Understanding the IVF process and treatment

Embryologist examining cells under the microscopeWhat is IVF and how does it work?

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).

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

A fertility specialist performing a pelvic ultrasound on a patient.

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

To book an appointment for IVF treatment in Melbourne with one of our caring, experienced fertility doctors, please call (03) 8080 8933 or email [email protected].

Using natural therapies in combination with fertility treatment

Naturopathy

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

A female in casual clothes performing mindfulness meditation with her eyes closed while seated on a bed next to window.

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


  1. 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 
  2. 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 
  3. 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 
  4. 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 
  5. 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 
  6. 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 
  7. 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 

Building resilience during IVF – how to cope with the highs and lows

Building emotional resilience can help you manage these emotions, recover from setbacks and cope with life’s difficulties and uncertainties.

What is resilience?

‘Resilience is the process of adapting well in the face of adversity, trauma, tragedy, threats or significant sources of stress.’1

Being resilient does not mean avoiding feelings of stress or emotional pain – rather, it is adapting to difficult or unexpected circumstances and bouncing back from the experience.

Resilience improves your wellbeing

Concerning fertility, research has shown that higher levels of resilience among couples struggling with fertility are associated with enhanced quality of life and emotional stability, as well as lower fertility-related distress.2
Beyond helping you cope during fertility treatment, building resilience can have a positive impact on your overall health and wellbeing, leading to3:

  • Fewer depressive symptoms
  • Improved adaptation to stress
  • Enhanced ability to cope during distressing experiences
  • Improved physical health.

Practices to build your resilience

Like progressively strengthening a muscle, you can learn to become more resilient to life’s challenges over time. Here are some examples that may help.

Grow supportive connections Cropped shot of two young women embracing each other

Drawing on the support of those around you, including your partner (where applicable), family or friends, can help share the emotional load of your experience as you continue with your fertility treatment.4 Help is a two-way street – in addition to accepting help, supporting your loved ones through difficult moments can help you feel connected to others while giving you a sense of satisfaction, in turn strengthening your resilience. Small and simple gestures like checking in with a friend or lending an empathetic ear while others are dealing with stress can also distract you from an inward focus where you feel stuck in your own problems.

Manage uncertainty

During fertility counselling sessions, we often dive into how to navigate feelings of uncertainty and lack of control that can be experienced during fertility treatment. This is because learning how to accept uncertainty – not just during fertility treatment but throughout life in general – can help develop resilience.

But merely accepting the unpredictability and ‘unknowns’ of your fertility care is not an easy thing to do, which is why we recommend practising mindfulness. Instead of latching onto feelings of uncertainty when these thoughts arise, acknowledge their existence and try to move through these feelings. This is one of the hardest things to do, so be kind to yourself while you work on this.

Set small, achievable goals

The pride and sense of accomplishment you feel when achieving a goal is motivating and energising, helping you to feel more optimistic. Research has shown that breaking down your overarching goal into smaller short-term goals can help reframe your mindset while also relieving feelings of disappointment after a negative fertility treatment cycle.4

So ensuring that your goals are achievable is a great way to build resilience. In this instance, the importance is not the goal itself but the process of setting small goals and noticing your progress.

Break down each step in your fertility treatment cycle into mini-goals – this might include taking your hormone injections each day, completing your blood tests and scans, having your embryo transfer or intrauterine insemination procedure, or getting through each day of the two-week wait before finding out whether the treatment resulted in the outcome you were hoping for.

Sprinkle in some joy

There can be moments of sadness and loss when trying to conceive, which can make it harder to appreciate other joys in life, particularly if your fertility journey is regularly on your mind (as it’s very easy for treatment to become a sole focus).

Try to maintain some ‘normality’ in your life by engaging in activities that bring you joy.4 Humour is also effective in helping to develop a more resilient nature, so exploring activities that make you laugh while giving you a break from treatment can help you stay connected to day-to-day life.

Take the time to reflect

Think back on obstacles that you have previously overcome and recognise that you have already been developing resilience over the years, perhaps without knowing it. Reflect on past situations that have caused you stress, grief or trauma and ask yourself:

  • What worked in helping you to cope during these times?
  • What didn’t work well?
  • Who were the best people to help you at those times?

Take these learnings with you on your fertility journey and draw on them when working through any disappointing or unexpected outcomes.

Connect with our supportive counselling team

Our compassionate Newlife IVF counsellors are here to guide you through every step of your journey.

At Newlife IVF, we are committed to supporting our patients the best we can, which includes providing you with additional counselling sessions at no extra cost. To book an appointment with one of our counsellors, call (03) 8080 8933 or email us at [email protected]. And to make things easy for you, we are more than happy to consult with you over the phone so you don’t have to take time off work.

We also offer our TLC group support sessions to help you overcome feelings of isolation during treatment and improve your connection with others. Please email [email protected] for upcoming meetings.

Remember, you have made it through rough times before. You’ve got this.

References


  1. American Psychological Association. Building your resilience. American Psychological Association. 2020. Accessed 20249. https://www.apa.org/topics/resilience 
  2. Herrmann D, Scherg H, Verres R et al. Resilience in infertile couples acts as a protective factor against infertility-specific distress and impaired quality of life. J Assist Reprod Genet. 2011;28(11):1111–1117. doi:10.1007/s10815-011-9637-2 
  3. Quyen G, Vandelanotte C, Cope K, et al. The association of resilience with depression, anxiety, stress and physical activity during the COVID-19 pandemic. BMC Public Health. 2022;22. 
  4. Bailey A, Ellis-Caird H, Croft C. Living through unsuccessful conception attempts: a grounded theory of resilience among women undergoing fertility treatment. J Reprod Infant Psychol. 2017 Sep;35(4),324–333. https://doi.org/10.1080/02646838.2017.1320366 

Newlife IVF’s millenary milestone

It’s a proud moment for us because when we established our clinic four years ago, we set out to provide patients with the highest standard of fertility care.

‘When starting Newlife IVF, I was very conscious of the people I surrounded myself with – I wanted to work alongside people who had been practising in their respective fields for many years and had significant experience, but who saw and wanted an opportunity to do things differently and injected our shared values into our work,’ said Dr Tiki Osianlis, Newlife IVF’s Managing Director and Scientific Director.

And we did just that! Our six founding doctors, including Dr Osianlis, Dr Chris Russell, Dr Nicole Hope, Dr Sameer Jatkar, Dr Hugo Fernandes and Associate Professor Martin Healey, already had a wealth of knowledge and experience at the time. So, they paired their expertise with a unique offering for the TTC (trying to conceive) community, centred around a more personalised, caring and supportive experience for couples and individuals wanting to begin or expand their families. Their intention was to create a service that enabled them to navigate the fertility journey alongside their patients.

Fertility specialists Dr Hugo Fernandes, Dr Sameer Jatkar and Dr Nicole Hope posing with a cake while celebrating the clinic's 1,000th baby milestone.

Staying true to this ethos has propelled Newlife IVF to where it is today – four years of scientific excellence accompanied by the gift of new life (1,000 new lives, to be exact!).

Helping others grow their families is what we do best

We’re pretty chuffed to have reached this momentous occasion. So, too, are the new parents of our 1,000th baby, Jess T and Luke.

‘We feel so privileged to be a part of this incredible milestone! It is amazing to think of how many families have been created thanks to Newlife IVF, and we will be forever thankful to count ourselves and our precious baby Liam among that number,’ said Jess T.

Like many parents-to-be, Jess T and Luke’s fertility journey came with challenges. ‘We had been trying to conceive for over a year without any success, including an early miscarriage. Friends of ours had also experienced infertility and recommended Dr Chris Russell and Newlife IVF. From our first consultation with Chris, we immediately felt like we were in good hands and that this would be our best chance to fulfil our dream of starting a family,’ she said.

It’s no secret that the path to parenthood is peppered with emotional highs and lows. For this reason, our team go above and beyond to help our patients feel supported, empowered, informed and in control throughout every step of their fertility journey.

‘Chris always made Luke and I feel like valued patients. He respected our input and preferences, and we always left our appointments feeling comfortable about the next course of action. Our counsellor also helped to put my mind at ease throughout my IVF journey. It was comforting knowing that I had extra support if I needed it,’ said Jess T.

Fertility treatment is more than just science

Fertility care hinges on more than just using the latest scientific tools and techniques (although we have those, too!). Rather, an exceptional fertility experience involves developing an empathetic and trustworthy relationship with your fertility provider. Just ask Jess S and Tim, who have recently conceived their third IVF baby with help from Dr Russell and the Newlife IVF team. In fact, they’ve been with us from the very beginning.

‘When we began our fertility journey with Chris, we didn’t know Newlife was only a month old. The care and support we received from the whole team was nothing short of exceptional. We always felt like we were in good hands’, said Jess S.

‘When we first saw Chris, we were so overwhelmed with grief and fear of potentially never being able to have a baby. We didn’t understand what was ahead of us. Chris was kind, gentle and understanding of all these emotions,’ she said.
The patient-doctor relationship grew from strength to strength, with Jess S and Tim returning to our clinic for babies two and three.

‘There was so much fear and anxiety when we first started the IVF process. But the staff at Newlife were so supportive and encouraging. The care and advocacy they provided was above and beyond. When we returned for our second and third transfers, we knew we would be looked after each time. And we were! Every time we’ve gone back to see Chris, it felt like we never left. He knew our journey, understood what we wanted for our family and supported us. I’m now halfway through my third pregnancy and feel like part of the furniture,’ said Jess S.

The Newlife IVF team celebrating the clinic's 1,000th baby milestone

Empathy lies at the heart of Newlife IVF

So it’s been four years of Newlife IVF, with 1,000 babies born, and many more to go. We feel extremely privileged to be part of our patients’ fertility journeys and are proud of all that we’ve achieved for them.

‘It’s immensely rewarding to help any patient achieve their dream family, but to help Jess and Tim have three babies in quick succession, and 1,000 babies in all over our first four years, really highlights the excellence that we are aiming for and achieving at Newlife IVF,’ said Dr Russell.

As we continue doing what we do best (building families and supporting our patients), we remain dedicated to offering you a more personalised, caring and supportive experience to bring you joy at the end of your journey with us.

So, here’s to the next thousand and all that follow thereafter!

Take the next step towards a new life

If you’re ready to begin your fertility journey, call us on (03) 8080 8933 or book online via our appointments page.

Assisted conception for LGBTQ+ couples

For lesbian (or assigned female at birth) couples

Your first step is to decide how you wish to access donor sperm. You will then need to select a method of bringing egg and sperm together, a process called insemination.

Donor sperm

There are two main ways of obtaining donor sperm: through a known donor or a clinic-recruited donor. Many fertility clinics maintain a sperm bank. For example, Newlife IVF has an on-site sperm bank with samples from local donors. We are also able to access donor sperm from an international sperm bank.

Using clinic-recruited sperm has several advantages. There are very clear-cut legal boundaries in place. The donor has no legal connection to the child, so they are ineligible for custody and do not pay child support. Additionally, the donor and the recipient do not know each other’s identity. However, details of the donor’s medical history, background and traits will be shared with you. Once your child turns 18, they can request information about the donor’s identity.

Another advantage of using a clinic-recruited donor is that the sperm undergoes a rigorous testing process before it is declared fit for use. Sperm samples are initially screened for quality, infectious diseases and genetic problems, before being frozen and quarantined. After three months, the donors are retested to ensure that the sample they provided is safe to use. The sperm is made available for use only after all of these checkpoints have been cleared.

The second alternative is to ask a friend or acquaintance to donate sperm. If you and your partner long for a child that is genetically related to you both, you may wish to approach a relative. Of course, the sperm donor cannot be related to the partner who will provide the egg and carry the baby.

A benefit of using a known donor is that you are aware of their background, appearance and other important traits. However, there is the potential for social and legal grey areas when using a known donor. For example, you and the donor might have conflicting expectations about their level of involvement in your child’s upbringing. It is important to set clear boundaries and discuss expectations with your donor before trying to conceive. You may wish to seek legal advice on the best way to do this.

If you do choose to use a known donor, we suggest involving a fertility clinic. We can check your donor’s sperm count and motility (movement) and recommend the most appropriate method of insemination with this in mind (discussed further below). Additionally, the sample can be thoroughly tested for safety in the same way we would test clinic-recruited sperm.

Insemination

The next consideration is how to introduce the sperm to your egg (or your partner’s egg). The most appropriate method will depend on several factors. These include the health and medical history of the partner who will carry the baby, the quality of the sperm sample you choose to use, and your specific circumstances and preferences.

The simplest method is home insemination, where sperm is injected into the vagina using a syringe at home. As this method is similar to natural fertilisation, it may be an appropriate option where sperm count and motility are normal. It is also the most cost-effective option. However, if the sperm donor or the partner who will carry the baby have fertility issues, other treatments are likely to be more appropriate.

Another option is intrauterine insemination (IUI). In IUI, the sperm sample is concentrated before it is used. This means that a very large number of sperm are introduced into the uterus directly after an egg is released, increasing the chance of fertilisation. In some cases, you may be advised to take medications to stimulate the release of an egg. This increases the chance of an egg being available at the time the sperm is introduced.

The final option is in vitro fertilisation (IVF). In IVF, several of your eggs (or your partner’s eggs) are introduced to sperm in laboratory dishes. Depending on your circumstances, intracytoplasmic sperm injection (ICSI) may also be recommended. In this procedure, the best sperm are selected and a single sperm is injected into each egg. ICSI is always used with clinic-recruited donors. However, if you are using a known donor with low sperm count and motility, ICSI may also be appropriate for you. Once the fertilised eggs have developed into embryos, one will be chosen for transfer into the uterus of the partner who will be carrying the baby. The remainder can be frozen and stored for future use, if required.

IVF is the most appropriate option if one or both partners has any fertility issues. It may also be recommended if other insemination methods have been unsuccessful, or you’re in your late 30s, early 40s or beyond (when fertility naturally declines).

IVF also enables egg sharing, where an embryo resulting from one partner’s egg is transferred to the other partner’s uterus. This allows both partners to have a biological connection with their child – one partner conceives the child with their genetic material, the other partner carries and delivers the child. In this process, the partner donating the egg will take medications to help mature several of their eggs. These mature eggs will then be collected in the clinic. The partner who will receive the fertilised egg (embryo) takes the oral contraceptive pill to synchronise their cycle with their partner’s. Medications are then taken to prepare the uterus for embryo transfer.

Before egg sharing can commence, both partners must undergo a health check and counselling. This may include blood tests and ultrasounds to check general health and fertility. It should be noted that egg sharing can involve a significant financial investment, as both partners require treatment.

For gay (or assigned male at birth) couples

To have a baby, you and your partner will need to find an egg donor and a surrogate. According to Victorian law, the surrogate and egg donor cannot be the same person.

Donor eggs

There are two options for obtaining donor eggs. You may choose to utilise a known donor, such as a friend or acquaintance, or a clinic-recruited donor. If both you and your partner want a genetic connection to your child, you may wish to approach a relative of the partner whose sperm is not being used.

In Australia, egg donation must be altruistic. That is, the egg donor cannot be financially compensated. Donor eggs and sperm will be introduced to each other using IVF (discussed earlier in this article) with one of the resulting embryos then transferred to your surrogate’s uterus.

Surrogacy

You may wish to ask a friend, acquaintance or family member to be a surrogate. Like egg donation, surrogacy must be altruistic. However, ‘reasonable’ medical costs can be paid by you. It is important to note that multiple medical consultations, counselling sessions and legal advice are required for both you and the surrogate prior to proceeding. You will also need to seek permission from the Patient Review Panel (this is a legal requirement in Victoria), and the sperm or embryos must be quarantined. This process can take several months.

Seeking a surrogate overseas may also be an option. However, according to Australian law, this is only legal if it is altruistic. Be aware that this is a very expensive route and you will need to plan to potentially be overseas for a few months after your baby is born to organise their entry into Australia.

For specific advice on finding a surrogate, you may wish to seek legal advice and see a fertility specialist. IVF clinics are not permitted to help you find a surrogate. However, our counsellors can connect you with the Victorian surrogacy community and provide support and information as you look for a surrogate.

Note that sperm mixing, where sperm samples from both partners are mixed together and introduced to an egg, is not legal in Australia when using a surrogate.

Take the next step

If you are ready to begin your fertility journey, book an initial consultation with one of our fertility specialists. At this appointment, we will discuss your preferences and expectations, take a detailed medical history from both of you, then advise you on the best way to proceed.

To book a consultation, call (03) 8080 8933 or book online.

Why didn’t my embryos grow?

The lab environment aims to mimic the conditions your embryos would experience if they were growing in your reproductive tract. This includes the right oxygen pressure, temperature and nutrients, as required for all the different stages of development. In addition, we continuously monitor the growth of your embryos using time-lapse imaging. However, despite these efforts, some embryos may not progress to the blastocyst stage.

In this video, fertility specialist Dr Nicole Hope details some of the changes that take place when a fertilised egg develops into a blastocyst embryo.

Embryo arrest

Approximately 60% of fertilised eggs become blastocysts. This means that around 40% of embryos stop growing before becoming a day 5–6 embryo. This is known as embryo arrest and occurs when an embryo stops dividing for 24 hours.

Not all embryos that reach the blastocyst stage are suitable for embryo transfer or freezing, as they may not have all the components necessary to result in a healthy pregnancy. Generally, around 40–50% of fertilised eggs become blastocysts that we can transfer or freeze. However, this varies greatly depending on your age and medical history. There is also a small group of individuals who have poor embryo development, which may be due to developmental-specific events or a pattern of embryo progression. Most IVF patients experience embryo arrest in some form, and it is usually a protective mechanism for stopping the development of abnormal or poor-quality embryos.

Causes of embryo arrest

There are many reasons why an embryo might stop developing. The embryo could have reduced metabolic activity or slow development and as a result, degenerate. In addition, embryos can stop growing during different stages of development. They may fail to reach the blastocyst stage for several reasons discussed below.

Chromosomal errors

Around 70% of arrested embryos display chromosomal errors.1 Chromosomes are rope-like structures inside your cells that contain DNA – i.e. the instruction manual that makes you unique. When sperm and egg come together, the mother and father pass on 23 chromosomes each, so that the resulting embryo has a total of 46 chromosomes.

Sometimes, chromosomes can fail to combine correctly leading to chromosomal errors. This may include having:

  • an abnormal number of chromosomes (called aneuploidy)
  • more than one full set of chromosomes (called polyploidy)
  • a combination of both normal and abnormal numbers of chromosomes (called mosaicism).

In addition, chromosomal errors can develop during the replication and division of the cells in the embryo. If an embryo divides abnormally during the early stages of its development (also known as the cleavage stage), this can lead to an abnormal distribution of chromosomes between cells and result in embryo arrest. Cells within the embryo can also have abnormal DNA replication and/or damaged DNA leading to embryo arrest.

Some chromosomal errors do not stop the embryo from growing, which is why preimplantation genetic screening (PGT) may be recommended.

Cell division errors

Embryo
Image of a blastocyst (a day 5–6 embryo). The cells on the outside become placental tissue and the group of cells in the middle develop into a foetus.

Usually, a cell within an embryo divides from one cell into two and distributes its chromosomes evenly. However, in some instances, a cell within an embryo divides from one cell to three. This is called Direct Uneven Cleavage (DUC). When DUC occurs in the first cell division, there is a higher chance of embryo arrest occurring.

The chances of embryo arrest occurring also depend on how much the cells are affected. Sometimes, an embryo may divide very quickly from one cell to two and three cells, and this rapid division can be difficult to differentiate from DUC. Under these circumstances, the rapidly dividing embryo has a greater chance of becoming a blastocyst.

Another cell division error can occur if the cell fails to divide but the nucleus (the information centre of all cells which contains your chromosomes and DNA) continues to replicate. This can lead to there being more than one complete set of chromosomes inside a single cell. If this occurs in several cells, the embryo will arrest; however, if this phenomenon is present only in a few cells, the embryo still has the potential to reach the blastocyst stage.

Poor embryo development

Early cleavage within the embryo relies on special products inside the egg to drive development. Sometimes, defects in the development of an embryo reflect the quality of the egg and can cause the embryo to stop dividing.

Embryos can also undergo instructed cell death (known as apoptosis). Apoptosis is a biological mechanism that aims to remove any unwanted or damaged cells from the embryo in its early stages of development. If enough apoptosis occurs, the embryo can fail to develop further.

Mitochondrial function

Mitochondria are like little organs inside a cell that act as a power supply. Specifically, they produce an energy-carrying molecule called ATP (short for adenosine triphosphate). Inherited only from the mother’s egg, mitochondria produce the energy that eggs and embryos need to function properly. During the early growth stages of an embryo, mitochondria undergo structural and positional changes that allow them to provide energy to the embryo and regulate their environment. These events are a key part of the development of an embryo before implantation takes place inside the womb.

As a woman ages, the quality of her eggs declines. Increasing maternal age can result in mitochondrial dysfunction due to changes or damage to the mitochondrial DNA – yes, mitochondria have DNA just like the nucleus of a cell. If the mitochondrial DNA is damaged, this can result in inadequate amounts of ATP or energy, as well as the loss of other important mitochondrial functions required following fertilisation. In addition, low mitochondrial DNA content is also associated with fertilisation failure and abnormal embryo development. Basically, if an egg or embryo does not have enough of a power supply, developmental processes will stop.

Between days two and three of embryo development, i.e. from the four-cell to the eight-cell stage, an embryo’s genome is activated. A genome refers to the genetic material (chromosomes containing DNA) inside a cell. When an embryo’s genome is activated, the embryo no longer relies on the egg to continue growing; rather, it uses its own cellular machinery. This change in embryonic genome activity is regulated by special products that mitochondria produce. Around 10% of embryos do not make the switch from maternal egg control to embryonic genome control. This means that an embryo on day two may be at the four-cell stage but fail to progress further if the genome switch does not occur.

Looking for more information?

There are many reasons why an embryo may not progress beyond a certain developmental stage. Throughout your cycle, our embryologists will phone you to keep you updated on the progress of your embryos. We know this can be an anxious time as you wait to hear how many of your eggs have been fertilised and then how many of these have developed into quality embryos suitable for transfer or freezing. If you have any concerns throughout this time, we encourage you to call us on (03) 8080 8933 for the extra support and information you need.

References


  1. Maurer M, Ebner T, Puchner M, et al. Chromosomal Aneuploidies and Early Embryonic Developmental Arrest. Int J Fertil Steril. 2015; 9(3):346-353. 

Selecting a sperm donor

Accessing donor sperm

There are several ways you can obtain donor sperm from both clinic-recruited and known donors.

Clinic-recruited donors

Most fertility clinics have access to a sperm bank with stored donated samples. Although these used to be known as ‘anonymous’ donors, it’s important to note that children conceived from these samples can request the identity of their donor after they turn 18. At Newlife IVF, our dedicated on-site sperm bank contains samples from local donors. We also offer the option to select donor sperm from an international sperm bank.

Known donors

Alternatively, you may choose to use a sperm sample from someone you know, such as a friend or acquaintance. Some couples wish for their baby to be genetically connected to them. In these circumstances, you may decide to approach a family member. It’s important to note that the sperm donor must not be related to the partner who will provide the egg.

So, how do I choose?

There are many factors to take on board when choosing a sperm donor. These will depend greatly on your situation and can be discussed with your fertility counsellor.

Sperm quality and medical screening

One of the benefits of accessing donor sperm from a fertility clinic such as Newlife IVF is that all sperm samples and donors undergo thorough testing. This includes a quality assessment of the sperm, as well as testing of the donor for any infectious diseases (such as HIV or hepatitis) and genetic conditions. Samples are then frozen and quarantined for at least three months before donors are retested for infectious diseases. This ensures that the sperm is safe for use. If you elect to use a sample from a known donor, we recommend contacting a fertility clinic. We can perform the same screening we normally would for clinic-recruited donors on known donors, as well as freezing the sperm for a similar quarantine process.

Legal considerations

An advantage of using a clinic-recruited donor is that they are fully aware of their obligations and rights. Typically, the donor will attend one or more counselling sessions informing them of the various legal boundaries in place to protect them, the recipient and the donor-conceived child. For instance, the donor has no legal relation to your child and cannot seek custody. In addition, clinic-recruited donors cannot donate to more than 10 women (including their own partners). Fertility clinics also keep specific information about the donor, such as their name and date of birth, as well as medical and genetic test results. Whilst the donor’s identity remains undisclosed to recipients, your child can request the donor’s identity when they turn 18. All donor-conceived births are reported to the Victorian Assisted Reproductive Treatment Authority (VARTA), a statutory authority that assists donors and donor-conceived individuals.

If you obtain donor sperm from someone you know, it’s important to create firm social and legal boundaries. You may choose to seek legal advice to assist with this process. As the level of donor involvement can vary greatly from situation to situation, it’s important to discuss expectations from all members involved (including any partners) before trying to conceive. For example, in co-parenting arrangements the donor may maintain an ongoing relationship with the child, whereas for other families the donor may have a limited level of involvement (or no involvement at all).

Personal preferences

Donor characteristics may also help guide your selection process. For example, some patients will want to choose a donor with a similar physical appearance. If you decide to go down the known-donor route, you will have a good understanding of their appearance, personality and perhaps why they are donating to you. Clinic-recruited donors are also asked to provide general information about their appearance, characteristics and personality. You may also take into consideration why they have chosen to donate. All clinic-recruited donors provide a donor statement as a part of their donor profile.

Newlife IVF deliberately recruits sperm donors from a wide range of backgrounds and ethnicities, with the aim of providing donor recipients with adequate choice and cultural representation.

The route to receiving donor sperm

Before you can select and obtain donor sperm, there are several appointments you will need to attend. At your initial consultation, your fertility specialist will explain in-depth the process of receiving donor sperm, including particular legal considerations such as using an identity release donor (i.e. donors who consent to releasing identifying information about themselves). Your fertility specialist may also request the person providing the egg and carrying the pregnancy to complete a medical evaluation with blood tests if they haven’t been done previously. This helps us develop an appropriate fertility treatment plan for you.

During your donor counselling appointment, you (and your partner if applicable) will meet with one of our fertility counsellors. The purpose of this session is to talk about common issues that can arise following the decision to use donor sperm. For instance, you may discuss topics like:

  • How to select a donor
  • The level of donor involvement during your pregnancy and child’s life
  • Handling conversations with a child conceived from donor sperm
  • Communicating about your fertility treatment with your inner circle and acquaintances.

Following this appointment, our donor profiles will be made available for you to access online (if you choose to use this service as opposed to known-donor sperm). If you select a donor from our sperm bank, a second counselling appointment and a consultation with a fertility nurse will be arranged to organise the various consents. For instance, donor consent is required to release identifying information upon your child’s request. During this session we will also arrange the details of your fertility treatment.

Further advice

If you are ready to begin your fertility journey or want to find out more about donor sperm, book a consultation with a Newlife IVF fertility specialist. We can recommend the most appropriate options for you based on your personal circumstances and preferences. To book an appointment, call (03) 8080 8933 or book online.

Repeated implantation failure – common causes and ways to improve the success of embryo transfer

Sometimes, however, embryos fail to implant. If this happens during three or more IVF cycles, we use the term ‘repeated implantation failure’. While this can be a frustrating hurdle for women and couples undergoing IVF treatment, there are ways to improve the success of embryo transfer depending on the likely cause of implantation failure.

Common causes of repeated implantation failure

Factors relating to either one or both parents can contribute to repeated embryo implantation failure, so we will typically use a range of tests to help investigate and determine the cause.

The quality of the egg or sperm

A high-quality egg and sperm are essential ingredients for a healthy embryo. Bearing in mind that healthy embryos have the best chance of implanting in the womb, it is important to use eggs and sperm of the highest quality possible during IVF. Unfortunately, numerous factors can reduce egg and sperm quality.

Age plays a major role in egg quality (and quantity). Once a woman reaches the age of 35, egg quality typically declines. This means that eggs collected from older women are less likely to successfully implant in the wall of the womb.

Two embryologists seated in front of a computer screen and analysing semen analysis results
Semen analysis can be used to assess sperm quality.

Sperm defects can also contribute to recurrent implantation failure. For instance, damage to the sperm’s genetic material – also known as DNA fragmentation – can affect the development of an embryo and, therefore, the likelihood of implantation. Aging and lifestyle factors like smoking, alcohol consumption and being overweight, as well as some underlying medical conditions and prescription medications, can damage the DNA in both sperm and eggs.

While there isn’t a test to assess egg quality, we can look for higher than normal levels of sperm DNA fragmentation when performing a semen analysis.

Chromosomal anomalies in the embryo

Variations to the chromosomes inside the embryo are a major cause of recurrent implantation failure. Chromosomes are special structures within cells that contain DNA, and are crucial for a healthy embryo transfer during the IVF process. Normally, each egg and sperm contains 23 DNA-housing chromosomes, and during fertilisation all 23 are passed on from each parent (giving the embryo a total of 46 chromosomes).

However, chromosomal errors can sometimes arise during the generation of an embryo. This includes abnormalities in the number of chromosomes present (known as aneuploidy) and structural changes affecting the size of chromosomes or how the DNA is organised within them. There can also be an increase in the amount of genetic material present in the embryo. No matter the type of error, chromosomal anomalies within the embryo are much less likely to result in an ongoing pregnancy.

Female age is the biggest contributing factor to chromosomal anomalies in the embryo. However, rarely a person can be born with a structural rearrangement in their own chromosomes, which can predispose them to producing mostly abnormal eggs or sperm. This can be detected by performing a karyotype test on the individuals providing the egg and sperm.

If we suspect chromosomal error, we can use pre-implantation genetic testing (PGT-A or PGT-SR) before transfer to assess an embryo’s chromosomal arrangement.

The environment of the uterus

For an embryo to successfully implant in the uterus, the endometrium (the tissue that grows on the internal lining of the uterus) must undergo biological changes. In preparation for a healthy embryo, the endometrium thickens and becomes responsive to potential implantation by the embryo.

A fertility specialist performing a pelvic ultrasound on a patient.
Our fertility specialists perform imaging studies to understand more about your fertility.

A number of conditions that cause inflammation and scarring, such as fibroids, polyps, adenomyosis, hydrosalpinges and endometriosis, can impact the structure of the uterine environment. Sometimes, the presence of these conditions can make it more difficult for the embryo to implant in the wall of the uterus, affecting the chances of a successful embryo transfer.

Imaging studies and surgical tests can help us determine if an inflammatory condition is affecting the uterine environment. These include pelvic ultrasound, as well as the insertion of a camera via hysteroscopy or laparoscopy.

Lifestyle factors and medical conditions

Health and lifestyle factors relating to one or both parents can impact the success of embryo transfer. In the mother, underlying health conditions, such as diabetes, thyroid disease and other endocrine disorders, as well as autoimmune disorders and clotting disorders (e.g. thrombophilia), can block the interaction between the embryo and the endometrium. In addition, alcohol consumption, smoking and other modifiable lifestyle factors in both parents (including poor diet, exercise and being overweight) may also contribute to recurrent implantation failure by affecting egg/sperm quality and the health of the uterine environment.

Improving the success of embryo transfer

To improve the chances of the embryo implanting in the wall of the uterus, our embryo transfer method is designed to both protect the embryo and help it reach its destination. A gentle tube called a catheter provides a pathway for the embryo from the incubator to the uterus. Along the way, we use ultrasound imaging to make sure that the placement of the embryo is precise.

Before transfer, we also put the embryo in a special substance called EmbryoGlue to boost the chances of it implanting in the uterus. EmbryoGlue contains a compound normally found in the uterus called hyaluronan that may help the embryo attach to the wall of the uterus.

If embryo transfer fails several times, we typically recommend testing for some of the common causes discussed above and may also recommend some additional treatments, described below.

IMSI and HA ICSI

IMSI (short for Intracytoplasmic Morphologically selected Sperm Injection) is a technique we sometimes use to help select a sperm for ICSI (or IntraCytoplasmic Sperm Injection). ICSI may be used during IVF to aid fertilisation. During ICSI we isolate a single sperm and inject it into the centre of a mature egg, helping to overcome any barriers to natural fertilisation. In the case of IMSI, we first look at all the available sperm under a powerful microscope, then pick the sperm with the healthiest-looking shape and structure to introduce into the egg via ICSI.

Hyaluronic acid (HA) ICSI, also known as PICSI (Physiological Intracytoplasmic Sperm Injection) is another technique we sometimes use to help select the best sperm for the ICSI procedure. Sperm that can bind to hyaluronic acid (a substance found naturally in your body) have low levels of DNA fragmentation. Choosing the best sperm increases the chances of a healthy embryo, which in turn, has a higher chance of implanting.

PGT

Before transfer, we can also assess your embryos for chromosomal or specific genetic defects using pre-implantation genetic testing (PGT). This may include PGT-A to screen for random chromosomal anomalies (e.g. due to age), or PGT-SR to detect structural rearrangements in the chromosomes inherited from the sperm or eggs. This assists us in choosing embryos for transfer that have the best chance of implanting and resulting in an ongoing pregnancy.

Treating inflammation

As mentioned above, a favourable uterine environment helps implantation to take place. Depending on the cause, location and severity of the inflammation, surgical treatments targeting conditions that impact the structure of the uterus may be useful. For example, laparoscopic surgery is frequently used in women with endometriosis and can help remove scar tissue and/or growths.

What to expect when receiving an IVF embryo transfer

An embryo transfer is a straightforward procedure where an embryo is placed into the uterus using ultrasound guidance to achieve pregnancy. Typically, only one embryo is transferred at a time. During this process, a long, thin instrument is used to gently insert the embryo through the vagina and cervix, and into the uterus. The experience is comparable to having a pap test, and no anaesthetic is required. After the procedure, the woman can return to her normal activities right.

Looking for more information?

Newlife IVF employs a range of advanced tools and techniques to improve the success of embryo transfer during an IVF cycle. If you would like to learn more about the options available for overcoming recurrent implantation failure or discuss your fertility needs with a specialist, call Newlife IVF on (03) 8080 8933 or book online.

What causes blocked tubes, and can I still have a baby?

In this video, fertility specialist Dr Lauren Hicks discusses the impact of blocked or damaged tubes on fertility, along with how this condition is diagnosed.

 

So, what causes blocked tubes?

Blockages can occur for a number of reasons. However, typically they are associated with conditions that cause inflammation and scarring.

Pelvic inflammatory disease

One common cause of inflammation is pelvic inflammatory disease (or PID for short). PID is an infection that can affect a woman’s reproductive organs, including the fallopian tubes. The inflammation resulting from PID can affect both the inside and outside of the fallopian tubes. Often internal inflammation is caused by infections that travel from the vagina and uterus into the fallopian tubes. These include infections due to the bacteria normally found in the vagina, as well as at times from sexually transmitted bacteria (like chlamydia and gonorrhea). On the other hand, external inflammation may arise due to trauma or infection inside the abdomen, as might happen following a burst appendix or recent bowel infection. Repeated bouts of PID have been shown to increase the risk of infertility in women.1 Therefore, it’s important to see a doctor if you have signs of a possible infection like fever or lower abdominal pain, although sometimes symptoms can be mild and go undetected. If an infection is detected, antibiotics will usually be prescribed.

Endometriosis

The endometrium is the tissue that grows on the internal lining of the uterus. In endometriosis, tissue similar to the endometrium grows on tissues and organs outside the uterus such as the fallopian tubes. Over time (particularly in advanced or late-stage endometriosis), tissue that has grown in and around the fallopian tubes can cause inflammation and subsequent scarring, resulting in blockages.

Congenital tubal disease

In extremely rare cases, an obstruction of one or both fallopian tubes may be present at birth. Many women with this condition are not aware that they have a blockage until they try to fall pregnant.

Scar tissue after surgery

Sometimes, excessive tubal scarring can follow abdominal or pelvic surgery, e.g. caesarean section, bowel surgery. This scarring also has the potential to block your fallopian tubes.

Are there any symptoms of blocked tubes?

Tubal obstructions can often slip under the radar – i.e. you may not notice any symptoms at all. In fact, many women do not know they have a blockage until they experience trouble falling pregnant. Some conditions that cause tubal blockages do have their own tell-tale signs. For example, women with PID may experience lower abdominal pain, pain upon urination and intercourse, as well as abnormal vaginal bleeding and/or discharge. For many women with endometriosis, the primary symptoms are pelvic pain at the time of their period and pain with intercourse. In addition, a hydrosalpinx (a collection of watery fluid which may complicate a tubal obstruction) can cause ongoing and mild discomfort on the affected side of the abdomen in some women. If you are experiencing any of these symptoms, it’s important to make an appointment with your doctor.

How can you tell if my tubes are blocked?

There are imaging and surgical tests that we can use to determine whether your tubes are blocked. However, the test that is most appropriate for you will depend on individual factors such as any underlying conditions you may have.

Pelvic ultrasound with contrast

The first port of call is usually a special type of ultrasound called a tubal patency ultrasound. During this imaging test, a fluid which shows up on ultrasound is injected through a thin catheter placed in the cervix. The fluid then runs through the uterus and if no obstruction is present, it will continue to run out the ends of the fallopian tubes (after the test is complete, the fluid is gradually absorbed by the body). At the same time, an ultrasound of your pelvic area is taken so we can see where the fluid travels. This provides a detailed view of your uterus and fallopian tubes, which helps us determine if an obstruction is present.

Hysterosalpingogram (HSG)

Similar to a tubal patency ultrasound, a HSG also involves inserting a special fluid into your uterus and fallopian tubes. However, instead of using ultrasound, x-rays are taken instead.

Laparoscopy with dye

A laparoscopy is a type of keyhole surgery enabling us to look at your uterus, fallopian tubes and ovaries. Following a general anaesthetic, a camera is inserted through some small incisions made in the lower abdomen. A fine catheter is also inserted into the cervix and then a blue dye is injected. It passes up through the uterine cavity and along the tubes, then comes out the ends of the tubes where the blue colour can be seen. If we notice any abnormalities during this procedure, we may be able to treat these at the same time, e.g. remove endometrial growths.

Getting pregnant with blocked tubes

Depending on the cause, location and severity of the obstruction, there are a couple of different treatments that can boost your chances of falling pregnant.

Surgical removal

As mentioned above, laparoscopic surgery can be used to both identify, then remove any growths and/or scar tissue that are blocking your fallopian tubes. This technique is frequently used in women with endometriosis and can improve natural fertility in the months following surgery. It can also increase your chances of pregnancy with IVF. Surgically removing a tube that is full of watery fluid or pus (known as a hydrosalpinx and pyosalpinx, respectively) can also lead to an improvement in IVF treatment success. A hydrosalpinx can be caused by endometriosis, infections within your pelvis or prior surgery, whereas as a pyosalpinx occurs when your fallopian tube becomes severely inflamed and pus is produced, usually as a complication of PID.

In vitro fertilisation (IVF)

Most times, removing a tubal blockage is not possible or the best option for our patients. In these instances, we may recommend IVF if you are trying to conceive. IVF can help you fall pregnant by bringing the egg and sperm together inside a laboratory dish, completely bypassing your fallopian tubes. If fertilisation is successful and an embryo forms, it can be transferred into your uterus. If the embryo is able to successfully implant in the wall of the uterus, a pregnancy results.

What about tubal flushing with oil?

Tubal flushing involves placing a tube through the cervix and flushing an oil-based solution into your uterus and fallopian tubes. It’s not used when a proven tubal blockage is present, e.g. it can’t break down scar tissue or reopen a blocked tube. However, a recent review found that oil-based tubal flushing in women with subfertility (those experiencing an unexplained delay in falling pregnant) may increase their chances of falling pregnant compared to women who do not have a flush.2 It’s not really understood how tubal flushing may improve the chances of pregnancy but presumably it works by helping to remove any stray mucus and cellular fragments out of the fallopian tubes. Tubal flushing may sometimes be performed together with diagnostic imaging studies and/or surgical procedures as an ancillary option when no obvious obstruction is detected.

Understanding your options

If you are struggling to conceive, blocked tubes is one of the first things your fertility specialist will want to rule out. To book an appointment with one of our specialists, call (03) 8080 8933 or book online via our appointments page.

References

Donating your eggs – what’s involved?

Whether you intend to donate to friends or family, or anonymously, there are several things to consider before you make your decision. Although it can be an incredibly rewarding experience, donating your eggs is a physical and emotional commitment with potentially lifelong implications. It is therefore important to be fully informed before you decide to become a donor.

Things to consider before donating your eggs

Understanding the legal landscape of egg donation in Australia

In Australia, donors have no legal connection to any child conceived as a result of their donation. This means they have no parental responsibilities and are not required to pay child support. Donors also have no legal rights to the child and cannot be granted custody. If you are donating as a known donor, you and the intended parents should discuss how much involvement, if any, you will have in the child’s life. Boundaries should be worked out before you embark on this journey and you may wish to seek legal advice to facilitate this.

If you intend to become an anonymous donor, it’s important to understand that donation is not truly anonymous in Victoria. Children born from your donation can legally request access to your identifying information after they turn 18. This means you may receive contact from them. Additionally, some of your details will be shared with potential recipients – these include eye colour, height, cultural background and health. However, your identity will remain hidden from potential recipients.

Financial considerations – what to expect when donating eggs

In Australia, egg and sperm donation must be altruistic. That is, you cannot receive financial compensation for your donation. However, reasonable expenses can be paid by the recipients, including medical and out-of-pocket costs (such as travel expenses).

Emotional implications of egg donation

Before you donate, you are required to attend mandatory counselling sessions. This is to make sure you fully understand the legal, social and emotional aspects of egg donation. How do you feel about someone else raising a child who is genetically related to you? How will your decision to donate affect your family and children (if you have them)? How do you feel about the potential for future contact with one or more children or adults born as a result of your donation?

At Newlife IVF, our experienced fertility counsellors can help you consider these questions and more. You will complete your counselling feeling fully informed and reassured about your decision and its possible effects on your life in the future.

Physical health and eligibility criteria for egg donors

To become an egg donor, you must be mentally and physically healthy, living a healthy lifestyle, with no family history of inheritable disease. You are also required to be at least 21 years old before you can donate. Ideally, you should be younger than 38 years old. A mandatory health check, including blood tests and ultrasounds, will be performed. You will also be asked lots of questions about your personal and family health history. Once you are given the all-clear, you will be able to donate.

What happens when you donate your eggs

The process of donating your eggs will differ depending on whether you already have frozen eggs available – i.e. from a previous in vitro fertilisation (IVF) cycle – or need to have your eggs collected. Below we discuss both scenarios.

Donating your stored eggs

If you’ve been through IVF and your family is complete, you may have frozen eggs you aren’t intending to use. In this case, you may wish to donate your eggs to an individual or couple who also needs help to have a child. In this case, assuming you fulfil the criteria to become a donor, you will be able to donate your existing frozen eggs.

Egg collection

This process is identical to the first half of an IVF cycle. Before your eggs are collected, you will be given medication to stimulate your ovaries to produce several eggs. This medication comes in the form of a daily injection that will need to be taken for 8 to 14 days. The injection is delivered through a pen device, so it is very easy to use. You can choose to give yourself the injection or ask a friend or family member to do it for you.

Injections will begin on the first day of your period. From around day 5 or 6, a second daily injection will be added, to stop your ovaries from releasing any eggs (ovulating) before they can be collected.

From day 8, you will be monitored using blood tests and ultrasounds to check whether your follicles (small, fluid-filled sacs within the ovaries, each containing a developing egg) are large enough for egg collection. Egg retrieval is usually done at around day 13. About 36 hours prior to collection, the injection that prevents ovulation will be replaced by a so-called ‘trigger injection’. This stimulates the eggs to fully mature before collection.

Egg collection is a day procedure done under light anaesthetic. You won’t be aware of the procedure while it’s happening, nor will you remember it. Egg retrieval is carried out by a fertility specialist, who will use an ultrasound to visualise your ovaries. A thin needle will be inserted through the top of your vagina and into your ovaries to collect the eggs. The procedure takes about 20 minutes, and between 8 and 15 eggs are typically collected.

About 90 minutes after the procedure you will be allowed to go home. After resting at home for 1–2 days, you can resume your normal activities. It is common to experience some abdominal discomfort and bleeding. However, the discomfort is typically fairly mild and manageable with Panadol and a heat pack.

A COVID-19 test is also required prior to the day of the procedure. You will need to isolate at home, separating yourself from others in your household, until the results come back.

After your eggs are collected, an embryologist will look at them under a microscope. If your recipient is ready, they can use the eggs straight away. The mature eggs that are ready for fertilisation will be introduced to sperm on the same day.

If your recipient is not ready, the mature eggs can be frozen until they are ready to be used. They will also be quarantined for a period of 3 months. After the quarantine period has passed, you will be asked to come in for another round of blood tests to double-check that you are healthy. Once you’re given the all-clear, your eggs are ready to be used.

How to donate your eggs

The information in this article is certainly not exhaustive. We recommend that you refer to the information provided by the Victorian Assisted Reproductive Treatment Authority (VARTA) to gain a more complete understanding of the issues pertaining to egg donation. If you have any additional questions, please do not hesitate to contact us.

If you are ready to take the next step to donate your eggs, book an appointment at Newlife IVF. Whether you want to donate to friends or family, or as an anonymous donor, we can facilitate the process for you. To book your appointment, call (03) 8080 8933 or book online.