In a series of stories exploring fertility, Mamamia chats to women, couples and experts about what it means to struggle to conceive.
Here, we get the answers to your nine most commonly asked IVF questions from IVF Australia fertility specialist, Dr Andrew Hedges.
We find out when, if and how to start the IVF process, and what your assisted fertility journey might look like.
Watch the trailer for Mamamia’s new podcast, Get Me Pregnant, where hosts Rachel Corbett and Leigh Campbell talk all things pregnancy and fertility. Post continues below.
1. We are ready to have a baby! How long do we keep trying to get pregnant naturally?
The typical answer is for couples to try to conceive naturally for 12 months before seeking help. But as Dr Hedges explains, generic advice should be carefully considered.
“Firstly, your age is key. If you are over 35 and want more than one child, I would advise against trying for a full 12 months. Natural fertility begins to decline more quickly after 35 so you don’t always want to wait to see a doctor,” Dr Hedges says.
“Secondly, don’t wait to seek help if you have a pre-existing medical condition. This might include already diagnosed conditions such as endometriosis, Polycystic Ovarian Syndrome (PCOS) or irregular periods and general ovulation issues. For the man, this may mean abnormal sperm production.”
2. We are having trouble conceiving – what do we do first?
Once you have identified there might be an issue falling pregnant naturally, Dr Hedges says the first step is to see your GP.
“Your GP will be able to organise some basic tests to ensure things like your immunisations are up to date and that there are no issues with your blood count or your thyroid. They may also be able to advise on ovulation and organise a sperm count for your partner.
“Depending on how complex your history is, a GP will then provide you with a referral to see a fertility specialist in your area.”
3. We are ready to see a fertility specialist! How can we improve our chances of getting pregnant, before discussing IVF treatment?
Only a small portion of couples that see a fertility specialist will immediately start IVF, says Dr Hedges. In fact, many couples find they fall pregnant after a few simple treatments.
“We start by looking at every couple or woman’s unique situation or set of circumstances. We discuss the basics such as the timing of intercourse and whether or not any lifestyle changes need to be made. For both men and women, factors like stopping smoking, weight management and reducing alcohol intake can all help to make a difference.”
“If you are not ovulating, there are a couple of medications, for example, Clomiphene, that can be taken to help. The tablets when used in conjunction with us monitoring your cycle with ultrasounds and blood tests, are proven to maximise your chance of conception.”
4. Tell me about artificial insemination or IUI, is that the same as IVF?
Depending on your unique situation, your fertility specialist may recommend you start with artificial insemination or Intrauterine Insemination (IUI) as Dr Hedges explains:
“Recommended as an initial treatment before IVF for certain couples, it involves inserting the male partner’s (or donor’s) prepared semen through the neck of the womb (cervix) and into the uterus, close to the time of ovulation.
“We also prefer to use ovulation induction and cycle tracking at the same time, for the greatest chance of success.”
5. We need to start IVF treatment – what are the first steps of the IVF and what if I don’t like needles?
Within the process of IVF, each couple’s journey can look quite different. But as Dr Hedges explains, each IVF cycle starts with taking medications.
“After meeting with a specialist and deciding on the course of action, a couple will start IVF by first collecting their medication. You will need to self-inject at home at the same time, on a daily basis.
“I understand that this can sound scary, but you are always shown how to do it correctly first and the needle is similar to a diabetic pen and easy to use with practice.
“A second medication stops ovulation so that we can take control of the cycle which we then closely monitor with regular blood tests and ultrasounds. When hormone levels and ovarian follicles are considered to be at optimum levels, you will administer a ‘trigger injection’ in the evening to instigate ovulation.”
6. How are my eggs collected and will I need to take time off work?
The procedure of egg collection doesn’t take long but it does depend on the individual couple and the style of IVF treatment, as to whether you need to take time off work, says Dr Hedges.
“Two days after the trigger injection, you will come into the clinic for egg collection. Depending on the type of IVF, this might be done in 30 minutes in day surgery or under a light anaesthetic in hospital.
“We offer appointments from 7am and after work hours to help women fit it in around a work day.
“Once collected, the eggs are taken to a laboratory to be fertilized with the sperm from either a partner or a sperm donor. The next day you will find out how many eggs have been fertilized and successfully developed into embryos.”
Listen to Mamamia’s new pregnancy podcast, Get Me Pregnant. In this episode, fertility specialist, Manuela Toledo talks about the less invasive assisted fertility options you can try before IVF. Post continues below.
7. What about embryo transfer – how and when does that happen?
Dr Hedges says that after five days of monitoring the development of the embryos, a successful embryo is transferred into the woman’s uterus via a fine tube in a day surgery environment.
“The procedure is very similar to a pap smear and mostly very well tolerated. Your partner is welcome in the room and you can both watch what is happening on the ultrasound screen,” Dr Hedges says.
“I find that the next part is the toughest for most couples as it involves an up to two-week waiting game for a pregnancy blood test, to see if the transfer was successful.
“We always advise couples make use of our specialist fertility counselling service, as the emotional strain can be really challenging.”
8. How do sperm and egg donation work?
In some cases, couples need extra help to fall pregnant and while there is good availability of sperm donors in Australia, egg donors can be found but it is a more complicated process. As Dr Hedges explains:
“Heterosexual couples, single women and same-sex couples can access a sperm donation program after speaking to their fertility specialist and seeking specialist counselling.
“Using an egg donor is possible, but in Australia women cannot be paid to donate eggs, unlike certain countries overseas.
“What we usually find is women have healthy relatives, friends or occasionally strangers donate eggs, as while we can’t recruit egg donors directly, we can advise you and provide practical advice on how to seek help.”
9. Are couples ever advised to stop IVF?
The simple answer here, Dr Hedges says, is yes.
“We have to be realistic and professional and we are constantly reviewing options for couples to help them decide on their best course of action.
“We want to help you understand what your chances of conception are at every stage of the treatment, so if needed we will discuss options like sperm and egg donors as well as embryo donors and adoption.”
Have you been through, or are you going through IVF? We’d love to hear from you in the comments.
Feature image: Getty.
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