If you've been trying to start a family but don't seem to be having any luck between the sheets, it might be time you saw a fertility specialist. But just because you're speaking to a specialist it doesn't mean you don't need to do your research. Asking the right questions could be all you need to conceive without taking the plunge into IVF.
Knowing the right questions to ask, however, is a different matter. In the emotionally-charged infertility setting it's easy to lose sight of what is important to you, your partner, your family and your health. In saying that, Australia has some of the best IVF success rates in the world so if your infertility woes can't be cured by a simple dose of good timing and health, then it's not time to call it quits just yet.
To help you keep on track during your journey towards a family, here are the 10 questions you need to ask your fertility specialist.
It's the obvious first question and, according to IVF specialist Professor Michael Chapman, it's the most common question couples ask.
"To answer, multiple factors affect a couple's chances of conception which is why seeing a specialist is the way to go," says Prof. Chapman.
"The most important things to consider are the woman's age as the number and quality of her eggs will decline with age. It's a slippery slope after age 35. Other factors include weight — for both partners — whether either partner smokes or drinks too much, or whether there are any medical conditions such as diabetes, PCOS or endometriosis that are affecting their chances of getting pregnant."
The factors affecting your infertility may come down to a simple matter of timing which is, again, something that a specialist can help you with. After that, the tests that you will undergo will start off with the least invasive being conducted first.
"The first thing we do is take a history and together we establish what precautionary investigations need to be done," says Dr. Malcolm Tucker, a fertility specialist with IVF Australia.
"Common investigations include a sperm count, blood tests, pelvic ultrasound and keyhole surgery. These will reveal any structural issues and any problems with sperm or ovulation. Some couples will find that everything is normal and it just needs more time, while others will experience unexplained infertility. Depending on the evidence, we look at treatment options then together we will establish a timeline for management, culminating in IVF if necessary," he explains.
If you want to give yourselves the best chance of making a healthy baby, it makes sense that both you and your partner need to be healthy, too.
To maximise your fertility, specialists at Fertility First recommend that you improve your diet by eating less fat and more fibre, limit your intake of alcohol and caffeinated beverages, stop smoking, avoid drugs, swap the tight undies for boxers, avoid hot tubs, saunas and electric blankets and try to limit your exposure to environmental chemicals such as lead, pesticides and organic solvents.
IVF is a relatively common procedure with one in every 33 Australian babies being born as a result of IVF. However, as with most medical interventions, there can be side effects.
According to specialists at the Westmead IVF clinic, some women will find they are very sensitive to the drugs used to stimulate egg growth and will respond by growing too many eggs. The very high hormone levels can cause an illness called ovarian hyperstimulation syndrome that results in abdominal swelling, severe pain and breathing difficulties.
The long-term effects of IVF on a woman's health are still unclear. Using Clomid for more than 12 months has been associated with an increased risk of cancer of the ovary — a cancer that is also more common in infertile women. However, fertility specialists at the Westmead IVF Clinic note a recent Australian study that has found no link in the risk of cancer of the breast, ovary or uterus associated with IVF treatment. Ultimately, long-term health effects are a possibility so you will need to weigh up the risks with your partner and fertility specialist before undergoing treatment.
Your chances of having a multiple birth do increase with IVF. In fact, approximately 20 per cent of IVF pregnancies at the Westmead IVF Clinic have been multiples. This is largely due to the previously common practice of transferring more than one embryo — usually two. However, it is now recommended that only one embryo be transferred at a time to reduce the risk of a multiple pregnancy.
Your specialist might have collected 10 eggs during your cycle, however, only mature eggs have a chance of fertilising normally. Unfortunately, determining whether your eggs are mature at the time they are harvested is an inexact science. Knowing this before you get too excited about a dozen potential offspring can help ease the heartache if a particular cycle is unsuccessful for you.
David Wilkinson from the City Fertility Clinic in Melbourne says he often had patients who could afford to keep going with IVF treatment but chose to stop due to the stress of repeated cycles.
"For most people persistence is normally the key, but there are a group of patients who find it much harder to conceive," Dr. Wilkinson said. "The emotional trauma of that can be quite significant but it's also that none of us can give answers as to why it's not working or offer any guarantees that they will eventually succeed. That can be the hardest thing to deal with."
This can be a very important question to ask for some couples, but one that is often overlooked in the excitement of making a baby.
At present, your unwanted embryos remain your property and will not be used for any form of embryo research without your prior consent. Generally, unwanted embryos are frozen for a period of up to 10 years with an agreement that they will be disposed of at that time unless you request otherwise.
The subject of when an embryo can be considered a life is a very sensitive and personal topic so if you have any concerns about this you should make a plan with your specialist before any eggs are harvested.
The average age of women using IVF has increased. Data from studies carried out by the Australian Institute of Health and Welfare reveals that the average age of women receiving treatment using their own eggs or embryos is 36 years, and the average age for women using donated eggs or embryos is 40.8 years. A quarter of all Australian IVF treatment is to assist women who are aged 40 years or over but only one in 100 women over 44 will deliver a live baby.
There's no national legislation imposing a maximum age for IVF in Australia, and doctors are divided over whether there should be an age limit. While there is no law to say you can't have a baby over 50, the government has placed an upper age limit on the amount of Medicare reimbursement available to patients undergoing infertility treatment.
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