Infertility, IVF and the festive season

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This post was contributed by Laura Oliver, one of Newlife IVF’s counsellors. 

Christmas often symbolises a time of joy and happiness. We plan celebratory events with family and friends, and take time to reflect on the end of another year. But this time of year can also be very difficult for women and couples who have been struggling with infertility and going through assisted reproductive treatment (ART) like IVF.

The focus at Christmas time is often on children and families, with Christmas cards and social media posts typically displaying pictures of family events or children with Santa. There can be a real sense of pressure to deliver good news at a time of year when many people are celebrating. However, if you’ve been struggling to fall pregnant or undergoing fertility treatment, the end of the year can serve as a painful marker that you have not achieved what you had hoped for this year, and for some of you, a reminder that yet another 12 months have gone by without a successful outcome.

All of this can bring up unwanted feelings of sadness, frustration, jealousy, anger and grief – and with a barrage of festive mementos and occasions around you to remind you that you’re not pregnant, it’s no wonder you feel this way!

Below are some tips on how you can manage the festive season while coping with fertility issues and undergoing treatment.

Be selective

Pre-plan and be selective about which events you attend at this time of year. If you do attend an event, consider how long to stay there for, and what you can do while there to minimise any feelings of stress or discomfort – for example, helping cook or wash up can help keep you busy and distracted, and may assist you to avoid topics of conversation you don’t want to be involved in.

Warn people in advance that you may find Christmas difficult – this doesn’t mean having to disclose information about your fertility; you can make more general references to having had a stressful or difficult year instead. Try to give your hosts time to understand that this year might look a little different for you, and to not be offended if you decide not to attend or only stay for a short while.

If you have a partner or a support person with you, plan a code word or signal to give when you need them to rescue you from a difficult conversation, or when you want to wind up and go home.

Celebrate

Celebrate how you want. Sometimes, this might feel a little selfish at a time when there are often traditions to uphold or family events to attend, but give yourself permission to celebrate in a way that is comfortable and meaningful to you at this time.

This could mean going away with a friend or just your partner (or staying home) and avoiding big family gatherings. Or starting a new tradition for this time of year. Do something that you know will bring you joy, no matter how small.

Re-charge

Use some of this holiday period to re-charge and take a break from treatment (if you feel you can). Take advantage of your time off work and prioritise self-care – pamper yourself! Get a massage, go away for a few days, plan some day trips to the beach or the countryside, or curl up with a good book.

Reflect

Take some time to reflect on your IVF journey so far, and perhaps think about your plans for treatment moving forward. Is there anything you could do differently next year? What are your expectations, and do you need to adjust these at all? Do you have questions to discuss with your specialist? Perhaps even think about how much longer you think you can continue with IVF treatment before needing to pause and reassess again.

Reflect on your own, with your partner (if you have one) or a support person. You could try using a journal to write down how you’re feeling, record the questions you may have, or come up with a list of pros and cons to aid future decision-making.

Ask for help

Use your supports (partner, family, friends) to help you work through any difficult feelings as they arise. Be open and honest with your networks about how you feel and the ways in which they can be of support to you. Be reassured that the way you are feeling, and the different types of emotions and thoughts that may be triggered at this time of year, are very normal. But we all cope in different ways, so make sure you do whatever it is you need to do to keep your heart, mind and body strong for the year to come. And above all else, remember to be kind to yourself!

Lastly, remember that the Newlife IVF counselling team is here to help. We can help you navigate and unpack your experiences and emotions. If you feel that you could benefit from the support of our counselling team, please call the Newlife IVF team on (03) 8080 8933.

If not IVF, then what? Fertility treatments explained

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In vitro fertilisation (IVF) is the most widely known fertility treatment, but it is not the only option available to help couples with fertility issues. This is due to the fact that there are many different reasons why an individual or couple may be experiencing fertility problems and treatment should be tailored accordingly. Thus, fertility treatment actually encompasses quite a wide range of methods, each of which can help people to overcome specific challenges and ultimately, conceive. We explain the different options below, including when they might be suitable.

First-line treatments

Ovulation induction

Ovulation induction may be recommended for women who are not ovulating regularly or who are not ovulating at all, and is commonly used for those suffering from polycystic ovarian syndrome (PCOS).

As its name suggests, ovulation induction involves the woman taking medication to increase the level of follicle-stimulating hormone (FSH) that causes ovulation. These medications may be in the form of tablets (clomiphene or letrozole) or direct injections of FSH. This stimulates the growth of ovarian follicles (fluid-filled sacs containing an egg). Once the follicles are large enough, another hormone is then given to release the egg from the follicle. Couples are advised to have intercourse at this time to increase their chances of conceiving.

Intrauterine insemination (IUI)

Intrauterine insemination (also known as artificial insemination) may be considered when a couple has difficulty having intercourse. It may also be appropriate for women with scarring or defects of the cervix that prevent sperm penetration, and for men with mild reductions in either sperm count or sperm motility (i.e. sperm that don’t move properly) where concentrating the semen sample and placing it in the uterus is likely to be of benefit. IUI may be used in combination with medications that stimulate ovulation – this combination can increase the chance of pregnancy in some cases.

During a treatment cycle, patients are monitored closely with blood tests and ultrasounds. At the time of ovulation, sperm are placed directly through the woman’s cervix and into her uterus (womb) using a long, thin plastic tube that is similar to a straw (hence, the name artificial insemination).

Laboratory treatments

In vitro fertilisation (IVF)

IVF is a form of assisted reproductive technology (ART) in which eggs are retrieved from the body of a woman and combined with sperm outside the body to achieve fertilisation. If this is successful and the fertilised egg continues to develop into an embryo, it is transferred back into the uterus (womb) in the hope that it will implant and grow, thereby achieving a pregnancy.

Intracytoplasmic sperm injection (ICSI)

ICSI is a technique where a single sperm is directly injected into an egg to achieve fertilisation. This technique may be recommended when the male partner in a couple has been diagnosed with fertility issues such as low sperm count, abnormal sperm morphology (shape) or motility (movement), has had a previous vasectomy or an unsuccessful vasectomy reversal. The ‘best’ sperm – based on size, shape and movement – is selected for the ICSI procedure.

Sperm retrieval procedures

Some men have no sperm in their semen (a condition known as azoospermia) due to a sperm production problem or a blockage that prevents the sperm from getting into the semen. These men may need to have sperm taken directly from the testis or the epididymis (a coiled tube that stores sperm and transports it from the testis).

  • Testicular sperm aspiration (TESA) is done by inserting a needle into the testis and taking a small amount of material from the seminiferous tubules – a network of tiny tubes where sperm is produced. The procedure is done using local anaesthesia in an operating theatre.
  • Percutaneous epididymal sperm aspiration (PESA) can be an option for men who have obstructive azoospermia from a previous vasectomy or infection. Under local anaesthesia, a small needle is inserted into the epididymis to extract sperm. PESA is also usually performed in an operating theatre.
  • Microdissection TESE (microTESE) may be used for men who have a sperm production problem. This procedure is done under general anaesthetic. The testis is first opened with a small incision, then an operating microscope is used to identify the seminiferous tubules most likely to contain sperm and take tissue samples from them.

Pre-implantation genetic testing (PGT)

PGT is a way to reduce the risk of an individual or a couple passing on a specific genetic or chromosomal abnormality to their child. It may also be used to check for genetic problems in older women (e.g. over the age of 38 years), women who have experienced several miscarriages, or cases of repeated IVF failure.

In PGT, embryos are produced through the usual IVF process and then cells taken from the embryo are tested for genetic conditions. If the embryo is unaffected, it is then transferred to the woman’s uterus.

Egg or sperm freezing

There are two main reasons for freezing eggs. Some women need to freeze their eggs for medical reasons such as impaired ovarian function or impending chemotherapy or radiotherapy for cancer. Other women choose to freeze their eggs because they want to give themselves the option to have children in later years.

A man may be advised to freeze his sperm if he is about to undergo treatment for cancer, or if he has decided to have a vasectomy but may potentially want to have children later on. Men also can freeze sperm prior to either IUI or IVF if they cannot be present on the day scheduled for the respective ART procedure.

Donor treatments

Donor insemination

Donor insemination may be used as part of IVF for a single woman or for women in a same-sex relationship. The process is the same as artificial insemination, but the sperm used is from a donor rather than a male partner.

Donor insemination may be considered when the male partner does not produce sperm (or the sperm is abnormal) or when there is a high risk of the man passing on an illness or abnormality to a child.

Donor eggs

Donor eggs may be an option when a woman is unable to produce eggs or her eggs are of a low quality. This may be due to age or premature ovarian failure (a condition in which a woman stops producing eggs earlier than usual).

Donor eggs may also be appropriate in cases of recurrent miscarriage or if there is a high risk of the woman passing on an illness or abnormality.

Donor embryos

In some cases, some people choose to donate frozen embryos they no longer need. Treatment using these donated embryos may be suitable for a person or a couple who need both donor sperm and donor eggs.

What is the best option for you?

If you would like advice about the next steps to take on your fertility journey, you can make an appointment with one of our fertility specialists by calling Newlife IVF on (03) 8080 8933 or by booking online via our appointments page. We’ll complete a comprehensive assessment before explaining the options available to you and your partner.