World-class study sheds light on schooling outcomes of IVF children

Written by

Understanding the long-term outcomes of IVF

Now, more than ever, couples and individuals are using fertility treatments such as IVF to begin or expand their families. In fact, 1 in 18 babies born in Australia are now conceived using IVF (as reported in 2020).1 Practically, this represents one to two children in every classroom.

Given the steady rise in IVF use throughout recent years, we must gain a deeper understanding of the long-term outcomes for these children, particularly regarding their developmental and educational milestones. Therefore, as part of my PhD research, I sought to discover if IVF-conceived children were at greater risk of developmental and educational delays than naturally conceived children.

The scientific proof is in the pudding

In the largest IVF-related Australian study, we assessed the schooling outcomes of 412,713 children aged between four and nine years (born between 2005 and 2014). The Australian Early Developmental Census (AEDC) – which examines physical health and wellbeing, social competence, emotional maturity, language and cognitive skills, communication skills and general knowledge – was used to assess developmental trends in children at school entry. Additionally, the National Assessment Program–Literacy and Numeracy (NAPLAN) test measured educational outcomes such as grammar and punctuation, reading, writing, spelling and numeracy, in grade 3.

The results from our study are reassuring to current and prospective parents and fertility specialists – we found equal developmental and educational outcomes between IVF and naturally conceived children. In fact, our findings indicated that IVF-conceived children performed slightly better in one learning domain, demonstrating they are more adept at writing than their peers.2 This suggests that school-based achievement is not adversely affected by IVF status.

Further to this, our results contradict previous studies that reported poorer school performance among IVF-conceived children. However, it’s worth noting that IVF technologies have evolved and advanced considerably since these studies, which date back to 2001. Therefore, our findings are more generalisable to modern-day fertility practice.

Results that set your mind at ease

Worry and anxiety are common in parenthood. However, these reassuring findings provide current and prospective parents with one less cause for concern. This robust analysis and large dataset have shown no link between IVF conception and adverse developmental outcomes for school-aged children, confirming that Australian IVF children have the same early childhood and schooling outcomes as their peers. While further research is needed to explore other long-term implications for IVF children, these results are encouraging and a good news story overall.

 

  1. Newman JE, Paul RC, Chambers GM. Assisted reproductive technology in Australia and New Zealand 2020. Sydney: National Perinatal Epidemiology and Statistics Unit, the University of New South Wales, Sydney, 2022. ↩︎
  2. Kennedy AL, Vollenhoven BJ, Hiscock RJ, et al. School-age outcomes among IVF-conceived children: A population-wide cohort study. PLoS Med, 2023;20(1): e1004148. doi: 10.1371/journal.pmed.1004148 ↩︎

How to boost your immunity during the COVID-19 pandemic

Written by

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.

References

  1.  Daly et al., 2012 ↩
  2. Hughes DA and Norton R, 2009 ↩

If not IVF, then what? Fertility treatments explained

Written by

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.

“So, when are you having a baby?”

Written by

If you’re finding yourself in this situation more and more, it can be helpful to think ahead about how you and your partner (if you have one) might respond. By considering what information you are willing to share with others and who you are happy to share this information with, you’re less likely to feel at sixes and sevens when people raise this topic with you.

And if you do find yourself put on the spot, humour can be a great form of defence. Along these lines, we did some asking around and here are some serious and not-so-serious responses our patients reported giving when they had been confronted with this question in the past:

  • “I don’t know, but I’m starting on my list of free babysitters now. Can I put your name down?”
  • “As soon as I figure out how. Have you got any suggestions?”
  • “I knew there was something I’d forgotten to do!”
  • “I have a cat/dog – that’s enough responsibility for now.”
  • “I don’t know but wouldn’t it be nice if it was sooner rather than later!”
  • “Oh, we’re trying. Every day and twice on Sundays, since you ask.”
  • “We’re focusing on our careers for the next little while, then we’ll think about kids.”
  • “We’d love to have a baby but for whatever reason, it’s not happening for us yet. In the meantime, I’d prefer if you didn’t keep asking me about it. But we’ll be sure to shout it from the rooftops as soon as we are.”
  • “I’m sorry but that’s quite a sensitive issue for me/us. I’d rather not talk about it if that’s okay.”

We also asked these patients what they had found most helpful in terms of dealing with the emotions that these kinds of conversations can trigger. Here are some of their suggestions:

Allow yourself 15 minutes to dwell, then let it go

A common strategy for dealing with any stressful event is to put a time limit on how long you allow yourself to dwell or perseverate on what has happened. So, if you find yourself in this situation, set the timer on your phone for 5, 10 or 15 minutes – whatever you think is reasonable. But when the alarm goes off, do a Taylor Swift and commit to ‘shake it off’. If it helps, give your brain a physical cue to move on and think about something else: push the thoughts away with your hands, vigorously shake your head free of its thoughts, brush the load off your shoulders, dance off the negative vibes around the kitchen bench – then get on with your day.

Use the art of distraction

Distraction is a wonderful way to quickly shift negative or unpleasant thoughts. Immerse yourself in a jigsaw puzzle, watch a movie, try a new recipe, read a book – the task can be joyful or meditative or intensely difficult. It just needs to take you out of the present and transport you to a different place for a little while. This will give you some time out from your thoughts and help you to focus your mind elsewhere.

Find an outlet

Physically, emotions can leave us feeling uptight and strung out. Exercising is a great way to release some of the physical tension and reboot your energy. It also has the additional benefit of stimulating the release of feel-good endorphins, helping to lift your mood in a healthy way.

Or you may prefer to seek comfort in a creative outlet instead. If you like writing, keeping a journal can be a great way to process your feelings and document the ups and downs of your fertility journey. You could also use a journal to keep a list of questions you want to ask your doctor – questions that come to mind in the heat of the moment but you then forget when your thoughts and feelings settle down.

Consider opening up

And last but not least, it can be helpful to remember that people who ask you about having a baby are likely to be well-meaning family or friends who have no intention of hurting your feelings. If you are comfortable doing so, you can use this opportunity to open up and talk to them about your experiences – whether it’s the pressure of trying to fall pregnant, the challenge of dealing with a miscarriage or the loneliness of going through the process by yourself. Talking about your journey and its emotional toll can give people a better understanding of what you are going through. As the old adage goes: a problem shared is a problem halved. Being asked this question might just be the best form of therapy.

Help to fall pregnant

If you are struggling to conceive and would like professional advice on the next best 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. You can also book online via our appointments page.

You may also find the following information useful:

Tips to optimise your fertility and prepare for pregnancy

Written by

Diet

A diet low in sugar, processed carbohydrates and trans-fats will improve your fertility by supporting regular ovulation. The best way to achieve this is by eating wholesome, non-processed foods. Cutting out sugary drinks is also a great strategy to reduce the amount of sugar in your diet. On top of this, we recommend that you increase your level of omega-3 by consuming flaxseed, fish oil, salmon, sardines or walnuts.

Exercise

The benefits of regular exercise on health and overall well-being are well known. As such, it’s hardly surprising that regular exercise can boost your fertility. We recommend 45 minutes of exercise 3–4 times a week, with weight training or high-impact interval training particularly beneficial. Ultimately though, find something that works for you. Of course, balance is critical – overdoing the exercise can make your menstrual cycle irregular and make it harder for you to get pregnant.

Exercise

Weight

Ideally, women should strive to maintain a healthy weight, with a BMI between 18.5–25 kg/m2. Outside of these limits, studies have demonstrated a decrease in spontaneous pregnancy rates and increased time to pregnancy. As an added incentive, maintaining a healthy weight during pregnancy also provides benefits for you and your baby. You can calculate your BMI using this handy online calculator.

Stress

Through its influence on hormones, persistently high stress levels may hinder your chances of becoming pregnant. At the same time, there’s no denying that the struggle to conceive can be emotionally taxing. It’s a vicious cycle that may sometimes be hard to break. Try incorporating activities into your routine that lower stress, such as mindfulness, yoga and counselling. Ensuring a nutritious diet, adequate exercise and a decent night’s sleep can also do wonders for your mental well-being. Perhaps most importantly, ensure you have supportive people around you throughout your fertility journey.

Caffeine

Don’t panic, you don’t need to cut out caffeine completely. However, it is thought that excessive caffeine consumption can reduce fertility. We recommend you limit yourself to one cup of coffee per day (a hard ask for some, we know).

A good night’s sleep

The relationship between sleep and fertility is not completely understood. However, recent studies suggest that regularly getting 7–8 hours of sleep each night is the optimum amount required to boost your fertility.

Smoking

Exposure to smoke (through smoking or second-hand smoke) makes it more difficult to become pregnant. Smoke can harm your eggs, disrupt the journey of a fertilised egg to the womb and change the level of hormones responsible for normal fertility. Furthermore, it can increase the chances of you miscarrying or giving birth prematurely. Men don’t get off scot-free either; smoking reduces their fertility too. On the bright side, these effects are reversed within a year of quitting. So, if ever there was a time to quit, it’s now.

Alcohol

No safe level of alcohol consumption has been established during pregnancy. Most women know that abstinence throughout pregnancy is important. However, what’s less commonly known is that heavy drinking can negatively impact your fertility. Studies show that women who consume a lot of alcohol take longer to get pregnant, and couples who do not drink during IVF treatment have more favourable outcomes than those who do drink.

Ultimately, if you’re planning a pregnancy, cutting out alcohol is the best option.

Review your medications

Certain medications may reduce your fertility. Your fertility specialist can advise whether this may be applicable to any medications you are taking.

Folate and multivitamins

While these don’t actually affect your fertility, they are very important in ensuring the healthy development of your baby early in pregnancy. In particular, adequate levels of folate can prevent deformities in your baby’s brain and spinal cord. Folate is present in a variety of foods and can also be taken in a pregnancy multi-vitamin. We recommend a taking good-quality pregnancy multi-vitamin when you’re trying to conceive and throughout the first trimester of your pregnancy.

Learn how to optimise your fertility

To meet with one of our fertility specialists and learn more about how you could improve your fertility, call Newlife IVF on (03) 8080 8933 or book online via our appointments page.