Understanding Infertility
"IVFAustralia provides the highest possible standard of fertility treatment in a caring, compassionate and personalised environment."
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Infertility
Infertility is defined as the inability to conceive a pregnancy after 12 months of unprotected sexual intercourse. It could be argued that the inability to successfully carry a pregnancy should be included in the definition, and we have a leaflet on miscarriage (click here to download). Infertility is a common problem affecting some 15% of the community.
To achieve a successful pregnancy several prerequisites are required: good quality eggs and sperm, an open fallopian tube and a receptive lining of the womb. A problem with any of these factors will reduce fertility and may cause infertility.
The normal monthly success rate (25% at age 25) decreases with increasing female age, particularly after 35 years of age.
Causes of infertility include:
Male (sperm) factor (45%)
Ovulation disorders (25%)
Tubal disease (15%)
Endometriosis (15%)
Combination of male and female (30%)
Chance of conception
The normal monthly success rate for couples trying to
conceive naturally at 25 years of age is 20% – this figure
decreases with increasing female age particularly after 35
years of age. For example 75% of couples aged 25 will conceive in less
than 6 months but by 35-39 years of age the chance of
conception drops to 25% in this timeframe. If you are not pregnant after 12 months of trying, talk with
your doctor, and sooner if you are over 35 years of age.
The average age of women having their first child in Australia
today is 29 and rising annually.
One in six Australian couples, of reproductive age, experience
difficulties conceiving a child. Infertility is defined by the World Heath Organisation
as the inability of a couple to achieve conception
after a 12 month period of unprotected intercourse.
Make informed decisions about starting a family.
“We didn’t realise we had a problem, we’d been
trying for a couple of years and just thought we
needed a holiday…”
Assessment Plan
After a thorough history and examination, several tests can be performed to estimate a couple's chances of natural conception. These include a semen analysis for the male and blood hormone tests for the females. Furthermore an anatomatical assessment of the female's pelvis to exclude tubal disease, uterine abnormalities and /or endometriosis may be performed. For this an ultrasound, x-ray and/or keyhole surgery (laparoscopy) can be used. Once the assessment has been made, a personalised treatment plan can be formulated beginning, where possible, with the simplest, most natural options.
Treatments Include
Ovulation Induction - Medications (oral or by injection) are used to stimulate egg production and often used with timed sexual intercourse or insemination.
Insemination - With this technique prepared sperm is inserted into the female's uterus at the most fertile time. This technique may use the male partner's sperm or, if required, donor sperm.
Fertility Surgery - This includes the treatment of endometriosis, tubal microsurgery, the removal of fibroids and the correction of uterine abnormalities.
IVF - After a course of ovarian stimulation, the eggs are collected from the ovaries using ultrasound-guided transvaginal needle aspiration. These eggs are placed in a dish with a large number of sperm allowing fertilisation to occur and some of these eggs go on to form embryos. These embryos can be transferred back into the uterus using a small plastic tube and some can be frozen and stored for later use.
 In Vitro Fertilisation (IVF)
ICSI - This is a different, more complicated, form of IVF where the scientist injects a single sperm into the egg. This technique is an excellent treatment if the sperm is of poor quality.
 Intra Cytoplasmic Sperm Injection (ICSI)
Blastocyst Culture - This procedure involves the growth of the embryos for 5 days in the laboratory, instead of the standard 2 or 3 days. This technique may help with embryo selection and give further information about embryo development.
Assisted Hatching (AH) - During AH a small area on the surface of the embryo's 'shell' is thinned to help with hatching, and therefore implantation, of the embryo. It may be of benefit in patients with previous treatment failure and those over 38 years of age.
Pre-implantation Genetic Diagnosis (PGD) - In this procedure a cell from the embryo can be tested for chromosmal and genetic abnormalities prior to placement into the uterus.
Cryo-storage - Freezing of embryos and sperm is possible for patients with excessive embryos or for those men about to have cancer treatment or a vasectomy. Egg freezing is technically less successful but is occasionally performed.
 An embryo
Egg, Sperm and Embryo Donation - These options are available on an anonymous (although traceable), or known, donor basis (See Donor Program).
Counselling - Professional counsellors are available to support all our patients with decision-making, throughout the treatment process, and for follow-up (See Counselling).
 » Download the "Understanding Infertility " leaflet
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