What is the first step in starting fertility treatment?
The initial step is scheduling a consultation with Dr Maha. During this comprehensive appointment, your medical history will be reviewed, and necessary tests will be conducted to determine the most suitable fertility treatment plan tailored to your unique needs.
What are the necessary initial investigations to be completed before being seen for a consultation?
There is a list of investigations to be done for both:
Investigations for the Female
Days 2-5 of periods- AMH, FSH, LH, Prolactin.
Days 5-8 of periods- E2 and cervical screen test if due and pelvic ultrasound with antral follicle count.
Days 21 on wards- FBC, Rubella serology, Syphillis serology, Varicella serology, blood group and antibodies, Hep B, C HIV, Hb Electrophoresis, progesterone, Vit D, fasting glucose and Insulin and Chlamydia and gonorrhoea as urine tests.
Investigations for the Male
Semen Analysis, Syphillis serology, HepB Hep C and HIV, chlamydia and gonorrhoea.
What is the time taken from investigations to being seen for a consultation?
It usually takes between 1-2 weeks for all the blood test and semen investigations to come through and perhaps a bit longer for the results of a PAP smear to come through, but patients can be seen even whilst waiting for all their investigations to be completed. The important thing is to get a GP referral through to ADORA addressed to Dr Maha for their initial consultation and both partners will require one, if separate GPs.
What does the initial consultation involve?
Once we have all the investigations and results sent through, the initial consultation involves looking through all the results and for Dr Maha to explain the cause of the subfertility where a cause can be found, making recommendations to optimise health towards fertility before recommending treatment options tailored to suit your situation.
What are the different treatments available to the patient?
The whole range of treatments from ovulation induction, to tracking, IUI, IVF, ICSI, Egg freezing, sperm freezing, addressing male factor subfertility, surgical sperm retrievals and sperm freezing and treatment with known egg or sperm donor is available to the patients. Treatment protocols are usually recommended after a thorough investigation of the couples’ history and results with tailored treatment plans to get the best outcomes for the patients.
What if I were to require surgery before fertility treatment?
Dr Maha specialises in all surgical treatments that can optimise outcomes for improving the chances of pregnancy. This will be discussed at consultation and if surgery is required to be done before fertility treatment, this can be arranged as a priority beforehand.
How long do treatments take?
Treatments such as Ovulation tracking or induction and IUI are all designed to work within the remit of a normal menstrual cycle over a period of 2 weeks for the treatment and up to 4 weeks until pregnancy test.
IVF treatment can take up to 5 weeks.
Can we start treatment as soon as we have had the consultation?
Once the consultation appointment is over it is generally suitable for most patients to start with their chosen treatment straightaway. However, there are instances where patients may require additional blood tests, scans to determine that surgery may not be needed, treatment of male factor subfertility and surgical sperm retrievals prior to starting IVF as well as methods to optimise their fertility by diet, weight loss and supplements before starting treatment. This will usually be dealt with in depth by Dr Maha at Consultation with a plan of action before you start.
How long does the IVF process take from start to finish?
The IVF process takes about 3 weeks from the start of taking medications to stimulate the ovaries to grow the eggs to creation off and the implantation of the embryo into the female partners womb.
What does treatment involve?
The process involves daily injections to stimulate the ovaries which is then followed by an egg retrieval procedure which is an ultrasound guided transvaginal procedure ending with the embryo creation and development in the lab following which the fully developed blastocyst stage embryo is then implanted into the uterus using ultrasound guidance. The pregnancy blood test is usually requested about 10 days from the embryo transfer process.
How much treatment will I need and what is my success rate based on?
It is difficult to estimate the number of treatments a person will need. Success rates are usually based on the female partner’s age, and can vary depending on other factors including the quality of sperm, co-existing chronic conditions that can affect both partners ability to achieve a pregnancy. That is why it is vital to seek the help of a Specialist early.
Can I just come to get my fertility assessed and what does this involve?
Fertility can be assessed by a simple blood test and pelvic scan for a woman, and a sperm test for the man. It is however important to come to see the specialist, who will take a careful history and conduct an assessment based on the investigations and clinical picture as to your chances of conception and if you need treatment.
My partner is FIFO. Can you help with this?
Certain types of fertility treatments such as Intra- uterine Insemination can be done to facilitate conception using frozen sperms. If your partner is FIFO freezing sperm means you can still have a chance of conception in the months when they are away . IVF treatment can also be done using frozen sperms.
Can I ask my GP to check my fertility?
It’s a good idea to see a GP if you have not conceived after a year of trying. Women aged 36 and over, and anyone who’s already aware they may have fertility problems, should see their GP sooner. They can check for common causes of fertility problems and refer sooner if you will need to see a fertility specialist. Especially relevant where a semen analysis shows a low count or if you have been trying for more than 6 months and fertility tracking
What does a fertility assessment include?
Blood tests to check hormone levels and ovarian reserve (the number of potential eggs remaining in a woman’s ovaries) and Minimally invasive procedures, such as ultrasound imaging (sonogram) and tubal assessment procedures such as HSG can give the specialist the information they need to process the baseline fertility of a couple.
Can I get pregnant without needing fertility treatment?
Optimising body weight, correcting and treating certain chronic conditions and harmonising irregular hormones can achieve natural fertility without treatment. It also important to stop smoking and reduce or stop alcohol consumption when a couple are trying to achieve a pregnancy. Using APPS that will help with ovulation timing and using LH hormone monitoring kits with help with the exact timing of ovulation and timely intercourse.
What are 4 causes for female infertility?
There are a lot of causes for female infertility, but the 4 main ones are:
- Endometriosis,
- Damage to the fallopian tubes,
- Polycystic ovary syndrome and
- Uterine fibroids.
What’s the first line of treatment for infertility?
Hearing the word “infertility” can be absolutely devastating to many couples. But the great news is that medical advances make it highly likely that you will eventually be able to get (or stay) pregnant with intervention, depending on your particular circumstance.
Medications can be the first-line treatment if your doctor diagnoses you with infertility. These medications are designed to help increase the likelihood of conception and pregnancy.
They can come in the form of hormone replacements to stimulate ovulation in women, or medications to treat erectile dysfunction in men. There are also medications that can be used to increase your chances of staying pregnant once you become pregnant, depending on your reasons for previous miscarriages if that was the case.
In addition, your doctor may recommend lifestyle changes for both partners, such as eating a healthy diet, limiting alcohol consumption, or stopping smoking.
I have been diagnosed with PCOS, and would like help with how I can improve my fertility. How can you help?
PCOS is a condition of anovulation where the woman is unable to ovulate regularly. This is worsened by an increased BMI and insulin resistance which causes hormonal imbalances that then affect how the ovary works. A Specialist consultation can help you understand how to manage this condition and to optimise your health to facilitate pregnancy.
I have had a vasectomy and would like to have a child . How can you help?
If you have had a vasectomy going through a surgical sperm retrieval will allow the collection of sperm form the duct or from the testes themselves to facilitate egg fertilisation and embryo creation in the lab. This is a day case procedure done under sedation anaesthetic and retrieved sperm is then frozen for use in the future.
Is fertility treatment covered by insurance?
Some insurers cover parts of the treatment such as the day case charges and fees to undergo egg collection and surgical sperm collection. The IVF/ICSI treatment is bilk billed through Medicare ,which them markedly reduces cost of treatment overall. Even the fertility medications are subsidised.