If you are trying and having trouble getting pregnant, you don’t have to go it alone. Women’s Health Melbourne is more than an express service straight to IVF.
It is a comprehensive fertility clinic, dedicated to helping you optimise your natural fertility and choose the most effective treatment so that you can get pregnant. Fixing some fertility problems can be really straightforward while other fertility issues can be complex. Dr Raelia Lew is a Melbourne Fertility Specialist, providing individualised advice and effective fertility care of the highest quality.
- I’m experiencing difficulty falling pregnant. What are my options?
- How long should I keep trying before seeing a doctor?
- What causes infertility in men and women? What increases my chances of infertility?
- How do I choose a fertility specialist?
- Is it possible to find out earlier if I/we have infertility issues?
- When I do see a doctor, what fertility tests can I expect them to perform?
- What are my treatment options?
- What medicines are used to treat male and female infertility?
- What are my chances of getting pregnant with fertility treatments?
- Can I fall pregnant if I have endometriosis?
Did you know there are different options for fertility treatment? You may not realise that modifying a few simple factors can be powerful in helping you to conceive naturally. The first step is a fertility assessment by a qualified expert, to check both you and your partner, identify problems and help you find solutions.
A normally fertile couple has a 20% chance of conceiving each month. Adding just one infertility factor reduces your chance to 5% per month. If two or more infertility factors are present, your chance of conceiving naturally per month may be down to 1% or less. That means statistically, it could take seven years to conceive without help, which is not great news if your biological clock is ticking. If you have been trying for six months or more and are over 35 years old, it is a really smart move to seek help now.
IVF is not always the first answer, although in some cases IVF might be a couple’s best choice. There are many other viable options depending on your circumstances, like achieving hormonal balance, assisted cycle tracking, ovulation induction and sperm optimisation and intrauterine insemination. IVF may be the best option for you if you have multiple reasons for infertility, especially where a severe sperm problem is involved.
The WHM Approach
Our philosophy is to acknowledge you as a unique individual and help you be the best and healthiest version of you. Optimising your natural fertility may be all the help you need. Sadly, some reasons for infertility can be more complex, requiring surgical management or advanced fertility treatments. Whatever the reason is that you are having trouble, Dr Raelia Lew will identify the problem and be on your team to help you to find a way to have a baby.
For individualised advice and effective fertility care of the highest quality, contact Women’s Health Melbourne today. We will endeavour to get back to you on the next working day.
The concept of a female" biological clock" is well known, but what does this really mean?Read more
Intrauterine Insemination (Artificial insemination / IUI)
Injecting optimised sperm into your womb in synchrony with ovulation.Read more
IVF (In-Vitro Fertilization)
IVF is an assisted reproductive technology, where sperm and egg are united outside of the body (in-vitro). An embryo formed is then replaced into the womb.Read more
ICSI (Intra Cytoplasmic Sperm Injection)
An advanced technique to help couples with a severe sperm problem.Read more
Preconception Genetic Screening
Genetic carrier screening of parents for "silent" (recessive) genes, to potentially prevent severe disease in your baby.Read more
Preimplantation Genetic Diagnosis (PGD) and Advanced Embryo Selection
PGD refers to genetic testing of embryos created by IVF, to diagnose embryos affected by genetic disease.Read more
When a woman is not regularly ovulating, her menstrual periods are irregular in timing and can be heavy or prolonged in duration.Read more
Polycystic Ovarian Syndrome
Polycystic Ovarian Syndrome (PCOS) is common, affecting 8-12% of Australian women.Read more
Donor conception, in some circumstances, is the right and sometimes the only way for many women and couples to create a family.Read more
I’m experiencing difficulty falling pregnant. What are my options?
The real question is not what are your options but why are you having trouble?
There are many causes of infertility out there. My approach is to investigate you fully as a couple, optimise your natural fertility by making sure your hormones are in balance and make sure unhelpful lifestyle factors are corrected. The best way to help you get pregnant will depend on the results of a thorough investigation of both you and your partner. I help some couples get pregnant naturally, via hormonal correction and cycle tracking. Others are best served by ovulation induction techniques, sometimes in combination with intrauterine insemination. Some couples can only get pregnant using IVF. In the end, I am motivated to use the treatment that will be the most successful in your case to help you to have a baby.
How long should I keep trying before seeing a doctor?
If you are worried about fertility, it is never too early to see a doctor. We all start our families a bit later these days. If you want to be pregnant now and you are concerned, why not see a fertility specialist? Let’s face it, none of us these days has a lot of time to waste, especially if you think you might want to have more than one baby in the long term.
As a minimum I would advise definitely seeing a fertility specialist if you have tried for 6-12 months and are not yet pregnant (leaning towards the 6-month mark if you are over 35). However, I am happy to see you and look into your fertility at any stage, as I put high value on both your time and peace of mind. Sometimes, just finding out there is no major problem reduces your stress and helps you to confidently keep trying naturally.
What causes infertility in men and women? What increases my chances of infertility?
There are so many causes of infertility in men and women. Some are acquired over time (like fibroids, endometriosis, infections, tubal blockage, hormonal problems, sperm antibodies, PCOS) and others are problems we are born with (abnormal anatomy, testicular obstruction, undescended testes). As humans, we are by far one of the least fertile species around with a best-case-scenario monthly chance of pregnancy of 20%. This is because, not so long ago, having babies 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 are having trouble is the first step towards helping you to have a baby.
How do I choose a fertility specialist?
Choosing your fertility specialist is an important step. It is critical to choose a doctor with the highest qualifications and medical skills. RANZCOG CREI subspecialists are recognised as having the highest qualifications.
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 a gynaecologist. She sat and passed rigorous and internationally recognised additional CREI examinations held by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists as part of her CREI subspecialty training.
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.
Is it possible to find out earlier if I/we have infertility issues?
Definitely. If you and your partner would like to be investigated early in your fertility journey, this is not only reasonable but in fact very sensible, especially if you are starting your family after 35. If you have a feeling or instinct that something may be wrong – see a fertility specialist early to find out if you are ok.
When I do see a doctor, what fertility tests can I expect them to perform?
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.
A woman should have a pelvic ultrasound and clinical examination, an up-to-date pap smear and blood tests to check her hormone levels and immunity to viruses like chicken pox (varicella) and rubella. If there is a risk factor in her history for blocked fallopian tubes, like a past pelvic infection with chlamydia or gonorrhoea or severe endometriosis, a tubal patency check should be performed. If I think there could be pathology in a woman’s womb or pelvis that needs to be physically corrected – like endometriosis, ovarian cysts, uterine polyps or fibroids, I would recommend a laparoscopy and hysteroscopy (key hole surgical procedure). If I am considering whether IVF may be a suitable treatment for a patient, I would perform an AMH (Anti-Mullerian Hormone) test, to check the level of a woman’s ovarian reserve. I would also perform an ultrasound to count the number of antral follicles on her ovaries, as a way of measuring egg supply.
What are my treatment options?
Common treatment options to help a woman get pregnant (after reversible infertility factors and hormone imbalances have been addressed) include cycle tracking with carefully timed intercourse, ovulation induction, intrauterine insemination, and IVF. Advanced IVF techniques can also help further in some circumstances by offering the chance to genetically test embryos to avoid serious diseases or chromosome imbalances. Some couples need IVF treatment with a donor egg or sperm to have a baby.
What medicines are used to treat male and female infertility?
Medicines can be used to restore male and female hormonal balance. There are a range of medications that can be used in ovulation induction, depending on the cause of infertility. These include clomiphene, letrazole, tamoxifen, HCG (human chorionic gonadotrophin) and FSH (follicle stimulating hormone).
IVF cycles can be performed using a range of medications in different combinations. Classes include FSH, LH (luteinizing hormone), HCG, GnRH agonists and antagonists (gonadotrophin releasing hormone), the oral contraceptive pill and progesterone formulations.
Certain medicines can also be used to improve sperm formation and development in certain circumstances. In addition to these 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 egg quality.
What are my chances of getting pregnant with fertility treatments?
It is impossible to answer this question generically as every person and every couple is different. Even at the exact same age, no two women or men are exactly the same when it comes to their chance of having a baby.
Some women will conceive naturally, even over 40. Some will conceive with IUI and some will need IVF. Some women will never conceive, even with IVF using their own eggs but can then have a baby using a donor egg. Fertility specialists can quote clinic and treatment type averages, but you may not be average! The reality is, to answer this important question accurately, honestly and fairly in your case, I need to investigate your fertility potential thorough an individualised specialist fertility assessment.
Can I fall pregnant if I have endometriosis?
Endometriosis can make getting pregnant naturally less likely and your chance of this occurring depends on the extent and stage of your disease. In some women, the impact of endometriosis is relatively minor, while in others it can cause severe anatomical distortion, completely blocking the fallopian tubes and rendering a women infertile. Surgical treatment of endometriosis can cure some women while fertility treatments like IUI and IVF can help others. The good news is pregnancy is great for endometriosis, and having a baby may be the best thing you can do to treat your condition. Operating on your ovaries can be a very bad idea, even if you have a small to medium endometrioma present as surrounding normal eggs can be damaged or destroyed during surgery. In some cases, it can be better to move straight to IVF.