The cause of infertility varies from couple to couple, therefore there are many varied infertility treatments. Depending on what the tests turn up, different treatments are recommended. Drugs or surgery are used to treat infertility in 80% to 90% of cases.
Infertility amongst couples tends to be 40 per cent related to female factors, 40 per cent related to male factors and unfortunately 20 per cent unexplained.
For women, the problems can be related to:
- physical problems such as blocked fallopian tubes or endometriosis;
- ovulation disorders such as PCOS;
- your age (and therefore the age of your eggs); or
- issues in your medical or family history.
On the male side of things, the main causes of fertility problems are:
- Physical issues; or
- Medical and family history.
You might already know what’s stopping you from conceiving or it just might be taking you longer to fall pregnant than you expected. Whichever of these situations best describes you, we can help you take the next steps. After your initial appointment with Dr Holland you will receive referrals to have tests to explore what it is that is hindering you from conceiving.
Ovulation induction with controlled ovarian stimulation is a lighter form of treatment we might recommend for women who have normal tubes, and whose partners have a normal semen analysis, but who rarely or never ovulate.
For women who do ovulate regularly, stimulation can also be used to increase the chance of pregnancy by increasing the number of follicles that develop fully and, therefore, increasing the number of eggs that are ovulated during a cycle.
Two types of hormones may be used to stimulate ovulation: tablets of clomiphene citrate (Clomid® or Serophene®) and injections of follicle stimulating hormone, or FSH (Gonal-F® or Puregon®).
Therapy with fertility drugs is often recommended for women with ovulation problems. The benefits of each drug and the side effects, which can be minor or serious but rare, should be discussed with the doctor. Multiple births occur in 10% to 20% of births resulting from fertility drug use.
If drugs aren’t the answer, surgery may be. Because major surgery is involved, operations to repair damage to the woman’s ovaries, fallopian tubes, or uterus are recommended only if there is a good chance of restoring fertility.
In the man, one infertility problem often treated surgically is damage to the vas deferens, commonly caused by a sexually transmitted disease, other infection, or vasectomy (male sterilization).
Assisted Reproductive Technology (IVF)
In some cases, a woman may not be able to become pregnant with her partner because his sexual problems make it impossible for him to ejaculate normally during sex, or because the sperm have to bypass the vagina if the vaginal mucus cannot support them, or for other reasons. In these cases, through artificial insemination, the semen is placed into the woman’s uterus or vaginal canal using a hollow, flexible tube called a catheter.
New, more complex assisted reproductive technologies, or ART, procedures, include in vitro fertilization (IVF). IVF makes it possible to combine sperm and eggs in a laboratory for a baby that is genetically related to one or both partners.
IVF is often used when a woman’s fallopian tubes are blocked, or when a medical reason for infertility cannot be found. During this process, medication is given to stimulate the ovaries to produce multiple eggs. Once mature, the eggs are removed from the ovaries (1) and placed in a laboratory culture dish with the man’s sperm for fertilization (2). The dish is then placed in an incubator (3). Five days later, one embryo is transferred to the woman’s uterus (4). If the woman does not become pregnant, she may try again in the next cycle.
Other ART procedures, based on many of the same principles, include:
- Donor egg IVF: For women who, for example, have impaired ovaries or carry a genetic disease that can be transferred to the offspring. Eggs are donated by another healthy woman and fertilized in the lab with the male partner’s sperm before being transferred to the female partner’s uterus.
- Frozen embryos: Excess embryos are frozen, to be thawed in the future if the woman doesn’t get pregnant on the first cycle or wants another baby in the future.
IVF Treatment with Genea Newcastle
Dr Holland is affiliated with Genea Newcastle. Genea Newcastle operates from Lingard Private Hospital at Merewether, where the IVF clinic has been operating since 1984. Genea Newcastle receives referrals from more than 2500 GPs and specialists from the Hunter and across Australia per year.
Routine Day 5 embryo transfers
Genea was the first clinic in Australia to introduce routine Day 5 embryo transfers. Growing the embryos in the lab a little longer before transferring them to the female lets us determine which embryos have the highest development potential and increases success rates. The time between Day 3 and Day 5 in an embryo’s life is critical because it’s when an embryo switches genetic control from the female’s genome to shared control between the female and male. This can be a point in the development of the embryo where problems occur and waiting to transfer embryos beyond it is far more successful. We have given our patients world leading success rates with this advancement for years, and other Australian clinics have only recently followed our lead.
Single embryo transfer
We were also the first clinic in Australia to introduce routine single embryo transfer. While many clinics transfer more than one embryo to try to improve their chances of success, our technology allows us to achieve higher success rates while transferring a single, carefully selected embryo.
Vitrification versus the old slow freeze method
Genea was the first clinic in Australia (it’s becoming a little repetitive isn’t it?) to develop and routinely replace the old slow freezing method for embryos, eggs and sperm with the more efficient and successful vitrification process. The technology, which is similar to snap freezing, has dramatically increased survival rates for thawed embryos. We’ve been using it routinely since February 2006 but some clinics still use the outdated slow freeze method.
We don’t just have access to the latest technologies – we pioneer them. Here are just some of the technologies we’ve played a major role in developing over the years.
Spending every day caring for your embryos, Genea’s embryologists are experts in what these precious potential babies need to survive and grow. So they developed a mini incubator that simulates the natural environment of human fallopian tubes by using low oxygen levels and introducing just the right amount of carbon dioxide to help embryos grow. The mini incubators or MINCs also maintain the optimal temperature to reduce stress on the embryo.
Genea Biomedx Culture Media – Gems™
The way we nurture and support eggs, sperm and embryos outside of the human body has been a key and consistent area of investment at Genea. For more than two decades, Genea scientists have been developing and refining culture media – the solutions which enable embryos to grow. Little surprise then that more than 600 clinics around the world nurture embryos using culture media developed by Genea. We’ve recently developed the next generation (Gems™) of this vital formula and have completed a rigorous clinical trial involving almost 1200 Genea patients across all age groups and more than 15,000 eggs. The results are very positive, and Gems™ is now exclusively available at Genea clinics.
Genea Biomedx Automated Vitrification – Gavi™
In 2014, our sister company Genea Biomedx will begin producing and selling an automated vitrification instrument – the first in the world. Genea’s scientists started with a simple question: “What if vitrification didn’t have to be a complex, time consuming task?” And in answer to that question, they conceived and designed Gavi™ – Genea Automated Vitrification Instrument – an instrument that automates the process of snap freezing embryos for use in later cycles. In the process, they’ve designed a tool which will standardise vitrification and, as a result, eliminate variation, and, we believe, ultimately improve outcomes for our patients.
World Leading Science
Genea are fertility pioneers. Our research and technologies virtually doubled IVF success rates for patients in the mid-nineties and our constant search for innovations and breakthroughs continues to improve outcomes today. In fact, data compiled by the Australian and New Zealand Assisted Reproduction Database (ANZARD) shows over the course of just one year we improved our success rates compared to other clinics from a 30 per cent better chance* to a 40 per cent greater chance** of taking home a healthy baby. ANZARD conducts an annual review of IVF in Australia and New Zealand and we believe it is the only true independent basis for comparison.
Our expertise in the science of fertility is a direct result of our commitment to funding research. At Genea we have a long and proud history of investing in research and taking innovations from the lab into our clinics, enabling us to help more of our patients (and patients from clinics around the world) realise their dream of creating a family.
We invest by far the most of any Australian clinic with at least 10 per cent of our annual revenue on average going back into research – and substantially more over the past few years. That investment has led to many fertility breakthroughs over the years and that trend continues with some exciting new developments underway.