A way forward for women and couples who need help to conceive
As an experienced fertility specialist, I provide a comprehensive approach to fertility care – from fertility testing through to assisted conception.
You may be referred to me for one or more of the following reasons:
Fertility issues are relatively common, with around 1 in 6 Australian couples experiencing a delay or difficulty in falling pregnant. Infertility can be caused by a number of factors, so a thorough assessment is important for determining the specific type of help you and your partner need to conceive.
I will start by taking a complete history of your fertility journey so far, as well as a medical history for both partners. Depending on what investigations you have had to date, further tests may be necessary. These may involve an ultrasound and blood tests to help me determine if there are any underlying medical problems, like endometriosis or polycystic ovary syndrome (PCOS), that are affecting your ability to fall pregnant. I will also assess your ability to ovulate (release an egg from your ovaries each month) and order an assessment of your ovarian reserve (to get an indication of how many eggs you have left).
I place particular importance on assessing the male partner at the same time. ‘Male factor infertility’ affects one in 20 men and plays a role in over a third of cases where couples can’t conceive. Like women, men may undergo a range of investigations, including blood tests and imaging. However, the pivotal test for males is a semen analysis to assess sperm number, motility and quality (e.g. shape, movement).
As your fertility specialist, I will carefully interpret the results of these tests within the context of your lifestyle, medical history and overall health, before recommending a fertility treatment plan that is right for you and your partner.
Help to fall pregnant
Thanks to advances in research and medical technology, there are now numerous options available for couples who find themselves needing help to fall pregnant. Be reassured that many couples with fertility issues don’t need IVF to conceive – other fertility treatments often suffice.
For example, some very simple measures like ovulation tracking and timing sexual intercourse correctly, are sometimes all that is needed to achieve a pregnancy.
The specific type of assistance you require will depend on the underlying cause of your fertility issues, but may include:
- Ovulation tracking: this involves tracking the woman’s cycle to determine the time of ovulation, then timing sexual intercourse to coincide with this fertile window.
- Ovulation induction (OI): this may be used when the underlying problem is abnormal or irregular ovulation. A hormone medication is given to stimulate the production of certain hormones in the body, causing the ovary to release an egg.
- Intrauterine insemination (IUI): this involves injecting a large number of sperm directly into the uterus to increase the chances of an egg and sperm meeting. It may also be used if donor sperm is required to conceive.
- In vitro fertilisation (IVF): IVF is a form of assisted reproductive technology (ART) that involves collecting the woman’s eggs and then fertilising them with her partner’s or donor sperm in a laboratory. The fertilised egg (now an embryo) is then placed back into your uterus (womb) in the hope that it will lead to pregnancy.
- Intracytoplasmic sperm injection (ICSI): This is a special procedure that may be used during IVF, typically when there is an issue with the man’s sperm. In this case, the sperm is directly injected into the egg in the laboratory to achieve fertilisation. This overcomes any issues with the sperm fertilising an egg on its own.
Based on your specific circumstances, I will advise which approach I believe is best for you and your partner. This will involve a discussion around the pros and cons of all the available options, so that we can agree a way forward that you are comfortable with.
If you’re thinking about ways you can preserve your fertility as you get older, then egg freezing might be right for you. It’s now a common and well-established procedure, whereby we collect, freeze and store your eggs, giving you the option of using these eggs with IVF or insemination in the future, should you find you need to go down this path.
You may consider freezing your eggs if:
- you are not yet ready to have a baby (for personal or other reasons) but want to preserve your chances of having a family in the future (particularly if age is a concern); or
- you are about to undergo medical treatment that may cause damage to your eggs or reproductive organs, such as chemotherapy or radiation to treat cancer.
These days, egg freezing is a relatively simple process, which I can facilitate for you via Newlife IVF’s egg freezing service.
Sperm freezing is also an option for men who want to preserve their fertility. Like egg freezing, sperm can be stored for a period of time and then thawed for use with IVF or insemination. I can also facilitate this service via Newlife IVF's treatment centre.
If you have suffered two or more pregnancy losses in a row (i.e. ‘recurrent miscarriage’), there may be an underlying cause. It’s important to seek the advice of a fertility specialist to understand if there is a particular reason you are miscarrying – so that we can treat the problem or help you avoid it in the future.
Possible causes include an unknown genetic condition in either partner, abnormal hormone levels including thyroid dysfunction and autoimmunity, as well as structural problems of the uterus.
Miscarriage, particularly when it happens more than once, can be incredibly upsetting and even traumatic, so it is important that you receive the right guidance and support. I can help you narrow down the possible reasons you may be miscarrying in order to determine what can be done to prevent a further miscarriage in the future.
IVF second opinion
If you are struggling with infertility, it’s only natural to want to explore every avenue available to you. As a fertility specialist, I have wide-ranging expertise across all aspects of fertility care. I welcome the opportunity to review the treatment you have received so far and offer a second opinion about your future options.
Some reasons for seeking a second opinion may include:
- You’ve explored some options with your GP or gynaecologist but still haven’t fallen pregnant.
- You have undergone one or more unsuccessful rounds of IVF at your current clinic and wish to try elsewhere.
- You want to try all possible options and your current clinic can’t offer a certain test or treatment.
- Your doctor has suggested that you seek a second opinion.
- You have concerns that something has been missed or suspect there may be more to your infertility diagnosis.
Whether you just want peace of mind or the opportunity to consider a different treatment approach, a second opinion can provide the reassurance you're after or open the door to new options.
Single women and LGBTI couples
Following legislative change in Victoria in 2010, single women and same-sex couples can now access IVF and other assisted reproductive techniques to have a baby. Assisted conception is made possible by the use of donor sperm or eggs, and for male couples, a surrogate.
If you are a single woman or lesbian couple, options include intrauterine insemination (IUI), whereby donor sperm is placed directly into your uterus via a small tube, or IVF. For gay male couples, a donor egg will be fertilised with the sperm of one partner, and the resulting embryo implanted in a surrogate to achieve a pregnancy.
While donor sperm and eggs are most commonly used to assist single women and same-sex couples to conceive, donor embryos may also be an option. These embryos typically come from a couple who have been through IVF to have their own family, and have chosen to donate their surplus frozen embryos to help bring joy to other couples.
Regardless of your personal circumstances and preferences, I can give you the expert guidance and support you need throughout your fertility journey.
When to seek help
For all couples, I advise seeking review immediately if a female partner has an irregular menstrual cycle. Otherwise, if you are under the age of 35, I advise you to seek help after 12 months of trying for a baby. If you are over 35, it’s best to seek help earlier, after just 6 months of trying, as fertility declines with age.
However, these are not hard and fast rules. If you’re concerned about your fertility at any point or either partner in a couple has an existing health condition that may affect fertility, I recommend seeking a specialist opinion as soon as possible.