First Steps

If you haven’t been successful in conceiving naturally, or you would simply like to find out about your fertility health before you start trying to conceive, there are a number of simple, non-invasive steps we can take with you to get a more rounded understanding of your unique circumstances.

The first step is to speak to your GP. Not only will your GP be able to provide advice, more importantly they can provide a referral for you to Fertility SA. Click here to download a referral form to take with you to your GP appointment.

If you aren’t quite ready to get a referral or make an appointment with your GP, we have a free consultation service available where you can discuss your situation with one of our highly trained and experienced fertility nurses who will be able to guide you towards a plan that works for you.

For your free nurse consultation, or to make an appointment with one of our specialist doctors, call (08) 8100 2900.

You’re in good hands.

Fertility SA is not just an IVF clinic. We pride ourselves on carrying out rigorous investigations to understand the root cause of infertility so that we can tailor-make a treatment plan based on your unique situation. We offer true fertility expertise with non-invasive treatments such as tracking cycles, ovulation induction and IUI. Our doctor team is highly skilled in reproductive surgery which enables us to provide specialist gynaecological, testicular and micro-surgery for fertility issues.

Fertility SA has outstanding Clinician Researchers.

Amongst our doctors are some of Australia’s key researchers and thought leaders on endometriosis. Our New Developments Director, Associated Professor Louise Hull has recently been appointed Advisor to the American Endometriosis Society. Professor Norman, our Medical Director is world-renowned for his expertise in the field of reproductive medicine and is the past director of the Robinson Research Institute at the University of Adelaide.

Fertility SA is a member of the NHMRC Centre of Research Excellence for PCOS, is involved with research with the Robinson Research Institute and participates in national and international research programmes.

Why Choose Fertility SA?

At Fertility SA, we are a highly specialised unit of dedicated professionals that care for you from the day you seek help, to the day you no longer need us. We are acutely aware of the anxiety associated with infertility. We also understand the concerns and fears associated with the treatments to overcome infertility.

We make decisions based on your individual circumstances.

We won’t truly know until we have all the science at hand. We also don’t want to create a sense of false hope. What we can promise is that our dedicated team of specialists and support staff will do everything in our professional power to find a way forward to fulfilling your dream of having a baby, irrespective of what others have told you in the past.

We are passionate about excellence, we genuinely care about creating the best possible outcomes for our patients. Most importantly, we put you first.

There are a number of reasons why our patients regard Fertility SA as the leading fertility clinic in South Australia:

  • We are the only independent fertility unit in South Australia owned by the medical staff who work there. This means that we are truly passionate about making a genuine difference to fertility outcomes and we reinvest in research and development to ensure that we deliver the excellence we promise.
  • We provide uncompromised, individualised care. This means that when you start down the road to growing your family with Fertility SA, you will have a specialist who personally takes care of you from the day you arrive, to the day you no longer need us, unlike other clinics which work on doctor availability.
  • We have some of the best educated, trained and experienced doctors and surgical specialists working with us. This means that if you need surgery, we don’t need to refer you elsewhere like other clinics do. There are 3 doctors on the team who have completed a further 3 years CREI specialty in fertility, a sought-after national 2-year program which accepts very few applicants per year. We also have a number of other specialists with their own areas of expertise in the field of reproductive medicine who are a fundamental part of the Fertility SA team.
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Our Services

Fertility SA is made up of compassionate, dedicated professionals who truly believe it is a privilege to share this significant part of your life with you. It is our purpose to assist you in navigating the challenges, to help you understand the reasons why infertility is an issue, to give you honest, well-informed advice, to discuss the options and guide you towards the most suitable solution for your individual needs. We will offer you counselling if or when you feel you need it, help you improve your lifestyle to boost your chances of a positive fertility outcome and work together towards making your dream of a healthy baby come true.

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CLINICAL PREGNANCY AND LIVE BIRTH RATES 2015

    

Our Success Rates

We are extremely proud of our results.
We also feel that you deserve an accurate sense of your chances of falling pregnant with a happy, healthy baby. To understand IVF success rates, it’s important to be aware that many clinics promote their success rates differently. However, accredited clinics in Australia and New Zealand report their success rates to a central body called ANZARD (Assisted Reproductive Technology in Australia and New Zealand), so it can be useful to compare your fertility clinic against the overall ANZARD statistics.
There are many factors to consider when looking at success rates including, but not limited to, age and medical history.
An important question to ask your doctor is,
“What is my individual chance, using my own eggs,
of having an embryo transferred and a live birth?”
Some clinics report on pregnancy rates per cycle but skew the data in favour of cycles that have a higher number of good prognosis outcomes, younger patients, the use of donor eggs, or a higher rate of pre-genetic screening which can make success rates look better. At Fertility SA, we practice transparency in everything we do.  We inform our patients of the risk of multiple embryo transfer.  We update our records regularly, and we include all patient groups across all time periods.

Our Costs

As of 1st August 2016, our costs are based on insured patients with hospital cover and Medicare eligibility. This excludes hospital admission and anaesthetic fees (if applicable). The extended Medicare Safety Net was effective on 1st January 2016. This is a separate benefit in addition to Medicare rebates and can be applied once your out of pocket medical costs during a calendar year reach a certain level. The threshold is $2,056.30. After Medicare and other rebates, final out of pocket costs will depend on your individual circumstances.

If you have any questions, please don’t hesitate to contact Bron, our Administration Manager or Rochelle, our Financial Services Administrator on (08) 8100 2900 to find out more information.

For detailed costs, including the Medicare and Safety Net rebates, please come in and speak to our reception staff.

In-Vitro Fertilisation (IVF)

IVF is a fertility treatment where the ovaries are stimulated to produce an increased number of eggs. These eggs are then put together with sperm where they fertilise to form an embryo. Once the embryo develops to an appropriate stage, it is transferred back into the uterus where implantation takes place.

At Fertility SA, your process with IVF happens in the following stages:

IVF

Ovarian Simulation

Ovarian Stimulation is where the growth of ovarian follicles is controlled by hormones from the pituitary gland. The stimulation phase of your treatment cycle commences on day 2 after the start of your period. This is followed on day 5 or 6 with an antagonist drug which stops the pituitary gland’s control of ovulation. The time from the start of treatment to a pregnancy test is approximately 4 weeks. Having such a short cycle is beneficial for your health as the process is less stressful and you suffer fewer side effects which often means you see results earlier.

Monitoring

Monitoring occurs as the follicles grow. Oestrogen levels can be measured through blood tests allowing us to modify your treatment if necessary. We can also measure the number of follicles and their size using ultrasound. You are likely to have several scans during your treatment cycle. Blood tests and scans are usually planned for 9 days after starting your hormone treatment with the results used to decide on the ideal time to retrieve your eggs.

Trigger

The Trigger happens when your follicles reach the appropriate size for retrieval and will involve you coming into the clinic for an injection that acts to speed up the ripening of your eggs and initiates changes in the follicle leading to ovulation. This is timed so that retrieval occurs approximately 34-36 hours later.

Egg Pick Up

The usual method for Egg Pick Up is via ultrasound and performed in the operating theatre at St Andrew’s Hospital as a day procedure. A light general anaesthetic is administered, although you may decide you would prefer to have a local anaesthetic. The procedure takes about half an hour, depending on the number of follicles to be collected. We recommend staying in hospital for at least 2 hours after the procedure and having someone stay with you overnight.

Semen Collection

Semen Collection happens after the egg retrieval. We recommend at least 2 days and no more than 7 days abstinence from sexual intercourse and ejaculation prior to the retrieval of your eggs. If you feel there might be problems producing a sample on request, please let us know as we may freeze semen samples prior to treatment as a backup. Occasionally the semen sample may contain insufficient motile sperm and if this happens, your partner will be asked to produce a second sample later the same day. If sperm retrieval is required, your doctor can help with explaining what this entails.

Embryo Development and Fertilisation

Embryo Development and Fertilisation is the process where washed sperm is matched with the eggs a few hours after collection and placed in an incubator overnight. The eggs are placed in a culture media or fluid that contains all the necessary nutrients to help fertilisation occur. 18-24 hours later, the sperm and eggs will be checked to see whether fertilisation has taken place. On average 70% of the eggs will fertilise.

Embryo Transfer

Embryo Transfer will be determined according to the length of time that the embryo has been allowed to develop, ie cleavage or blastocyst stage. The procedure takes just 15 minutes and is done as an outpatient so does not require any anaesthetic. We welcome your partner to be present and you even have the opportunity to see your embryos on a TV monitor prior to transfer.

Luteal Phase Management

Luteal Phase Management is where you are given progesterone to help maintain the inner lining of the uterus, the endometrium. During this time you may experience abdominal cramps, abdominal distension, sore breasts and ovarian tenderness. If you have any concerns at all, our nurses are only a call away. A pregnancy test is performed about 18 days after your egg retrieval. If your period commences, it’s important to let our nursing staff know.

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Ovulation Induction

In situations where you aren’t ovulating, Clomiphene or Letrozole is often the first line of treatment. They cause the pituitary gland to produce more Follicle Stimulating Hormone (FSH) than happens in a natural cycle and this, in turn, stimulates the ovaries to produce more eggs.

These Drugs are usually administered between day 5 and day 9 of the menstrual cycle. In women who have extremely irregular periods, a progesterone medication called Primolut® or Provera ® may be administered for 10 days prior to starting the stimulating drug. A low dose of Clomiphene is used in the first cycle and this is gradually increased each cycle until ovulation occurs.

There are a number of conditions which result in the loss of ability to mature eggs in the ovary and irregular or absent periods, most of which are treatable with ovulation induction.

    1. Hypothalmic Amenorrhea Some women don’t ovulate because the ovaries aren’t exposed to enough hormones produced by their pituitary glands. A hormone deficiency like this can occur because there is damage to the pituitary gland, but commonly result because the body is trying to conserve energy or cope with stress. This tends to relate to women who are underweight, who exercise a lot, or who are subject to a lot of stress. Additional injections may be required and will be advised by the clinic.
    1. Polycystic Ovary Syndrome Some women fail to ovulate because their ovaries are overstimulated and produce excessive amounts of testosterone which interferes with the egg ripening process.
  1. Hyperprolactinaemia There are other women who lose their ability to ovulate because they produce too much prolactin (the milk hormone). This can be a side effect of certain prescription medication, due to thyroid or kidney disease, or as a result of a small growth on the pituitary gland.

If you struggle to ovulate on oral fertility drugs, we will try to induce ovulation through gonadotrophin therapy. The drug used in this case is recombinant FSH (Follicle Stimulating Hormone) which is given as a subcutaneous injection daily into the thigh or the abdomen. These injections commence on day 2 or 3 of your menstrual cycle.

The ovulation induction process looks like the below:

Ovarian Stimulation begins on day 2 or 3 of your period. As the follicle grows, it produces oestrogen which can be measured in the blood.

The Cycle Monitoring process involves a combination of blood tests to tell us how your ovaries are responding to treatment, as well as ultrasound scans to monitor how your follicles are developing.

Once the follicles have reached the optimal size, the hormone injections will cease and you will have an hCG injection to complete the ripening of the oocyte within the follicle which then leads to Ovulation.

Approximately 10 days later, you enter the Luteal Phase where you will need to have a blood test to confirm that ovulation has occurred.

If your period commences, it’s important to get in touch with our nursing staff. We understand what an emotional time this can be and are here to support you every step of the way.

If your period still hasn’t happened 16 days after ovulation, we will perform a pregnancy test and the progress of your pregnancy may be assessed weekly until approximately 8 weeks into pregnancy. At this point, we will perform an ultrasound scan and you should be able to see the fetus and detect a fetal heartbeat.

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Intrauterine Insemination

This method of fertility treatment involves placing washed sperm within the uterine cavity and close to the site of fertilisation, with the procedure timed close to ovulation.

It’s a technique used in circumstances such as male infertility, where there is a physical issue with sexual intercourse, where there might be an ethical issue with procedures like IVF, or where couples would prefer an alternative to IVF.

The first step is to assess the patency of the fallopian tubes. IUI can be used with a natural cycle or supported by hormone treatment used to induce ovulation. In each situation, your cycle will need to be monitored with blood tests and ultrasound scans. Based on these results, the IUI procedure will be timed close to ovulation.
IUI is generally performed using fresh semen, so the male partner will need to be available to produce a semen sample on the day of the procedure. The sperm is then washed and concentrated in the lab before insertion.

The IUI procedure takes just a few minutes using a speculum to view the cervix and a small catheter to insert the sperm into the uterine cavity near the site of fertilisation.

A pregnancy test will be performed approximately 16 days after the IUI procedure.

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Intracytoplasmic Sperm Injection (ICSI)

Rather than an oocyte being added to a droplet containing a multitude of sperm as happens in standard IVF treatment, ICSI involves the injection of each oocyte with a single immobilised sperm using a very fine glass needle.

ICSI is the method used when the number of sperm or the quality of sperm available is low and a pregnancy hasn’t occurred through natural means. ICSI also happens when fertilisation of oocytes has failed to occur in a previous attempt with standard IVF, or when the male partner has no sperm to ejaculate but has motile sperm that can be collected surgically.

There have been some concerns specifically related to ICSI. As the procedure has only been available since 1993, the follow-up of ICSI conceived children has been limited. Current studies suggest that there is an increased risk of congenital abnormalities in children conceived by ICSI, an increase of 1-2% above the standard background risk, although this is probably related to the cause of infertility rather than the procedure itself.

It has been reported that approximately 15% of men with zero or very low sperm counts have a deficiency of genes on their Y chromosome. This condition may be passed on to any male offspring. A blood test is available (covered by Medicare) to check that the chromosome number is normal and there is another test available (not covered by Medicare) to detect the gene deficiency, known as micro-deletion.

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Frozen Embryo Transfer (FET)

If you wish, and they are available, embryos of a suitable quality in excess of those used for transfer can be frozen and stored for use in a later cycle. This can be helpful if pregnancy doesn’t occur in a stimulated cycle.

If you chose to have a frozen embryo thawed and transferred, we will need to monitor your cycle with blood or urine tests, as well as pelvic ultrasound scans. Monitoring usually begins 4 to 5 days before the expected day of ovulation and continues until blood hormone levels or urine tests confirm that ovulation is imminent. Your embryos are thawed approximately 72 hours later.

Women who have regular cycles will usually have their natural cycles monitored. For women with irregular cycles where ovulation doesn’t occur, medication is required in order to time the transfer appropriately. This usually involves a combination of oral oestrogen tablets, sometimes additional oestrogen patches, as well as progesterone pessaries or vaginal gel.

Between 60-70% of frozen embryos will thaw successfully and can be used for transfer. In some cases, none of the embryos may survive and so a transfer may not be possible.

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Embryo Screening

We all dream of having a healthy baby that grows up a healthy child. Unfortunately, in some cases, it is not always how things turn out. Certain genetic conditions can cause birth defects or things that start to show up as the child develops. Certain factors, such as knowing you have a family history of a genetic disease, or being of an advanced maternal age can increase the likelihood of your baby being affected.

Pre-implantation Genetic Diagnosis (PGD) is a world-leading way for you to reduce or remove that risk. It involves carefully removing a small number of cells from an embryo for analysis. From this tiny sample, we are able to test whether an embryo has a wide range of genetic diseases such as Huntington’s Disease and Cystic Fibrosis. Each of the conditions is tested for separately, depending on your history, and we will always discuss which conditions need to be considered. When no genetic disease has previously been identified, we offer preimplantation genetic screening (PGS) which informs you of the number and integrity of the chromosomes in the embryo.

In a standard IVF treatment, every time a cycle produces more than one embryo, a decision has to be made about which embryo will be transferred. That choice is determined by the development and appearance of the embryos, usually assessed over a 5 day period to work out which one has the best chance of pregnancy.

Scientific advances mean that PGD/ PGS gives us another way to make that decision based on the genetic health of your embryo. The genetic tests help our embryologists and scientists rule out embryos that contain any abnormalities. The tests generally entail a count of the chromosomes and/or a molecular examination for a particular gene or mutation, if known in advance.

At Fertility SA, we use the latest next generation sequencing (NGS) technology to do PGD testing.

If you’re considering IVF, PGD could be an important part of the equation towards achieving your dream.

PGD is recommended if you:

    Are affected by or carry a known genetic disease, such as cystic fibrosis.

If two cystic fibrosis carriers conceive a child, there is a 25% chance that the baby will have it, a 50% chance that the baby will be a carrier and a 25% chance that the baby will be unaffected.

    Are of an advanced maternal age.

It’s an unfortunate fact of reproductive science that the frequency of chromosomal abnormalities (when your embryo is missing a chromosome or has an extra one) increases with age. The abnormalities can result in a failure of the embryo to implant or miscarry or for the baby to be born with serious developmental problems or conditions like Down Syndrome.

    Have had multiple miscarriages.

Random chromosome problems are thought to be the cause of the majority of miscarriages and unfortunately, miscarriages aren’t uncommon. Approximately 1 in 5 pregnancies ends in miscarriage.

PGS is used by our scientists to screen your embryo to ensure it has the correct number and sequence of chromosomes in the DNA to avoid the genetic abnormalities causing the embryo to miscarry. We then only go on to transfer genetically healthy embryos which gives you the best chance of a successful pregnancy.

    Have had a number of failed embryo transfers.

One of the reasons your IVF cycles might not be working is that your embryo fails to implant after transfer. If this has happened a couple of times, your specialist will likely recommend PGS testing. Our embryologists and scientists will screen your embryos with Next Generation Sequencing to check for abnormalities before implanting.

    Need to prevent the transmission of sex-linked genetic disease.

Selecting the sex of your embryo through PGD is only allowed in Australia if the test is being used to avoid passing on a specific sex-linked genetic disorder to a child.

The National Health and Medical Research Council’s Assisted Reproductive Technology (ART) guidelines restrict the use of PGD for sex selection (see sections 11 and 12).

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Egg or Sperm Freezing

Women who are at risk of losing the opportunity to conceive with their own eggs, such as women with low ovarian reserve, imminent premature menopause, or cancer treatment may wish to preserve their fertility by harvesting their eggs or creating embryos with their partner to freeze and store for future use. Some patients may be entitled to a Medicare rebate which results in a cost very similar to a regular IVF cycle.

We currently offer egg freezing with vitrification which is a state of the art freezing technique that minimises damage to the eggs and gives you the best opportunity for a successful pregnancy.

Men may also consider freezing a sample of their semen for later use. There a number of reasons why you might consider this, such as when chemotherapy treatment is planned to treat testicular or other cancers, when prostate surgery or vasectomy is planned, or during IVF and IUI treatments where a backup sample is used in case producing fresh semen on the day or on demand proves difficult.

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Sperm Retrieval

For most of human history, fertilisation of a single egg produced by the female partner involved a race between millions of sperm. Modern infertility treatments such as ICSI (Intracytoplasmic Sperm Injection) and IVF (In-Vitro Fertilisation) now make it possible to extract a single sperm and use it to directly fertilise an egg under controlled conditions. The latest surgical sperm retrieval techniques combined with ICSI and IVF methods also mean that infertility can be overcome in men who produce hardly any sperm. A low sperm count is a common cause of male infertility, but if a man produces even the tiniest number of sperm in his semen, these can be collected fairly easily.

A man that produces no sperm in his semen is said to have azoospermia. This may be due to a blockage in one of the tubes that carry the sperm from the testes out to the penis during ejaculation.
Other conditions that can cause non-obstructive azoospermia include having an abnormal cystic fibrosis gene. Men who have this condition may not show all the symptoms, but they often have no vas deferens. Surgical sperm retrieval is possible in this case, but there is a 50% chance that any embryo produced by subsequent ICSI or IVF will have the same genetic abnormality. Options, in this case, would include using a sperm donor and IUI or IVF or having a pre- implantation genetic diagnosis (PGD) performed on the embryos to select ones that carry the normal gene.

If the problem that underlies poor sperm production is physical rather than genetic, or if a couple wants to have children after the male partner has gone through with a vasectomy that cannot be reversed, surgical sperm retrieval is something that can help overcome this.

The overall techniques of PESA and TESA are similar, involving the insertion of a needle under local anaesthetic directly into the epididymis or testicle to obtain small amounts of the sperm producing tubules. This is done under low suction and the tissue then needs to be carefully processed in the lab to obtain sperm.

The PESA procedure usually happens on the same day as the egg retrieval and takes no more than 30 minutes. TESA is an alternative procedure employed if PESA is unsuccessful but works in a similar way.

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Polycystic Ovaries Syndrome & PCOS

There is a common misconception and confusion among women when it comes to understanding the difference between Polycystic Ovaries (PCO) and Polycystic Ovarian Syndrome (PCOS).

Polycystic Ovaries is more prevalent than PCOS with up to 1 in 4 women of reproductive age having ovaries that appear to contain a high density of partially mature follicles (collections of fluid which contain eggs), something which is visible on ultrasound but with no other symptoms. PCO is simply a normal variation of a woman’s ovary, whereas PCOS is a metabolic disorder with short and long term consequences.

Polycystic Ovarian Syndrome (PCOS) is a common hormonal condition that affects 12-18% of young women of reproductive age. Women with PCOS may have enlarged ovaries that contain a collection of fluid (known as follicles) located in each ovary, something which can be seen during an ultrasound exam. However, not all women who have PCOS have ovaries that look this way and not all women who have ovaries like this have PCOS.

Fertility SA is recognised as an NHMRC PCOS Centre of Excellence.

While the exact cause of PCOS is unknown, hormonal imbalances and genetics play a significant role. You are more likely to develop PCOS if your mother or sister also has the condition. May of the symptoms associated with Polycystic Ovarian Syndrome are due to higher than normal levels of male sex hormones (known as androgens), with testosterone being the most common. All women naturally produce small amounts of androgen, but women with PCOS often produce much higher levels which has a significant impact on the menstrual cycle causing infrequent or prolonged menstrual periods, excess hair growth, obesity and acne. In teens, infrequent or absent periods may raise suspicion for the condition. High levels of androgen can also affect the development and release of eggs during ovulation causing difficulty with ovulation.

The increased production of androgens is commonly caused by excess insulin due to insulin resistance. This is present in up to 80% of women who suffer from PCOS. One of the roles that insulin plays in the body is to ensure that the levels of glucose in the blood stable after eating. With insulin resistance, the body doesn’t use insulin effectively to stabilise glucose levels and because this process isn’t working effectively, the body produces more insulin and these high levels can simultaneously increase the production of androgens in the ovaries.

Insulin resistance is caused in part by lifestyle factors, including being overweight, having a poor diet or from physical inactivity. While women without PCOS who are overweight can have this form of insulin resistance, women with it are more likely to have insulin resistance caused by genetic factors, and slim women can have this condition too.

Symptoms of PCOS show as early as puberty and symptoms can vary in type and severity. Very few women have the same set of symptoms so your experience of PCOS will be very personal to you. Whilst not symptoms of the condition itself, many women who have PCOS have other simultaneous health problems, such as diabetes, hypertension and high cholesterol. These are mainly seen with the weight gain associated with PCOS.

There is no single conclusive test for PCOS and it can be a complex condition to identify as symptoms and features vary from person to person. To make a diagnosis, your doctor will review your medical history and symptoms, perform tests such as a physical exam to exclude other possible conditions. Blood tests may also be required to measure reproductive hormone levels, thyroid function, blood sugar and cholesterol.

While we can’t cure PCOS completely, we can treat it in a number of ways. The focus is on managing the symptoms to help prevent complications and varies from person to person. Lifestyle management is the first and best option for treatment.

The oral contraceptive pill may be prescribed to treat acne, regulate the menstrual cycle and lower levels of male hormones in women who don’t want to become pregnant yet.

For those who do want to have a baby, anti-androgen drugs can be prescribed to help reduce levels of male hormone, to help stop any excess hair growth and reduce acne. Diabetes medication such as metformin are also considered to lower blood glucose levels and testosterone levels.

There are also some surgical solutions, such as ovarian drilling and bariatric surgery that can help, but ultimately studies indicate that it is lifestyle management that is the first and best solution.

Women with untreated PCOS have a higher risk of developing:
  • High blood pressure
  • High cholesterol
  • Diabetes
  • Depression and anxiety
  • Sleep apnoea
  • Endometrial cancer

There may be a higher rate of miscarriage associated with Polycystic Ovarian Syndrome, a higher risk of gestational diabetes, premature delivery and there may be a need for extra monitoring during pregnancy. The earlier PCOS is diagnosed and treated, the lower the risk of developing all these complications.

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Donor Services

We offer known-donor programs for sperm, eggs and embryos.

If you’re interested in the donor program, you will need to set up an appointment with one of our specialists to discuss your suitability for the program prior to any appointments being made with the known-donor.

It’s important to note that recipients are responsible for the full cost of their own and their known-donor’s treatment. For this reason, we recommend that patients use known-donors that are eligible for Medicare. We also recommend that any egg donors are under 38 years of age.

As it is illegal to pay for donor gametes in South Australia, Fertility SA is unable to facilitate treatment for couples contemplating treatment overseas.

If you require a ‘sperm bank’ where the clinic supplies donor sperm, we can help as we have our own Clinic Supplied Donor Sperm Program. We offer a number of donors with a variety of different characteristics. All our donors are required to meet strict criteria, under our own standards, as well as the legal requirements stipulated for Assisted Reproductive Technology clinics in South Australia.

On occasion, some of our patients may wish to enquire about specific ethnicity, religious or other characteristics and in these cases, Fertility SA offers a personalised sperm recruitment service to meet your individual needs. It’s worth being aware that as this is a bespoke service, it can be more expensive and take a little longer.

There are many reasons why some couples consider a Donor Egg Program. The decision to use donor eggs or to become a donor is a complex one with lifelong implications.

The SA Reproductive Technology Act 1988 states that the welfare of any child conceived using this kind of technology is of utmost importance and we must therefore consider this carefully at all times whilst planning to go ahead with treatment. As the interests of the child are paramount, parents should be prepared to share the information regarding their child’s conception in line with current evidence. ‘Donor Conception – Telling your Child’ is available from Parenting SA and ongoing support is offered through the counselling service at Fertility SA. For this reason, we only offer treatment to recipients with known-donors.

Women may need eggs from a donor if their own eggs fail to fertilise or create embryos capable of sustaining an ongoing pregnancy, if their ovaries have failed due to chemotherapy treatment for cancer, or if they suffer from premature ovarian failure or menopause. Egg donation is also an option for women who have a high chance of passing on a serious genetic condition. It is illegal in Australia to receive payment for human tissue, including donated eggs.

Known Donation of Embryos is possible for couples using embryos created during the donor couple’s course of IVF treatment. This is often an opportunity for women who would rather donate than dispose of their embryos in order to help another couple facing the challenge of completing their family.

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Counselling

Our philosophy at Fertility SA is to focus on supporting you every step of the way towards achieving your dream of having a baby. We recognise that the decision to pursue fertility treatment is an emotive and difficult one. It is our goal to guide and support you through the highs and the lows.

Our counsellors, Julie Potts and Rebecca Kerner, are available free of charge and in total confidence throughout your journey with Fertility SA. They are here to help you weather the emotional storms associated with treatment, to help with pre-treatment planning, or to talk to you about any other concerns you might have.

Fertility problems can affect all areas of your life. In the general community, often it isn’t recognised just how demanding and painful it is to have to wait or to try hard without success to conceive naturally.

Our counsellor can assist in the following circumstances:

Debriefing Sessions

Those who conceive a pregnancy may wish to schedule an appointment following the ultrasound scan at 8 weeks.

Information

You may want to gather information about support groups, current status of adoption, or to seek advice about how others in a similar situation may have dealt with different issues or decisions. If stress is a major concern, Julie may recommend a variety of relaxation therapies, planning techniques and other services which are available to you. This also applies to relationship or family stress as this can also have a significant impact on you during the treatment process or before.

Support

It can be a huge relief to talk to someone who fully understands the ups and downs associated with infertility, as well as the unique aspects of your treatment, and dealing with pregnancy loss.

Existing Conditions

For anyone who suffers from existing conditions, whether the implications are genetic or physical, our counsellor can help you understand the difficulties associated with a situation that is very personal to you.

Decision-making

You may have concerns about the treatment options available to you, or about differences in opinion between you and your partner. You may also want to discuss your plan for treatment, whether to stop trying, or how to make the treatment fit in with other goals that you both may have. Our counsellor can help you navigate these decisions in a way that works for you both.

Change

There are times when all the waiting and trying can feel overwhelming. Working out what is normal stress or normal grief, where the pressures are coming from and how to tackle them can be extremely difficult. You may have lost sight of or be unaware of the personal strengths you bring into this precious endeavor and counselling can be an opportunity for you to identify those strengths and use them effectively to reduce your stress and improve your outcome.

If you wish to make an appointment or speak to our counsellor, please give us a call on (08) 8100 2900. There is absolutely no charge for this service and you are welcome to make use of it as often as you need.

 

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Endometriosis

Endometriosis is an often painful condition which results when tissue that normally lines the inside of the uterus – endometrium – grows outside of the uterus. It most commonly involves your pelvis, your ovaries and fallopian tubes. During menstruation, the displaced tissue acts as it normally would, it thickens, breaks down and bleeds, but because it has no way to exit the body it becomes trapped. When endometriosis involves the ovaries, cysts called endometriomas may form and become irritated and inflamed, eventually developing scar tissue and adhesions, abnormal bands of fibrous tissue that can cause the pelvic tissues and organs to stick together. Especially during menstruation, the pain associated with endometriosis can be incredibly severe and it can also cause infertility issues.

Approximately 1 in 5 of our patients at Fertility SA present with endometriosis. Diagnosis and treatment of infertility in this group of patients requires specialist management through medication and, where necessary, surgery.

The prevalence of endometriosis in women of reproductive age is approximately 10% and the prevalence in sub-fertile women is far higher, from 30-50%. However, the relationship between endometriosis and fertility is not clear. Some women who suffer from endometriosis conceive easily, whilst others with minimal indications of the disorder cannot. This suggests that the relationship between the two may not always be causal.

In cases of minimal or mild endometriosis, the effects on fertility have centred around inflammatory toxins and cytokines which may interfere with the quality of eggs, the function of the fallopian tubes and the viability of sperm. Recent studies have indicated that the eutopic endometrium in women with endometriosis functions differently to that of women without the disorder which raises the possibility that endometriosis may have a negative effect on the implantation of eggs.

Another cause of fertility problems associated with endometriosis is the avoidance of sexual intercourse due to the pelvic pain caused as a result. Studies have shown that women who suffer from pain from endometriosis experience a relief from this pain following excisional endometriosis surgery. However, while it may seem logical that a step like this should also restore your fertility, unfortunately, studies haven’t supported this conclusion.

While the excision of minimal to moderate endometriosis does improve a sub-fertile woman’s chance of natural conception by a significant percentage (25-40%) compared with diagnostic laparoscopy alone, fertility following the surgery still remains well below the expected norm.

Possible reasons for this include other factors like the quality of eggs, untreated microscopic disease, post-op adhesions and changes in the uterine epithelium.

A good endometriosis surgeon knows how to operate, a better endometriosis surgeon knows when to operate, but the best endometriosis surgeon knows when not to operate.

While there is certainly evidence to support that pregnancy rates are reduced in women with endometriosis in proportion to the severity of the disease, unfortunately, studies into IVF success rates haven’t proven that surgical excision of endometriosis leads to any improvement in success rates.

We believe that it is extremely important to be as conservative as possible with respect to ovarian surgery, particularly in cases where the excision of endometrioma is concerned, or the division of adhesions, especially in women who have already had excisional surgery and in women with low ovarian reserves. Overzealous stripping of endometrioma can lead to a loss of normal ovarian tissue and hence reduce ovarian reserves even further.

You may be considering surgical excision for a number of reasons, including the pain associated with endometriosis, a desire to maximise your chances of conceiving naturally, having endometriomata that are especially large (more than 3cm) or because you have suffered recurrent IVF failure. It’s important that your decision is taken with the utmost care and consideration and our doctors are here to guide you towards the best solution for your unique situation.

Diagnostic laparoscopy is currently the only definitive way to exclude or diagnose endometriosis. There are some exciting developments in the pipeline which include a possible diagnostic blood test which is presently the research focus of our New Developments Director, Associate Professor Louise Hull who has recently been appointed as advisor to the American Endometriosis Society. We are committed to remaining at the cutting edge of research and developments in the field of reproductive medicine. Amongst our doctors are some of Australia’s key researchers and thought leaders on endometriosis.

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