Your guide to a successful egg collection

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What is egg collection?

Egg collection (also referred to as ‘egg retrieval’ or ‘egg pickup’) is the process by which we collect eggs from your ovaries. The eggs collected can then be frozen and stored, or used in the next step of an IVF cycle. Usually, we will be able to collect around 8–12 eggs but this is dependent on multiple factors, including your age.

Sometimes, you may need to undergo more than one egg collection, so we have a good quantity of eggs available (in the double digits is ideal). The number of eggs is important, whether you are freezing your eggs for potential use in later life, or whether you are moving on to the next step in the IVF process straightaway.

How do I prepare for my egg collection?

Two weeks before your egg collection

You will require regular hormone injections for around 8–14 days before your egg retrieval. This varies based on how your body is responding to the fertility medications and which regimen your fertility specialist decides is best for you. These injections encourage the maturation of eggs that would otherwise deteriorate. This is important as only mature eggs are capable of fertilisation when combined with sperm (an egg and sperm must successfully unite in order for an embryo to form).

While injections can sound painful and daunting, the needles are very small and easy to use. We will teach you (or a partner or another preferred person) how to give the injections at home.

You can read more about how we stimulate the ovaries to produce mature eggs.

The week prior to egg collection

An ultrasound image showing the number of follicles within a woman's ovary
Ultrasound imaging is used during fertility treatment to track the development of ovarian follicles.

About a week after you start these medications, you will have a vaginal ultrasound so we can view your ovaries and count the number of follicles present. Usually, each follicle will contain one egg. The number of follicles gives us a good idea of how well you are responding to the fertility medications, while the size of the follicles is a good indicator of egg maturity. Unfortunately, small follicles usually contain immature eggs, which can be difficult to retrieve – they tend to stick to the follicle wall during collection. Thus, we may need to adjust your fertility medications to encourage more growth.

Ultrasound and blood tests also help us to determine the best time to collect your eggs. As such, these tests will be performed over the course of this week with the exact timing of your egg collection updated in line with your results. This change in schedule can sometimes be frustrating for patients, particularly in the midst of work commitments, but it ensures we are collecting your eggs at the optimal time in terms of both egg quantity and quality – the more mature eggs, the better!

1–2 days before your egg collection

Around 35–36 hours before your scheduled egg collection, you will have a ‘trigger injection’. This is a different hormone medication and will trigger ovulation (the release of eggs from your ovaries).

We will also ask you to fast from 6 hours before the time of your scheduled procedure (this reduces the risk of nausea and vomiting later).

Morning of your egg collection

On the morning of your egg collection, you may feel both excited and nervous – and hungry (!) from fasting. There are just a few things we need you to remember:

  • Continue to eat and drink nothing. Small sips of clear fluids are okay up to 2 hours before your procedure
  • Brush your teeth – we understand the last thing you want to do is to break our ‘nothing to drink’ rule but it’s okay to brush your teeth!
  • Wear loose fitting, comfortable clothing
  • Do not wear any makeup or jewellery, and
  • Confirm the availability of the person you have organised to drive you home after your procedure and to ideally spend the rest of the day with you while your sedation wears off.

What will happen when I arrive for my egg collection?

On arrival, please make your way to our Ground Floor reception to complete your admissions paperwork. We will then guide you through to a waiting area where you can change into a hospital gown. There will usually be a period of waiting at this point, as we schedule your admission time an hour before your procedure. We recommend bringing a good book or podcast along.

Next, we will discuss the procedure with you, check when you took your trigger injection, answer any last-minute questions you may have, and ensure you understand and feel comfortable with what will happen next.

When it’s time for your procedure, we will guide you through to the procedure room and give you some light sedation. Once the sedation has kicked in (you will feel drowsy and relaxed), we will insert an ultrasound probe into your vagina. This provides a clear view of your ovaries and the follicles inside them (the eggs are located inside these follicles). We will then guide a fine needle attached to the probe into each of the follicles, one at a time. A suction device attached to the needle drives the fluid inside the follicle up the needle and into a heated test tube. This entire process takes around 20–30 minutes.

An image of oocyte-containing fluid collected from an egg retrieval procedure
During the egg retrieval procedure, fluid is collected from ovarian follicles, which contain eggs (the dark, circular spots).

The fluid collected is taken straight through to our lab for examination by one of our embryologists. Under a microscope, they can carefully identify the eggs and discard the fluid. Our lab is directly adjacent to our day surgery so your eggs don’t have very far to travel!

If your egg collection is for the purposes of egg freezing, any mature eggs we find will be frozen and stored within a few hours of your procedure. If your egg collection is part of an IVF cycle, we may also freeze the mature eggs for use at a later date. Alternatively, we may proceed to the next step of the IVF process straightaway, placing your eggs with specially-prepared sperm from your partner or donor (this is called ‘insemination’).

Depending on how many eggs were collected and the volume of sperm available, 1–2 eggs will each be placed in a petri dish with a concentrated sperm sample containing around 100,000 sperm! Ideally, each egg will be fertilised by a single sperm, with every normally fertilised egg having the potential to grow and develop further into an embryo. However, it’s important to note that not every egg we collect will be mature, and not every mature egg placed with sperm will be fertilised. Hence, by collecting multiple eggs, we increase the chances of success at this step in the IVF process. You can read more about fertilisation and what impacts its success.

What happens after my egg retrieval?

Around 90 minutes after your procedure, your designated person can take you home. Before you leave, let us know if you need a medical certificate. We recommend taking it easy for the rest of the day.

If you are planning to freeze your eggs, we will generally call you later that day to tell you how many mature eggs were collected. If we are proceeding with insemination, we will usually call you the next day instead, so we can also tell you how many of these eggs were successfully fertilised overnight. Any fertilised eggs will be placed in an incubator in our lab. Here, their development will be monitored closely with the hope that they continue to grow into healthy embryos, ready for the next step in the IVF process – embryo transfer.

How can I best support my recovery after an egg collection?

Most women will experience some mild pain or discomfort after an egg collection and it may take weeks for this discomfort to ease completely. To help support your recovery, we recommend:

  • Placing a heat pack over your belly and resting if you’re experiencing any cramping or discomfort. If your pain continues, take some paracetamol. Note: do not take any antihistamines, ibuprofen, aspirin or non-steroidal anti-inflammatory medications if you are planning to have an embryo transfer
  • Consuming clear fluids if you are nauseous until you feel better
  • Looking out for any vaginal bleeding (but don’t worry if you notice some light spotting or bleeding for a few days – this is completely normal)
  • Avoiding vaginal creams, lubricants or spermicides (aside from the progesterone cream we may have given you)
  • Avoiding all heavy lifting or vigorous exercise such as running or cycling for a few weeks
  • Staying away from hot tubs and Jacuzzis
  • Limiting your caffeine and alcohol intake
  • Avoiding intercourse for a few days or until you feel comfortable. Engaging in intercourse around this time can result in natural conception; however, it’s important to listen to your body and only do what it feels physically ready for.

Are there any symptoms I should watch out for?

There are a few symptoms to watch out for after this procedure, including fever; pain, nausea or vomiting that’s not improving; heavy vaginal bleeding; feeling overly weak, faint or dizzy; shortness of breath; pain in your shoulder area; severe stomach bloating; rapid weight gain; or little to no urination despite drinking plenty of water.

If you are concerned or worried about anything you are experiencing, please call our clinic for advice on (03) 8080 8933. Alternatively, you can contact your fertility specialist. After-hours, you should visit your closest emergency department.

Still got questions?

If you have an upcoming egg collection booked and still have questions, don’t hesitate to give us a call on (03) 8080 8933. If you’re interested in learning more about egg freezing or IVF, check out the rest of our website for further information. For personalised advice, you can also book an appointment with one of our fertility specialists.

Newlife IVF is Climate Active certified!

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Our efforts to implement sustainable business practices that reduce our carbon footprint have allowed us to become members of a community of progressive organisations known as the Climate Active network. This Australian initiative represents our nation’s collective effort to measure, reduce and offset carbon emissions that contribute to global warming.

What it means to be Climate Active

We’re serious about sustainability and addressing climate change – so much so that we’ve become a carbon-neutral organisation. This means that we’ve calculated our carbon emissions and have taken action to remove the equivalent amount of carbon that our business produces from the earth’s atmosphere. We’re also continuing to look for ways to reduce our carbon footprint even further.

Improvements we’ve made so far include introducing a recycling program to limit our waste. We’ve converted paper-based processes to digital workflows and, in doing so, have become a 95% paperless business. We also opt for reusable and environmentally friendly products whenever possible while sourcing as many materials as we can from Climate Active certified suppliers. Our electricity is now sourced from a carbon-neutral energy retailer, and we have also invested in Australian and international emission reduction projects.

To ensure that we remain accountable and on track, we’ve assigned ‘climate champions’ to each business department who are responsible for increasing environmental awareness and driving behavioural change in line with our sustainability goals. Collectively, these initiatives will help our business remain Climate Active, while also working towards our future ambitions of further reducing carbon emissions year after year.

How will these changes affect our fertility care?

They won’t! We may have developed a green thumb, but it’s business as usual, and Newlife IVF will continue to offer an exceptional standard of fertility care at an affordable price.

There is, however, a broader implication for our patients – this certification helps you identify brands and businesses working towards a bright and sustainable future. Therefore, you can choose to work with Climate Active organisations that are doing their part to support climate leadership and sustainable business practices.

Change happens when we all play our part, and we are proud of the efforts we have made so far to combat climate change.

Learn more about Newlife IVF’s accreditations.

Climate Active Accreditation logo

Your fertility treatment and COVID-19, including vaccination advice

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Is IVF treatment going ahead?

The current restrictions to non-elective surgery that led to the suspension of some IVF services in Victoria will be lifted from 11.59pm on Tuesday 25 January 2022. This means that IVF stimulation cycles can resume from 26 January 2022. However, as the 26th is a public holiday, in-clinic procedures such as egg collection will effectively resume on 27 January 2022. Please contact your fertility nurse on Day 1 to check in as you usually would.

In the meantime, all other procedures continue as planned, including IVF cycles that commenced prior to 6 January 2022, frozen embryo transfers (FET), intrauterine insemination (IUI), ovulation induction, urgent medical egg freezing (e.g. due to impending cancer treatment), semen analyses and sperm freezing.

Should I have the COVID-19 vaccine (or booster) if I’m undergoing fertility treatment or IVF?

Yes. Based on advice from the Australian & New Zealand Society of Reproductive Endocrinology and Infertility, we support the decision to get a COVID-19 vaccination, including boosters, during fertility treatment. There is no evidence that the vaccine will affect your overall fertility or current treatment, nor the pregnancy that follows. This is true for both men and women.

We recommend that you avoid having the vaccine (or booster) in the days leading up to your admission to the hospital for embryo transfer or egg collection. Approximately 15% of patients have a fever following vaccination. Whilst this in itself is not worrying, hospital protocols may prevent patients who have a fever from being admitted to the hospital.

Should I have the COVID-19 vaccine (or booster) if I am pregnant?

Yes. The Pfizer vaccine is now recommended for all women who are pregnant. There has been extensive use of this vaccine in the US and UK with no specific pregnancy complications and no increase in overall complications compared to non-pregnant recipients. There has been no increase in fetal abnormalities or birth defects, nor is there any plausible reason for how this could occur. What has been seen with vaccine administration is a reduction in the chance of the pregnant woman getting COVID-19, and we know that pregnant women are more likely to get severe COVID infection requiring hospitalisation, admission to an Intensive Care Unit, and death.  Increased rates of premature delivery of babies has been seen in pregnant women with severe COVID, and this can be reduced through vaccination.

Does the COVID-19 vaccine (or booster) cause miscarriage?

No. There is no evidence of an increased risk of miscarriage or abnormalities in the physical development of your baby.

Should I have the COVID-19 vaccine (or booster) if I am breastfeeding?

Yes. COVID-19 vaccines are thought to be safe and not considered to be a risk to your child.

How do COVID-19 vaccines work?

These vaccines protect you from COVID-19 by fooling your immune system into making an immune response to small proteins that are associated with the SARS-CoV-2 virus (the virus causing the disease COVID-19). Your body will then have pre-built immunity should you ever be exposed to the real virus and you will be protected. For an adequate response, it is recommended that you receive the vaccine twice, several weeks apart (for Pfizer, which is currently the only vaccine recommended for use during pregnancy or for men and non-pregnant women aged 40–59) and several months apart for AstraZeneca (which men and non-pregnant women aged 18–39 may receive if they provide informed consent). A booster shot is now also recommended. At the time of writing, it is recommended that Victorians have their booster 3 months after their second vaccination. Further booster shots may be recommended in the future.

What are the side effects of the COVID-19 vaccine?

There are minimal side effects that remain uncommon. These include a sore injection site, headache, fatigue, temperature rise and muscle weakness. These symptoms are not from you having ‘mild COVID-19’; they are a result of the immune response that your body mounts in response to the vaccine.

What should I do if I am newly pregnant?

Get the vaccine as soon as possible! As above, the Pfizer vaccine has been determined safe for use during pregnancy in Australia.

What effect does the COVID-19 pandemic have on my fertility treatment?

As of 27 January 2022, we will be back to offering all of our usual fertility treatments. In the meantime, Newlife IVF remains open, and our fertility specialists, nurses and counsellors are all available, with consults taking place virtually (via telehealth or videoconferencing). Patients are still able to attend face-to-face appointments with their fertility specialist when an examination is required. During IVF cycles, patients are able to attend for pathology and ultrasound tracking in person, as well as undergo their fertility procedures in our on-site partner day surgery, Epworth Eastern Ekera.

Please note: Newlife IVF must follow directives from the Department of Health, as well as the policies of Epworth Eastern Hospital, and these are subject to change. Currently, all patients undergo exposure risk screening prior to attending our facilities, and in some circumstances, a COVID-19 swab is required.

Further, any patient actually diagnosed with coronavirus will be managed by the Department of Health, and they will be unable to attend the clinic while infectious.

As we all know, Government and Department of Health advice can change at short notice. However, we are hopeful that there will be no further forced interruptions to IVF or fertility treatment once all treatment resumes on 27 January 2022.

If I am having difficulty conceiving, is it still safe to seek help?

It is safe to undergo fertility assessment and treatment due to the numerous precautions we’re taking during the process. We still advise you to seek help from one of our specialists in line with our usual recommendations:

  • If you are under 35, we advise seeking help after 12 months of trying for a baby without success.
  • If you are over 35, we recommend seeking help after just 6 months of trying.

We can arrange a virtual consult or see you in our rooms with suitable precautions in place. Our clinic is taking a number of steps to ensure safety, such as maintaining social distancing by staggering patient appointments and temperature checks. Please ensure good hand hygiene and frequent hand washing or use of hand sanitiser if attending in person.

We recommend patients remain proactive about their fertility assessment and treatment throughout this period due to the natural decline in fertility with age.

What should I do during this period if I’m undergoing fertility treatment?

We are encouraging our patients to do all the recommended actions to reduce their risk of being exposed to COVID-19 including social distancing and hand hygiene, and we are strongly supporting vaccination against COVID-19 before and during fertility treatment. It’s even more important than usual to keep healthy by eating well and exercising to benefit your physical and mental health – see our blog for useful tips.

What happens if I am quarantined during or before my fertility treatment?

During your period of quarantine, we will be following advice from the Department of Health and Human Services, who may advise that you are unable to attend Newlife IVF clinics for appointments, ultrasounds, blood tests or fertility procedures (such as embryo transfer). If you suspect you need to self-quarantine or have been told to undergo quarantine, please contact our nursing team as soon as practicable by calling (03) 8080 8933. While our first priority is to reduce the spread of coronavirus through our community, we will do what we can to facilitate your care and continue with your treatment, if it’s appropriate and safe to do so. For example, some appointments can be managed by teleconference, or home delivery of medications may be appropriate. Your fertility nurse will advise what is possible in your particular situation.

What effect does COVID-19 have on pregnant women?

Over the course of the pandemic, lots of information has been gathered on the impact of COVID-19 on pregnancy.  We can now say with confidence that:

  • There is no direct effect on a baby’s physical development if his/her mother is infected with COVID-19. By this, we mean, the virus itself does not lead to an increase in fetal abnormalities.
  • There are some reports of COVID-19 causing an infection in an unborn baby, but the risk must be quite low.
  • There is an increase in premature birth if the mother is infected with COVID-19.
  • Pregnant women are not more likely to become infected with COVID-19 than non-pregnant women.
  • Pregnant women are more likely to have severe COVID-19 infections. Severe infection includes a much higher rate of hospital admission, respiratory distress syndrome, and intensive care unit admission for mechanical ventilation (breathing with a tube). This is the major contributor to the increase in preterm birth; pregnant women can be so unwell that the baby must be delivered, regardless of the gestation, in order to save the mother’s life.
  • Pregnant women are more likely to die from COVID-19 infection than non-pregnant women.

However, it is important to note that most pregnant women who have a COVID-19 infection experience a mild infection only and recover fully with no impact on the pregnancy.

Can I pass coronavirus on to my baby?

It is possible but very unlikely.

If I am diagnosed with coronavirus during my pregnancy, what effect will it have on my baby?

The major risk to your baby is that premature birth is more likely.  It does not increase the chance of abnormalities in your baby.

I’m still worried – what can I do?

It is understandable to feel anxious at this time on top of the normal worries associated with fertility treatment and pregnancy.  Don’t feel like you have to cope alone. We are always here to help, and the coronavirus pandemic is no exception. Please do not hesitate to call (03) 8080 8933 to speak to one of our team members or email [email protected].  We will then direct you to our fertility specialists, nursing or counselling team, as appropriate, for support and information.

This is certainly an extraordinary time but we will all get through it together.

If you have any further questions, do get in touch!

Stay safe and take care, from Chris and the rest of the Newlife IVF team.

#inthistogether

Disclaimer: all information in this post is correct as of 20 January 2022 and will be regularly updated as new information and advice from health authorities comes to hand.

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.

Infertility, IVF and the festive season

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This post was contributed by Laura Oliver, one of Newlife IVF’s counsellors. 

Christmas often symbolises a time of joy and happiness. We plan celebratory events with family and friends, and take time to reflect on the end of another year. But this time of year can also be very difficult for women and couples who have been struggling with infertility and going through assisted reproductive treatment (ART) like IVF.

The focus at Christmas time is often on children and families, with Christmas cards and social media posts typically displaying pictures of family events or children with Santa. There can be a real sense of pressure to deliver good news at a time of year when many people are celebrating. However, if you’ve been struggling to fall pregnant or undergoing fertility treatment, the end of the year can serve as a painful marker that you have not achieved what you had hoped for this year, and for some of you, a reminder that yet another 12 months have gone by without a successful outcome.

All of this can bring up unwanted feelings of sadness, frustration, jealousy, anger and grief – and with a barrage of festive mementos and occasions around you to remind you that you’re not pregnant, it’s no wonder you feel this way!

Below are some tips on how you can manage the festive season while coping with fertility issues and undergoing treatment.

Be selective

Pre-plan and be selective about which events you attend at this time of year. If you do attend an event, consider how long to stay there for, and what you can do while there to minimise any feelings of stress or discomfort – for example, helping cook or wash up can help keep you busy and distracted, and may assist you to avoid topics of conversation you don’t want to be involved in.

Warn people in advance that you may find Christmas difficult – this doesn’t mean having to disclose information about your fertility; you can make more general references to having had a stressful or difficult year instead. Try to give your hosts time to understand that this year might look a little different for you, and to not be offended if you decide not to attend or only stay for a short while.

If you have a partner or a support person with you, plan a code word or signal to give when you need them to rescue you from a difficult conversation, or when you want to wind up and go home.

Celebrate

Celebrate how you want. Sometimes, this might feel a little selfish at a time when there are often traditions to uphold or family events to attend, but give yourself permission to celebrate in a way that is comfortable and meaningful to you at this time.

This could mean going away with a friend or just your partner (or staying home) and avoiding big family gatherings. Or starting a new tradition for this time of year. Do something that you know will bring you joy, no matter how small.

Re-charge

Use some of this holiday period to re-charge and take a break from treatment (if you feel you can). Take advantage of your time off work and prioritise self-care – pamper yourself! Get a massage, go away for a few days, plan some day trips to the beach or the countryside, or curl up with a good book.

Reflect

Take some time to reflect on your IVF journey so far, and perhaps think about your plans for treatment moving forward. Is there anything you could do differently next year? What are your expectations, and do you need to adjust these at all? Do you have questions to discuss with your specialist? Perhaps even think about how much longer you think you can continue with IVF treatment before needing to pause and reassess again.

Reflect on your own, with your partner (if you have one) or a support person. You could try using a journal to write down how you’re feeling, record the questions you may have, or come up with a list of pros and cons to aid future decision-making.

Ask for help

Use your supports (partner, family, friends) to help you work through any difficult feelings as they arise. Be open and honest with your networks about how you feel and the ways in which they can be of support to you. Be reassured that the way you are feeling, and the different types of emotions and thoughts that may be triggered at this time of year, are very normal. But we all cope in different ways, so make sure you do whatever it is you need to do to keep your heart, mind and body strong for the year to come. And above all else, remember to be kind to yourself!

Lastly, remember that the Newlife IVF counselling team is here to help. We can help you navigate and unpack your experiences and emotions. If you feel that you could benefit from the support of our counselling team, please call the Newlife IVF team on (03) 8080 8933.

If not IVF, then what? Fertility treatments explained

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In vitro fertilisation (IVF) is the most widely known fertility treatment, but it is not the only option available to help couples with fertility issues. This is due to the fact that there are many different reasons why an individual or couple may be experiencing fertility problems and treatment should be tailored accordingly. Thus, fertility treatment actually encompasses quite a wide range of methods, each of which can help people to overcome specific challenges and ultimately, conceive. We explain the different options below, including when they might be suitable.

First-line treatments

Ovulation induction

Ovulation induction may be recommended for women who are not ovulating regularly or who are not ovulating at all, and is commonly used for those suffering from polycystic ovarian syndrome (PCOS).

As its name suggests, ovulation induction involves the woman taking medication to increase the level of follicle-stimulating hormone (FSH) that causes ovulation. These medications may be in the form of tablets (clomiphene or letrozole) or direct injections of FSH. This stimulates the growth of ovarian follicles (fluid-filled sacs containing an egg). Once the follicles are large enough, another hormone is then given to release the egg from the follicle. Couples are advised to have intercourse at this time to increase their chances of conceiving.

Intrauterine insemination (IUI)

Intrauterine insemination (also known as artificial insemination) may be considered when a couple has difficulty having intercourse. It may also be appropriate for women with scarring or defects of the cervix that prevent sperm penetration, and for men with mild reductions in either sperm count or sperm motility (i.e. sperm that don’t move properly) where concentrating the semen sample and placing it in the uterus is likely to be of benefit. IUI may be used in combination with medications that stimulate ovulation – this combination can increase the chance of pregnancy in some cases.

During a treatment cycle, patients are monitored closely with blood tests and ultrasounds. At the time of ovulation, sperm are placed directly through the woman’s cervix and into her uterus (womb) using a long, thin plastic tube that is similar to a straw (hence, the name artificial insemination).

Laboratory treatments

In vitro fertilisation (IVF)

IVF is a form of assisted reproductive technology (ART) in which eggs are retrieved from the body of a woman and combined with sperm outside the body to achieve fertilisation. If this is successful and the fertilised egg continues to develop into an embryo, it is transferred back into the uterus (womb) in the hope that it will implant and grow, thereby achieving a pregnancy.

Intracytoplasmic sperm injection (ICSI)

ICSI is a technique where a single sperm is directly injected into an egg to achieve fertilisation. This technique may be recommended when the male partner in a couple has been diagnosed with fertility issues such as low sperm count, abnormal sperm morphology (shape) or motility (movement), has had a previous vasectomy or an unsuccessful vasectomy reversal. The ‘best’ sperm – based on size, shape and movement – is selected for the ICSI procedure.

Sperm retrieval procedures

Some men have no sperm in their semen (a condition known as azoospermia) due to a sperm production problem or a blockage that prevents the sperm from getting into the semen. These men may need to have sperm taken directly from the testis or the epididymis (a coiled tube that stores sperm and transports it from the testis).

  • Testicular sperm aspiration (TESA) is done by inserting a needle into the testis and taking a small amount of material from the seminiferous tubules – a network of tiny tubes where sperm is produced. The procedure is done using local anaesthesia in an operating theatre.
  • Percutaneous epididymal sperm aspiration (PESA) can be an option for men who have obstructive azoospermia from a previous vasectomy or infection. Under local anaesthesia, a small needle is inserted into the epididymis to extract sperm. PESA is also usually performed in an operating theatre.
  • Microdissection TESE (microTESE) may be used for men who have a sperm production problem. This procedure is done under general anaesthetic. The testis is first opened with a small incision, then an operating microscope is used to identify the seminiferous tubules most likely to contain sperm and take tissue samples from them.

Pre-implantation genetic testing (PGT)

PGT is a way to reduce the risk of an individual or a couple passing on a specific genetic or chromosomal abnormality to their child. It may also be used to check for genetic problems in older women (e.g. over the age of 38 years), women who have experienced several miscarriages, or cases of repeated IVF failure.

In PGT, embryos are produced through the usual IVF process and then cells taken from the embryo are tested for genetic conditions. If the embryo is unaffected, it is then transferred to the woman’s uterus.

Egg or sperm freezing

There are two main reasons for freezing eggs. Some women need to freeze their eggs for medical reasons such as impaired ovarian function or impending chemotherapy or radiotherapy for cancer. Other women choose to freeze their eggs because they want to give themselves the option to have children in later years.

A man may be advised to freeze his sperm if he is about to undergo treatment for cancer, or if he has decided to have a vasectomy but may potentially want to have children later on. Men also can freeze sperm prior to either IUI or IVF if they cannot be present on the day scheduled for the respective ART procedure.

Donor treatments

Donor insemination

Donor insemination may be used as part of IVF for a single woman or for women in a same-sex relationship. The process is the same as artificial insemination, but the sperm used is from a donor rather than a male partner.

Donor insemination may be considered when the male partner does not produce sperm (or the sperm is abnormal) or when there is a high risk of the man passing on an illness or abnormality to a child.

Donor eggs

Donor eggs may be an option when a woman is unable to produce eggs or her eggs are of a low quality. This may be due to age or premature ovarian failure (a condition in which a woman stops producing eggs earlier than usual).

Donor eggs may also be appropriate in cases of recurrent miscarriage or if there is a high risk of the woman passing on an illness or abnormality.

Donor embryos

In some cases, some people choose to donate frozen embryos they no longer need. Treatment using these donated embryos may be suitable for a person or a couple who need both donor sperm and donor eggs.

What is the best option for you?

If you would like advice about the next steps to take on your fertility journey, 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. We’ll complete a comprehensive assessment before explaining the options available to you and your partner.

Is egg freezing right for you?

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In principle, egg freezing sounds simple enough – have some eggs collected, freeze them for storage, then thaw them when you’re ready to undergo fertility treatment – providing you with a chance to store your eggs while you’re still young and beat the biological clock. But what exactly does egg freezing involve and are you an appropriate candidate?

Why freeze your eggs?

You may want to consider freezing your eggs if you’re worried about your fertility declining but your life circumstances mean that you’re simply not ready to start a family. Alternatively, you may have a medical condition or be receiving medical treatment that could affect your fertility. If you’re a female transitioning to a male, you may wish to preserve your fertility before starting reconstructive or hormonal therapy, which can lead to a loss of your fertility.

What does the egg freezing process involve?

The first stage of egg freezing is ovarian stimulation, which involves 10–14 days of hormone injections to stimulate your ovaries to produce multiple eggs. There are various techniques used for stimulation and your fertility specialist will decide, together with you, which is most suitable for you. The developing follicles, which contain your eggs, are monitored by ultrasound and sometimes by blood hormone levels to determine when they are ready to be collected.

When mature, your eggs are collected (usually while you’re under sedation rather than general anaesthetic), frozen and put into storage. In most cases, frozen eggs can be stored for up to 10 years.

When you’re ready to have a baby, the eggs are then thawed and used in IVF treatment. This involves fertilising your eggs with sperm using a method called intracytoplasmic sperm injection (ICSI), whereby sperm is injected directly into the egg. The embryos are then grown in the lab for up to 6 days and then transferred to your uterus (womb).

Factors to consider when deciding whether to freeze your eggs

1. Success rates

Egg freezing is an established procedure. It has now been two decades since the world’s first pregnancy using frozen eggs and over this time, there have been notable improvements in the technology and processes we use. High rates of success can now be expected when circumstances are optimal. A 2017 study showed that freezing 20 eggs before the age of 35 gives a 90% chance of having a baby.1

When considering these statistics, it is important to note that the number of women who actually go on to use their frozen eggs is still quite low. In 2017–18, less than 1% of IVF cycles in Victoria involved the use of a woman’s own thawed eggs.2  The data on egg freezing success rates are challenging to compile because many women choose not to use their eggs for many years after freezing and some may not use them at all. Furthermore, current figures may not reflect advances in egg freezing technology because the results are from a period when clinics were using different ‘slow freezing’ techniques.

In terms of understanding the success rates for frozen eggs compared to ‘fresh’ (recently retrieved) eggs, a study published in the Journal of Human Reproduction in 2010 examined the success of IVF in 600 women, half of whom were assigned ‘fresh’ eggs while the other half were given frozen and thawed eggs.3 The study found no significant difference in pregnancy rates between the two groups of women, concluding that freezing eggs and thawing them for later use has no effects on success rates. According to these findings, the likelihood that your eggs will result in a pregnancy will be the same whether you choose to freeze and use them later or use them straightaway.

2. Age

The age at which you choose to freeze your eggs is key to your chances of having a baby – the younger you are, the better. Egg quality declines more rapidly after the age of 35, so the best time to freeze your eggs is in your 20s and early 30s.4 Unfortunately, eggs collected from older women are less likely to form viable embryos and are also less likely to successfully implant in the wall of the womb. Thus, if you decide to freeze your eggs when you are older, we typically need to collect more eggs to ensure at least one egg is of suitable quality to result in a baby. However, as women age, they also have fewer eggs, so only a small number of eggs may be available for collection and freezing. If this is the case, you may need more than one treatment cycle to collect an adequate number of eggs for storage.

Both the number and quality of eggs available for freezing are important, because at each step in the freezing and subsequent IVF process, there is a risk that some are lost. Of the eggs that are collected, some may not be appropriate for freezing, some may not survive the thawing process, and some may not be fertilised or successfully develop into embryos.

3. Costs

In Australia, fertility treatment is only covered by Medicare and other government subsidies when there is a medical need for the treatment. If you freeze your eggs for non-medical reasons (i.e. ‘elective egg freezing’), you won’t be eligible for Medicare assistance.

For detailed information about the costs associated with egg freezing, please visit our fees page.

*Does not include hospital fees; †Does not include medications or hospital fees.

What are the alternative options?

If freezing your eggs is not a suitable option for you, other potential options include:

When considering your fertility and the options for extending it, there is no one-size-fits-all approach. As with all aspects of fertility care, the best decision for you is the one that is personalised to your individual situation.

Learn more information about Newlife IVF’s egg freezing services. If you would like to discuss your options with one of our fertility specialists, please call Newlife IVF on (03) 8080 8933. Alternatively, you can book online via our appointments page.

References

  1. Munné S et al. Human Reprod 2017; 32(4):743–749.
  2. Victorian Assisted Reproductive Treatment Authority. Annual Report 2018.
  3. Cobo A et al. Human Reprod 2010; 25(9):2239–2246.
  4. Saumet J et al. J Obstet Gynaeocol Can 2018; 40(3):356–368.