Although IVF and embryo development can be complex topics, Tiki and Tasha endeavour to make the science more accessible. The podcast episode breaks down the laboratory advances that Newlife IVF embryologists use day-to-day, in a way that’s easy to understand.
During the episode, host Tasha asks Tiki about the details of embryo development that patients often seek more information about. Sharing plenty of embryology pearls of wisdom along the way, Tiki describes the differences between a day 3 and day 5 embryo, the top factors that stop embryo growth, and the fine details of embryo grading and ranking.
However, as Tiki put it: ‘don’t agonise over grading’. Instead of getting too caught up in embryo grading, patients are encouraged to rely on the expertise of an embryologist, who can provide valuable insight into what their results truly mean.
Tiki also explains what mosaic embryos are, whether they are suitable for implantation, what PGT testing is and the special circumstances when PGT testing may not be recommended.
‘Genetic testing of embryos, including insights into mosaic embryos, offers a window into chromosomal normalcy but must be evaluated on a case-by-case basis,’ says Tiki.
Blending expertise in fertility care
You may notice from the podcast that Tiki and Tasha talk with an easy flow. This is not just their communication skills shining through – they have shared conversations in the past over their mutual passion to educate and inform patients.
As a naturopath and nutritionist, Tasha has a wealth of experience and specialist expertise in overcoming fertility challenges. She is passionate about supporting patients to achieve their best fertility health before ovulation and she regularly shares this expertise on ‘Conceive Baby Podcast’, as well as through media appearances, speaking seminars and journal publications.
As for, Tiki, she oversees our state-of-the-art laboratory – drawing on a wealth of experience in embryology and IVF. She is a driving force behind Newlife’s commitment to best scientific practice. Tiki is passionate about ensuring that the latest scientific fertility advances are offered to patients to help them achieve a healthy family as soon as possible.
‘Behind the laboratory doors, there are so many people that are hoping for our patients to have a fantastic outcome,’ says Tiki.
Putting patients first
If there was one thing that shone through from Tiki and Tasha’s conversation, it was the care that every team member has for their patients. This is integral to the ethos both Tiki and Tasha bring to their fertility work. Over a patient’s fertility journey, the team is cheering them on – they share in the highs and the lows and are deeply invested in supporting each patient to achieve their fertility goals.
‘And I do want to say that every embryologist that I’ve ever come across – and I’ve seen many of them – genuinely care about what they’re doing and they care so much about the patients,’ says Tiki.
Tune in now!
Whether you’re on a fertility journey yourself or simply curious about embryology, be sure to listen to the podcast episode. You can find it here.
Victoria Devine aims to make finance easier in every area of life, including fertility care. To do this, she strongly advocates that you take the time to do your research. Whether it be a new sweater, a first home or your future fertility – it pays to educate yourself first.
Victoria sat down with Dr Hope and asked her all about egg freezing. With a straightforward clarity that comes from her decades of fertility experience, Dr Hope outlined the egg freezing and IVF processes, and the differences between the two. She also explained how fertility care is timed to match the natural rhythms of your body. For this reason, a lot of fertility treatments are timed around your menstrual cycle.
‘The body has it all worked out and everything we do is actually trying to mimic or replicate what happens in the body,’ said Dr Hope.
Having covered the fundamentals, Victoria and Dr Hope then dived into the costs of egg freezing and IVF, as well as who is eligible for Medicare deductions to their fertility treatment. Dr Hope also discussed some of the patient financing options available to help people manage the costs of fertility care more comfortably.
Cutting out hidden fees at Newlife IVF
When it comes to any major expenses, Victoria recommends that it can be helpful to budget for both the known costs and any additional expenses that may come your way. In the case of egg freezing – depending on the healthcare provider you choose – you may have costs tacked on outside of the initial quote.
This is why at Newlife IVF, transparency with patients is a priority. It is rare for a patient to receive an unexpected or additional cost – and if there is a medical need for one, this will always be discussed beforehand.
‘People shouldn’t be getting too many extra costs outside what they are quoted,’ said Dr Hope.
Dr Hope also explained that all Newlife IVF patients receive an appointment with a member of the finance team before any treatment is started. This appointment helps people understand the costs of treatments and services, and the financing options available, which can help them make informed decisions about whether the treatment/service is right for them.
Infertility is more common than you may think
To complement Dr Hope’s fertility guidance, Victoria shared her own pregnancy experience, as well as the fertility journeys of some of her friends. It quickly became clear how varied fertility journeys can be and that there is no one-size-fits-all for family planning. This led Victoria to ask if there are any factors that can affect someone’s fertility.
Dr Hope explained that the quality of a woman’s eggs is one of the main contributors to their chances of having a baby. She added that although egg quality is affected by many factors, age is often the most crucial.
‘For women, the single biggest thing that predicts when we can get pregnant is our age,’ said Dr Hope.
Drawing on her proactive approach to fertility treatment, Dr Hope also talked through what people can do to improve their egg quality at any age.
A brief background about the webinar presenters
Victoria Devine is a multi-award-winning financial advisor, business owner, podcaster and author. She hosts the popular podcasts She’s on the Money and The Property Playbook, and is the CEO of Zella, a financial services company. Through all her ventures, Victoria aims to transform the way millennials think about money to make their financial dreams achievable.
Dr Nicole Hope is a highly experienced fertility specialist and the Medical Director of Newlife IVF. She also holds an advanced Certificate in Reproductive Endocrinology and Infertility (CREI). This is the highest level of qualification you can have in fertility care and less than 100 Australian fertility specialists have it! Above all, Dr Hope is passionate about helping her patients start or grow their families, and she prioritises the importance of providing the right information and support at each step of fertility care.
Learn more about the financial side of egg freezing
Watch the webinar for a full breakdown of egg freezing, the costs and the financing options available.
Sperm contributes half of the genetic material needed for embryos to form. Issues related to sperm quality or function can lead to difficulties in embryo development, including issues with:
Genetic material quality: For successful fertilisation and healthy embryo development, ideally sperm DNA should remain intact. Damage to this genetic material – whether from oxidative stress, environmental factors or ageing – can lead to chromosomal abnormalities or improper DNA variations in the embryo, increasing the risk of developmental issues or miscarriage.
Sperm chromatin structure: Sperm chromatin, the DNA arranged within the sperm cell, must be tightly packed and properly organised to protect against DNA damage. Normal sperm chromatin structure is needed for successful fertilisation and embryo development. Abnormalities in chromatin structure can result in poor DNA repair, leading to embryo fragmentation (when tiny pieces of the cells that make up the embryo break away from the cells during division) or developmental arrest (when an embryo stops developing).
Sperm motility (movement): Sperm with low motility (asthenospermia) may struggle to reach and fertilise the egg through natural conception or IVF. Even if fertilisation occurs, impaired motility – depending on its cause – can impact early embryonic development, as the sperm may not deliver the essential signals and factors needed for optimal growth.
Sperm morphology: Sperm with abnormal morphology (size or shape) can affect fertilisation and embryo development. For instance, abnormal sperm may struggle to penetrate the egg, preventing fertilisation or causing abnormal embryo development. Structural defects, such as head or tail abnormalities, may prevent the sperm from properly interacting with the egg’s membrane, making fertilisation difficult in both natural conception and IVF. Therefore, abnormal sperm morphology is indicative of low sperm quality.
Sperm epigenetics: Sperm carries epigenetic information – modifications that influence how genes function without changing the underlying DNA sequence. Disrupted sperm epigenetics can lead to improper gene expression in the embryo, increasing the risk of developmental issues, infertility or genetic disorders.
Oxidative stress: Sperm are vulnerable to oxidative stress – an imbalance between free radicals and antioxidants in the body – caused by factors such as smoking, alcohol consumption, environmental toxins or prolonged heat exposure. This oxidative damage can lead to DNA fragmentation, where sperm DNA strands break, potentially compromising embryo development after fertilisation.
Paternal age: As men age, their sperm quality may gradually decline, making conception more challenging. Although men do not experience a sudden decrease in fertility like women, ageing impacts sperm health, testicular function and pregnancy outcomes. For instance, older men may produce lower-quality sperm, reducing the chances of fertilisation. Sperm from older men are also more susceptible to DNA damage, which can increase the risk of miscarriage and DNA changes contributing to genetic conditions, including autism or schizophrenia in children.
Lifestyle changes to support sperm health
While some factors affecting sperm health are beyond control, lifestyle choices can play a significant role in improving sperm quality. Making positive changes may help enhance sperm function and increase the chances of successful conception. Suggestions that may assist with sperm quality include:
Keep the testicles cool
High temperatures can damage sperm. Avoid hot tubs, saunas, car seat warmers, placing your laptop on your lap for long periods, and carrying your mobile phone in your front pocket. Wear loose-fitting underwear to keep your testicles cool and prevent overheating.
Maintain a healthy diet
A balanced diet rich in vitamins, minerals and antioxidants from fruits, vegetables, nuts, seeds, whole grains and lean proteins can help protect sperm from damage.
Additionally, fertility-boosting nutrients such as vitamins C, E and folic acid, as well as zinc and selenium, have been linked to improved sperm quality. These are present in citrus fruits, leafy greens, eggs and nuts.
Consider fertility supplements
If you’re finding it difficult to obtain enough nutrients from your diet, you may wish to consider fertility supplements. Specifically, supplements such as zinc, folic acid, selenium and CoQ10 may support sperm health. However, please consult your fertility specialist before starting any new supplements.
Engage in regular exercise
Moderate physical activity can help maintain a healthy weight and improve overall health, which supports sperm production. However, excessive exercise or overtraining can have the opposite effect, leading to reduced testosterone levels and impaired sperm quality. Additionally, prolonged cycling (over 1.5 hours) should be avoided.
Avoid smoking and limit alcohol
Smoking and vaping are associated with poor sperm quality, including reduced count and motility and increased DNA damage. Quitting should be a priority for those looking to improve fertility.
Excessive alcohol consumption can also negatively affect sperm count and quality, so keep your intake to moderate levels for optimal reproductive health.
Maintain a healthy weight
Being overweight or obese can lead to hormonal imbalances, reduced sperm quality and lowered overall fertility. Achieving and maintaining a healthy weight through diet and exercise can help improve sperm health.
Avoid exposure to toxins
Minimise exposure to harmful chemicals such as pesticides, heavy metals and industrial toxins, as they can negatively affect sperm health. Avoid contact with pollutants in some cleaning products, plastics and air pollution – and skip drinking from plastic water bottles.
If chemical exposure is unavoidable (i.e. due to your work environment), always use appropriate protective equipment, such as gloves and masks, to reduce risk.
Attend regular medical assessments
Prioritising your overall health is essential, as conditions like diabetes, high blood pressure and infections can negatively affect sperm quality. Regular check-ups with your GP or healthcare professional can help detect and manage these issues early.
If you’re trying to conceive, inform your fertility specialist about any medications or supplements you’re taking, as some may impair sperm function.
Avoid drug use
Recreational drug use, such as marijuana or anabolic steroids, can significantly reduce sperm count and quality. If you’re using these substances, consider seeking help to quit.
Manage stress
Chronic stress can negatively impact hormone levels, affecting sperm production. Consider practising relaxation techniques like meditation, yoga, deep breathing, exercise or hobbies that help you relax.
Get enough sleep
Quality sleep is essential for overall health and plays a crucial role in hormone regulation. Poor sleep can disrupt hormone levels, including testosterone, which is vital for sperm production. To support reproductive health, prioritise restful sleep and aim for 7–9 hours of quality rest each night.
Limit caffeine intake
Excessive caffeine may negatively affect sperm quality. Limiting your intake to moderate levels (one or two cups per day) can be beneficial.
When to seek help
Making these lifestyle changes can help improve sperm quality over time. However, if you and your partner have been trying to conceive without success – 12 months if the female partner is under 35 years or six months if over 35 years – it may be time to seek specialist guidance. A fertility specialist can provide personalised advice and may recommend fertility testing to gain a clearer understanding of your reproductive health.
To book an appointment with one of our fertility specialists and explore your options, call Newlife IVF on (03) 8080 8933 or schedule a consultation online via our appointments page.
As we enter a new year, it’s important to remind ourselves not to panic and to remain proactive when trying to have a baby. Below we discuss some of the changes you can make to optimise your fertility and how a fertility specialist can assist you.
Things you can do to improve your chances
Lifestyle changes
How you live can have a big impact on your fertility, and making some changes to your lifestyle can increase your likelihood of conceiving. For instance, quitting smoking and avoiding the use of recreational drugs benefits the overall reproductive health of both men and women. Other lifestyle changes that we recommend making when trying to fall pregnant (particularly over the silly season) include:
Consuming caffeine in moderation (1–2 teas/coffees per day)
Enjoying a safe amount of alcohol (including at least two alcohol-free days per week)
Exercising regularly but not excessively (30–40 minutes three times per week)
Maintaining a healthy weight/BMI (there is a lower success with IVF if BMI > 30).
Having a healthy and balanced diet is essential for both your general and reproductive health. Studies have shown that omega-3 fatty acids can improve fertility in women, while diets high in trans fats may reduce fertility. Diet also affects semen quality in male partners – for instance, men who consume fish, shellfish, poultry, wholegrain cereals and fruits and vegetables typically have a better semen analysis than those with diets high in sugar and processed meats and cereals. It’s also important to note that before enjoying your favourite meals, you should avoid reheating food in plastic containers. This reduces your exposure to estrogenic material which can also affect fertility.
Supplements
Folic acid is the main essential supplement we recommend taking while you are trying to conceive. Although folic acid doesn’t directly affect your fertility, it is very important for lowering the risk of spina bifida in the baby. We also recommend taking a good-quality multi-vitamin when you’re trying to fall pregnant.
Stress and anxiety
It’s normal to feel overwhelmed or anxious and to experience lots of uncertainty when embarking on your fertility journey. However, feelings of continual stress can affect your hormones and in turn reduce your chances of falling pregnant. Therefore, we recommend finding a stress management technique that works for you and your lifestyle, which may involve simply stopping and slowing down or calling someone you trust to share how you are feeling. Other ways that you can help lower your stress levels include:
Incorporating meditation or mindfulness exercises in your daily routine (e.g. with guided apps like Headspace, Smiling Mind, Calm)
Engaging in a relaxing activity (e.g. cooking, gardening, drawing)
Trying acupuncture, traditional medicine, naturopathy (seek those with specialist fertility backgrounds).
Online resources specific to fertility and IVF can also help you manage stress and anxiety. Some of these include:
Apps that provide guided relaxation and mindfulness (e.g. Mindful IVF, IVF relax)
Podcasts available on Spotify or other streaming services (e.g. IVF warrior playlist by Lisa Dickinson, Fertility meditations imagery and visualisations for IVF by Jackie Brown)
It’s also important to try not to engage in unhealthy coping mechanisms when feeling stressed, such as consuming alcohol or drugs and binge eating.
It’s all in the timing
Timing intercourse significantly increases your chances of successfully falling pregnant. Out of 100 fertile couples who conceived without timed intercourse, 50% fell pregnant within three months. On the other hand, 76% of similar couples who used a method for timed intercourse conceived within the first month of trying.
Women have a fertile window of about five days before until one day after ovulation. While sperm can survive 3–5 days in the uterus and tubes, an egg usually only survives for 12–24 hours in the tubes. This means that in order to have the highest chance of falling pregnant, intercourse should occur during the 2–3 days before ovulation. Cycle lengths vary from woman to woman, so finding the right time to have sex will be based on the individual. Hormone tests that measure LH (a hormone that rises and leads to ovulation) can be used to help work out the best time for intercourse. Other timing techniques include having intercourse when cervical mucus is slippery and clear, or when the basal body temperature of the female partner is lower (it usually rises after ovulation). There are also a number of smartphone apps available to help track your cycle so you can give yourself the best possible chance of conceiving.
Studies have found that pregnancy rates are slightly better in couples who have intercourse daily (37%) than those who have sex every second day (33%). However, couples should decide on the frequency based on their relationship and dynamics, as daily intercourse is also associated with higher stress levels. We normally advise couples to have sex second daily in the lead up to ovulation to boost their chances of falling pregnant.
Becoming fertility aware
Understanding your fertility better (such as when to time intercourse) will help you troubleshoot what may be going wrong. For additional resources on understanding fertility and optimising conception, see this Fertility 101 video series by Two Lines Fertility.
When to seek assistance
Women under 35 years of age are advised to seek help following 12 months of unprotected and frequent intercourse. As fertility declines with age, women between 35 and 40 are advised to seek specialist opinion after 6 months of trying. Some women who may need to seek help despite trying for less than 6 months include:
Women over 40 years of age
Women with oligomenorrhoea/amenorrhoea (infrequent or no periods)
Women with a history of chemotherapy, radiation therapy or advanced endometriosis
Women with known or suspected uterine/tubal disease.
Male partners with a history of groin or testicular surgery, adult mumps, impotence or any other sexual dysfunction, chemotherapy and/or radiation or a history of subfertility with another partner, are also advised to seek specialist opinion as soon as possible.
Your fertility specialist may ask you to undergo some fertility testing in order to fully understand your fertility needs. Some of these tests are described below.
Male factor evaluation
Semen analysis is the primary test for male fertility. A typical semen analysis involves assessing semen volume, sperm concentration and count, sperm motility (movement) and sperm morphology (shape). If the semen analysis appears abnormal, a second semen analysis will be done six weeks later, followed by consultation with a fertility specialist.
Female factor evaluation
There are a number of different tests that can be used to investigate female fertility, including:
Basic blood tests to check thyroid function and usual pre-pregnancy screening for infectious diseases
Laparoscopy and hysteroscopy (especially for women with symptoms of potential endometriosis).
Tubal flushing can also help determine the patency of the fallopian tubes and is sometimes used as a dedicated intervention to increase fertility.
What if all that still doesn’t work?
Couples who have been trying to conceive for a year commonly require assistance with some form of fertility treatment. There are a few different options available depending on your individual fertility needs.
Ovulation induction
Ovulation induction involves taking medications (tablets or injections) to stimulate the production of hormones that grow and release an egg from a woman’s ovary.
IUI (intrauterine insemination)
Intrauterine insemination involves placing a large number of concentrated sperm into the uterus. By doing so, this boosts the chances of sperm meeting an egg and resulting in fertilisation.
IVF (in vitro fertilisation)
In vitro fertilisation is a procedure that involves fertilising the egg with sperm outside of the woman’s uterus, prior to it being transferred back into the womb for the remainder of the pregnancy. There are two steps in an IVF cycle – egg retrieval and embryo transfer. Egg retrieval is performed in hospital under light anaesthetic and typically takes 15–20 minutes. Patients are usually home 90 minutes later and may require paracetamol for the 1–2 day recovery period. Embryo transfer is a short, five-minute procedure guided by ultrasound. Patients do not routinely require an anaesthetic and are able to go back to work afterwards.
IVF with ICSI (intracytoplasmic sperm injection)
Typically, standard insemination is used during the IVF process – the sperm meets the egg and fertilises it within a laboratory dish. However, intracytoplasmic sperm injection (ICSI) is usually recommended when there is suspected or confirmed poor fertilisation results with standard insemination. ICSI involves directly injecting a single sperm into the centre of an egg, bypassing the outer covering of the egg and making fertilisation a bit easier.
In a nutshell
Making your dream of having a baby a reality can take a little time and persistence. There are some things you can do to help improve your chances and some things we can do to help too. Remember, if you are trying to fall pregnant over the silly season, take your multivitamins and don’t party too hard!
To meet with one of our fertility specialists and learn more about how you can improve your fertility or to discuss your fertility treatment options, call Newlife IVF on (03) 8080 8933 or book online via our appointments page.
IVF is an assisted reproductive technique that helps people overcome fertility challenges to start or grow their families. This process involves fertilising an egg with sperm in a specialised laboratory, with the resulting embryo carefully transferred into the uterus with the aim that it will lead to a pregnancy.
Whether you’re just beginning your fertility journey or considering your options, understanding the IVF process is an empowering first step. In this article, we’ll guide you through the process that we use at our fertility clinic in Melbourne, to help you make informed decisions about your next steps.
A step-by-step guide to the IVF process at Newlife IVF in Melbourne
From the initial consultation through to the embryo transfer procedure, IVF involves a series of carefully coordinated stages – tailored to your unique needs – that are designed to give you the best chance of pregnancy success.
Initial consultation with our Melbourne-based fertility specialist
If you’re concerned about your fertility and would like to seek advice from a fertility specialist, you will need a referral from your GP to attend our IVF clinic.
During your initial consultation, your fertility specialist will assess your health and the factors contributing to your fertility issues, as well as provide tailored advice, including recommendations about diet and lifestyle. This process involves taking a thorough medical history from you, performing relevant examinations and ordering appropriate tests. Your fertility specialist will also discuss all available treatment options with you so you can make an informed decision about whether the IVF process is right for you.
If it is decided that IVF treatment is appropriate, we will register you as a patient at our fertility clinic. At this stage, mandatory tests, such as screening for infectious diseases, will be conducted if they have not been done previously.
Personalised fertility treatment planning
As no two fertility journeys are the same, fertility care at our IVF clinic in Melbourne is never one-size-fits-all. Our approach begins with uncovering the root causes of your fertility challenges and guiding you through the treatment options that best suit your unique circumstances. These options can range from straightforward solutions like fertility optimisation and ovulation induction to advanced treatments, such as intrauterine insemination (IUI), IVF, or IVF with intracytoplasmic sperm injection (ICSI).
In some cases, and after a careful review of your medical and IVF history, your fertility specialist may prescribe adjuvant treatments to complement an IVF cycle.
Ovulation induction and hormone stimulation
Ovulation induction is a commonly used fertility treatment for individuals with ovulatory dysfunction. Often serving as an early intervention, it can be effective as a standalone treatment or combined with others, such as IUI or IVF, to improve the chances of conception. Ovulation induction involves using fertility medication to stimulate your ovaries to produce one or more mature eggs and assist with ovulation. For those undergoing IVF, hormone stimulation with fertility medications is used to stimulate your ovaries to produce a higher number of mature eggs than they normally would. This is a critical step in preparation for egg retrieval.
During this stimulation phase, self-administered hormonal injections are given over 8–14 days to encourage the development of multiple eggs, increasing the number available for retrieval and fertilisation.
Fertility blood tests and monitoring
Careful monitoring plays a vital role throughout the stimulation phase. Using a combination of blood tests and ultrasounds, your fertility specialist will closely track how your ovaries are responding and how the follicles (sacs in the ovaries that contain eggs) are developing. These tests allow your specialist to assess if everything is progressing as planned and fine-tune your fertility medication to optimise your results.
As you near the end of the stimulation phase, monitoring is used to determine the optimal time for the ‘trigger injection’, which prepares the eggs for ovulation (i.e. their release from the ovaries). Your fertility nurse will liaise with your fertility specialist and guide you on when to administer the injection, as precise timing is essential – the egg retrieval procedure must occur before natural ovulation. Monitoring usually takes place at one of our Newlife IVF locations in Melbourne. However, you don’t have to be in Melbourne to access treatment. We have patients that live in rural or interstate locations and we work with local pathology and ultrasound providers to assist with our patients’ monitoring needs.
Egg retrieval procedure at our IVF clinic in Melbourne
Egg retrieval, also known as egg collection or egg pickup, is a key step in the IVF process. This procedure involves collecting eggs from your ovaries, which can be frozen for future use or fertilised in the next stage of your IVF cycle.
Performed at our IVF clinic under sedation, egg retrieval is a straightforward procedure that typically takes 20–30 minutes. During this time, your fertility specialist carefully collects eggs from your ovaries using a fine needle guided by ultrasound imaging. On average, 8–12 eggs are retrieved, although the exact number depends on factors such as age, ovarian response to the medication and health history.
Collecting multiple eggs at once is important to IVF success. A higher number of eggs increases the chance of developing the healthy embryos needed for a successful embryo transfer and pregnancy.
Our team understands that undergoing egg retrieval can feel both exciting and a little nerve-wracking. But you can rest assured that we’re here to support you every step of the way so that you feel informed and comfortable throughout the entire IVF process.
Sperm collection and ICSI treatment
On the day of egg retrieval, fresh semen samples are collected from the male partner. If you’re using frozen or donor sperm, our embryologists will ensure the sample is thawed and ready for use.
For standard IVF, the semen sample is carefully prepared by removing the seminal fluid (the fluid that contains sperm), isolating the motile sperm and removing immotile sperm before the insemination procedure
For ICSI, the process is more precise. Only a single sperm is used for fertilisation, requiring experienced embryologists to select the healthiest and most viable sperm and inject it directly into the egg.
Selecting the ideal sperm is a delicate process requiring years of expertise. Our embryologists are trained to identify sperm with the best shape and structure to maximise the chances of successful fertilisation.
Fertilisation and embryo development
The next step in the IVF process is fertilisation, where egg and sperm are brought together.
In some cases, depending on the sperm quality and the patient’s previous history, we use standard insemination, where each egg is placed in a laboratory dish and exposed to thousands of prepared sperm. The fittest sperm may then fertilise the egg naturally, mirroring what would occur in the body.
However, if there are challenges such as low sperm count or abnormalities in sperm quality, an advanced technique called ICSI may be used. With ICSI treatment, a single, healthy-looking sperm is carefully injected into an egg to increase the chances of fertilisation. While this method offers additional precision, it’s important to note that not all eggs will successfully fertilise.
If fertilisation occurs, the resulting embryos are carefully placed in an incubator that mimics the conditions of the female body. Over the next five days, these embryos grow and divide, preparing for the next stage of the IVF process – embryo transfer.
The embryo transfer procedure
The embryo transfer is one of the quickest yet most important stages of the IVF process. During this procedure, a carefully selected embryo is placed into your uterus with the hope that it will successfully implant and lead to pregnancy.
Performed under ultrasound guidance, the transfer involves using a long, thin instrument to gently release the embryo through the vagina and cervix into the uterus. For most women, the procedure feels similar to a routine pap test. It is quick, requires no anaesthetic and allows you to resume your usual activities afterwards.
At Newlife IVF, our fertility specialists and embryologists are committed to providing the highest standard of care and technology to maximise your chances of IVF success.
Pregnancy testing and ongoing support
The pregnancy test represents the culmination of weeks of preparation. This fertility blood test measures the level of human chorionic gonadotrophin (hCG) in your body – a hormone produced when a fertilised egg (an embryo) implants into the uterus. Elevated hCG levels can indicate a successful IVF cycle and the achievement of pregnancy.
This test is performed approximately eleven days after the embryo transfer, giving your body the necessary time to respond to implantation. While waiting for results can be an emotional experience, our dedicated team is here to support you regardless of the outcome.
This webinar, presented by fertility specialists Dr Chris Russell and Dr Nicole Hope, provides a more detailed explanation of the IVF process.
Why choose Newlife IVF?
At Newlife IVF, we understand how significant the IVF process is, and we’re committed to walking beside you on your journey to parenthood. Whether celebrating your success or exploring the next steps, you’ll always have compassionate care and expert guidance from our team.
Clinician-owned and led fertility clinic in Melbourne
As one of few independent specialist fertility centres in Victoria, we take pride in offering a more personalised, compassionate and supportive experience compared to corporate-owned clinics.
State-of-the-art IVF treatment in Melbourne
Every aspect of our practice is thoughtfully designed with your needs in mind, from our expert-led care to our state-of-the-art laboratory and scientific tools and techniques.
Advanced scientific techniques and high IVF success rates
We incorporate cutting-edge scientific advancements into every step of our IVF treatment process, helping to give you the best possible chance of achieving a successful pregnancy.
Our approach includes the use of the EmbryoScope time-lapse system, which provides continuous monitoring of embryo development, sequential media to nurture embryos, and EmbryoGlue to enhance implantation potential when transferring embryos into the uterus.
For ICSI treatment, we take it a step further with egg spindle visualisation technology, allowing us to carefully select eggs with the greatest potential for fertilisation.
Our IVF success rates reflect the effectiveness of these methods, consistently exceeding the national average and giving our patients a better chance of achieving their dream of parenthood.
Accessible and affordable IVF treatment in Melbourne
At Newlife IVF, we believe that everyone deserves the opportunity to build their family, which is why we are committed to providing affordable IVF treatment. Our fee structure is designed to be transparent and accessible, ensuring that fertility treatment, including IVF, is reasonably priced and doesn’t involve the stress of unexpected costs.
Contact Newlife IVF – your trusted fertility clinic in Melbourne
Fertility is largely influenced by the quality of both eggs and sperm. Age is the biggest determinant of egg quality1, but other factors such as diet, weight, physical activity and exposure to toxins (including illicit drugs or medications) also play a role. The good news is that whilst you cannot modify your age, there are things that you can do to improve egg quality and your chances of getting pregnant.
This involves making changes (if needed) to areas of your life that can influence various biological processes in the body – fertility included. With the proper modifications, you can protect your eggs from the harm caused by these factors and increase your likelihood of conceiving.
Why is age such a big factor?
Fertility starts to decline at the beginning of a woman’s 30s, but the decline is more rapid after age 35.1 This is because women are born with a lifetime supply of eggs – around 1-2 million – and this reserve gradually decreases over time. Egg quality also declines with age as the DNA in eggs becomes more susceptible to damage.
Eggs of lower quality are less likely to fertilise and develop into an embryo, affecting the chances of pregnancy. Additionally, older eggs are more likely to be affected by chromosome imbalance, which is associated with difficulty falling pregnant, an increased risk of miscarriage and a higher incidence of children born with a chromosome disorder (e.g. Down Syndrome).2
Unfortunately, once an egg’s DNA is damaged or the egg has an incorrect number of chromosomes (we call this aneuploidy), it cannot be reversed or repaired. For this reason, it’s important to protect your egg quality as much as possible.
Tips to improve your egg quality
Smoking
Women who smoke or are exposed to second-hand smoke often face delays in conceiving. Smoking damages egg DNA, which reduces fertility and increases miscarriage risk.3 It also increases the chance of ectopic pregnancy and makes embryo implantation harder, while increasing the risk of pregnancy complications.4 Therefore, avoiding smoking and second-hand smoke is crucial when trying to conceive and during pregnancy.
Additionally, researchers are still learning about all the risks of e-cigarettes (vapes) on conception and pregnancy. At this stage, no amount of vaping is considered safe when trying to conceive.
Alcohol
If you’re trying to conceive, drinking alcohol can affect your ability to get pregnant and stay pregnant. Some studies suggest that even low to moderate alcohol consumption is associated with reduced fertility.5 Drinking alcohol can alter hormone levels and disrupt the menstrual cycle and the ability to ovulate, therefore reducing the chances of conceiving. So, cutting down or cutting out alcohol can improve your chances of falling pregnant, along with helping you embrace a healthier lifestyle.
Coffee/caffeine
Some studies have shown reduced fertility and increased risk of miscarriage with excessive caffeine consumption.6 Most studies also indicate that the risk of infertility rises with higher levels of caffeine intake. Unfortunately, a safe daily amount of caffeine has not been established. For this reason, we recommend limiting your intake to one caffeinated drink per day (<80–100 mg of caffeine). If you can go without all together, even better!
Illicit drugs
Taking recreational drugs reduces the chances of becoming pregnant and having a healthy baby. For instance, cannabis and opioids are known to disrupt normal hormone production, leading to problems with ovulation and menstrual cycle disturbances.7 Additionally, stimulants such as cocaine and crystal meth have been linked to higher rates of miscarriage.8 Therefore, avoiding illicit drug use is one of the simplest ways to preserve your fertility.
Extreme exercise
Over-exercising can hinder ovulation and hormone production – specifically progesterone production, which is critical in supporting a pregnancy as it helps to thicken the lining of the uterus (needed for embryo implantation). Excessive exercise has also been linked to miscarriage.9 Vigorous exercise should not exceed 4 hours a week. However, lighter activities, such as walking and Pilates, are not limited.
Diet
The Mediterranean diet is often recommended for individuals undergoing in vitro fertilization (IVF) due to its potential benefits for reproductive health – and this may include egg quality. This diet emphasises the consumption of whole foods, including fruits, vegetables, whole grains, legumes, nuts, fish and healthy fats like olive oil, while limiting processed foods, red meat and added sugars.
Research suggests that adherence to the Mediterranean diet may improve fertility outcomes by promoting a healthy weight, reducing inflammation and optimising insulin sensitivity, all of which can positively influence ovarian function and embryo quality.10,11
Maintaining a healthy weight
Being underweight or overweight is associated with reduced pregnancy rates. This is because carrying too little or too much weight can disrupt the balance of hormones in your body, leading to ovulatory issues and irregular periods, along with an increased risk of miscarriage. Even if a woman has a regular cycle, fertility may still be reduced compared to women within the healthy weight range (a body mass index between 18.5 and 25).
Weight loss in overweight people doesn’t have to be drastic to improve fertility. Research has shown that even a modest drop in body weight (5–10%) can increase the chances of pregnancy – not to mention many other health benefits, such as a reduced risk of conditions like diabetes and heart disease, and a lower rate of pregnancy-related complications.12 Weight training and improving your lean body mass is also crucial for optimising your metabolism and reducing insulin resistance.
Weight loss is difficult, but your care providers can help you navigate the weight management journey. Talking to your GP or fertility specialist about weight is a great first step. We’ll make sure you have the support you need.
Medical conditions and medications
Conception is most likely to occur when you’re in good health. Untreated medical conditions, especially hormonal disorders (e.g. thyroid issues) and gynaecological conditions (e.g. endometriosis), can hinder fertility. It’s essential to manage these conditions before trying to conceive. Additionally, ensure that any prescribed medications are safe to take during conception and pregnancy by discussing these with your fertility specialist.
Night shift work
Night shift workers may experience reduced fertility because disrupted or insufficient sleep can interfere with the body’s circadian rhythm, leading to hormonal imbalances. Research on patients undergoing IVF has shown that women working night shifts tend to produce fewer eggs suitable for embryo development.13 Meanwhile, other studies have linked shift work to higher miscarriage rates.14 If possible, avoid night shift work and stick to a regular shift schedule rather than rotating between day and night shifts, as consistency can help reduce the impact on hormone levels.
Supplements for improving egg quality
In addition to lifestyle changes, certain supplements are often recommended. While evidence supporting their impact on egg quality and IVF success rates is limited, some studies suggest potential benefits, whereas others show no significant improvements in fertility outcomes. However, when taken at recommended doses, these supplements are generally considered safe.11
For instance, antioxidants like vitamin E and coenzyme Q10 may enhance IVF outcomes by reducing DNA damage and improving egg quality, particularly in older women or those with diminished ovarian reserve. Other commonly suggested supplements include vitamin D (especially for those with a deficiency) and omega-3 fatty acids.11
Additionally, all women trying to conceive should take a supplement containing at least 400 mcg of folic acid, which is crucial for DNA synthesis and reducing neural tube defects, along with 150 mcg of iodine to support thyroid function.11
Small changes can lead to big results
Simple yet impactful lifestyle changes go a long way towards preserving egg quality, preventing egg damage and improving your overall fertility. By addressing these modifiable factors and prioritising your overall wellbeing, you can boost your chances of conception and a healthy pregnancy.
If you’re ready to explore your options for having a baby or are concerned about your fertility, you can make an appointment with one of our specialists by calling (03) 8080 8933 or by booking online.
References
Better Health Channel. Age and fertility [internet]. Victoria (AU): Better Health Channel; 2023 [updated 2023; cited 2024 Oct]. Available from: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/age-and-fertility ↩↩
Winship A, Stringer J, Liew S et al. The importance of DNA repair for maintaining oocyte quality in response to anti-cancer treatments, environmental toxins and maternal ageing. Hum Reprod Update. 2018;24(2): 19–134. doi: https://doi.org/10.1093/humupd/dmy002. ↩
Pineles BL, Park E, Samet JM. Systematic review and meta-analysis of miscarriage and maternal exposure to tobacco smoke during pregnancy. Am J Epidemiol. 2014;179(7):807–23. doi: 10.1093/aje/kwt334. Epub 2014 Feb 10. PMID: 24518810; PMCID: PMC3969532. ↩
Better Health Channel. Pregnancy and smoking [internet]. Victoria (AU): Better Health Channel; 2022 [updated 2022; cited 2024 Oct]. Available from: https://www.betterhealth.vic.gov.au/health/healthyliving/pregnancy-and-smoking ↩
Fan D, Liu L, Xia Q et al. Female alcohol consumption and fecundability: a systematic review and dose-response meta-analysis. Sci Rep. 2017;7(1):13815. doi: https://doi.org/10.1038/s41598-017-14261-8 ↩
Lyngsø J, Ramlau-Hansen CH, Bay B et al. Association between coffee or caffeine consumption and fecundity and fertility: a systematic review and dose-response meta-analysis. Clin Epidemiol. 2017;9:699–719. doi: 10.2147/CLEP.S146496. PMID: 29276412; PMCID: PMC5733907. ↩
The Society of Obstetricians and Gynaecologists of Canada. Substance use and fertility [internet]. Ontario (CA): The Society of Obstetricians and Gynaecologists of Canada; 2024 [cited 2024 Oct]. Available from: https://www.pregnancyinfo.ca/before-you-conceive/fertility/substance-use-and-fertility/ ↩
Smid MC, Metz TD, Gordon AJ. Stimulant use in Pregnancy: An Under-recognized Epidemic Among Pregnant Women. Clin Obstet Gynecol. 2019;62(1):168–184. doi: 10.1097/GRF.0000000000000418. PMID: 30601144; PMCID: PMC6438363. ↩
Barakat R, Zhang D, Silva-José C et al. The influence of physical activity during pregnancy on miscarriage-systematic review and meta-analysis. J Clin Med. 2023;12(16):5393. doi: 10.3390/jcm12165393. PMID: 37629435; PMCID: PMC10455409. ↩
Hart RJ. Nutritional supplements and IVF: an evidence-based approach. Reprod Biomed Online. 2024;48(3):103770. doi: 10.1016/j.rbmo.2023.103770. ↩
Yang J, Song Y, Gaskins AJ, et al. Mediterranean diet and female reproductive health over lifespan: a systematic review and meta-analysis. Am J Obstet Gynecol. 2023;229(6):617-631. doi: 10.1016/j.ajog.2023.05.030. ↩↩↩↩
Haase CL, Varbo A, Laursen PN et al. Association between body mass index, weight loss and the chance of pregnancy in women with polycystic ovary syndrome and overweight or obesity: a retrospective cohort study in the UK. Hum Reprod. 2023;38(3):471–481. doi: https://doi.org/10.1093/humrep/deac267 ↩
Liu Z, Zheng Y, Wang B et al. The impact of sleep on in-vitro fertilization embryo transfer outcomes: a prospective study. Fertil Steril. 2023;119(1):47–55. doi: 10.1016/j.fertnstert.2022.10.015 ↩
Mínguez-Alarcón L, Souter I, Williams PL, et al. Occupational factors and markers of ovarian reserve and response among women at a fertility centre. Occup Environ Med. 2017;74:426-431. doi: 10.1136/oemed-2016-103953 ↩
Naturopathy takes a holistic approach to your wellbeing and focuses on treatments that support your body to heal itself. A naturopath may recommend a combination of therapies such as herbal remedies, nutritional supplements, and diet and lifestyle advice.
Some evidence suggests that a holistic, naturopathic approach to care can benefit aspects of reproductive health. For example, a study in overweight women with polycystic ovarian syndrome (PCOS) compared the combined effects of herbal supplementation and lifestyle changes with lifestyle changes alone.1 While the combination was not shown to specifically increase conception rates, it did improve other markers of fertility like menstrual cycle regularity (which can support ovulation) and enhanced mental wellbeing scores for depression.1
Herbal remedies
Herbal remedies are commonly used in naturopathy and include plants or parts of a plant – such as roots, flowers, bark, seeds and stems – that are often made into pills, teas or ointments for convenient consumption.
Simple acts like drinking a mug of herbal tea or using moisturisers infused with flower essences can relieve stress and create a sense of inner peace. And specifically regarding gynaecological findings, some herbal therapies have shown benefits. For instance, a study assessing the use of clomiphene (a medication that supports ovulation) combined with black cohosh supplementation in women with subfertility demonstrated increased endometrial thickness and improved hormone profiles.2 Theoretically, this can improve the chances of conception by creating a more receptive uterine environment for embryo implantation.2 However, the study findings did not specifically show an increase in pregnancy rates.2 If you would like to try a herbal remedy, keep in mind that they can affect your fertility treatment medications, so it’s essential to check if a herb is safe with your fertility specialist first.
Acupuncture
Acupuncture is a Chinese medicine practice in which thin needles are inserted into the skin at select acupuncture points. These acupuncture points mark lines of energy flow (called meridians) within the body, and the insertion of acupuncture needles at these points is intended to stimulate this energy flow.
There is limited evidence showing that acupuncture enhances fertility. However, patients may find acupuncture beneficial for stress reduction3 and overall emotional wellbeing.4
Mind-body practices
Mind-body practices are centred on the belief that your mindset can influence your health. Some mind-body practices include mindfulness meditation, yoga, music therapy, hypnosis, art therapy, aromatherapy, guided imagery and cognitive behavioural therapy.
Mindfulness meditation
Mindfulness meditation is a type of meditation that teaches you to become more aware of what you are thinking and feeling. Over time, mindfulness meditation can help you experience each moment with more compassion and less expectation – which may help ease the highs and lows of your fertility journey.
Research has linked mindfulness meditation with fewer difficult emotions, such as depression and stress, and less rumination, which can help you bounce back more easily from the highs and lows of your fertility journey.5
Yoga
Yoga is an ancient Indian mind-body practice that guides you through various postures and stretches. There are multiple styles of yoga, from gentle movements to more physically challenging practices. However, all yoga practices are a form of mindful movement.
The focus on flowing through physical motions and synchronising your movements with your breath can help you reconnect with your body and take a step back from the thoughts passing through your mind. This was evident in a six-week yoga program for women who were waiting for IVF treatment, where yoga was associated with fewer negative thoughts and feelings about fertility and an improved sense of wellbeing.6
Reflexology
Reflexology is a form of massage for the feet, hands and ears, where pressure is applied to select points that are believed to be linked to the function of broader body parts. By applying pressure to these points, reflexology aims to relieve stress and support healing in the body part each point is associated with.
A study comparing reflexology to gentle foot massage in women experiencing infertility found that reflexology did not improve ovulation or pregnancy rates. However, reflexology was associated with lower depression scores, which can help strengthen your resilience and overall fertility treatment experience.7
Take a balanced approach
Current medical research does not directly link complementary remedies to enhanced fertility. However, if such remedies benefit your emotional wellbeing and do not interfere with your current medical treatments, they could be a positive addition.
Always explore these options in consultation with your fertility specialist to ensure that these won’t interfere with your treatment.
There are also other changes you can make to maximise your chances of getting pregnant, such as:
Drinking caffeine in moderation
Incorporating regular movement into your routine
Maintaining a healthy weight
Enjoying a balanced, nutritious diet
Taking the recommended supplements.
If you would like to learn more about lifestyle changes to improve your fertility, you can also read ‘What can I do differently in 2024 to fall pregnant?’ by Newlife IVF fertility specialist Dr Nicole Hope.
Still got questions?
To meet with one of our Newlife IVF fertility specialists and learn more about how you can improve your fertility, you can reach our team by calling (03) 8080 8933 or book online via our appointments page.
References
Arentz S, Smith CA, Abbott J et al. Combined lifestyle and herbal medicine in overweight women with polycystic ovary syndrome (PCOS): A randomized controlled trial. Phytother Res. 2017;31(9):1330-40. doi:10.1002/ptr.5858 ↩↩
Clark N, Will M, Moravek M et al. A systematic review of the evidence for complementary and alternative medicine in infertility. Int J of Gynaecol Obstet. 2013;122(3):202-6. doi: 10.1016/j.ijgo.2013.03.032
HealthProfessional/#:~:text=Today%2C%20black%20cohosh%20is%20most,irritability%20%5B5%2C6%5D ↩↩↩
Xi J, Chen H, Peng ZH et al. Effects of acupuncture on the outcomes of assisted reproductive technology: an overview of systematic reviews. Evid-Based Complement and Alternat Med. 2018;2018:7352735. doi: 10.1155/2018/7352735 ↩
Hassanzadeh Bashtian M, Latifnejad Roudsari R, Sadeghi R. Effects of acupuncture on anxiety in infertile women: a systematic review of the literature. J Midwifery Reprod Health. 2017;5(1):842-8. doi: 10.22038/jmrh.2016.7949 ↩
Patel A, Sharma PSVN, Kumar P. Application of Mindfulness-Based Psychological Interventions in Infertility. J Hum Reprod Sci. 2020;13(1):3-21. doi: 10.4103/jhrs.JHRS_51_19 ↩
Oron G, Allnutt E, Lackman T et al. A prospective study using Hatha Yoga for stress reduction among women waiting for IVF treatment. Reprod Biomed Online. 2015;30(5):542-8. doi: 10.1016/j.rbmo.2015.01.011 ↩
Holt J, Lord J, Acharya U et al. The effectiveness of foot reflexology in inducing ovulation: a sham-controlled randomised trial. Fertil Steril. 2008;91(6):2514-19. doi: https://doi.org/10.1016/j.fertnstert.2008.04.016 ↩
For instance, it can feel overwhelming when you have to manage multiple appointments – including tests, scans and procedures – alongside a busy work schedule. Below, we explore common patient experiences when navigating a career as well as fertility treatment, along with advice from our counsellors to help you manage this balancing act.
To tell or not to tell
Some people find it easier to communicate with their workplace manager about their upcoming fertility treatment so that they can negotiate time off or flexible working arrangements when beginning a treatment cycle. Being upfront and open about what is required of you throughout your fertility treatment journey can help you and your manager plan around the quantity of work you can do, along with arrangements to suit your treatment schedule, such as reduced travel, flexible hours or the option to work from home if needed.
Unfortunately, there are instances where workplaces are not supportive of their employees, and women choose to withhold their family-building plans from their workplace for fear of discrimination or missing out on opportunities due to future pregnancy. If you elect not to disclose your fertility treatment with your workplace, have a plan in place to help you manage your scheduled appointments, including time off work for your procedures. Without going into the specific details, you may consider disclosing that you are ‘having a medical procedure’ and leave it at that.
Managing questions
Having your colleagues ask questions about your fertility or why you’ve had time off lately is a common experience for many of our patients. Some people are inherently curious about your family-building plans even though it isn’t necessarily their business. Just as you may be doing with family and friends, you might consider having a plan to manage these questions. For instance, coming up with some standard responses can be a good trick to have up your sleeve so that you can reply promptly and nip that curiosity in the bud.
If you’ve already opened up to others about your infertility, you might find yourself fielding questions. For instance, there may be interest about when you’re starting treatment or how far along you are in your treatment cycle, along with how you’re feeling and whether you’re pregnant yet. While these questions are often well-intended and come from a good place, sometimes they are misplaced or poorly timed.
If you have told others about your fertility treatment journey, consider setting boundaries with them from the start – let them know that you will update them when you have news or need their support, and kindly ask them to give you space during this time. For many patients, the workplace can serve as a place to remain busy and distracted, so being interrupted with questions related to your fertility treatment can impinge on your ability to distract yourself.
Should I take leave?
Patients often ask us for advice on whether they should take a few days or weeks off work during their treatment. In our experience, this decision is highly individual and often determined by whether it is financially viable for you to do so or if you have enough annual leave accrued to facilitate this.
During our counselling sessions, we also discuss whether it is helpful to maintain a normal routine. On one hand, sticking to your routine can give you a sense of normalcy and preserve your emotional health and wellbeing. Meanwhile, extended leave from work may leave you feeling like you have too much time on your hands, causing you to ruminate on your treatment. On the other hand, if you find that work is exacerbating your distress about your fertility journey, perhaps it’s worth considering a few days of planned leave or working from home during the more stressful periods of your treatment cycle.
We generally advise patients to take a day off work on the day of egg collection (and likely the next day). While there is a lesser need to do so for intrauterine insemination (IUI) and embryo transfers, it can be an opportunity for you to have a day off to do something enjoyable and celebrate. After all, you may have just made a baby! Taking sick leave for these days is how most patients manage their treatment, and you will be given a medical certificate on the day of your procedure to accommodate this.
Self-care at work
Some patients have found that they are less engaged and ‘switched on’ at work while undertaking fertility treatment or that they are falling short of their usual high standards. In these instances, it’s important to remind yourself that your medications (which mimic your body’s hormones) and the potential stress of fertility issues can affect how you function at work. You also may find that your focus shifts away from work and towards the practical and emotional demands of fertility treatment.
Making your work a lesser priority can feel strange and uncomfortable, particularly if you have a strong work ethic. It may take some time to adjust to these new feelings, so be kind to yourself in this space – and be mindful of the pressure you place on yourself at work. Consider lowering the expectations you have for yourself. You don’t always need to function at 100% capacity.
You may find that telling a trusted colleague about your treatment can help provide you with emotional support and practical help when dealing with these feelings. Perhaps even consider devising strategies for when you’re feeling under pressure, such as leaving your office for a walk, practising mindfulness or breathing exercises, talking to your support person or a friend, or even leaving work early.
Our counselling team is here to help
The Newlife IVF counsellors are very experienced in providing support during and after IVF treatment. If you would like to book an appointment with one of our counsellors, please do not hesitate to contact us. You can reach our team by calling (03) 8080 8933. And to make things easy for you, we are more than happy to talk with you over the phone, so you don’t have to take more time off work.
‘Ovarian reserve’ refers to the pool of eggs left in your ovaries with reproductive potential. Because women are unable to make new eggs, your egg supply (and fertility) naturally declines with age until menopause when you no longer ovulate at all.
A bit of biology
Your ovaries are oval shaped, around 3–5 cm long and found on either side of your uterus (womb). Ovaries contain follicles which act like a nest for immature eggs. Each month, your hormones stimulate many of these follicles, triggering the eggs inside them to mature. Even though a number of follicles are activated (often referred to as the ‘cohort’), the ovary will usually only release one dominant egg each month (‘ovulation’), leaving the other eggs to deteriorate. If the mature egg released from the ovary meets and unites with any sperm present in your reproductive tract (‘fertilisation’), pregnancy results (as long as the fertilised egg continues to develop and successfully implants in the wall of the uterus). This is why sexual intercourse is recommended around the time of ovulation.
Egg numbers change as we age
Even though women start with 1–2 million eggs, by the time you reach puberty only about 300,000–400,000 of the eggs you were born with remain. The monthly cycle described above then continues throughout a woman’s life until there are no eggs left. You will have around 27,000 eggs remaining in your late 30s and around 1000 at the onset of menopause. As the total number of remaining eggs decreases, so does the size of the monthly ‘cohort’. This means there are fewer follicles from which the ovary is able to select an egg for release each month and fewer potential eggs available for pick-up when an older woman undergoes egg collection for IVF or egg freezing. In total, your ovaries will release around 500 mature eggs throughout your fertile years (puberty to menopause).
It’s not hard to see why age plays such a major role in a woman’s potential to fall pregnant. Generally, the most fertile period of a woman’s life is between her 20s and early 30s – when egg quantity and quality are at their best. Women will typically find it more difficult to fall pregnant after the age of 35, when there is a sudden, sharp decline in egg count, along with a reduction in egg quality.
Counting eggs
There are two tests commonly used by fertility specialists to check a woman’s ovarian reserve. The first is the AMH (anti-Mullerian hormone) test, more colloquially known as the ‘Egg-timer test’. AMH is a hormone secreted by the follicles in the ovaries. However, as a woman matures, AMH levels naturally decrease. By measuring AMH levels in the blood, we can gauge how many eggs remain in your ovaries – high AMH levels are a strong indicator of a high number of eggs. Dr Chris Russell discusses the AMH test in more detail in this video.
The second test we use is called an ‘antral follicle count’. This test involves viewing your ovaries via an ultrasound scan (typically in the first week after a period). This enables us to count the number of egg-containing follicles in your ovaries.
It’s important to note that although both these tests provide valuable information about egg quantity, neither is able to assess egg quality.
Can I improve my ovarian reserve?
While there aren’t any proven ways to hold onto your eggs for longer, certain lifestyle factors have been shown to accelerate egg loss. For example, cigarette smoking may lead to the premature deterioration of your eggs. Thus, avoiding smoking is one of the simplest ways to preserve your fertility.
Are there other reasons my ovarian reserve may be low?
While a low (or diminished) ovarian reserve is a normal part of every woman’s biological clock, egg loss can occur earlier than expected for some women. Besides smoking, common causes of diminished ovarian reserve include various genetic conditions (e.g. Fragile X), ovarian surgery (e.g. for endometriosis or ovarian cysts) and some cancer treatments (e.g. certain chemotherapies and radiation therapy).
What role does egg freezing play in fertility preservation?
It is now very common for women who expect to start a family later in life (when they know their natural reserve of eggs will be lower) to consider freezing some of their eggs. Freezing your eggs is a safe and effective form of fertility preservation that can help limit the impact of expected age-related fertility decline. The best time to freeze your eggs is in your 20s and early 30s (when you are most fertile and you have a lot of good-quality eggs).
Egg freezing is a common way to preserve a woman’s fertility.
Egg freezing involves four steps:
Ovarian stimulation: We stimulate the ovaries with hormone injections to promote the development of egg-containing ovarian follicles
Monitoring: We monitor the developing follicles via ultrasound to help guide the timing of egg collection
Egg collection: Under light anaesthesia, we collect around 15–20 eggs (but this number is highly dependent on the ‘cohort’ size)
Storage: We identify and freeze any mature eggs, which can then be stored for up to 10 years.
If a woman encounters difficulty falling pregnant when she is ready to start a family, she then has the option of thawing her frozen eggs and trying for a baby via IVF.
Falling pregnant when egg numbers are already low
Women with a low ovarian reserve may still be able to have children with the help of assisted reproductive techniques like IVF. However, IVF success is reduced in women with low ovarian reserve and the risk of miscarriage is higher due to lower egg quality. If a woman’s ‘cohort’ size (i.e. the number of ovarian follicles activated each month) is significantly reduced, even very high doses of stimulating hormone will only produce one or two poor-quality eggs for collection during the IVF cycle. In this case, using donor eggs instead may be an option for some women.
Discussing your options
If you would like to learn more about low ovarian reserve or understand if your egg supply could be affecting your fertility, you can make an appointment with one of our fertility specialists by calling (03) 8080 8933 or by booking online.
Assuming you are relatively healthy, your immune system is already capable of preventing you from getting an infection most of the time. Occasionally, however, bacteria or viruses do overwhelm our immune defences and we get sick. When faced with the possibility of coming into contact with a strong virus like COVID-19, the idea of boosting one’s immunity is even more attractive than usual, particularly if you are looking to fall pregnant. We all want a strong immune system that is well-primed to defend us from any harmful infections that may be lingering in the community. Unfortunately, research has not identified any single lifestyle strategy, supplement or food with the ability to strengthen the body’s immune defences. This means that if you are healthy, your immune system is probably already as ‘boosted’ as it’s going to get. That being said, if you shift your focus to giving your immune system everything it needs to ‘stay boosted’, there is still plenty you can do. Other than following the latest hygiene and social distancing recommendations, maintaining a healthy diet and lifestyle will enable your immune system to function at its best.
What can I do to stay healthy?
You can support your overall health and give yourself the best chance of staying well by following these tips:
Diet
Although ‘comfort foods’ may tempt you during this time, maintaining a nutritious diet has never been more important. Deficiencies in nutrients such as zinc, iron, and vitamins C, A and E may impact your immune system’s ability to protect you. For this reason, foods that help ‘boost’ your immune system are simply those that allow you to get the nutrients you need. Enjoy a wide variety of vegetables, wholegrains, fruits and protein-rich foods such as lean meats, reduced fat dairy products, legumes, nuts and seeds. For more information on how to eat right, download the Australian Dietary Guidelines Healthy Eating brochures. While it is always best to try and improve your dietary habits first, if your day-to-day diet is lacking in micronutrients, a women’s multivitamin may be of benefit. Of course, if you are planning a pregnancy, you should already be taking a pregnancy supplement containing at least 400mcg of folate.
Vitamin D
For many of us, staying home has meant less time in the sun, leading to fewer opportunities to make vitamin D. Known as the ‘sunshine vitamin’, this important vitamin is produced when your skin is exposed to sunlight. As we head into the cooler months, deficiency becomes more common. In fact, approximately 50% of Australian women are deficient in vitamin D during winter.1 As vitamin D deficiency has been shown to increase the risk of respiratory infections2, correcting a deficiency may, in effect, ‘boost’ your immunity. If you aren’t able to consistently meet the sun exposure guidelines for adequate vitamin D, or you haven’t met them for a while, we suggest you speak to your GP about whether or not you meet the criteria for getting your vitamin D level checked.
Exercise
While Netflix is an appealing way to pass the time as you #stayhome, maintaining a regular exercise routine will promote your general health and support your immune system. Resist the pull of the couch and make sure you engage in at least 30 minutes of moderate exercise 3-4 times a week. Go for a jog, bike ride or brisk walk in the park, or see if your local gym is currently offering online classes instead. Just make sure you observe social distancing recommendations if you’re exercising outside and stay at least 1.5 metres away from people who are not part of your household. For in-home exercise, you may like to try an app called Daily Yoga which is great for building strength, stretching and relaxation.
Stress management
It is common (and absolutely normal) to feel stressed and anxious at this time. Unfortunately, research does indicate that persistent stress may impair your immune system’s ability to defend you. In this case, the best way to help your immune system ‘stay boosted’ is to reduce the level of stress and anxiety you are feeling. Try these techniques to get you started, but if you are struggling and need additional support, know you’re not alone. As a Newlife patient, you are always welcome to reach out to Newlife’s team of specialist counsellors. A quick phone or Zoom chat may be all you need to unpack your ‘mental load’ and quell the frustrations that come with isolation.
Sleep
Studies indicate that inadequate sleep can increase your risk of getting sick if you are exposed to a virus such as the common cold (however, note that there is currently no evidence relating to COVID-19 and sleep). Aim for the recommended 7 to 9 hours per night, and use these tips to get a better night’s sleep. If you are having trouble sleeping because you are stressed, finding ways to actively reduce your stress level will naturally help improve your sleep and ‘boost’ your immunity.
When to get help
If you are feeling anxious and overwhelmed, or are worried about the implications of delaying or pausing your fertility treatment because of COVID-19, we are here for you. Get in touch with our team by calling (03) 8080 8933 or emailing [email protected]. We’ll be able to direct you to one of our fertility specialists, nurses or counsellors for further support as appropriate. In the meantime, here’s to staying safe and staying well.
What is IVF and how does it work?
