IVF TREATMENT AT WOMEN’S HEALTH MELBOURNE – SPECIALISTS IN IVF
At Women’s Health Melbourne, we are a boutique IVF clinic that provides elite personalised IVF care. Dr Raelia Lew, CREI Fertility Specialist, leads our expert team. At WHM our supportive multidisciplinary clinical team provide holistic fertility treatments and IVF (In Vitro Fertilisation) services, assisting couples and individuals achieve their dreams of starting a family.
Our approach to IVF treatment services is to customise your treatment plan to meet the unique needs of each patient, supported by cutting-edge technology and personalised care, second to none. Our patients' best laboratory outcomes are supported by Melbourne IVF.
YOUR GUIDE TO IVF TREATMENT
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WHAT IS IVF (IN VITRO FERTILIZATION)?
IVF stands for In-Vitro Fertilization, which is defined by uniting egg and sperm outside of the human body to form an embryo, the earliest form of human life. Embryos created and grown in our state-of-the-art Melbourne IVF laboratory can then be returned to a woman’s womb with the goal to create a healthy pregnancy.
IVF is an amazing medical technology, overcoming fertility barriers to help people have a family. Since the birth of Louise Brown, the world’s first IVF baby in 1978, more than 12 million healthy IVF babies are estimated to have come into the world.
HOW DOES IVF TREATMENT WORK?
IVF works by helping women and couples overcome barriers that may be stopping them from getting pregnant.
Through IVF we can:
Ask a woman’s body to produce multiple eggs in one month, creating more opportunities to form healthy embryos.
Help sperm and egg to meet, unite and successfully fertilise with significant help using laboratory techniques.
Place an embryo perfectly in the womb, overcoming issues associated with fallopian tube dysfunction.
Freeze embryos that you can use at a later date, to successfully conceive even when you are older and might naturally have been unable to get pregnant.
Use genetic screening and testing technologies to make sure only healthy embryos are transferred. This can help avoid diseases and reduce a mother’s risk of having miscarriages.
IVF can also be extremely useful in helping doctors and patients understand otherwise “unexplained” infertility. Observing how eggs, sperm and embryos evolve under the microscope helps us to diagnose and design solutions for problems couples face for which there is not an external test or obvious explanation.
IVF is a continually evolving area of medicine where cutting-edge innovations in IVF are designed, researched and adopted to improve pregnancy outcomes for our patients.
THE IVF PROCESS OVERVIEW
It takes a village to create an IVF baby, involving strategic vision and coordinated teamwork. IVF is a process and a journey, and the birth of your child is its destination. An IVF cycle occurs over the timeline of a month, just like your natural menstrual cycle.
At WHM, IVF is lead by CREI Fertility Specialist Dr Raelia Lew, who is also the Medical director of Melbourne IVF. On your journey you will meet incredible nurses, a counsellor, a patient care administrative concierge team to support you, talented scientists and other medical team members. It is very normal and often expected that your IVF treatment may occur over a series of months before you reach your goals. We’ll support you every step of the way.
THE IVF PROCESS (STEP BY STEP)
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At your second appointment, you will get to know Dr Raelia Lew as your chosen WHM CREI Fertility Specialist. This appointment will be explanatory, educational and strategic. Raelia will review your history and test results in depth. Together, we will consider the most effective treatment options open to you. We will create a fertility treatment plan that addresses your needs specifically to help plan your family.
Fertility tests are performed to help Dr Raelia as your CREI Fertility Specialist understand, to the best of her ability, why you have not become pregnant naturally and also how she might be able to help you.
These include:
Blood tests checking for immunity, metabolism, genetic issues (karyotype evaluation) and hormones (for both men and women)
Pelvic Imaging assessing your uterus, ovaries, fallopian tubes and pelvic anatomy
Preconception genetic screening checks
Sperm testing and follow up imaging if needed of the male genital tract
For some women and couples, surgical procedures may be indicated prior to IVF treatment - for example a laparoscopic or hysteroscopic pelvic evaluation and management of underlying issues such as endometriosis and endometritis.
Men may likewise require surgical management of conditions such as varicocoele or surgical sperm retrieval such as microtese prior to IVF.
Dr Raelia will rely on your test results to create a treatment plan individualised to address the fertility concerns and challenges faced by you and your partner.
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Prior to IVF treatment, necessary preparations are made. You will meet collaborative team members who will support you on your journey. Informed consent for all elements of your treatment will be formally documented. You will be provided with video resources to watch and ensure you fully understand the treatment Dr Lew has planned for you.
A formal counselling session with an ANZICA trained fertility counsellor is legally mandatory prior to having IVF treatment in Victoria. Your counselling session will educate you and your partner about the Victorian legal environment, how regulations relate to IVF treatment and also to the long term storage of eggs, sperm and embryos. Our counselling team is also present to offer you emotional support throughout your IVF treatment.
A second pre-treatment session will be booked with a Melbourne IVF fertility nurse. They will educate and guide you so that you understand every single element of your individual IVF treatment plan on a very practical level.
You will learn about your prescribed medications and will come to understand and feel confident in actioning self directed elements of your IVF treatment plan.
Our kind and extremely knowledgeable Melbourne IVF and WHM nurses will always be there in the background to support and guide you throughout your IVF journey.
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Depending on your treatment plans and goals your IVF cycle may commence:
With a “Day 1” start. “Day 1” refers to the first day of a menstrual period (the beginning of your menstrual cycle) When you call us on Day 1, your treatment medications actually commence between the second to fourth day of your menstrual period with some flexibility. In order to be organised, we ask that you “ Call on Day 1”, alerting our nursing team of your intention to commence treatment on the day you get your period. If Day 1 falls outside of normal working hours, please be in touch as soon as you can.
A planned start IVF cycle can commence any time in the menstrual cycle and can be organised in advance, planned and diarised. This type of IVF cycle is suitable for embryo or egg freezing cycles. This cycle type suits patients who have less flexible schedules and require a greater idea of treatment appointment and procedure predictability. There is no disadvantage to this treatment type in terms of number of eggs collected or quality embryos formed.
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IVF aims to create a statistical advantage by collecting multiple eggs for you. Eggs can be fertilised with sperm in order to give you the chance to create several embryos if you can. Each embryo created through IVF represents a chance for you to become pregnant.
In your natural menstrual cycle, usually only a single egg will ripen and release.
In IVF treatment, your WHM and Melbourne IVF CREI Fertility Specialist Dr Raelia Lew will prescribe hormone medications including one or more forms of FSH (follicle stimulating hormone). By stimulating and collecting multiple eggs, we create “a numbers game”, improving your chance of creating at least one healthy embryo.
Through numerical advantage, IVF can amplify your chances of conception by making more eggs and embryos available each month that you undertake an IVF treatment.
Medications used in different IVF treatment approaches vary substantially and are administered in different ways. Many IVF medications are delivered as subcuticular injections that are self administered. However in modern IVF practices, other medication formats including oral tablets, nasal spray delivery systems and subcutaneous implants may also be used in IVF cycle where we stimulate your ovaries.
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During your IVF treatment cycle, you will have valuable and available support from our Melbourne IVF specialist nursing team. At least one ( and sometimes more than one ) ultrasound monitoring appointment will need to be attended in person during your treatment.
Depending on the type of treatment planned for you, monitoring may or may not include blood tests in addition to pelvic ultrasound progress tracking. Trans-vaginal pelvic ultrasound is commonly recommended, however a transabdominal assessment may be offered in specific cases.
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Your egg retrieval procedure will be scheduled once your ovarian follicles on ultrasound assessment reach an appropriate size.
You will be prescribed a “trigger” medication and will be asked to action this at a specific time. Your trigger medicine is planned with precision, 35 to 37 hours prior to your oocyte retrieval procedure time.
The trigger medication starts a cascade reaction in the ovarian follicle allowing eggs to complete the maturation process necessary for successful collection and fertilisation of mature MII oocytes.
There are different types and different doses of IVF trigger medication that may be prescribed. Both the choice of trigger and the coasting time between trigger medication administration and your egg collection procedure will relate to your individual clinical circumstances and personal IVF plan.
Your egg collection will occur in a day hospital (at Melbourne IVF Procedure Centre, co-located with Melbourne IVF) setting under sedation anaesthetic. This type of anaesthetic, often called a twilight sedation, is a very safe and gentle form of very light anaesthesia. Under this treatment you will feel no pain and have no significant recollection of your egg collection procedure. After your procedure you will awaken quickly and in most cases will be able to go home within 1 to 2 hours.
An egg collection is an ultrasound guided ovarian follicle aspiration. A fine needle is passed, via your vagina into your ovary, ovarian follicles are aspirated and eggs are retrieved. Follicles present from both ovaries are drained wherever possible so that a maximal number of available eggs can be used in IVF. Dr Raelia Lew is a believer in egg and embryo centred care as a principle to achieve your best possible outcomes in IVF. She will plan for your egg collection procedure to be scheduled at the optimal time for your best clinical outcome. To accomplish this goal, Dr Lew leads a team of exceptional Melbourne IVF fertility specialists in a collaborative care arrangement, working together to perform egg collection procedures 5 days a week. Your egg collection procedure will be performed with expertise and kindness at the perfect time predicted to achieve your best success.
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Sperm for IVF treatment can come from various sources including
A freshly ejaculated sample provided by a partner on the morning of your egg retrieval that is subsequently filtered, prepared, concentrated and optimised in the IVF andrology laboratory.
A frozen sperm sample stored in advance (created by a partner or sperm donor)
Testicular sperm that is procedurally retrieved, for example post vasectomy or in the case of obstructive or non obstructive azoospermia. Examples of testicular sperm retrieval techniques include fine needle testicular sperm aspiration (TESE), per-epidydimal sperm aspiration (PESE), open testicular biopsy or micro-TESE.
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Once mature eggs have been retrieved and successfully transported to the Melbourne IVF laboratory, in order to create embryos, eggs and sperm must be brought together. There are broadly speaking two main modalities via which eggs and sperm are united.
Standard IVF insemination: IVF refers to when eggs are exposed to a concentrated droplet of laboratory optimised sperm. We require a normal concentration of motile sperm in the ejaculate for this technique to be recommended.
ICSI (Intacytoplasmic sperm injection). This is where a single sperm is injected with micro-manipulation to enter into the oocytes cytoplasm (eggs interior) to achieve fertilisation. ICSI is recommended in contexts where sperm is of poorer concentration or quality. ICSI is also recommended in some other circumstances such as where genetic testing of embryos for inherited diseases is planned, or where the male partner has a serious communicable disease such as HIV.
We expect in IVF treatment that just over half (60%) of the mature eggs collected will successfully fertilise on average. It is normal and expected that a proportion of eggs will fail to fertilise normally for biological reasons.
We can tell that an oocyte has successfully and normally fertilised when we observe the sign of two discrete pronuclei on the day after sperm and egg were united (2PN).
In our Melbourne IVF laboratory, your embryos will be closely observed and scored, both by human embryology experts and AI empowered technology systems, from the time of fertilisation to embryo transfer or embryo vitrification.
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Human embryo development is beautiful to watch and involves the exponential division of cells within the embryo.
Stages of normal embryo development are as follows:
Day 0: Egg and sperm unite
Day 1: We observe the formation of a single celled embryo known as the zygote
Day 2: The embryo cleaves forming 2-4 cells
Day 3: Further cleavage development results in a higher discrete number of cells
Day 4: The embryo becomes a morula, where individual cells become harder to see
Days 5 to 7: The embryo compacts, forms an inner fluid filled cavity, and expands to become a blastocyst. The best quality blastocysts reach this developmental milestone on day 5.
In modern IVF, embryos are generally transferred, biopsied and stored by vitrification cryopreservation at the blastocyst stage of development.
Only one in 5 eggs collected on average will successfully complete normal development to reach the blastocyst stage of development.
Advanced Embryo Screening Technologies
WHM in collaboration with Melbourne IVF and Virtus Diagnostics are proud to offer our patients access to cutting edge technologies involving safe embryo biopsy and advanced screening to detect genetic errors where required.
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To achieve a pregnancy, an embryo will be transferred inside your uterus.
For some patients it may be appropriate and the best plan for you to transfer an embryo “fresh”, 5 days after an egg collection treatment.
For other patients a frozen embryo transfer may be recommended. This may often occur preferentially in a natural or hormonally optimally prepared cycle.
It is known that luteal phase deficiency is a major problem that always occurs in stimulated IVF cycles where a fresh embryo transfer is planned. For this reason, if a fresh embryo is transferred in your case, high dose progesterone medication must begin following your egg collection to balance out this problem.
Medical progesterone supplementation represents luteal phase rescue therapy. This level of mandatory progesterone replacement can be avoided with natural cycle frozen embryo transfer.
Different forms of progesterone medication are available. Progesterone is most commonly available and prescribed in the form of vaginal gels, vaginal tablets, vaginal capulets, vaginal compounded pessaries, subcuticular injections or intramuscular injections. Due to side effect and absorption profiles, micronised progesterone is seldom administered in oral forms, however oral dose top up may be utilised in combination progesterone therapy regimens.
How does the embryo transfer procedure occur?
Embryos can be transferred to the womb via a gentle procedure with the patient awake. This is an exciting moment. It is amazing to be able to see your embryo at such an early stage - one that parents who conceive naturally never experience. Embryo transfers can proceed 7 days a week and will be timed optimally to coincide with your best chance of becoming pregnant. Dr Raelia Lew will endeavour, in most circumstances, to perform your embryo transfer personally. In her IVF practice, Dr Lew also enjoys the back up and support of her esteemed Melbourne IVF Fertility Specialist colleagues. You will always receive the highest level of expert care and respect in our practice.
An embryo transfer should not cause any pain. It is a procedure where your embryo is placed gently via your cervical canal, into the cushioned cavity of your womb (the endometrium) using a specially designed very small, flexible device known as an embryo transfer catheter.
Preparing for your Embryo Transfer
During your embryo transfer, an ultrasound will be placed on your tummy. Having a full bladder is really important to help your specialist see your womb clearly on ultrasound. This helps to place your embryo perfectly, providing you with your highest chance of becoming pregnant.
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Where a fresh or frozen embryo transfer has occurred, we must wait for approximately two weeks ( a minimum of 10 days) before we can know if you have become pregnant.
Pregnancy hormone, secreted by the developing baby’s placenta (trophectoderm and trophoblast cells) can be detected in the maternal urine or blood once this pregnancy tissue has developed to a critical mass.
Many patients find the two week wait to be both an exciting and stressful time. Support can be provided if you find this stage of treatment challenging emotionally.
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This can represent a day of hope or a day of sorrow.
Many IVF patients who ultimately conceive will require more than one treatment before they find success. Most women and couples who go through IVF will therefore have the experience of receiving news of a negative pregnancy test.
We are here to help and support you to move forward with confidence, even if you experience this disappointment.
A positive pregnancy test is exciting, however we encourage you to guard your emotions in early pregnancy. If you register a positive pregnancy test, you may be asked to repeat the test in 48 hours to assess your pregnancy hormone levels. In normal circumstances, a healthy early pregnancy will display an approximate doubling of b-HCG hormone levels every 48 hours. Patterns of b-HCG rise that differ from this expectation can sometimes represent failing biochemical pregnancies or ectopic pregnancies.
We are usually unable to visualise a pregnancy on ultrasound prior to the pregnancy hormone having risen to > 1000 IU/L.
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A pregnancy ultrasound is arranged for patients who have conceived through IVF at approximately 6.5 weeks gestation. At this time a baby is approximately the size of a grain of rice and has developed a heartbeat.
This ultrasound is to assess the location and viability of your IVF pregnancy.
We offer this service at both WHM Caulfield and WHM Collingwood for your convenience.
MEDICATIONS AND HORMONAL TREATMENT IN IVF
During IVF treatment a range of medications are utilised for various reasons. There are many strategic methodologies that can be employed during IVF and fertility treatment.
Medications and Supplements may be used:
To optimise egg and sperm quality pretreatment
To stimulate the ovaries during treatment
To prevent premature ovulation during treatment
To trigger pre-ovulatory changes needed to mature your eggs prior to their retrieval
To support the luteal phase and to optimise progesterone hormone levels
To support nutrition
To support successful embryonic implantation
To manage background medical and immune system disorders
To correct the fertile microbiome
To reduce risks of miscarriage
To support placental health
The types of medication and holistic support recommended for your treatment at WHM will be individualised and unique to your case.
Medication classes that may be part of your treatment might include:
GnRH agonists
GnRH antagonists
Pregnancy hormone BHCG
Follicle stimulating hormone in recombinant, biosimilar and urinary subtypes
Luteinising hormone
Progesterone and progestagens (oral, vaginal, subcuticular or intramuscular subtypes)
Medications with anti-platelet actions such as aspirin and enoxaparin
Vitamins and Antioxidant therapies
Intralipid and PRP therapies
Immune system modulating therapy
Vaginal probiotic therapies
Antibiotic agents
GET STARTED
If you are contemplating IVF treatment and would like to know more about your options, contact Women's Health Melbourne to arrange a fertility health check assessment.
WHO IS IVF TREATMENT FOR?
IVF is used to treat a variety of infertility issues including blocked fallopian tubes, endometriosis, male infertility and unexplained infertility.
IVF can be chosen to manage complex PCOS and for embryo banking and long term family planning. IVF also allows for genetic testing of embryos preconception, a way women and couples can avoid passing on a genetic illness or disease trait to their child.
IVF can reduce a couple’s risk of miscarriage via genetic screening for chromosome abnormalities which are known to be responsible for at least 50% of miscarriages and become much more frequent over the age of 35 years as a consequence of the egg’s aging process.
IVF can also be used to achieve pregnancy with donor sperm for single mothers and same sex couples. Reciprocal IVF is when a woman carries a pregnancy using an embryo generated from her female partner’s egg and donor sperm. Gestational surrogacy is where a woman acts as a surrogate mother, carrying a pregnancy for another person or couple for medical or social reasons.
AGE AND HEALTH CONSIDERATION IN IVF TREATMENT
The age you are when you attempt IVF has significant impacts on your chance of success.
Most women in their 20’s and early 30’s who attempt IVF to conceive will ultimately be successful. After the age of 35, female egg quality decline becomes serious, impacting IVF success rates with autologous (own egg) IVF. Over the age of 40, IVF success rates decline further. A significant proportion of women aged over 40 and nearly all women aged over 45 will require consideration of donor egg IVF treatment in order to successfully conceive via IVF.
Becoming pregnant carries additional risks when pregnancy is planned over the age of 45. In this context, additional preconception tests are undertaken and a maternal-fetal medicine preconception maternal health assessment will be recommended. Our clinic’s upper age limit for assisting women to conceive using donor eggs or eggs they froze for themselves earlier in life is 51 years.
I IVF AGE LIMITS: A SUMMARY
IVF treatment using you own egg: 45 years (treatment completed before your 46th birthday)
IVF treatment using donor/frozen eggs: 51 years (Treatment completed before your 52nd birthday)
IVF patients have been studied over the past four decades. Long term effects following IVF treatment have been carefully monitored. Thankfully experts have observed a very minimal risk of excess downstream health problems in women who have had IVF in the past.
IVF is also safe for children conceived, although male offspring conceived via ICSI whose fathers had male factor infertility are more likely to suffer the same medical problems as their fathers.
School age development and health testing of IVF conceived children has been found to be exactly on par with same age naturally conceived peers.
POTENTIAL RISKS AND SIDE EFFECTS OF IVF TREATMENT
IVF is extremely safe but like any procedure or treatment in medicine, common and rare side effects and complications of treatment can sometimes occur.
The most common side effects experienced by women undertaking IVF are related to hormonal changes happening in their bodies during treatment. These can include mood effects, feeling, happy, sad, nervous, anxious and mood labile. Physical side effects of IVF medications may include bruising and pain at injection sites, bloating, breast tenderness, abdominal swelling, appetite changes and nausea.
The most serious medication related side effect of IVF is ovarian hyperstimulation syndrome, commonly abbreviated to OHSS. OHSS occurs when there is an exaggerated response to ovarian stimulation medications. OHSS is an iatrogenic condition meaning it does not occur naturally and is a complication of medical therapy. Risk of OHSS can be minimised in modern IVF practice by using safer, more sophisticated medication choices. IVF strategies that take a freeze-first approach can radically reduce and almost completely eliminate the risks of developing OHSS. Watch our WHM freeze first philosophy education video to learn more.
IVF also carries risks of things that can go wrong in your ultrasound guided egg retrieval. Egg retrieval procedures are often abbreviated to OPU (oocyte pick up) or EPU (egg pick up) and are also known as an oocyte aspiration scan (OAS) .
Egg retrieval is achieved via an ultrasound guided needle aspiration of ovarian follicles, usually via a transvaginal approach. Rarely OPU may be performed transabdominally or laparoscopically.
Serious complications of OPU are rare, affecting fewer than 1 in 1000 procedures. Infection, damage to pelvic structures or significant bleeding following an OPU can occur. Failure to find any eggs at an OPU can occur, while finding a lower number of eggs than predicted by ultrasound follicle count commonly occurs. This is because not every follicle that can be visualised by ultrasound actually contains a viable egg. In some follicles the egg cell never formed, had previously died and broken down (oocyte atresia, oocyte degeneration) or may not have properly matured (egg immaturity/maturation failure/arrest).
It is most common for patients undertaking IVF or egg freezing to ultimately require treatment over several cycles and over serial months to achieve their personal reproductive treatment goals.
Commonly in IVF, fewer embryos result than eggs found. Not every egg will successfully fertilise and not every early embryo will progress to become an advanced embryo (blastocyst) of high quality that is suitable for transfer, biopsy for genetic testing or freezing via vitrification. Embryos are provided with a grade utilising the Gardner grading system prior to being transferred, tested or frozen. They are also given an AI enabled score based on their developmental milestones achieved via the embryoscope time-lapse incubator system. Both of these scores are useful in determining the order in which embryos will be selected for transfer.
IVF TREATMENT AT WOMEN'S HEALTH MELBOURNE
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DR RAELIA LEW
CREI Fertility Specialist
Medical Director of Women’s Health Melbourne and Melbourne IVF -
MANDI AZOULAY
Integrative Chinese Medicine Practitioner and Acupuncturist
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WENDY FEDELE
Clinical Dietitian
SUCCESS RATES OF IVF TRAINING
IVF success rates are often discussed to assist future parents to understand their chance of having a baby each time they undertake an IVF treatment.
There are many different ways IVF success rates can be expressed.
One way is to speak about the chance of getting pregnant following an IVF embryo transfer.
Another way is to consider what is known as the cumulative pregnancy rate from a series of IVF treatments, for example, serial transfer of embryos created from one stimulated IVF treatment (when fresh and/or frozen embryos are sequentially transferred until a pregnancy is achieved).
Your chance of having a baby through IVF will be influenced by your (and your partner’s) underlying medical concerns and also by your age.
Unfortunately egg, sperm and embryo quality are seriously compromised, compared to when patients are younger, for all IVF patients over the age of 35 years.
In Australia and New Zealand, all IVF cycle data is reported to ANZARD.
A report is published that establishes average IVF success rates for fresh and frozen embryo transfer cycles.
Melbourne IVF laboratory success rates are among the highest in the world. Despite this we are ever striving for improvement, pushing the boundaries and creating new frontiers of what may be achieved through research and dedication of our world famous team, lead by Professor David Gardner.
Factors that can influence IVF success rates positively includes:
optimisation of patient factors
optimisation of laboratory factors
intelligent medical and precise procedure management strategies.
Women’s health Melbourne is a CREI Lead practice and we offer our patients every opportunity for success through optimisation of clinical and laboratory management.
We are a tertiary referral practice. Dr Raelia Lew philosophically makes herself available, providing advice and care even to patients with the most challenging concerns and difficult roads to success.
We are an inclusive clinic and do not impose an arbitrary BMI cut off for patients requiring IVF care. However, we do encourage our patients and assist them to achieve medical assisted weight and metabolic modification pretreatment where possible to improve their individual IVF success rate and health in pregnancy.
THE BENEFITS OF IVF TREATMENT
IVF is a treatment that can allow a woman and her partner to achieve a higher chance of pregnancy both currently and also over time as embryos may be cryopreserved and stored for future embryo transfer.
By stimulating the ovaries to produce many eggs, embryos can be formed outside the body. Instead of releasing one egg naturally which has one chance to form a viable embryo, IVF allows doctors and scientists to create multiple opportunities for eggs to form viable embryos within the boundaries of a single menstrual cycle.
Many patients who seek help to conceive face serious problems and barriers including advanced age, sperm and egg quality problems, and various hormonal, structural, genetic, autoimmune or inflammatory conditions. Often the reasons for a couple's infertility is multifactorial.
IVF allows science to overcome barriers to conception for the majority of couples by either overcoming or detouring around the problems they face.
More than 80% of couples where infertility is hard to explain will ultimately conceive via IVF. IVF is very targeted at tackling male factor problems, can be used to genetically test and select more viable embryos and can be used to get around problems of hormone and age related infertility.
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There are many ways in which IVF can increase the chance of pregnancy occurring, both within an IVF treatment cycle and cumulatively (overall).
In modern life, where many women and couples start and aim to complete their families later in life than previous generations, age related infertility can become a serious obstacle to natural fertility.
IVF can be utilised both to assist conception and also to create a bank of embryos that can be frozen and preserved via vitrification. Stored embryos do not perish or lose their potential to make a baby with time. While couples may age and their fertility declines beyond the hope of conceiving naturally, with good forward planning, they can still use stored embryos to have a family when they choose.
Couples who face infertility often are affected by poor embryo quality overall. This can be age related or due to other medical, genetic or disease related factors.
IVF allows a woman or couple to create multiple embryos in parallel from which we can choose. In the embryology and IVF laboratory, we see a selection process play out where not every embryo is equal. Some embryos will fail in their development at an early stage or may display physical characteristics which can predict a poorer outcome. Other IVF laboratory based selection tools that exist include genetic assessments based on embryo biopsy and analysis or artificial intelligence tools which may aid selection. By selecting the healthiest embryo available for transfer, IVF improves the chances of pregnancy for couples struggling to conceive.
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IVF can offer a sense of hope to couples who are unable to conceive in other ways.
Almost without exception, every couple who comes to IVF has considered and first tried to conceive naturally.
IVF, when compared to natural conception, radically improves the odds of pregnancy in many circumstances.
For severe male factor infertility concerns, IVF can provide hope for men and couples to have their own biologically connected children, even in cases where natural conception would be impossible.
For women with conditions like endometriosis, damaged or absent fallopian tubes, adenomyosis, fibroids and many other conditions, IVF can help overcome the barriers they face to become pregnant and have a baby. IVF can restore a sense of hope for men, women and couples struggling with infertility.
Age related infertility is a condition that eventually affects, partially or seriously all women who try to conceive beyond the age of 35. For some the impact of age is expressed as delay to conception and a higher chance of having a miscarriage or a baby with a spontaneous age related genetic condition, for example a chromosomal trisomy.
For some, age related infertility will pose a more serious barrier. For some women this will represent an absolute barrier using their own eggs. IVF can help in both these cases.
Through creating an amplified ovarian response in a stimulated IVF cycle, the body can be called on to develop a series of eggs in a single IVF cycle. Compared to the “one egg at a time’ dynamic of the natural menstrual cycle, IVF provides strength in numbers so that even at a time in life where most eggs have poor quality, the chance or statistical probability of finding a good egg that won’t make errors is higher in IVF than naturally.
This amplified ovarian response, calling on multiple eggs and creating multiple embryos to choose from is why some people describe IVF as “a numbers game”.
For those who cannot create a baby with their own eggs due to absolute age related infertility, IVF can be used in a different way. IVF allows the possibility of conceiving with egg donation. The gift of healthier, more fertile eggs can make all the difference, taking a woman’s chance of conceiving from poor to excellent.
Emotional benefits of undertaking IVF treatment include a sense of relief due to action, knowing you are doing everything possible to achieve your goal. During IVF treatment at WHM your every step is supported by a team of expert professionals who are all on your side, sharing your burdens, applying their knowledge to help you and cheering for your success.
For those struggling with infertility, IVF counselling can be a key element of your treatment. This can take the form of pretreatment counselling or ongoing therapy throughout your treatment.
COSTS AND FINANCIAL SUPPORT FOR IVF TREATMENT
At Women’s Health Melbourne, we focus on providing care excellence. We provide high value care and are a private billing clinic. Transparent informed financial consent for any treatment recommended by your WHM specialist is documented and provided to you in advance of your planned therapy.
Melbourne IVF proudly provides competitive pricing for IVF excellence. Some treatments may be contributed to by Medicare and by private health insurance.
Some couples choose to access superannuation funds for infertility care, however this is not something encouraged by WHM. For those who wish to explore this option, the first step is seeking a report from a qualified psychologist as access to superannuation for fertility treatment is available only under mental health care provisions (to assist with the psychological stress of IVF and associated barriers and costs).
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WHM is aligned with Melbourne IVF. IVF costs are charged to our patients via Melbourne IVF, while consultation costs and procedures that fall outside of IVF specific treatments are charged separately through WHM.
At Melbourne IVF, the cost of a single IVF cycle are transparently published. Eligible patients can receive rebates from Medicare and the Pharmaceutical Benefits Scheme (PBS), which may reduce out-of-pocket expenses by more than half. Private health insurance can further decrease costs, depending on individual coverage.
The most significant expenses arise from stimulated cycles, which involve egg retrieval. Subsequent embryo transfer cycles are less costly, depending on the specific treatment. Many Australian couples undergo approximately three egg collection cycles and three embryo transfer attempts to achieve a live birth.
While Medicare and PBS provide substantial rebates for medically indicated IVF treatments, private health insurance coverage varies, and patients should consult their provider to understand entitlements.
Learn more about:
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WHM as a specialist medical practice does not facilitate an internal payment plan or personal loan system. IVF takes a village, and costs represent not just the long timeline, multiple care episodes and procedures and technology involved in IVF, but also the involvement of specialised support staff enabling your care. Your fertility specialist, your fertility nurses and administrative support team, tests, equipment and materials needed for your treatment, your scientists and counsellor support are all funded from IVF fees.
Contact Melbourne IVF for more information about relevant zip money finance and payment plans available to assist our patients.
Please note for the avoidance of any conflict of interest, WHM has no direct or indirect benefit from organisations involved in IVF financing.
PREPARING FOR YOUR IVF JOURNEY
Choose your fertility specialist wisely. Dr Raelia Lew is a CREI Fertility specialist with more than a decade’s experience helping patients to succeed and form families. Raelia is fully trained to offer you the highest quality fertility treatment and care.
Optimise your global health.
Seek help at a reasonably early stage: younger patients have a better treatment prognosis in IVF. Reaching out for help in a timely fashion helps your fertility specialist and their treating team to assist you most effectively.
WHAT TO EXPECT BEFORE STARTING IVF TREATMENT
Getting ready for IVF treatment includes the following steps:
Diagnostic work up - this is where you meet with your WHM CREI fertility specialist Dr Raelia Lew to arrange and review important investigations, create a hypothesis of why IVF may be the correct choice for you and to explain all treatment options that may be relevant, including surgery, fallopian tube functional optimisation, health optimisations for both partners, IVF and other assisted reproductive treatment modalities.
Deciding to undergo IVF: An informed consent process occurs, explaining your IVF treatment plan in depth. This includes a discussion of predicted IVF outcomes, and possible treatment complications including those that rarely occur. You will be provided with access to written and multimedia resources to ensure your understanding is comprehensive and complete.
Counseling: In Victoria pretreatment ANZICA counseling is mandated by law. During this session you will have the opportunity to learn about Victorian legislation affecting IVF patients and you’ll have the opportunity to ask questions. Supportive counseling is also available to ensure embarking on IVF treatment is as emotionally supported as possible.
Nursing education: You will have an orientation teaching session with a Melbourne IVF nurse educator to learn all the practical details of your individualized treatment plan. While your plan will have been discussed with your specialist in more high level terms, your IVF nurse will support you in important practical elements including medication teaching and orientation around your individualized medication and treatment schedule.
Starting your cycle: You can choose to undertake either a “day 1 cycle start”, calling our team on the day you get your period, or alternatively your IVF plan may be suitable to undertake a planned cycle start which can be diarised and commenced on a date you nominate. A planned cycle start is suitable for egg freezing and embryo freezing IVF cycles. A day 1 start is required for any IVF or embryo transfer cycle where attempting a pregnancy in the same month is planned.
Pretreatment self care: We encourage you to engage in our holistic health team and to follow their advice in getting your body globally as healthy as you can be prior to commencing your IVF treatment. This can include nutrition review, weight and metabolism optimisation, antioxidant therapy, lifestyle review and acupuncture.
IVF SUCCESS STORIES
While WHM like all medical practices cannot due to advertising restrictions enforced by AHPRA list or post any patient testimonials, we do our work with joy every day encouraged by our patients’ successes.
From treating endometriosis to male factor infertility, from helping women and couples conceive using donor sperm, to creating rainbow families, we love creating families and helping our patients to successfully have babies.
To hear more from our patients, telling true stories about their IVF, egg freezing and assisted reproductive treatment journeys, helpful hints, science and complex medical concepts made accessible, tune in to our extensive knocked up podcast back catalog.
Listen to some of our patient's stories:
WHY CHOOSE WOMEN’S HEALTH MELBOURNE FOR IVF TREATMENT?
Women’s Health Melbourne is a CREI and AGES Subspecialist affiliated boutique fertility and women’s health practice. Our specialists have advanced expertise in the management of male and female fertility issues across the entire care spectrum.
We are expert at individualisation of IVF care to ensure each patient we treat hasahs the opportunity to reach their fertility potential and is given the opportunity to “zoom out” and intelligently plan the number of children ultimately hoped for to complete their family.
We have a philosophy of engagement and are willing to think outside the square, incorporating advanced knowledge and skill, evidence based medicine and a creative and flexible approach. We are inspired and strive to stretch the boundaries of what is possible, adopting proven technology to advance patient care.
We do not turn difficult or second opinion cases away but rather we assess them holistically, communicate prognosis honestly, discuss every option and turn every stone to help women and couples find what success looks like for them.
Each member of our WHM team has been consciously selected, always with our key aims in mind of providing excellence in patient care and treatment outcomes.
OUR ADVANCED IVF TECHNOLOGY AND PERSONALISED CARE
IVF is where the science of medical diagnosis, problem solving and advanced technology meets connection, care and empathy.
Adoption and innovation of advanced technology allows IVF physicians and scientists to have the ability to push the boundaries of what is biologically possible to help women and couples to overcome the burden of infertility.
At WHM we adopt a strong commitment to evidence based care. Our clinicians are leaders in their fields and are active in medical research pioneering new ways to help our patients to achieve pregnancies against the odds. Your goals are our goals. Your battle is ours also.
Read more about some of the technology we use in the IVF laboratory to help break down infertility barriers and make healthy IVF babies.
FREQUENTLY ASKED QUESTIONS ABOUT IVF
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On average, a stimulated IVF cycle results in the creation of 2-3 blastocyst embryos suitable for storage by vitrification or fresh embryo transfer.
On average, one in three embryo transfer cycles results in the birth of an IVF baby.
IVF transfer cycles can involve freshly created embryos in a stimulated IVF cycle in the week following an ovum pick up (egg collection procedure), or may involve the transfer of a warmed embryo that was previously frozen. When frozen embryo transfer is planned, this can occur in a natural or medically augmented cycle context. For some demographics in IVF, frozen embryo transfer has been shown to result in relatively higher success rates. Several factors are implicated in this observation including the benefits of embryo transfer in a natural cycle and selection of high quality embryos for vitrification.
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Depending on the type of treatment planned, IVF treatment can take 2-4 weeks.
A stimulated cycle with embryo freezing intention takes approximately 2 weeks from start of cycle to egg collection procedure.
A cycle where an embryo transfer occurs takes 4 weeks from start of cycle until understanding the outcome of a pregnancy test.
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In Australia today, our government at a state and federal level forbid doctors and scientists from practicing sex selection in IVF. The technology to sex select, which involves PGT (Preimplantation Genetic Testing) of embryos exists and is accessible for patients in order to screen for chromosome aneuploidy. Biological sex is conveyed by the sex chromosomes X and Y. Female embryos have two copies of the X chromosome (one from each of the sperm and egg that created them). Male embryos have one X chromosome (from the egg) and one Y chromosome (from the sperm).
Patients who have had PGT-A (screening for embryonic aneuploidy) are allowed to ask their doctor to retrieve information about their baby’s sex at a very early stage of pregnancy (essentially as soon as we know you are pregnant). However, to prevent the temptation for anyone to break the law by prospectively applying sex selection for reasons of patient preference or family balancing, this information is witheld from patients, doctors and scientists prior to embryo transfer.
The above description is a reflection of the law and current circumstances in Australian IVF practice. In overseas jurisdictions such as the United States of America, sex selection IVF is available and is a routine option patients can choose in the practice of IVF.
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IVF treatment always carries some side effects. Common concerns include abdominal swelling and bloating, slowing of bowel transit times under the hormonal influence of progesterone, and hormonal effects on mood and wellbeing.
Having said this, at WHM we proactively choose treatments that are modern, effective and gentle to minimise discomfort for our patients as they undertake IVF treatments.
It is normal after an egg retrieval procedure to feel low level abdominal tenderness for several days. Severe pain following an egg collection is unexpected and if you experience this symptom, please be in touch urgently for further advice.
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At Women’s Health Melbourne, we are experts at tackling infertility. Be assured you will be given information and access to the full spectrum of treatment options that may be relevant to you.
It is important to stress that some interventions simply are not targeted to certain problems and may not be relevant or sensible to offer an individual or couple trying to conceive. Individualisation of patient care and intelligent treatment planning is central to achieving the outcome you desire. Your WHM CREI Fertility Specialist Dr Raelia Lew will recommend a course of treatment that provides the best prognosis for success in your individual circumstance.
Treatments offered by CREI and affiliated practitioners in our practice at WHM range from endocrine therapies, andrology interventions, ovulation induction therapy, natural cycle augmentation and modifications, PRP and intralipid therapies, superovulation in-vivo with intrauterine insemination, advanced reproductive surgical interventions, fertility acupuncture and of course the full spectrum of IVF care, including ICSI, IMSI, blastocyst culture, assisted hatching, embryo biopsy and PGT.
