By Dr David Wilkinson, Medical Director at City Fertility Centre Melbourne.
If going to see a fertility specialist and thinking you will automatically end up doing IVF makes you freeze with fear, then you can defrost, because I am pleased to tell you otherwise.
There are in fact a range of early fertility treatment options to consider first.
Our statistics show that only about 20 to 30 per cent of our patients who see our fertility specialists actually go on to IVF treatment.
Often IVF is not required as there are a number of simpler fertility treatment options that can substantially improve a person’s chances of pregnancy. These include looking at lifestyle factors, timing, ovulation induction (OI), intra-uterine insemination (IUI), surgery, and hormone therapy.
There are a number of lifestyle changes that can be implemented to maximise your chances of conception and give your baby the best start in life. When trying to conceive, the reproductive health of both the male and female is equally important. Factors like weight, stress, diet, alcohol, caffeine, medications and other habits can be assessed to determine if they are impacting your chances of success.
Timing of ovulation is critical to successfully conceiving. The general rule is ovulation usually occurs about two weeks before your period starts. With the help of a specialist you may be able to more accurately pinpoint your ovulation dates as it is very individual and dependent on how long the menstrual cycle is and will not always be on day 14.
This involves stimulating the ovaries to encourage or regulate ovulation. Various fertility medications are available for ovulation induction, and your physician will choose the drug or combination of stimulation drugs that is best in each case. The two most common methods are:
- Clomiphene citrate: This involves the use of medication (Clomid or Seraphine) to stimulate the ovaries and encourage or regulate ovulation. This medication is normally prescribed to women with infrequent periods and long ovulation cycles.
- Follicle-stimulating hormone (FSH): Ovarian stimulation is stronger with this method, stimulating the development of the fluid-filled sacs containing the eggs. At City Fertility Centre we are very careful to regularly monitor our patients to minimise possible complications relating to overstimulation.
Intra-uterine insemination is a procedure in which treated sperm is inserted into a woman’s uterus directly, in order to improve the likelihood of fertilisation. IUI can involve the use of fresh sperm (from the partner) or frozen sperm (from the partner or a donor). It can be useful in diagnoses of irregular ovulation, unexplained infertility or sexual dysfunction.
For women, surgery can often improve the chances of conception when the cause of infertility can be traced to past inflammation or infections which have created scarring or conditions such as fibroids, endometriosis and other tubal or uterine issues. The surgery aims to remove or minimise any issues that may be preventing successful conception.
For men, surgery for a condition known as varicocele can sometimes help. This condition is where the veins of the scrotum become abnormally enlarged, may be surgically treated by clipping or tying the veins.
Hormonal imbalances that affect sperm development can be treated by gonadotrophin therapy. Gonadotrophins are protein hormones sometimes used to treat unexplained male infertility in the cases of abnormally low sperm counts or when less than 40% of sperm are mobile.
Other drug treatments include using antibiotics to treat infertility caused by infections.
Careful consideration should be made when deciding which treatment options are right for you and these can be discussed with your fertility specialist.
If you have not achieved a pregnancy after a year (or six months if you are over 35) of unprotected intercourse, you should seek medical advice from your GP or a specialist.
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