One in six Australian couples will have a fertility issue at some point in their lives and one in 10 couples will have trouble conceiving their second child. You are not alone.
Don’t panic, your fertility journey doesn’t have to be an express service straight to IVF. Some simple changes can improve your chance of conceiving naturally.
It's important to remember the emotions, worries and thoughts you are currently trying to deal with are valid and common. You are not alone. Read on
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The World Health Organisation predicts that infertility will be the third most serious health condition in the 21st Century
We're dedicated to helping you achieve your dream - having a baby. We offer a range of services - from IVF to genetic diagnosis of pre-implantation embryos - all with the aim of easing your journey to successful pregnancy.
Are you a female struggling to conceive? Read through potential reasons why, or learn more about testing options.
With 40% of fertility issues being male related, find out what may be causing you troubles, or learn more about male fertility testing
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Because of the care, technology and expertise we put into your care, we maximise the potential of having a baby.
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Ovarian stimulation is the first medical step in an IVF cycle and it’s a balancing act. By prescribing a carefully controlled dose of Follicle stimulating hormone (FSH) and other hormones and monitoring their effects, your Genea Fertility Specialist aims to bring to maturity as many of your immediately available follicles as possible, while also preventing them from ovulating prematurely.
It's important to understand that no amount of FSH will stimulate more follicles than are available to be recruited. The dose needs to be enough to stop the usual competition that takes place among them, but once that threshold is reached there isn't a lot of control possible over the number of recruits that will grow.
Secondly, using FSH injections does not use up follicles and their eggs any faster than they're already being used anyway. They actually began their development months earlier. And the non-recruits - those that don't produce mature eggs - are simply reabsorbed.
More is not better when it comes to FSH dosing. If the dose is too high it can be damaging to the eggs and may also put a woman at risk of ovarian hyperstimulation syndrome. The duration of FSH administration is also important - the normal length of the follicular phase generally needs to be made available to the growing follicles, which takes 11 days or more.
At Genea, we usually check a woman's estrogen level after three or four days of stimulation. If there does not seem to be much response, the dose of FSH can be increased. If the response has been too brisk, the dose of FSH can be reduced gradually.
You will have your first ultrasound after seven or eight days of stimulation. Ultrasonographers who are very familiar with follicle tracking perform the ultrasound examinations.
The need for further monitoring will be determined by your individual response to the treatment at this point. You may need to have blood tests and ultrasounds every other day until the follicles reach 18-20mm in diameter - large enough to contain a mature egg.
In this step, we shut down communication between your brain and your ovaries so that your eggs are not released before they can be collected. We do this using a group of drugs - GnRH-analogs - closely related to the natural hormone, gonadotrophin releasing hormone (GnRH). GnRH is a hormone produced by hypothalamus in the brain and it controls the release of FSH and Luteinizing hormone (LH) by the pituitary gland.
There are two types of analogs - agonists and antagonists - that prevent an LH surge in different ways.
GnRH agonists first cause a flare of FSH and LH as they stimulate and then inhibit, or down regulate, the pituitary. There are two agonists available in Australia - a nasal spray called Synarel® and an injection called Lucrin®.
GnRH antagonists are a newer class of injectable medication with the advantage that they drop levels of FSH and LH without first causing the flare, meaning they are given for a much shorter period of time. They are usually started on the sixth day of FSH stimulation.
The antagonists, marketed in Australia as Cetrotide® and Orgalutran®, are a little more expensive than the agonists and are no more effective in preventing the LH surge or in leading to pregnancy. Nonetheless, they may be of value in women who produce only a low number of eggs in an IVF cycle (particularly older women) or for women who prefer the convenience of a shorter treatment time.
Which drug your Genea Fertility Specialist prefers to use will depend on factors such as your age, previous response to treatment and convenience.
Finally, we trigger ovulation by replacing the LH surge at mid cycle with an injection of human chorionic gonadotropin hCG.
It's not presently possible to use synthetic LH to mimic the natural surge, as the duration of action of LH is too short. Using hCG (human chorionic gonadotrophin) to replace the natural LH surge sets in motion everything that makes ovulation happen, causing the egg in the mature follicle to be fertilisable and loosening it from the wall of the follicle so that it comes out with the follicular fluid at egg retrieval.
It takes just over 38 hours for ovulation to occur after an injection of hCG. Eggs are mature and can float free from about 34 hours after hCG, giving a four-hour window for egg retrieval, which is typically scheduled 36 hours after the hCG trigger.
hCG is marketed either as Pregnyl®, a powder that must be mixed and is covered by Medicare, or Ovidrel®, delivered in a pre-filled syringe costing approximately $100.
NB: Intercourse must be avoided from Day 3 of FSH stimulation, as not all of the eggs might be collected. From that point there is a small chance of spontaneous conception, which increases the risk of a multiple pregnancy when additional embryos are transferred. For further information on what you can and cannot do during a cycle, we encourage you to read our checklist.
It is possible to have an IVF cycle without having any hormone treatment. This is called a natural cycle, and just one egg is collected for fertilisation in the laboratory. However, we want to make use of all the eggs that are developing in the month of treatment in order to improve your treatment outcomes with just one IVF cycle.
A small fluid-filled cyst on the ovary in which the eggs grow until released and which produce...
The hormone produced by the pituitary gland which controls growth of ovarian follicles and...
A hormone which plays a pivotal role in the ability of a woman to fall...
The use of drugs to stimulate the development of follicles in the ovaries to undergo...