CONSULTATION
STEP 1: MEETING YOUR FERTILITY SPECIALIST
At your first appointment Professor Chapman will review your medical history, assess your general health, and arrange initial tests and investigations for you and your partner.
Please bring a doctor’s referral from a GP (valid for 12 months) Ensure the referral includes both partners’ names.
For women, depending on the level of testing already performed, the fertility specialist may order further pathology tests. For men, a blood test for hepatitis B and C, HIV and a sperm analysis are all routinely conducted.
Pre-pregnancy screening for some genetic conditions such as cystic fibrosis is available and can be discussed with your specialist.
Other diagnostic tests may include some or all of the following:
BLOOD TESTS FOR WOMEN
Rubella immunity (German measles),
Chicken pox,
Hepatitis B and C,
HIV,
Full blood count, checking your blood group, your thyroid status and
Current pap smear (within last 2 years);
OTHER FERTILITY TESTS FOR WOMEN
Vaginal ultrasound to check for fibroids, polyps, ovarian cysts, and to act as a ‘baseline’ for reference during your treatment
BLOOD TESTS FOR MEN
HIV
Hepatitis B and C
OTHER FERTILITY TESTS FOR MEN
Semen analysis to check for antibodies and any possible infection
FERTILITY INVESTIGATION
One in six Australian couples experience trouble conceiving. A good first step is to see a Fertility Specialist who can assess your overall reproductive health and conduct some simple tests to identify any underlying causes of pregnancy delay. These fertility tests typically include:
Female Infertility Tests
A combination of blood tests and ultrasound scans to help identify any specific issues such as PCOS or endometriosis and to check ovulation is occurring each month.
Egg count (AMH) Test
A simple blood test that measures the level of Anti-Mullerian Hormone (AMH) in the blood and provides a good indication of ovarian reserve.
The most important male fertility test which measures the number of sperm in a sample as well as their motility and morphology.
Genetic Testing – make this in capitals
For patients who are at risk of a variety of inheritable conditions we offer sophisticated scientific techniques to test for genetic disorders.
Natural Killer Cells
A simple blood test to measure that number and activation levels of the Natural Killer Cells, the main immune-cell type found in the uterus involved in the implantation of an embryo.
What is ovulation induction?
Ovulation induction involves taking medication to induce ovulation by encouraging eggs to develop in the ovaries and be released, increasing the chance of conception through timed intercourse or artificial insemination
Artificial Insemination (IUI)
A technique that involves inserting prepared sperm into the female’s uterus close to the time of ovulation.
IVF Treatment
After a course of ovarian stimulation, eggs are collected from the ovaries and fertilised with sperm in a laboratory. One of the resulting embryos is then transferred back into the uterus.
PCOS CARE
There are a number of options available, depending on the main issue you are experiencing.
Weight loss can be more difficult because of the higher levels of testosterone, but it has a very beneficial effect on balancing hormones and restoring regular periods in obese women. So exercise and a change of diet could have a significant impact.
Insulin sensitisers, such as Metformin, reduce the impact of insulin resistance and can also assist in weight loss.
Ovulation inducing drugs such as Clomiphene (Serophene or Clomid) can stimulate the ovaries.
If you do not respond to Clomiphene, injectable drugs (FSH) can be used, but these require specialist facilities and close monitoring of the response to avoid severe side effects and multiple pregnancies.
IVF treatment may be necessary in very difficult situations.
WOMEN OVER 38 YRS OF AGE
- for a woman aged 35 or under, one stimulated cycle would result in the collection of 10 – 12 eggs of which 7 – 9 would be suitable for vitrification and storage
- Approximately 80-90% if eggs would survive warming in the future
- Approximately 50-80% of surviving eggs would fertilise
- Approximately 80-90% if fertilised eggs would develop into embryos
- A single embryo would have a 20-35% change of developing into a pregnancy
Success rates are lower for women over 35 and egg freezing in women over the age of 38 is unlikely to lead to a pregnancy.
The expected success of the procedure can be ascertained from an initial assessment of the ovarian reserve using a blood test for anti-Mullerian hormone (AMH) and an ultrasound scan of the ovaries and uterus. The AMH test can provide insight into the quantity of eggs remaining, although it does not give information about the quality of the eggs.
Egg freezing cannot ever be guaranteed to lead to a pregnancy and birth of a healthy baby later in life. Women who freeze their eggs may not know the outcome for many years and may lose the opportunity to have a baby naturally.
ENDOMETRIOSIS
The presence of the normal lining of the uterus [called the endometrium] in abnormal
locations in the body such as the Fallopian tubes, ovaries and peritoneal cavity.
RECURRENT MISCARRIAGES
Coping with miscarriage
Sadly, miscarriages are a common occurrence, with one in six pregnancies ending before week 20. This is little consolation when you have lost a baby through miscarriage, and you may want to find out why it occurred and if you can reduce the risk of it happening again.
The vast majority of patients who have experienced a miscarriage will go on to achieve a healthy family, so it’s important to stay positive. However, a small percentage of couples will experience more than one consecutive miscarriage. If you have three or more consecutive early pregnancy losses this is called recurrent miscarriage, and affects about 2% of women trying to have a baby.
POLYCYSTIC OVARIAN SYNDROME
Symptoms of PCOS include irregular periods (or no periods at all), increased hair growth, acne, obesity and difficulty falling pregnant. You might experience very heavy yet infrequent periods, along with pain, bloating and tenderness.
Imbalances in hormonal production affect ovulation, which may occur irregularly or not at all. There may also be a mild increase in testosterone levels, causing darker and thicker hair growth and acne.
Hormonal imbalances also cause problems with sugar metabolism, leading to weight gain – and a higher risk of gestational diabetes if you fall pregnant.
