask the right questions and make sure they're properly tested to identify the cause of their infertility and the best treatment.

INVESTIGATE IVF

Only after investigations - ranging from testing women for ovulation, other hormone levels and chromosomal abnormalities, plus using imaging techniques and assessing the number and quality of the man's sperm, hormones and chromosomes - should treatment options be considered.

Professor Winston says IVF is appropriate when fallopian tubes are so badly damaged that tubal surgery has failed or can't be done, if a women isn't ovulating and ovulation-stimulating drugs have repeatedly failed, or if a man has an abnormal or low sperm count, but the sperm are still potentially capable of fertilising an egg. It may also be useful in some cases of endometriosis and unexplained infertility, where there are problems with the cervix, where couples have multiple fertility problems, and when there's a high risk of couples having genetically abnormal babies so preimplantation genetic screening (PGS) is needed.

EXPLOITATION

Professor Winston adds: "IVF is not the only treatment for infertility, and it's often not the best treatment or the most successful. There are many treatments depending on the cause, and the cause should be established first."

He adds: "The desperation to get pregnant makes people very vulnerable and capable of being exploited, and one of the issues is to understand that very often expectant treatment, ie. waiting to get pregnant, is likely to be more effective than IVF.

"The reason for writing this book is to try to get couples to ask the right questions and to understand that if they've got a condition that would prevent IVF working, for example, they have to get that treated first.

"People need to make sure they have the most accurate information and that they see responsible doctors who are prepared to listen to their concerns and respond to them rather than just shoving them into a mechanical treatment because they're not thinking about what the various alternatives are."

:: The Essential Fertility Guide by Professor Robert Winston is published by Quadrille, £10. Available now.

ASK THE EXPERT

Q: "My three-year-old daughter always makes a scene when I take her into nursery, and doesn't really play with the other children. Her speech also seems poor, and someone's suggested she may have autism. Are her symptoms typical of autism?"

A: Professor Jacqueline Roberts, co-author with Professor Katrina Williams of Understanding Autism: The Essential Guide for Parents (Exisle Publishing, £14.95), says: "Early signs of autism include social communication difficulties, particularly lack of engaging with other people, except when necessary to get needs met. Young children with autism don't seem to be wired to find interacting with other people a positive, rewarding experience they can learn from - in fact, socialising may be unpleasant and something they avoid as much as possible.

"Some children with autism also experience sensory input in unusual ways, especially sound. For example, some sounds may be experienced as very loud and painful. If the child with autism experiences these sensory sensitivities and distortions, they'll find new places and situations even more difficult to manage.

"Because children with autism have difficulty making sense of the world around them, especially the social world, they often resist new experiences like starting preschool or childcare.

"If you have concerns about your child's development, talk to your doctor and ask for a referral to a paediatrician. Ideally, developmental assessments are done by multidisciplinary teams and you'll have opinions from a speech pathologist about her communication and from a psychologist about her thinking and learning, as well as a medical assessment.

"It's important to find out if your child has autism as there are services you can access to support her social communication development and manage her environment to make it easier for her to participate and learn."

READY FOR RAIN

Powell Craft Woodland Print Raincoat

A hooded shower-resistant unisex raincoat with a woodland animal print and two front pockets. The coat has a soft outer shell, is lined in soft cotton towelling, and fastens with poppers. Available in sizes from one to seven years. £32, www.childrensalon.com

Fulton Children's Umbrellas

A range of umbrellas that include a design featuring stars that change colour when the rain falls, a reflective print, and flower and animal designs. From £10, www.fultonumbrellas.com

Frugi Puddle Buster Wellington Boots

Available in three prints that kids will love, these natural rubber wellies have a PVC-free non-slip sole and taped seams, to help keep little feet warm and dry. Available from children's size 4 to adult size 2. £24, www.welovefrugi.com