Melbourne Fertility Specialists and Doctors

Science tells us that a woman’s fertility peaks in her late teenage years to early 20’s, but for many women this timing doesn’t align with their goals in modern life. While experts agree that the best way for a woman to achieve spontaneous fertility is to try for a baby as early on in her adult life as possible, planning for a family isn’t always practical or desired during this life stage. We’re here to help you understand your options and empower you with all the knowledge you need to make the best choices for your future.

Learn more about female fertility and age

Polycystic Ovarian Syndrome (PCOS) is a common hormonal condition that affects between 8 to 12 per cent of Australian women. PCOS is characterised by a combination of insulin resistance and elevated androgen levels, which can cause a number of issues throughout the body. In relation to fertility, women with PCOS are prone to developing multiple small, hormonally active follicles on each ovary, a so-called polycystic ovarian appearance.

In actual fact, these follicles are not true cysts but represent numerous ovarian follicles, each containing an egg cell. Each follicle is also a small hormone-making factory, working together to produce high levels of ovarian steroid hormones, which can perpetuate a vicious cycle of irregular periods or anovulation (failure to ovulate) and make achieving pregnancy very difficult.

PCOS can also trigger peripheral androgen effects, such as unwanted hair growth, skin pigmentation and acne. Some women with PCOS may also experience significant scalp hair loss, which can be distressing. At Women’s Health Melbourne, we understand the far-reaching impact that PCOS can have on a woman’s life. Our holistic team of doctors and allied health experts work together seamlessly to help each of our patients take back control and solve any associated problems.

Learn more about PCOS and fertility

If you’re experiencing irregular, heavy or prolonged periods, your ovulation may be impaired. This could be due to a variety of factors, including thyroid or adrenal gland issues, stress, eating disorders, excessive physical exertion, genetic conditions and systemic illnesses. Without regular ovulation, the chances of falling pregnant naturally can be greatly reduced, which is why our team work with you to identify the cause and problem-solve for the best outcome.

Secondary infertility is a term used for a woman or couple who have had one or more children together, but are now having difficulty conceiving another baby. As we age, both men and women’s fertility can change with time, along with many other medical and environmental factors.

While many women often assume that it’s their fertility at fault, both male and female infertility factors can occur. At Women’s Health Melbourne our approach involves a thorough investigation of both partners, which allows for the most timely diagnosis and solutions-focused treatment plan.

Learn more about secondary infertility

In-Vitro Fertilisation (IVF) is an assisted reproductive technology, where sperm and egg are united outside of the body (in-vitro). Embryos formed are assessed and compared, before a woman’s strongest and best embryo is replaced through her cervical canal into her uterus. IVF is recommended to couples struggling to overcome a variety of fertility barriers, including fallopian tube blockage or post-surgical absence.

Women’s Health Melbourne is Australia’s leading boutique fertility clinic, with a highly respected team of multi-disciplinary practitioners that are experts in their field. While IVF treatment can seem a difficult or daunting task, we believe in providing all our patients with the most advanced, personalised care to ensure the best possible experience and outcome.

Learn more about IVF treatment

Over the past decade we’ve seen revolutionary developments in the technology of egg freezing, cementing its place as a life-changing treatment opportunity for modern women. Freezing a good number of eggs at a young age (as close as possible to a woman’s peak fertility) can create an amazing resource for any woman to call upon later in her reproductive years. Vitrification is a proven freezing method where more than 85 per cent of frozen eggs now survive the warming process for use in IVF, allowing eggs to retain their fertility potential (relative to the age a woman was at the time of egg-freezing).

As the founder and Medical Director of Women’s Health Melbourne, Dr Raelia Lew is highly specialised in egg freezing and remains a leading academic researcher in the field. She is also the author of the ANZSREI (Australian and New Zealand Society of Reproductive Endocrinologists and Infertility Subspecialists) Consensus Guideline on elective oocyte cryopreservation. Raelia has developed effective, forward-thinking strategies to maximise each patients’ treatment success, so you can feel confident in our care.

Learn more about egg freezing

Healthy ovulation is crucial to conceive naturally, but there are a number of common causes that can disrupt your menstrual cycle rhythm. Polycystic Ovarian Syndrome (PCOS) is one of the most prevalent, but irregular ovulation may also be related to a variety of other factors, including your genetics, nutrition, stress and environment. However most patients struggling with these issues can successfully conceive with ovulation induction treatments (OI).

OI involves a range of techniques that work in conjunction with cycle monitoring and accurately timed sexual intercourse to ensure ovulation occurs, giving you the best chance for a natural pregnancy. At Women’s Health Melbourne, we provide you with the option of carefully monitoring your cycle with ultrasound follicle tracking, blood tests and luteal phase progesterone support to ensure your best chance of conception.

Our team of specialists and nurses are experts in OI treatment, providing innovative OI techniques with a proven track record of helping women to successfully conceive naturally. While OI can be linked to an increased probability of twins (and more rarely, higher-order multiple pregnancies such as triplets), our team are equipped with the experience to ensure the lowest possible risk of multiple pregnancies.

Learn more about ovulation induction

Intra-Uterine Insemination (IUI) is categorised as a less invasive alternative to IVF, where sperm from a male partner or donor is washed, prepared, concentrated and optimised before being inserted directly through a woman’s cervix into the womb. At Women’s Health Melbourne, we plan your treatment to perfectly align with your ovulation, allowing the sperm to reach the fallopian tubes and find an egg with increased aim and accuracy.

While pregnancy success rates with IUI are lower than that of IVF, your WHM specialist may feel that it’s a worthwhile treatment to combat milder male factor concerns (such as sperm problems, or sexual dysfunction with erectile and ejaculatory disorders) and vaginismus, where natural sexual intercourse is hard to achieve. Depending on the strength and available quantity of frozen donor sperm, in some cases IUI may also be used for donor sperm conception.

Preconception Genetic Embryo Testing (PGT) is the genetic testing of embryos created by IVF, which can identify embryos affected by an inherited genetic condition. PGT can also be utilised to detect random whole chromosome errors that become more common in women aged 35 and over. This process ensures that only embryos clear from the genetic disease or DNA imbalance are transferred for a healthy pregnancy, which is particularly beneficial for families at risk of having a baby with a serious or lethal genetic disease.

The PGT process involves the biopsy of an embryo, with the removal of approximately 5 to 7 cells for testing. To ensure the removal of cells does not impair the embryo’s potential to result in a pregnancy, the biopsy is usually conducted between days 5 to 7 of development (the blastocyst stage), where the embryo has more than 200 cells. The area of the embryo that is sampled is the trophectoderm, destined to become the baby’s placenta, so that the inner cell mass, which is to become the baby itself, remains untouched.

Sophisticated genetic diagnostic techniques, including Polymerase Chain Reaction, Karyomapping, massively parallel gene sequencing, comparative genomic hybridization and single nucleotide polymorphism arrays, are used to determine both the chromosome makeup of the embryo (PGT-A) and whether an inherited genetic mutation (PGT-M) or chromosome structural rearrangement such as a translocation or chromosome inversion (PGT-SR) is present.

Learn more about preconception genetic screening

Donor conception is the use of sperm, egg and sometimes both (or a donated embryo) to conceive and have a baby. At Women’s Health Melbourne, we know that families come in all shapes and sizes, which is why we aim to facilitate options to suit your unique goals. Donor conception, in some circumstances, is the right (and sometimes the only) way for many women and couples to start a family.

Learn more about donor conception

Advancements in technology have greatly expanded the choices for women when it comes to starting a family. Women are now empowered to decide when and how they would like to conceive, which for many means exploring the path of single parenthood.

Whatever your circumstances, becoming a parent is a lifelong dream for many that is no longer reliant on having a partner. Our Women’s Health Melbourne team believe that pursuing motherhood without a partner is a brave and deeply personal choice that should always be supported without stigma, which is evident in our empathetic, individualised patient care.

Learn more about IVF for single women

Acupuncture works by stimulating specific points in the body to improve circulation, regulate hormones and relieve stress-factors that all play a crucial role in reproductive health. Many women choose acupuncture to support ovarian function, increasing blood flow to the ovaries and enhancing both egg quality and quantity. It also helps regulate menstrual cycles by supporting hormonal balance, ensuring ovulation occurs predictably and that the body is optimally prepared for pregnancy.

At Women’s Health Melbourne, we combine these time-honoured techniques with modern fertility treatments to help optimise natural conception and IVF success.

Learn more about fertility acupuncture

The real question is, what is the reason behind why are you having trouble? Infertility can be the result of a wide variety of factors, which is why Women’s Health Melbourne is committed to a full investigation of your circumstances and history, as both individuals and as a couple. Our shared goals will be to optimise your natural fertility first by making sure your hormones are balanced and any unhelpful lifestyle factors are identified and addressed.

The best way to help you get pregnant will depend on your individual circumstances. We will consider the results of the thorough investigations we have conducted for both you and your partner, which helps us to clarify the barriers you may be facing and also your strengths as a couple.

Some couples will conceive naturally after hormonal correction, anatomy optimisation and cycle tracking. Others may need ovulation induction therapy, sometimes with a sperm boost via intrauterine insemination of a concentrated and laboratory-optimised sperm sample (IUI). Some women may need reproductive surgery, while some couples can only get pregnant using IVF.

Ultimately, our team of dedicated fertility experts are motivated to identify a treatment that aligns with your philosophy, providing the most successful outcome to help you to have a baby.

If you’re concerned about fertility, you don’t need to wait a certain amount of time to see a doctor. Stress can have a very negative impact on your body, so it is never too early to seek answers and often reassurance. As a society, we are now starting our families a bit later in life, so if you want to be pregnant now and you are concerned, seeing a fertility specialist is a great option. Time may be of the essence, especially if you think you might want to have more than one baby in the long-term.

If you have been trying to conceive for 6-12 months and are not yet pregnant (leaning towards the 6-month mark if you are over 35), it is definitely advisable to see a fertility specialist. However, Women’s Health Melbourne will happily see you and look into your fertility at any stage, as our team places a high value on both your time and peace of mind. Sometimes finding out that there is no major problem reduces your stress and subsequently helps you to confidently keep trying naturally.

There are many causes of infertility in men and women, and in combination as a couple. Some factors are acquired over time (like fibroids, endometriosis, infections, tubal blockage, hormonal problems, sperm antibodies, autoimmune causes) and others are problems that we are born with (abnormal anatomy, testicular obstruction, undescended testes).

As humans we are by far one of the least fertile species, with a best-case-scenario monthly chance of pregnancy of just 20 per cent.

In an evolutionary sense, not so long ago, having babies (both pregnancy and childbirth) was quite dangerous for women. Lower fertility actually conveyed a survival advantage to our ancestors by reducing the number of times in her lifetime a woman had to give birth. Finding out the reason (or sometimes multiple reasons) that you might be struggling is the first step towards helping you to have a baby.

Choosing your fertility specialist is potentially the most critical step towards helping you overcome infertility. It is ideal to choose a doctor with the highest qualifications and medical skills. RANZCOG board certified CREI subspecialists are recognised as having the highest qualifications in Reproductive Endocrinology and Infertility Medicine, Surgery and Assisted Reproductive Technology.

Dr Raelia Lew was chosen to complete three years of subspecialty training in Reproductive Endocrinology and Infertility in addition to her six years of postgraduate specialist training to become an Obstetrician and Gynaecologist. She sat and passed rigorous and internationally recognised CREI examinations held by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists as part of her CREI subspecialty training and trained in complex male and female fertility management.

Dr Raelia Lew also holds a PhD in clinical genetics and is a recognised expert in genetic applications of IVF including preconception genetic screening and embryo diagnosis.

In addition to medical credentials, it is also best to choose a doctor who is kind, who listens to what you have to say, respects what you want and is someone you can relate to. Women’s Health Melbourne was founded to unite the highest level of expertise in fertility with a compassionate, holistic approach to patient care, so you can feel comfortable and confident in your treatment with us.

Definitely, especially if you are starting your family after the age of 35. Investigating both you and your partner in the early stages in your fertility journey is a very reasonable and potentially advantageous option. If you have an instinct or feeling that something may be wrong, we recommend seeking the support of a fertility specialist sooner rather than later to find out more about your options.

For a man, a first-line fertility check involves checking the sperm to see if it looks like it will be able to swim to find and normally fertilise an egg. General health and hormone checks and sexually transmitted infections (STI) screening are other elements of a male fertility work-up.

A woman can expect to undergo a pelvic ultrasound to examine her pelvic anatomy, an up-to-date cervical screening test (previously called a pap smear) and blood tests to check her hormone levels and immunity to viruses like chickenpox (varicella) and rubella. Sexually transmitted infectious diseases are also screened for to identify latent infections like chlamydia and gonorrhoea. If there is a risk factor in her history for blocked fallopian tubes, such as a past pelvic infection or severe endometriosis, a tubal patency check should be performed.

If our team believes there could be pathology in a woman’s womb or pelvis that needs to be physically corrected with surgery, like endometriosis, ovarian cysts, uterine polyps or fibroids, we will recommend a laparoscopy and hysteroscopy (a key-hole surgical procedure performed to restore and optimise female fertility). If we are considering whether IVF may be a suitable treatment for a patient, we will perform an AMH (Anti-Mullerian Hormone) test to check the level of a woman’s ovarian reserve. We will also perform an ultrasound to count the number of antral follicles on her ovaries to measure egg supply.

Both male and female patients should be offered genetic screening tests for chromosome balance (karyotype) and silent inherited recessive conditions that can be passed on to babies, which are sometimes implicated in underlying causes of infertility.Initial investigations typically include blood tests to assess hormone levels and ovarian reserve (AMH and FSH), a pelvic ultrasound to evaluate the ovaries and uterus, and a semen analysis for situations that involve a male partner. Depending on your history, additional investigations such as genetic testing, a hysterosalpingogram (to assess the fallopian tubes), or further imaging may also be recommended.

Common treatment options to help a woman get pregnant (after reversible infertility factors and hormone imbalances have been thoroughly investigated and corrected) include laparoscopic surgery, fallopian tubal flushing, ovulation cycle tracking with carefully timed intercourse, ovulation induction therapy, intrauterine insemination, and IVF.

Advanced IVF techniques such as ICSI (intracytoplasmic sperm injection) and IMSI (intracytoplasmic morphologically assisted sperm selection) can assist fertilisation against the odds where severe irreversible male factor infertility exists.

Advanced genetic testing techniques can also help further in some circumstances by offering the chance to genetically assess embryos prior to transfer, either to avoid serious diseases or age related random chromosome imbalances. Some couples may need IVF treatment with a donor egg, donor sperm or donor embryo to successfully have a baby.

Medicines can be used to reverse male and female hormonal balance. For women, a range of medications can be used in ovulation induction, depending on the cause of ovulation dysfunction behind anovulatory infertility. Some popular medication choices include letrazole, clomiphene, tamoxifen, FSH (follicle stimulating hormone) and HCG (human chorionic gonadotrophin).

There are estimated to be more than 2000 ways to stimulate a woman’s ovaries in IVF treatment when the range of available medications, their doses and combinations are considered. Medication classes include FSH, LH (luteinizing hormone), HCG, GnRH receptor antagonists and agonists, (gonadotrophin-releasing hormone), the oral contraceptive pill and various progesterone formulations.

For men, medicines and antioxidant supplements can be used to improve sperm formation and development in certain circumstances. In addition to more mainstream medications, a range of adjuvants can also be used in IVF including medications that modulate the process of implantation and agents aiming to improve ovarian response and cellular egg and sperm quality.

There is no generic answer to this question, as every person and every couple is different. Even at the exact same age, we face different challenges and bring with us unique strengths and barriers to overcoming infertility. No two women or men are exactly the same when it comes to their chance of having a baby.

Some women will conceive naturally without delay, even over 40. Some will conceive with IUI and others will need IVF. Some will choose IVF to take advantage of the technology to freeze embryos, which can improve their chance of extending their family further with serial pregnancies planned over time. Long-term family planning of this kind can be a great strategy for women and couples starting their family over 35.

Some women will never conceive, even with IVF using their own eggs, but can have a baby using a donor egg. Fertility specialists can quote clinic and treatment type averages, but if your circumstance is not average, average estimates won’t be accurate for you. The reality is, to answer this important question accurately, truthfully and fairly in your case, we need to investigate your fertility potential through an individualised specialist fertility assessment.

Endometriosis is a common condition affecting 1 in 9 Australian women. It is a condition that is even more prevalent in women who present with delay to pregnancy. Endometriosis can make getting pregnant naturally less likely, with the severity, anatomical location and stage of your disease all affecting your chance of pregnancy. In some women the impact of endometriosis is relatively minor, while in others the disease can cause severe anatomical distortion, completely blocking the fallopian tubes and rendering a woman infertile.

Surgical treatment of endometriosis can assist some women to conceive naturally while fertility treatments like IUI and IVF can be beneficial to others. Operating on your ovaries using diathermy heat energy can be a very bad idea, as normal surrounding eggs can be damaged or destroyed during endometrioma surgery. A fertility-focused, specialist approach with a goal to preserve your egg reserve is of paramount importance. In some cases, despite the obvious presence of endometriosis on ultrasound, it can be better to move straight to IVF. Happily, while you are pregnant, endometriosis becomes relatively dormant as the hormones of pregnancy can be suppressive of active disease.