What causes blocked tubes, and can I still have a baby?

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In this video, fertility specialist Dr Lauren Hicks discusses the impact of blocked or damaged tubes on fertility, along with how this condition is diagnosed.

 

So, what causes blocked tubes?

Blockages can occur for a number of reasons. However, typically they are associated with conditions that cause inflammation and scarring.

Pelvic inflammatory disease

One common cause of inflammation is pelvic inflammatory disease (or PID for short). PID is an infection that can affect a woman’s reproductive organs, including the fallopian tubes. The inflammation resulting from PID can affect both the inside and outside of the fallopian tubes. Often internal inflammation is caused by infections that travel from the vagina and uterus into the fallopian tubes. These include infections due to the bacteria normally found in the vagina, as well as at times from sexually transmitted bacteria (like chlamydia and gonorrhea). On the other hand, external inflammation may arise due to trauma or infection inside the abdomen, as might happen following a burst appendix or recent bowel infection. Repeated bouts of PID have been shown to increase the risk of infertility in women.1 Therefore, it’s important to see a doctor if you have signs of a possible infection like fever or lower abdominal pain, although sometimes symptoms can be mild and go undetected. If an infection is detected, antibiotics will usually be prescribed.

Endometriosis

The endometrium is the tissue that grows on the internal lining of the uterus. In endometriosis, tissue similar to the endometrium grows on tissues and organs outside the uterus such as the fallopian tubes. Over time (particularly in advanced or late-stage endometriosis), tissue that has grown in and around the fallopian tubes can cause inflammation and subsequent scarring, resulting in blockages.

Congenital tubal disease

In extremely rare cases, an obstruction of one or both fallopian tubes may be present at birth. Many women with this condition are not aware that they have a blockage until they try to fall pregnant.

Scar tissue after surgery

Sometimes, excessive tubal scarring can follow abdominal or pelvic surgery, e.g. caesarean section, bowel surgery. This scarring also has the potential to block your fallopian tubes.

Are there any symptoms of blocked tubes?

Tubal obstructions can often slip under the radar – i.e. you may not notice any symptoms at all. In fact, many women do not know they have a blockage until they experience trouble falling pregnant. Some conditions that cause tubal blockages do have their own tell-tale signs. For example, women with PID may experience lower abdominal pain, pain upon urination and intercourse, as well as abnormal vaginal bleeding and/or discharge. For many women with endometriosis, the primary symptoms are pelvic pain at the time of their period and pain with intercourse. In addition, a hydrosalpinx (a collection of watery fluid which may complicate a tubal obstruction) can cause ongoing and mild discomfort on the affected side of the abdomen in some women. If you are experiencing any of these symptoms, it’s important to make an appointment with your doctor.

How can you tell if my tubes are blocked?

There are imaging and surgical tests that we can use to determine whether your tubes are blocked. However, the test that is most appropriate for you will depend on individual factors such as any underlying conditions you may have.

Pelvic ultrasound with contrast

The first port of call is usually a special type of ultrasound called a tubal patency ultrasound. During this imaging test, a fluid which shows up on ultrasound is injected through a thin catheter placed in the cervix. The fluid then runs through the uterus and if no obstruction is present, it will continue to run out the ends of the fallopian tubes (after the test is complete, the fluid is gradually absorbed by the body). At the same time, an ultrasound of your pelvic area is taken so we can see where the fluid travels. This provides a detailed view of your uterus and fallopian tubes, which helps us determine if an obstruction is present.

Hysterosalpingogram (HSG)

Similar to a tubal patency ultrasound, a HSG also involves inserting a special fluid into your uterus and fallopian tubes. However, instead of using ultrasound, x-rays are taken instead.

Laparoscopy with dye

A laparoscopy is a type of keyhole surgery enabling us to look at your uterus, fallopian tubes and ovaries. Following a general anaesthetic, a camera is inserted through some small incisions made in the lower abdomen. A fine catheter is also inserted into the cervix and then a blue dye is injected. It passes up through the uterine cavity and along the tubes, then comes out the ends of the tubes where the blue colour can be seen. If we notice any abnormalities during this procedure, we may be able to treat these at the same time, e.g. remove endometrial growths.

Getting pregnant with blocked tubes

Depending on the cause, location and severity of the obstruction, there are a couple of different treatments that can boost your chances of falling pregnant.

Surgical removal

As mentioned above, laparoscopic surgery can be used to both identify, then remove any growths and/or scar tissue that are blocking your fallopian tubes. This technique is frequently used in women with endometriosis and can improve natural fertility in the months following surgery. It can also increase your chances of pregnancy with IVF. Surgically removing a tube that is full of watery fluid or pus (known as a hydrosalpinx and pyosalpinx, respectively) can also lead to an improvement in IVF treatment success. A hydrosalpinx can be caused by endometriosis, infections within your pelvis or prior surgery, whereas as a pyosalpinx occurs when your fallopian tube becomes severely inflamed and pus is produced, usually as a complication of PID.

In vitro fertilisation (IVF)

Most times, removing a tubal blockage is not possible or the best option for our patients. In these instances, we may recommend IVF if you are trying to conceive. IVF can help you fall pregnant by bringing the egg and sperm together inside a laboratory dish, completely bypassing your fallopian tubes. If fertilisation is successful and an embryo forms, it can be transferred into your uterus. If the embryo is able to successfully implant in the wall of the uterus, a pregnancy results.

What about tubal flushing with oil?

Tubal flushing involves placing a tube through the cervix and flushing an oil-based solution into your uterus and fallopian tubes. It’s not used when a proven tubal blockage is present, e.g. it can’t break down scar tissue or reopen a blocked tube. However, a recent review found that oil-based tubal flushing in women with subfertility (those experiencing an unexplained delay in falling pregnant) may increase their chances of falling pregnant compared to women who do not have a flush.2 It’s not really understood how tubal flushing may improve the chances of pregnancy but presumably it works by helping to remove any stray mucus and cellular fragments out of the fallopian tubes. Tubal flushing may sometimes be performed together with diagnostic imaging studies and/or surgical procedures as an ancillary option when no obvious obstruction is detected.

Understanding your options

If you are struggling to conceive, blocked tubes is one of the first things your fertility specialist will want to rule out. To book an appointment with one of our specialists, call (03) 8080 8933 or book online via our appointments page.

References

  1. Trent M, Bass D, Ness RB, Haggerty C. Recurrent PID. Subsequent STI, and reproductive health outcomes: findings from the PID evaluation and clinical health (PEACH) study. Sexually Transmitted Diseases. 2011;38(9):879-881 ↩
  2. Mohiyiddeen L, Hardiman A, Fitzgerald C, Hughes E, Mol BWJ, Johnson N, Watson A. Tubal flushing for subfertility. Cochrane Database of Systematic Reviews. 2015;5: CD003718 ↩

Donating your eggs – what’s involved?

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Whether you intend to donate to friends or family, or anonymously, there are several things to consider before you make your decision. Although it can be an incredibly rewarding experience, donating your eggs is a physical and emotional commitment with potentially lifelong implications. It is therefore important to be fully informed before you decide to become a donor.

Things to consider before donating your eggs

Understanding the legal landscape of egg donation in Australia

In Australia, donors have no legal connection to any child conceived as a result of their donation. This means they have no parental responsibilities and are not required to pay child support. Donors also have no legal rights to the child and cannot be granted custody. If you are donating as a known donor, you and the intended parents should discuss how much involvement, if any, you will have in the child’s life. Boundaries should be worked out before you embark on this journey and you may wish to seek legal advice to facilitate this.

If you intend to become an anonymous donor, it’s important to understand that donation is not truly anonymous in Victoria. Children born from your donation can legally request access to your identifying information after they turn 18. This means you may receive contact from them. Additionally, some of your details will be shared with potential recipients – these include eye colour, height, cultural background and health. However, your identity will remain hidden from potential recipients.

Financial considerations – what to expect when donating eggs

In Australia, egg and sperm donation must be altruistic. That is, you cannot receive financial compensation for your donation. However, reasonable expenses can be paid by the recipients, including medical and out-of-pocket costs (such as travel expenses).

Emotional implications of egg donation

Before you donate, you are required to attend mandatory counselling sessions. This is to make sure you fully understand the legal, social and emotional aspects of egg donation. How do you feel about someone else raising a child who is genetically related to you? How will your decision to donate affect your family and children (if you have them)? How do you feel about the potential for future contact with one or more children or adults born as a result of your donation?

At Newlife IVF, our experienced fertility counsellors can help you consider these questions and more. You will complete your counselling feeling fully informed and reassured about your decision and its possible effects on your life in the future.

Physical health and eligibility criteria for egg donors

To become an egg donor, you must be mentally and physically healthy, living a healthy lifestyle, with no family history of inheritable disease. You are also required to be at least 21 years old before you can donate. Ideally, you should be younger than 38 years old. A mandatory health check, including blood tests and ultrasounds, will be performed. You will also be asked lots of questions about your personal and family health history. Once you are given the all-clear, you will be able to donate.

What happens when you donate your eggs

The process of donating your eggs will differ depending on whether you already have frozen eggs available – i.e. from a previous in vitro fertilisation (IVF) cycle – or need to have your eggs collected. Below we discuss both scenarios.

Donating your stored eggs

If you’ve been through IVF and your family is complete, you may have frozen eggs you aren’t intending to use. In this case, you may wish to donate your eggs to an individual or couple who also needs help to have a child. In this case, assuming you fulfil the criteria to become a donor, you will be able to donate your existing frozen eggs.

Egg collection

This process is identical to the first half of an IVF cycle. Before your eggs are collected, you will be given medication to stimulate your ovaries to produce several eggs. This medication comes in the form of a daily injection that will need to be taken for 8 to 14 days. The injection is delivered through a pen device, so it is very easy to use. You can choose to give yourself the injection or ask a friend or family member to do it for you.

Injections will begin on the first day of your period. From around day 5 or 6, a second daily injection will be added, to stop your ovaries from releasing any eggs (ovulating) before they can be collected.

From day 8, you will be monitored using blood tests and ultrasounds to check whether your follicles (small, fluid-filled sacs within the ovaries, each containing a developing egg) are large enough for egg collection. Egg retrieval is usually done at around day 13. About 36 hours prior to collection, the injection that prevents ovulation will be replaced by a so-called ‘trigger injection’. This stimulates the eggs to fully mature before collection.

Egg collection is a day procedure done under light anaesthetic. You won’t be aware of the procedure while it’s happening, nor will you remember it. Egg retrieval is carried out by a fertility specialist, who will use an ultrasound to visualise your ovaries. A thin needle will be inserted through the top of your vagina and into your ovaries to collect the eggs. The procedure takes about 20 minutes, and between 8 and 15 eggs are typically collected.

About 90 minutes after the procedure you will be allowed to go home. After resting at home for 1–2 days, you can resume your normal activities. It is common to experience some abdominal discomfort and bleeding. However, the discomfort is typically fairly mild and manageable with Panadol and a heat pack.

A COVID-19 test is also required prior to the day of the procedure. You will need to isolate at home, separating yourself from others in your household, until the results come back.

After your eggs are collected, an embryologist will look at them under a microscope. If your recipient is ready, they can use the eggs straight away. The mature eggs that are ready for fertilisation will be introduced to sperm on the same day.

If your recipient is not ready, the mature eggs can be frozen until they are ready to be used. They will also be quarantined for a period of 3 months. After the quarantine period has passed, you will be asked to come in for another round of blood tests to double-check that you are healthy. Once you’re given the all-clear, your eggs are ready to be used.

How to donate your eggs

The information in this article is certainly not exhaustive. We recommend that you refer to the information provided by The Health Regulator to gain a more complete understanding of the issues pertaining to egg donation. If you have any additional questions, please do not hesitate to contact us.

If you are ready to take the next step to donate your eggs, book an appointment at Newlife IVF. Whether you want to donate to friends or family, or as an anonymous donor, we can facilitate the process for you. To book your appointment, call (03) 8080 8933 or book online.

Getting pregnant with endometriosis

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What is endometriosis?

In endometriosis, tissue similar to the lining of the uterus (known as the endometrium) grows on organs and tissues outside the uterus. It typically affects the ovaries, fallopian tubes and the tissue lining the pelvis. However, it can grow anywhere in the pelvis.

Just like the lining of your uterus, this abnormal tissue builds up, breaks down and bleeds each month in response to changing hormone levels. However, unlike your period, there is no way for this blood and debris to leave the body. This leads to inflammation (irritation and swelling of the affected areas) and the formation of scar tissue known as ‘adhesions’. Over time, these fibrous bands of scar tissue may cause tissues and organs to stick together. In more advanced disease, this knitting together of structures can interfere with an organ’s normal function.

Typical symptoms

About 20 to 25% of women with endometriosis do not experience any symptoms at all.2 In fact, some women only find out they have it when they experience trouble falling pregnant.

For other women, pain is the predominant symptom. Pain is typically worse during a woman’s period, but can occur at any time throughout the month. Endometriosis is also usually associated with heavy periods, longer periods (greater than five days), and spotting or bleeding between periods.

Depending on the structures involved, endometriosis may also cause bladder or bowel irritation. This can lead to pain, urinary frequency and difficulty with bowel movements. Some women may also experience pain during intercourse.

How endometriosis affects fertility

Between 30 to 50% of women with endometriosis will experience trouble conceiving.2 There are a few different ways endometriosis may cause fertility issues.

In advanced or late stage disease, endometriosis can interfere with the function of reproductive structures like the fallopian tubes and ovaries. For example, one or both fallopian tubes may become inflamed and the ovaries may develop cysts, known as endometriomas. The tubes may become blocked, making it difficult for eggs to enter or travel along the tubes towards the uterus. These blockages can also hinder sperm from entering the fallopian tubes, making it harder for sperm to meet and fertilise an egg.3

When endometriosis affects the ovaries, cysts and scar tissue can also prevent ovulation (the release of an egg from the ovary each month), particularly if the ovary has become stuck to the wall of the pelvis. In this case, there is no egg available for fertilisation, even if sperm is able to gain access to the fallopian tubes. Inflammation and its related toxins may also reduce egg quality and ovarian reserve (the number of good quality eggs remaining in the ovaries), reducing the chances of a successful pregnancy.

Additionally, pain associated with endometriosis may make it difficult to conceive naturally, as chronic pain and pain during intercourse may make sex very difficult.

We don’t fully understand how endometriosis leads to fertility issues in women with milder disease. In this case, the reproductive organs are not severely affected. However, the inflammation associated with endometriosis may be toxic to the egg, sperm and/or embryo. It may also reduce the ability of an embryo to implant in the lining of the uterus,4 an important step in conception.

It is important to note that endometriosis does not always affect fertility. If you have endometriosis and are experiencing difficulty conceiving, it’s important to undergo a thorough assessment by a fertility specialist to help determine if it is your endometriosis and/or other issues that are affecting your ability to conceive. An assessment of the male partner (where relevant) is also important for identifying any male-factor infertility that may be contributing to a delay in falling pregnant.

Getting pregnant with endometriosis

There are a range of treatments that can help women with endometriosis conceive. These include assisted reproductive techniques (ART), as well as options that increase your chances of falling pregnant naturally. The most appropriate treatment for you will depend on your medical history, the severity of your endometriosis, and whether your fertility specialist believes that this is the primary cause of your fertility issues.

Intrauterine insemination

Intrauterine insemination (IUI) is a procedure where a very large number of sperm are introduced into your uterus to increase the chances of egg and sperm meeting. In this procedure, a sperm sample from a partner or donor is concentrated in the lab to contain a very high number of sperm. The concentrated sample is then injected into your uterus soon after you have ovulated.

Your fertility specialist may also prescribe medication to help your body release more than one mature egg from the ovary before you undergo IUI, as there is evidence that this increases the chances of success in endometriosis.4 IUI is most likely to be suitable for women with mild to moderate endometriosis who have no blockages in their fallopian tubes.

Laparoscopic surgery

Laparoscopic (keyhole) surgery is a minimally invasive procedure that can identify and treat endometriosis. In this procedure, a small incision is made near the belly button, and a thin and flexible telescope is used to look inside the abdomen. Any growths that are found are then treated. Removing endometriosis that is blocking or ‘distorting’ reproductive organs may improve their function and improve fertility.3

In the months following surgery, natural fertility may increase. Laparoscopic surgery can also give you a better chance of successful pregnancy after ART, such as in vitro fertilisation.

In vitro fertilisation (IVF)

IVF is most likely to be recommended as a first-line treatment when there are other factors also impacting your fertility. This may include older age (fertility naturally declines with age), advanced endometriosis, or low sperm quality in the male partner.

In IVF, several of your eggs are extracted from your ovaries and mixed with sperm in laboratory dishes. If the sperm are of good quality and swim well, they are left to enter the eggs on their own, much like they would in natural conception (this is called ‘standard insemination’). In cases where the sperm sample is lower quality or doesn’t move well, the best sperm can be selected and injected directly into each egg, making it much easier for them to unite and form an embryo. This process is called intracytoplasmic sperm injection (ICSI). The highest-quality embryo will then be placed in your uterus, where it will hopefully embed and develop into a successful pregnancy. Any remaining embryos can be frozen and stored for later use, if needed.

Depending on your medical history and circumstances, your doctor may prescribe medication to reduce your oestrogen levels for three to six months before IVF. Oestrogen is the main female sex hormone and promotes the growth of the endometrium in the first half of your menstrual cycle. Remember that endometriosis responds to hormones in the same way your uterus does; reducing oestrogen levels can therefore help to reduce the volume of abnormal growth prior to IVF. As a result, these medications may improve IVF success rates in women with endometriosis.3

Tubal flushing with oil

Tubal flushing is commonly used as a diagnostic technique to check for blockages in the fallopian tubes. However, tubal flushing with oil can also increase your chances of conceiving naturally in the months following the procedure. In tubal flushing, an oil-based liquid is introduced into the uterus through a tube placed in your cervix. The solution then makes it way through your fallopian tubes, ‘flushing’ them out and potentially removing blockages.

Freezing your eggs

In many women, endometriosis progresses with time. In addition, natural fertility declines with age. This means it may be harder to have a baby when you are older. If you are young and not ready to have a baby, we may advise you to consider freezing your eggs. This will ensure you have some high-quality eggs available should you find you need the assistance of IVF in the future.

Get help to have a baby with endometriosis

If you have endometriosis and have been struggling to conceive, book a consultation with one of our fertility specialists for expert advice specific to you. Call (03) 8080 8933 or book online today.

  1. Endometriosis Australia | Research. endo-aust. Accessed August 31, 2020. https://www.endometriosisaustralia.org/research ↩︎
  2. Bulletti C, Coccia ME, Battistoni S, Borini A. Endometriosis and infertility. J Assist Reprod Genet. 2010;27(8):441-447. doi:10.1007/s10815-010-9436-1 ↩︎
  3. Koch J, Rowan K, Rombauts L, Yazdani A, Chapman M, Johnson N. Endometriosis and Infertility – a consensus statement from ACCEPT (Australasian CREI Consensus Expert Panel on Trial evidence). Aust N Z J Obstet Gynaecol. 2012;52(6):513-522. doi:10.1111/j.1479-828X.2012.01480.x ↩︎
  4. Johnson NP, Hummelshoj L, for the World Endometriosis Society Montpellier Consortium, et al. Consensus on current management of endometriosis. Human Reproduction. 2013;28(6):1552-1568. doi:10.1093/humrep/det050 ↩︎

Single and ready to have a baby – what are my options?

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I’m a single woman – what are my options?

Donor sperm – clinic-recruited versus known donors

Essentially, there are two options for obtaining sperm: accessing donor sperm through a fertility clinic’s sperm bank, or using a sample provided by someone you know.

At Newlife IVF we have an on-site sperm bank containing samples recruited from local and international donors. The benefit of using sperm from our clinic-recruited donors is that it is thoroughly tested for infectious diseases and common genetic problems. After we freeze the sperm, it is then quarantined before donors are retested to make sure it is high quality and safe to use.

When you use a clinic-recruited donor, you also have the advantage of very clear legal boundaries. The donor has no legal connection to your child – they are not entitled to custody and do not have to pay child support. They also remain anonymous to a large extent; that is, you will not know the donor’s identity (but you will know their family medical history and some of their traits). However, your child can request that the donor’s identity be revealed to them when they turn 18.

If you choose not to go the clinic-recruited donor route, you may consider using a sperm sample from a friend or acquaintance. A benefit of using a known donor is you will likely have a good understanding of their appearance, background and traits. However, the social and legal boundaries are not as clear-cut as they are when using a clinic-recruited donor. Discussing expectations and creating firm boundaries with a known donor requires careful negotiation, and you may wish to seek legal advice on how best to proceed.

If you do decide to use a sample from someone you know, it’s best to involve a fertility clinic. That way, you can have the sample rigorously tested for safety and quality in the same way we test donor sperm.

In this video, Dr Chris Russell talks about donor sperm and its use in IVF and IUI procedures.

Insemination – how egg and sperm meet

The next consideration is how best to introduce the sperm sample to your egg. There are a few different options for insemination, and the most suitable will depend on your specific circumstances.

One possibility is home insemination. In this method, sperm is injected into the vagina using a syringe at home. As this mimics the natural fertilisation process, home insemination is effective when the donor has a normal sperm count. It is also one of the most cost-effective options. However, it does not afford the same degree of protection from infectious disease as undergoing a similar process via a fertility clinic.

The clinic-based alternative is intrauterine insemination (IUI). This is where a sperm sample is concentrated to contain a very high number of sperm. It is then injected directly into your uterus soon after your ovaries release an egg. Using a concentrated sperm sample increases the chances of a sperm fertilising your egg. Depending on your circumstances, your specialist may recommend combining IUI with a medication to stimulate the release of an egg from your ovaries, further increasing the chance of success.

The last option is in vitro fertilisation (IVF). In this process, several of your eggs will be introduced to sperm in laboratory dishes. When utilising clinic-recruited donor sperm, the best sperm may be selected and a single sperm injected directly into each egg, a process called intracytoplasmic sperm injection (ICSI). One of the best embryos resulting from IVF insemination will then be transferred back to your uterus. The rest can be frozen and stored for later use, if necessary.

Two embryologists performing the intracytoplasmic sperm injection procedure.In ICSI, a single sperm is injected into the centre of a mature egg.

There are a few reasons you may be advised to undergo IVF. If you have known infertility, you’re in your late 30s or early 40s (when female fertility naturally declines significantly), or you struggle to get pregnant through other forms of insemination, your specialist may recommend this procedure. Likewise, IVF may be advisable if you’re using a known sperm donor with low sperm quality or quantity for other methods of insemination. If you wish to do preimplantation genetic testing, which is the process of genetically testing your embryos before they are transferred to your uterus, IVF will be necessary. For more information about these procedures in relation to your particular circumstances, chat to your fertility specialist.

I’m a single man – what are my options?

To have a baby as a single man, you will need the help of an egg donor and a surrogate. According to Victorian law, these must be two different women.

You may choose to use a clinic-recruited egg donor, or a known donor, i.e. a friend, acquaintance, or a family member (note: the last is only okay if you are not using your own sperm). Egg donation must be altruistic in Australia, meaning no financial compensation is paid for providing eggs. Once the donor eggs are ready, your sperm will be introduced to them using IVF (discussed earlier in this article), and the best resulting embryo will be transferred to your surrogate’s uterus. If you are not using your own sperm, donor embryos may be an appropriate option for you.

It’s common to ask a friend, acquaintance or family member to be a surrogate. Surrogacy is also an altruistic process in Australia, however ‘reasonable’ medical costs can be paid by you. Keep in mind that in Victoria, multiple medical consultations, counselling sessions and legal advice are required for both you and the surrogate prior to proceeding. You will also need to seek permission from the Patient Review Panel (this is a legal requirement in Victoria), and the sperm or embryos must be quarantined. This process can take several months.

Seeking a surrogate overseas may also be an option. However, according to Australian law, this is only legal if it is altruistic. Be aware that this is a very expensive route and you will need to plan to potentially be overseas for a few months after your baby is born to organise their entry into Australia.

For advice related to your particular circumstances, you may wish to seek legal advice and talk to a fertility specialist. Unfortunately, Newlife IVF is not permitted to assist you in finding a surrogate (nor can any other IVF provider). However, our counsellors can certainly orientate you to the Victorian surrogacy community and provide support and information as you look for a potential surrogate.

Ready to have a baby on your own?

Make an appointment with one of our caring and experienced Newlife IVF fertility specialists to discuss the most appropriate way forward based on your medical history, circumstances and preferences. Call (03) 8080 8933 or book online and take the next step towards your dream.

Budget versus premium-priced IVF clinics: does success cost more?

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The first point to make is that the cost of fertility treatment will always vary from couple to couple. This is because the type of treatment offered depends on the specific cause(s) of a couple’s fertility issues. But even when treatment is similar (e.g. standard IVF), the total cost of treatment can still differ because not every couple will achieve success straightaway. One couple may achieve success in just one treatment cycle while another couple may require two or more cycles. The latter scenario will lead to additional costs for storage of frozen embryos and repeat stimulation cycles or frozen embryo transfers (FET). Further, the cost of a round of treatment and ancillary costs, like storage fees, vary by provider.

In Australia, private fertility clinics typically fall into one of two service models: ‘budget’ or ‘premium’. So how do you choose between them – and is there an alternative to a low-cost or high-cost clinic? Before I answer that, let me explain some important differences between low and higher-cost clinics.

How do budget clinics differ from other providers?

A budget clinic is typically able to offer fertility treatment at low or no out-of-pocket costs by restricting the types of services they provide. For example, they may not offer care for all types of fertility issues, excluding those that incur a higher cost to the clinic. They may also choose not to offer specialised services such as pre-implantation genetic testing (PGT), donor conception (requiring donor eggs, sperm or embryos), surrogacy, or embryo freezing and storage.

Some budget clinics may also only offer standard medication protocols. For example, a woman who is 30 years old, within a specific weight range and has a certain number of eggs, may be assigned ‘Protocol A’ treatment without the option for an individualised treatment plan. Further, the doctors who consult at budget clinics are often on rotation, so you may see a different doctor for each of your appointments, much like an outpatient clinic at a public hospital. Budget clinics may also limit the number of IVF cycles that the clinic can start at any given time, which can lead to significant delays in treatment initiation and sometimes even a missed opportunity to conceive.

In contrast, non-budget clinics are more likely to offer all types of fertility treatment and extend their care to patients with more complex fertility issues. These clinics may also offer additional services such as PGT. The other benefit of these clinics is that you can choose which fertility specialist you want to manage your care. This specialist will provide personalised care specific to your needs and remain with you throughout your entire treatment journey. Lastly, these clinics don’t usually restrict the number of IVF cycles they can run at any one time, meaning you will be able to start treatment when you’re ready, rather than when the clinic can fit you in.

Do success rates vary between low-cost and higher-cost clinics?

Variations in each clinic’s patient populations make it difficult to draw a direct comparison between the success rates of two clinics. For example, some clinics may have a higher proportion of easy-to-treat patients versus patients with complicated fertility issues, which is likely to impact their success rates. Further, clinics can report ‘success’ in different ways, e.g. pregnancy rates may be reported as per egg collection OR per embryo transfer. Similarly, some clinics may report ‘success’ as a positive pregnancy test at the end of a treatment cycle, while others may report success only when a live pregnancy is seen on an early ultrasound (clinical pregnancy) or if a baby is born (live birth rate). Thus, if you are comparing ‘results’ between clinics, it’s important to check that they are using the same definition to report success.

Success rates may also not reflect the different ways patients can journey through IVF. For example, if a couple has all their embryos frozen because the woman is at risk of ovarian hyperstimulation, some clinics may record this stimulated cycle as one where the woman failed to proceed to embryo transfer. This doesn’t reflect that a fresh transfer was deliberately not attempted and that embryos were frozen for use in future FET cycles. Likewise, if pregnancy rates are reported after a FET cycle, it is not always clear if the embryo underwent PGT, which is likely to increase the chance of success.

I can only afford fertility treatment with a budget clinic – is it worth it?

Despite some limitations, there is a definite place for budget fertility clinics in Australia. If cost alone is the only barrier to starting fertility treatment, then a budget IVF clinic may still offer you a better chance of starting a family than trying to conceive on your own.

However, you should be mindful that the prices listed on a clinic’s website may not accurately reflect the total costs that you will incur throughout your care. The following questions are a great place to start when enquiring about treatment costs:

  • Are there additional fees for freezing surplus embryos?
  • What ongoing costs are associated with storing frozen embryos?
  • How much does a frozen embryo transfer cycle cost?
  • What fees do you charge for advanced lab procedures, such as intracytoplasmic sperm injection (ICSI) or PGT?

How do Newlife IVF’s fees compare to other providers?

One of the reasons we established Newlife IVF was so that we could offer patients high-quality fertility care at reasonable prices. As a doctor-owned clinic, we do not have the pressure of shareholders nor the need to meet the same profit margins required by larger, corporate fertility clinics. Not only do we offer premium fertility care at an affordable price, but our ‘routine’ treatments also include advanced lab techniques that other clinics typically bill as ‘add-ons’ on top of their standard service costs.

Some of these advanced techniques include the use of the EmbryoScope time-lapse system, sequential media and EmbryoGlue for all IVF treatments, as well as egg spindle visualisation for all ICSI procedures. These extra lab techniques help us to select the best embryo to transfer into the womb, improve the chance of the embryo implanting, while also providing more information about egg quality and embryo development. We include these techniques as standard because we want to give our patients the best chance of success, right from their very first treatment. If the first cycle is not successful, we use information gathered from the EmbryoScope and/or egg spindle visualisation to provide our patients with meaningful feedback, and to help inform future treatment decisions.

What additional value does Newlife IVF offer?

At Newlife, we pride ourselves on offering our patients a highly personalised fertility journey. We find our patients’ feedback speaks volumes about the exceptional standard of care we provide. Below are the top three things our patients say differentiate Newlife IVF from other IVF providers:

  1. Even though we are a new clinic, it’s clear that our fertility specialists, and supporting clinical, technical and administrative teams all have a wealth of experience in caring for patients who need help building a family.
  2. Our attentive and caring staff offer regular feedback and support throughout a patient’s treatment journey, so they feel confident we are looking after them and their embryos, which makes them feel less like a ‘number’.
  3. Our patients appreciate coming to the same fertility clinic and seeing their dedicated doctor for all of their appointments. Since Newlife IVF isn’t located in a large hospital, it feels less clinical and more personal.

How can Newlife IVF help individuals and couples who have not found success elsewhere?

If you’ve not been successful elsewhere, one of our highly-skilled fertility specialists can offer a fresh perspective and a second opinion.

Further, our in-house laboratory was specially designed to reduce volatile organic compounds (VOCs) and harmful blue light in order to provide ideal conditions for embryo growth. We also employ extra lab procedures that you may not have had access to at your previous clinic. These procedures are included as standard to optimise embryo development and give your embryo the best chance of successfully implanting in the womb.

Last word

Our best advice is not to take treatment fees at face value. Not all IVF clinics are equal, and the cost of care doesn’t necessarily equate to the overall value a clinic provides throughout your fertility journey. You can receive premium fertility care at affordable prices by choosing an independent provider with leading fertility specialists and a commitment to best scientific practice. At Newlife IVF, we offer high-quality care at reasonable prices, so you can focus on the task of falling pregnant without the worry of undue financial duress.

You can book an initial fertility consultation with one of our fertility specialists by calling (03) 8080 8933 or booking online.

Further reading

 

 

 

Switching on the ovaries – using fertility treatment to harvest your egg supply

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In women with regular menstrual cycles, an egg is usually released from the ovaries every month (‘ovulation’). However, in some women, the small fluid-filled sacs inside the ovaries (follicles) don’t always mature and ovulate (this typically affects women with polycystic ovarian syndrome). In this case, the release of eggs from the ovaries is unreliable – it either doesn’t occur at all, or only happens every now and again, leading to difficulty in falling pregnant.

If absent or irregular ovulation is contributing to your fertility issues, hormones and other special medications may be used to help your ovaries develop and release mature eggs. These medications may be used on their own to simply induce ovulation (‘ovulation induction’), with sexual intercourse then timed accordingly. However, these medications may also be used in combination with other fertility treatments if there are other factors contributing to your fertility issues. For example, if the quality and/or quantity of your partner’s sperm is also an issue (male-factor infertility), then simply getting the ovaries to release mature eggs is unlikely to be successful on its own. You may also need the help of artificial insemination (to insert a concentrated dose of sperm into the reproductive tract) or IVF (to collect the eggs for fertilisation outside the body).

How do we stimulate the ovaries to produce mature eggs?

The process we use to stimulate your ovaries to produce and release eggs is as follows:

1. Stimulation

Your fertility specialist will prescribe medication for you to take orally or by injection. There are a few different types of medications that may be used but they all work to increase the amount of follicle-stimulating hormone (FSH) in your body. Although your body naturally produces this hormone, the medication provides you with much more of it than what you would naturally produce on your own. The increased level of FSH is what causes the follicles inside your ovaries to develop and mature. At the start of puberty, you have around 400,000 follicles in your ovaries with the potential to develop into mature eggs. The number of follicles decreases year-on-year thereafter, with the greatest decline occurring after the age of 35.

2. Control

We will monitor you closely with blood tests and ultrasounds to see how your follicles are responding to the medication and to monitor for any side-effects. The aim is to allow the follicles time to mature while preventing the premature release of any eggs (‘ovulation’).

3. Egg release (ovulation)

You will usually be given an injection of human chorionic hormone (hCG) to trigger the release of eggs when the follicles are a good size. This is timed with sexual intercourse or artificial insemination to ensure there is sperm ready to meet the egg your ovaries release, in the hope that the egg and sperm will come together and develop into an embryo. Alternately, if ovarian stimulation is being used as part of the IVF process, then we won’t just ‘let nature take its course’. Instead, we will use ultrasound to help us physically retrieve the eggs your ovaries have produced. After we have collected your eggs, we will place them with your partner’s sperm in a special laboratory dish to fertilise. One fertilised egg (embryo) is then placed in your womb where it will hopefully ‘stick’ to the wall of the uterus and develop into a pregnancy.

Do all ovaries respond to stimulation?

Every woman responds differently to these medications. Thus, the dose of medication is tailored to each woman and closely monitored. However, even with this fine-tuning, sometimes the ovaries don’t respond well, in which case there may be no eggs or only a few eggs released. This is more likely to occur in older women (>37 years), women with elevated hormone levels, and women with reduced ovarian reserve (a low number of follicles to start with).

The type and dose of medication given will also depend on the type of fertility treatment you are having. If these medications are being used to facilitate the success of timed intercourse or artificial insemination, then we may use a more gentle mode of stimulation (e.g. oral tablets), as we are simply trying to mimic what would happen during your normal menstrual cycle – that is, have one egg lying in wait for your partner’s sperm to arrive.

However, if you are having this medication as part of the IVF process, then we would typically use injectable hormones at a dose that’s adequate for producing multiple eggs. Even if IVF circumstances are at their very best, not every egg placed with the male’s sperm in the laboratory will fertilise to form an embryo – and not every embryo will survive or be suitable for implanting into the womb. Therefore, the more eggs we make available for fertilisation by sperm during IVF, the higher the likelihood of producing a good number of high-quality embryos, which increases the chances of IVF success.

If my ovaries release lots of eggs, won’t that increase my chances of a multiple pregnancy?

Yes, these medications do stimulate the development of multiple follicles, so the ovary may end up releasing more than one mature egg. While this is desirable for IVF where the aim is to collect as many eggs as possible, it’s not ideal when these medications are used with timed intercourse or artificial insemination, as there is then an increased chance of having twins (or more). Although twins may sound like a lovely idea, multiple pregnancies do come with risks, both for the mother and babies. Thus, your fertility specialist will watch out for this via ultrasound monitoring – if too many eggs are developing, we may recommend abstaining from intercourse or adjusting the dose of your medication.

Multiple pregnancy is not an issue if ovarian stimulation is being used as part of the IVF process, as the eggs are being collected for fertilisation outside the body (in a laboratory dish) and we only implant one embryo into the womb at a time.

What are the potential side effects of these medications?

You may have heard that one of the more unpleasant aspects of fertility treatment is the side-effects of the medications used to stimulate the ovaries. Unfortunately, these medications do make you feel ‘hormonal’ and you may find yourself experiencing exaggerated PMS symptoms. The most common symptoms are temporary physical side effects, such as nausea, vomiting, headaches, cramps and breast tenderness. Mood changes, including mood swings, anxiety and depression, are also common. Bear in mind, however, that the emotional demands of infertility or IVF treatment can lead to similar feelings.

If you have injections, these may cause local skin irritations, but it is rare to have an allergic reaction to the medications.

The key risk associated with this type of treatment, particularly when higher doses are used as part of the IVF process, is ovarian hyper-stimulation syndrome (OHSS). This represents the body’s exaggerated response to the excess load of circulating hormones. It is characterised by enlarged ovaries and fluid accumulation in the abdomen. The chance of OHSS occurring is greater in women who become pregnant during the cycle in which the hormones are given and in women with polycystic ovary syndrome (PCOS). Close monitoring allows us to discontinue or adjust your medication if we start to see the signs or symptoms of OHSS. Be reassured that your fertility specialist will explain all the symptoms you should look out for, so you can let them know if you experience anything concerning.

Is ovarian stimulation right for me?

Ovarian stimulation plays a key role in many fertility treatments – from ovulation induction and timed intercourse to artificial insemination and IVF. For more information on how it could help you, make an appointment with one of our fertility specialists by calling Newlife IVF on (03) 8080 8933 or by booking online via our appointments page.

Further reading

Seeking a second opinion about your fertility treatment

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Living with infertility is emotionally and physically challenging – even more so if you have been on this journey for a long time. It’s only natural that you want to make sure you’ve explored every option available to you, or, be reassured that what you are doing is exactly what you should be doing. In this setting, seeking a second opinion can identify if there is an alternative treatment approach worth trying or provide reassurance that your current treatment plan is indeed the best way forward.

Psychologically, it can be very important for a woman or couple dealing with infertility to know that they’ve done everything they can to be successful. If you feel like getting a second opinion is an important part of this process, then don’t feel guilty about asking to see someone else or worry that your current doctor will perceive you as a difficult patient. Seeking a second opinion is very common (across all areas of medicine) but is especially important in the setting of infertility, when time is such an important factor in your success. The hard fact is: the older a woman gets, the lower her chances of falling pregnant, even with fertility treatment. Time is truly of the essence.

If you’re feeling uncertain about whether now is the right time to seek the advice of another doctor or clinic, here are some common reasons that you may be able to relate to:

“I still haven’t fallen pregnant”

If you’ve faced an extended period of failed IVF attempts and repeated disappointment, now may be the right time to look elsewhere for advice. How long you choose to stick with your current specialist depends on your individual circumstances. Fertility treatment often takes time, regardless of the specialist or clinic involved, so it’s important to be sure that you are seeking a second opinion for the right reasons and at the right stage of your care. The fact is, there are are many factors that can influence your chance of success with IVF – having another clinician review why IVF may not be working for you, may be the key to your future success.

“I want to explore different treatment options”

If you have doubts about the approach your doctor is taking and they won’t or can’t offer you any alternative treatment options, a second opinion may open the door to new possibilities and set your mind at ease. Remember, not all fertility doctors have the same level of expertise or experience. Some doctors may have a preferred treatment approach, as this is what they are used to, or have had the most success with. In this case, talking to someone new could reveal other options worth trying or better suited to your circumstances.

“I’m not happy with my level of care”

A woman or couple’s fertility is a highly sensitive topic and different people need different levels of support. If you feel like you haven’t been getting the level of attention you require or you sense a lack of care or compassion from your current clinic or specialist, a change in provider may lead you to a doctor with whom you have greater rapport and who gives you greater peace of mind. Besides the fertility specialist, also consider the wider fertility team with whom you have to interact with during the course of your care – the fertility nurses and counsellors, even the receptionists. If the ‘vibe’ you get from the people involved in your care is not on par with your expectations, then you may find that another fertility clinic is more ‘up your alley’.

“I have concerns about the cost of treatment at my current clinic”

If your current clinic cannot offer treatment in a price range you find acceptable, a change in provider may be a very practical solution for you. Undergoing fertility treatment is stressful enough – you don’t want to have to worry about your finances as well. If your funds are running low (or were low to begin with!), you may find that another fertility clinic offers the same treatment at lower rates, so that your overall out-of-pocket expenses are lower. This is particularly true for IVF, as the cost of IVF can vary considerably from one clinic to the next.

How to go about it

You aren’t alone in your fertility journey – talking to others who have first-hand experience with fertility treatment can help shed light on other clinics and fertility specialists and what they are like to deal with. This could be a great time for you to speak to your peers or join a fertility support group to help you decide what you should do next.

If you have a good relationship with your current fertility specialist, be open with them about wanting to seek a second opinion and ask them if there is someone else they might suggest. In this case, they will usually write a referral letter and/or call the specialist they are referring you to, in order to explain your fertility journey to date and outline what they see as the key outstanding issues in your care. You may feel uncomfortable about having this conversation with your doctor, particularly if you’ve been through a lot with them, but remember that they ultimately have your best interests at heart and also want you to do what’s necessary to be successful.

Lastly, you can also ask your GP if there is another specialist or clinic they would recommend. GPs see many patients with fertility issues, so may know someone with similar issues to you that had success with a particular treatment, approach, or doctor.

If you’d like a second opinion from Newlife IVF, just ask

If you would like a fresh perspective on your fertility treatment from Melbourne’s caring, experienced fertility specialists, the doctors at Newlife IVF would be very happy to review the treatment you’ve received thus far, and provide advice on the options available to you. To make an appointment, call (03) 8080 8933 or book online.

Secondary infertility – when baby #2 (or 3 or 4 …) doesn’t come easily

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Secondary infertility, defined as the inability to conceive despite having conceived in the past, affects approximately 10% of women.1 It is different from primary infertility, which is when a woman who has never conceived before struggles to fall pregnant.

Secondary infertility can produce similar heartache to primary infertility, especially if you feel your family is not yet complete, you want to provide your children with a sibling, or you long for the son or daughter you don’t yet have. It’s important to recognise that your feelings and concerns are valid, and shouldn’t be brushed aside simply because you already have one or more children – you are equally deserving of seeking help to achieve a second or subsequent child, as are a woman or couple yet to have any children.

What causes secondary infertility?

There are a number of factors that are commonly associated with secondary infertility. These include:

Age

It’s common knowledge that women have a ‘biological clock’ – that is, the age-related decline in a woman’s fertility, due to a decrease in the number and quality of her eggs. This decline accelerates once a woman hits 35. Given that a woman is usually older when planning subsequent pregnancies, her increasing age can be a significant contributing factor to any difficulty she is experiencing second (or third or fourth …) time round. This is particularly true nowadays due to the societal trend towards older age at first pregnancy, meaning women can be well over 35 when they are ready to start trying for another child. For men, there is also a gradual age-related fertility decline from the age of 40, even if their sperm count is reported as normal.

Lifestyle

Successful conception requires unprotected sexual intercourse to occur at the right time – around the time of ovulation, when an egg is released from the ovaries. Consequently, unprotected sex every one to two days during this ‘fertile window’ each month provides the best chance of falling pregnant. However, with one or more young children to take care of, maintaining regular sexual intercourse, let alone doing it at the ‘right’ time, can be difficult. Further, you may not be taking care of yourself as well as you usually would, as you put the needs of your little one/s first. A good diet and regular exercise can fall by the wayside for mums of busy toddlers. This, combined with potential weight gain, can also contribute to sub-optimal fertility at this time of life.

Complication from a prior pregnancy or delivery

Scar tissue can sometimes form inside the uterus (womb) or cervix. This may be an issue if you have ever had a procedure called a dilatation and curettage (D&C) to remove tissue from the uterus due to a miscarriage or retained placenta after a previous birth. Although uncommon, the presence of scar tissue can prevent a pregnancy. However, it can usually be removed via a simple procedure called a hysteroscopy.

Secondary infertility can also be caused by many of the same factors that cause primary infertility. For women, this includes ‘structural’ disorders that may be affecting the health of your reproductive organs (e.g. endometriosis, fibroids, polyps), as well as hormonal disorders like polycystic ovarian syndrome (PCOS) and thyroid disease. Thus, a full check-up with your gynaecologist is a good first step if your next pregnancy isn’t coming as quickly as you would like or expect.

What should I do if I’m experiencing secondary infertility?

The advice for those experiencing secondary infertility is the same as for those experiencing primary infertility. If you are under 35, seek help after 12 months of trying. If you are over 35, seek help after 6 months of trying. Depending on your circumstances, fertility treatment may be as simple as ovulation tracking and fertility optimisation through lifestyle changes. For advice specific to you, you can make an appointment with one of our fertility specialists by calling Newlife IVF on (03) 8080 8933 or by booking online via our appointments page.

Exercise

Further reading

 

Reference
  1.  Mascarenhas et al. PLoS Med. 2012;9(12):e1001356. ↩

The ART of falling pregnant later in life

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So, why is age so important?

Put simply, as you get older, the number and quality of your eggs decreases. Unlike men, who continue to produce new sperm throughout their lives, a woman is born with all the eggs she will ever have. While sperm quality (shape and speed) falls as a man ages, there is little effect on fertility or the child until men enter their mid 50s.

Thus, if you are over 35 and haven’t fallen pregnant within six months of trying, we may begin our assessment by checking your ‘ovarian reserve’. There are two tests we commonly use. The first involves measuring the level of anti-mullerian hormone (AMH) in your blood. This hormone is secreted by the cells that surround and protect the eggs, so it gives us an idea of how many eggs you have left (the higher the hormone, the higher the number of eggs you are likely to have left). We can then assess if your egg reserve is about what we would expect given your age. The second test we can use is called an ‘antral follicle count’. An ultrasound is performed (usually in the first week after a period) to look at your ovaries and count the number of follicles (small ovarian cysts containing the eggs that will grow that month). Both tests will help inform our approach to fertility treatment. Unfortunately, neither test tells us anything about the quality of your remaining eggs.

What are my options for falling pregnant later in life?

While it may be hard to hear that you are statistically less likely to conceive after the age of 35 than you were in your 20s, the good news is that there are now a number of fertility treatments available to assist couples who start trying for a baby later in life but then find that they’re unable to conceive naturally.

Some of the options that may be presented to you include:

1. Ovulation tracking

­This is a relatively simple approach where we track your menstrual cycle using blood and ultrasound tests. By doing so, we can tell you when you are most fertile (i.e. most likely to release an egg from your ovary), so you can align the timing of sexual intercourse accordingly. Basically, we want egg and sperm to both be in the same place at the same time, thereby improving your chances of fertilisation (i.e. egg meeting sperm and joining to form an embryo). This is a bit like the old TV show ‘Perfect Match’, where one girl (i.e. one egg) has her choice of a few different men (i.e. the millions of sperm present in a man’s semen), but it doesn’t necessarily mean she’ll hit it off with any of them. We are more likely to try this approach first if your AMH test shows that you have a good egg reserve. Note: if you have tried an over-the-counter home ovulation kit, be aware that ovulation tracking in the clinic is more accurate.

2. Ovulation induction

If your egg reserve is good, we may use medication to encourage your ovaries to release a small army of mature eggs. Again, sex is then timed accordingly, so a team of eggs and a team of sperm are both ‘hanging out’ in your reproductive tract at the same time – the equivalent of a group date where you just have to wait and see if anyone hits it off! Occasionally, we will also use medication to ‘trigger’ the release of eggs at the optimum time.

3. Intrauterine insemination (IUI)

If we think there is an issue with sperm getting to where it needs to be in your reproductive tract (i.e. having sex at the right time is not the problem), we may suggest pre-collecting your partner’s semen, so that we can ‘flush’ a large amount of highly concentrated sperm directly into your womb (with a syringe) around the time of ovulation. We may use this approach in combination with ovulation tracking or induction to ensure an egg is also available to meet the sperm.

4. In vitro fertilisation (IVF) using your own eggs

IVF involves stimulating your ovaries to produce multiple mature eggs, collecting these eggs, then placing them with sperm in a laboratory dish. Ideally, the sperm will then fertilise one or more of your eggs resulting in an embryo/s. One embryo is then placed into your womb in the hope that it snugly implants in the wall of your uterus, leading to pregnancy (any other embryos remain frozen for future use). By placing egg and sperm together outside the body, we help overcome any barriers that may be preventing this process from occurring naturally. Unfortunately, the revolutionary science of IVF cannot make up for the natural decline in fertility that occurs with age, including a drop in egg quality, which means that IVF success rates do tend to drop as women get older.

5. Pre-implantation Genetic Testing (PGT) of embryos as part of the IVF process

If you are an older woman undergoing IVF, we may recommend genetically testing your embryos before placing them in your womb to help improve your chances of a successful cycle. You can read more about PGT elsewhere on our website, but essentially these tests involve checking your embryos for genetic anomalies, so that we can select the embryo with the best potential for development for transfer into your womb. These tests can be particularly helpful for older women because the incidence of genetic abnormalities increases with age, leading to higher rates of implantation failure and miscarriage with IVF. Thus, if we can identify the highest-quality embryo for transfer, we give IVF the best chance of success.

6. In vitro fertilisation (IVF) with ICSI or IMSI

ICSI or IMSI may also be used during IVF to improve your chances of success. Again, you can read about ICSI and IMSI elsewhere on our website, but in general, these techniques help overcome any sperm-related issues that may be impacting your ability to fall pregnant naturally. While sperm ‘problems’ are not necessarily a sign of older age, certain health or lifestyle issues can be more common with age, which may impact the quality and quantity of your partner’s sperm. ICSI may also be used if there are no obvious sperm problems but fertilisation failed during one or more previous IVF cycles (i.e. when eggs and sperm were placed together in a laboratory dish, no pairs came together to form an embryo).

7. In vitro fertilisation (IVF) using donor eggs

If you’re older and do not succeed with IVF using your own eggs, egg donation from a younger woman may improve your chances of having a baby via IVF. Studies show that if an older woman undergoes IVF using eggs from a younger donor, her chances of having a baby match the donor’s age group. IVF using donor eggs is also an option for women whose ovaries don’t produce any mature eggs despite hormonal stimulation or who have entered menopause prematurely (< 40 years old).<

8. ‘Going it alone’

If you are an older, single woman without a male partner but want to try for a baby on your own, donor sperm with the help of IUI or IVF now makes this very possible. However, it’s better to make this decision earlier rather than later, while you are still likely to have a good number of quality eggs. Every year after 35 reduces your chances of having a successful pregnancy, even with the help of IUI or IVF.

When to seek help

If you’re over 35, we advise seeking help from a fertility specialist if you don’t fall pregnant after 6 months of trying. If you’re a single woman over 35 and want to explore the option of donor sperm, we advise seeking professional help as soon as possible, as there can be a wait-list for donor sperm.

For advice specific to you, you can make an appointment with one of our fertility specialists by calling Newlife IVF on (03) 8080 8933 or by booking online via our appointments page.

Further reading

Sperm donation – separating fact from fiction

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Wanted: a few good men!

As a growing number of single women make the decision to embark on solo parenting, lesbian couples embrace techniques like artificial insemination and IVF to help them have a family, and fertility issues become more common for heterosexual couples who meet and marry later in life, there’s never been a more appropriate time for Australian men to donate their sperm.

However, despite a clear need for more donor sperm, there’s still a lot of myths around sperm donation, and understandably, men are often hesitant to put themselves forward. Here, we explore the truth behind the most common misconceptions to help overcome some of the fears men may have about becoming a donor.

“Gay men can’t donate sperm.”

A gay man can donate sperm just like any other healthy male. In Australia, sexual orientation plays no part in deciding whether or not you can become a sperm donor (admittedly, this is a clear contrast to the policies of some international sperm banks). Unfortunately, because men who have sex with men are prevented from donating blood – due to a perceived increased risk of sexually transmitted diseases – some people assume that gay men can’t donate sperm either. However, that’s simply not the case and here in Australia, gay men have actually been credited for increasing the availability of donor sperm.

The fact is, all sperm donors – no matter their sexual orientation – are screened for infectious diseases before their sperm is cleared for use. This includes blood tests at the time of donation and again at 3 months. Sperm is only made available to potential recipients after both sets of blood tests have been given the all clear (this is why donor sperm is not used straightaway but quarantined for 3 months).  Simply put, sexual orientation doesn’t form part of the eligibility criteria for sperm donors and is irrelevant to your ability to donate. Whether you’re gay, bi or straight, your intent is exactly the same – to give in order to help others in need.

“My sperm could be used to make hundreds of children.”

You may have come across news stories about men abroad who have fathered many, many children through sperm donation (some well into the double figures!). However, Australian law simply does not permit this. In Victoria, sperm from a single donor is only allowed to be used by a maximum of 10 different patients or ‘families’. This effectively limits the number of potential children that can be conceived by any one donor.

On the other hand, there is no limit to the number of children that can be born from the same sperm donor within each of these families. This gives families the opportunity to bear siblings who are genetically related. So if a recipient has success with your sperm, they may choose to use your sperm again in the future when trying for baby #2 or 3 in order to give their child a biologically-related brother or sister.

But it’s also important to realise that your sperm may never be used or may only be used once or twice. If it is used, there is also no guarantee that the process of assisted conception (e.g. IVF or IUI) will be successful for the recipient, i.e. a child may not result every time your sperm is used. Further, the semen we collect from you may also not ‘stretch’ to ten different families. This, along with unsuccessful IVF attempts, is why we like donors to provide a few sperm samples over time.

“If you donate sperm, you’ll have children showing up on your doorstep for years to come.”

The Victorian government was one of the first to query the ethical implications of the secrecy surrounding sperm donorship. As such, current legislation states that a donor-conceived person can request identifying information about their donor once they turn 18. This loss of guaranteed anonymity is one of the main reasons why the number of sperm donors has dropped over recent decades. However, although a donor-conceived child has the option of getting in touch with you once they are an adult, this doesn’t necessarily mean they will do so. Some children may not know they are donor-conceived while others will simply have no inclination to reach out.

If a child conceived from your sperm does choose to get in contact with you, you still have no legal, financial or parental responsibilities to that child. However, you may find that you are happy to build and maintain a relationship with them. In this case, you can discuss and agree together the extent of any future contact, in line with what you both feel comfortable with.

“If you’re a sperm donor, you’re a father of all the children who are born.”

When you donate your sperm, it provides the biological means to create a baby only. Men who donate sperm anonymously through a registered sperm bank are not legally or financially responsible for any child born from their sperm. Sperm donor recipients (i.e. the mum and dad to be) must also receive counselling to ensure mutual understanding of your rights as a donor. Put simply, you are just the sperm donor, not the Dad. And we make sure that everyone involved knows that they do not have the right to ask or expect you to be anything more than that.

“Only good-looking men’s sperm will be used”

Don’t think your sperm will be wanted? Think again! The reality is that recipients often have their own ideas of the ‘dream’ sperm donor. And this could be you! When it comes to donor selection, your physical attributes (e.g. blue eyes, brown hair, height) are listed but photos are never provided. More often than not, recipients will choose a donor based on other information provided, including your age, medical history, hobbies/interests, ethnic background, and reason for donating. For example, we know one woman who chose her donor based on the fact that he (like herself) had a penchant for trivia, a trait she hoped would be passed on to her future child!

The fact is, the most important attribute of any sperm bank is variety, thereby enabling choice. That’s why we welcome donors from a wide range of nationalities, cultures, professions, and stages and ages of life. This ensures that women and couples have the opportunity to choose a donor that aligns with their personal preferences, particularly if bearing a child with a clear physical resemblance or from a certain ethnic background (e.g. Asian, Anglosaxon) is important to them.

Donate life, change lives with Newlife IVF

Newlife IVF loves hearing from new sperm donors – single men, fathers, gay individuals or couples. Come one, come all! If you have been thinking about becoming a donor but haven’t yet taken the next step, please call us on (03) 8080 8933 or email [email protected] so we can give you all the facts and get your swimmers to those who need it sooner rather than later!

Further reading