Dr Neil Astill

IUI and IVF: What’s the difference? If you’re exploring fertility treatment options like IUI and IVF, and wondering which treatment is best for you, you’re not alone. While your fertility specialist will guide you on these treatments many people like to know the difference between them before their consultation. In this blog we share some key facts about two of the more common assisted reproductive procedures: Intrauterine Insemination (IUI) and In Vitro Fertilisation (IVF). A simple way to understand the main difference between IUI and IVF is: IUI involves placing prepared sperm directly into the uterus, while IVF involves fertilising eggs outside the body in a laboratory before transferring an embryo into the uterus. IUI is less invasive, more affordable and often used as a first where some people like to start on their fertility journey. Here are some quick facts for you on each of the procedures: Intrauterine Insemination (IUI) What exactly is IUI? IUI also known as artificial insemination, is a fertility procedure in which washed and concentrated sperm is directly inserted into a woman’s uterus around the time of ovulation to improve the chances of conceiving. Sperm is brought closer to the egg, bypassing the cervix and giving it a better chance of meeting, so the egg can then be naturally fertilised. Naturally only around 15% of sperm make it into a woman’s uterus and fallopian tubes after sexual intercourse. IUI ensures 100% of selected sperm enter the uterus. IUI is less invasive and more affordable introduction to fertility treatment, often used as a first step in treatment or when donor sperm is required. To learn more about the IUI process click here. Who is a good candidate for IUI? Many people question whether they should do IUI or IVF. IUI treatment is not suitable for everyone and depends on various factors, including age and the result of a semen analysis. Your fertility specialist will determine if this is a suitable treatment for you. IUI is usually recommended for people experiencing unexplained infertility, ovulatory disorders, mild endometriosis, where there is hostile cervical mucus and for single women and same-sex couples. It’s important to note that while IUI is less expensive per cycle, costs can accumulate with multiple cycles, especially if success is not achieved early on. What is IVF? IVF used to treat infertility that has not responded to other medical interventions. It is a more advanced fertility treatment option for individuals with complex fertility challenges. Whilst it is more invasive than other fertility treatments, IVF offers one of the highest success rates providing the best chance to have a baby. The process of IVF involves fertilising an egg with sperm outside the body in a specialist incubator. After several days the fertilised egg, which is now an embryo, is transferred back into the female partner’s uterus. The whole process, up to the embryo transfer stage, usually takes around three to four weeks. Some of the common assumptions with IVF include: I’m likely to have twins with IVF – Advances in science have seen single embryo transfer become standard practice in Australia, reducing the risk of multiple pregnancies. IVF is only for severe infertility – Yes, IVF is recommended for complex infertility but its not a last resort treatment. It’s used for unexplained infertility, male infertility and when IUI has failed. IVF drugs can cause cancer or early menopause – Fertility drugs have not been proven to increase breast, ovarian or uterine cancer risk or early menopause. What is the IVF procedure? IVF literally means “fertilisation in glass”. The process involves stimulating the ovaries to produce multiple eggs. The eggs are retrieved under general anaesthetic and fertilised with the partner or donors’ sperm in an incubator outside the body. The best embryo, which has been carefully selected, is transferred into the woman’s uterus in a quick procedure similar to a pap smear in the hope of achieving a pregnancy. The transfer procedure takes only a few minutes and is usually not uncomfortable. Any spare embryos that are of good quality can be frozen for the future. To learn more about the IVF process, click here. Who is a good candidate for IVF? IVF is commonly used for more complex fertility issues including advanced maternal age (over 35 years), blocked or damaged fallopian tubes, low sperm count or motility and severe endometriosis. It is also recommended after unsuccessful IUI cycles or when IUI treatment is not suitable. Your fertility specialist will discuss all fertility treatment options and recommend if IVF is best for your age and individual needs. While IVF is more invasive and typically more expensive than IUI, it also has higher success rates. IUI vs IVF success rates IVF offers higher success rates than IUI. At City Fertility our success rates for IUI using partner or husband’s sperm is 10% for women aged under 39 years* In comparison, our average IVF success rates are 42.5% for women under 40 years* (This is based on City Fertility national data collected in 2024 from all clinics in the age group under 40 years). It is generally recommended that you progress to IVF if IUI has been unsuccessful after two attempts. For more information about our success rates, click here. FeatureIUI (Intrauterine Insemination)IVF (In Vitro Fertilisation) Cost$1,050 (Approx. $975 out-of-pocket after Medicare rebate)$10,300 - $10,600 (Approx. $4,805 -$5,105 out-of-pocket for initial cycle) InvasivenessMinimally invasiveMore invasive – requires egg collection and embryo transfer TimelineShorter – typically coordinated with a natural cycleLonger – approximately 3 - 4 weeks for a complete cycle Success Rates~10% per cycle (under 39 years)*~42.5% per cycle (under 40 years)* Medicare RebateYes – partial rebate availableYes – partial rebate available Who it’s forIndividuals/couples with mild infertility, ovulation issues, donor sperm use, or same-sex couplesIndividuals/couples with more complex fertility issues (e.g. age >35, low sperm count, endometriosis, failed IUI) Common Use CasesUnexplained infertility, mild male factor, single womenSevere infertility, tubal issues, advanced maternal age, IUI failure *Success rates are based on City Fertility national data collected in 2024     Next Steps on Your Fertility Journey Understanding the differences between IUI and IVF is an important when considering fertility treatment. While IUI may be less invasive and more affordable, IVF offers higher success rates. Your fertility situation is unique to you, and we encourage you to book an appointment with a City Fertility specialist to determine is IUI or IVF is best for you.

In an effort to reduce the average year-long patient waiting period for donor eggs from its Australian egg donor bank (Egg Donors Australia), City Fertility has recently formed a partnership with US egg bank, The World Egg Bank. Dr Neil Astill, Medical Director at City Fertility Brisbane Southside, said for some people waiting up to a year for an egg donor is just too long due to advancing age and declining fertility. “As a woman ages, the quality of her eggs is reduced. For the infertile woman over 40, the chance of a successful IVF pregnancy and live birth is substantially reduced when using her own eggs and this is one of the many reasons driving demand for donor eggs,” said Dr Astill. “We currently have over 120 patients on our donor egg waiting list and they are always amazed that the wait is that long. The wait is often just another disappointment for them on what is already a difficult journey. It could be the difference between becoming a parent and not becoming a parent,” said Dr Astill. Due to a lack of Australian egg donors, City Fertility was forced to look abroad for a safe and credible donor egg service that complied with all Australian state laws and national regulations. “We looked into many options and The World Egg Bank met and surpassed many of the Australian requirements,” Dr Astill said. Unlike many other egg banks, The World Egg Bank has a centralised model guaranteeing they use best practice protocols for egg freezing, and they ensure quality control of the eggs with all donor stimulations and retrievals are carried out at one singular location. “The quality of the eggs is paramount for our patients to optimise their chances of success,” said Dr Astill. With this latest partnership, Dr Astill said City Fertility patients now have two options for egg donors, they can wait for one from our Australian egg donor service or they select from The World Egg Bank. “Despite COVID, there is currently no delay in receiving the donor eggs from overseas, and we can receive eggs within two weeks of selection, which patients are pleased about,” said Dr Astill. Those in need of donor eggs can include women: who have had repeated unsuccessful IVF attempts; who have undergone premature menopause; who for genetic reasons cannot use their eggs; are women born without ovaries; who have undergone treatment for cancer; and surrogacy cases. The World Egg Bank donors must donate altruistically and be screened to all Australian standards. The service offers patients a range of options including frozen eggs or embryos and a choice of selection criteria. Some options include a guarantee of one embryo per group of eggs or you receive a replacement group of eggs for free. Interestingly, City Fertility’s Australian egg donor service (Egg Donors Australia) said they are currently seeing a small increase in local donors. “We have up to 10 women across Australia currently going through the process to donate, but it is still not enough to meet demand,” Dr Astill said. Australian egg donors must be altruistic, and we find most of them have a connection to someone who has experienced fertility issues, said Dr Astill. In Australia and New Zealand, over 3,000 IVF cycles were performed using donor eggs (or embryos) in 2017 with 707 live births reported. Dr Astill said clinic-recruited egg donors are a safe option due to the rigorous counselling, screening and clinical protocols that are followed.   Payment Plan options available Through The World Egg Bank The World Egg Bank has developed a unique structure: they are the only egg bank that focuses only on providing quality donor ova. They built a state-of-the-art facility that solely focuses on egg freezing. Their unique centralized model ensures they conduct all egg vitrification with proven protocols and the same experienced laboratory systems and professionals. They manage all donor stimulations and retrievals in one single location. They manage quality. Peace of Mind Payment Plan™ The Peace of Mind Payment Plan™ allows you to divide the cost of your donor selection into three equal payments over a three month period. This program applies only for services and products supplied by The World Egg Bank. You do not have to complete an application or qualify to take advantage of this payment plan. Ova Assurance If your shipment arrives at City Fertility damaged and unusable due to freight mishandling in transit, The World Egg Bank will send a new cohort of eggs for free. Ova Assurance does not void or change any existing guarantees. Through City Fertility City Fertility offers payment plan options for IVF cycles such as accessing superannuation. To learn more about City Fertility IVF payment plans please visit our Payment Options page.   Please note this service is only available in Queensland and New South Wales. For more information about the options available through The World Egg Bank, download our booklet The World Egg Bank Recipient Information or contact us today at 1300 354 354 or email us at contact@cityfertility.com.au  

  By Dr Neil Astill, Clinical Director at City Fertility Centre Brisbane Southside Did you know that your nutritional intake, weight and even environmental toxins can influence your reproductive health? If you’re hoping to start a family soon, making some small changes to boost your fertility will not only give you the best chance of conceiving, but also help with the health of the baby once born. Here are some simple tips that can assist in increasing fertility in both men and women. Stay Nourished Eating well is vital to ensuring you are at your most fertile. Being either overweight or underweight can make conception more difficult as it can cause hormonal imbalances. So, ensure you have a balanced diet that helps maintain a healthy body mass index (BMI). Do your best to avoid sugar and saturated fats, and be sure to eat plenty of lean protein, fruit and vegetables. These foods contain iron, zinc, and vitamins B and C, all of which are vital to fertility. Keep Fit To maintain a healthy body weight, try to find time for at least 30 minutes of mild to moderate exercise every day. There’s no need to overdo it – something as simple as going for a walk can make a big difference to your fitness. Be Aware of the Fertility Window The days leading up to ovulation are the most fertile ones in a woman’s menstrual cycle. This corresponds with the second week and the beginning of the third, in a 28-day cycle. During this time, the egg is moving down the fallopian tube, waiting to be fertilised. Therefore, intercourse before ovulation is more likely to result in pregnancy than at or after ovulation, as the sperm are ready and waiting for the egg. Avoid Environmental Toxins Both male and female fertility can be impacted by toxins. Pesticides, like those commonly used to control weeds on crops, often have harmful chemicals in them. If you work in the agricultural industry, or your partner does, then occupational pesticide exposure is a serious threat. Even if your profession has nothing to do with farming, research suggests that eating fruit and vegetables with high levels of pesticide residue can lower sperm count. If you work with paints or diesel fumes, to name a couple, you need to be using protective face masks etc. Pollutants can cause DNA damage to sperm, so give them a wide berth while trying to conceive, or take all safety measures possible while using them. Also, the use of plastics, including water bottles and take away containers, may have a negative impact on fertility. Quit Smoking It is common knowledge that pregnant women should not smoke, but the toxins found in cigarettes can also affect fertility in men and women when you are trying to conceive. Smoking can cause female ovaries to age prematurely, interfering with the egg implantation process. It can also impact on sperm count and quality. Minimise Alcohol Intake For women, alcohol consumption can increase the risk of miscarriage. The current Australian recommendation is that if you are pregnant or are planning to conceive, avoiding alcohol is the safest option. For men, studies have shown that as little as one beer a day can affect the sperm, increasing the risk of miscarriage and reducing the chance of a live birth. Therefore, restrict alcohol intake if trying to conceive. Other Factors to Consider Reduce stress levels Limit caffeine intake Avoid recreational drugs Increase folic acid (women) and zinc/antioxidant (men) supplements Avoid lubricants.   Watch Dr Neil Astill’s video for further advice. Please note: This video may not be copied or used, in whole or in part, without the prior written permission of City Fertility Centre © 2017.   Image courtesy of Shutterstock.com

By Dr Neil Astill, Clinical Director at City Fertility Centre Brisbane Southside.  The menstrual cycle occurs within the female ovaries and uterus for the purpose of reproduction. It is a complex process controlled by many different glands and the hormones that these glands produce. It is essential for the production of eggs and preparation of the uterus for a pregnancy, and should occur monthly from puberty until menopause. For many women, trying to conceive can be a challenging time and by learning to better understand your body’s menstrual cycle and to recognise the signs of ovulation, it may help you feel more in control. Here are a few of the top facts about the menstrual cycle: 1.Menstrual Cycles vary The average menstrual cycle length can vary from 25 to 35 days. A menstrual cycle is the number of days from the first day of your last period to the first day of your next period. 2. A Menstrual cycle has four phases The four phases of the menstrual cycle are: The Follicular phase: where the ovarian follicles mature and prepare to release an egg. Ovulation: is where a mature egg is released from a follicle. The Luteal phase: where the remaining follicle that produced the egg now produces hormones to provide nutrition to an embryo should one be created and implant successfully. Menstruation: is the elimination of the lining of the uterus (endometrium) and is usually a sign that pregnancy has not been achieved. 3. Ovulation is a female’s most fertile time of the month Ovulation is when the egg is released from the ovary and is definitely a female’s most fertile time of the month. The likelihood of conceiving is substantially increased if you have sexual intercourse in the three days leading up to and including ovulation, which are the most fertile days in your menstrual cycle. This is when the egg is moving down the fallopian tube waiting to be fertilised. The egg can survive for up to 24 hours after ovulation, while sperm can survive and fertilise an egg for two to three days in the fallopian tubes. If you are wishing to conceive, you should have unprotected intercourse every two days throughout the female’s “fertile window”. This means that sperm are ready and waiting for the egg when the female ovulates. If you wait until after ovulation to have sex, it is likely you will have missed the opportunity to conceive that month. 4. Calculating your fertile window is vital To calculate your “fertile window”, you need to know the length of the menstrual cycle (which can vary from 23 to 35 days or longer). So, if your cycle is 28 days, subtract 14 days from the first day of your last period to identify the day you are likely to ovulate. If your cycles are irregular, or vary in duration each month, your ovulation date will be difficult to calculate. While ovulation urine tests may be useful, you may want to consider seeking further advice from your GP or a fertility doctor. A Fertility Awareness Calendar can help you predict your ovulation date. 5. Irregular menstrual cycles can indicate a problem with ovulation Irregular menstrual cycles may suggest a problem with ovulation. As previously mentioned, the menstrual cycle is determined by a complex interaction of hormones, so any hormone imbalance can make a period irregular. Although, in most cases, irregular cycles are not dangerous, it is important to determine what is causing the irregularity. There are several ways to help regulate menstrual cycles.   Image courtesy of Shutterstock.com

By Dr Neil Astill, Clinical Director, City Fertility Centre Brisbane Southside. The preconception health of men is just as important as women’s despite the societal focus having been more on the female’s fertility health to date. We are now well aware that sperm quality impacts on fertility, and the lifestyle choices men make for up to three months before conception can have an effect. For almost a generation there has been emphasis on needing super-fast “Formula 1” sperm to make a baby, with the theory that the first sperm to reach the egg must be the best quality. However, we are now aware that a good sperm count and motility do not necessarily mean good-quality sperm. The process of maturing sperm occurs in cycles, taking roughly three months, with several hundred million cells reaching maturity daily. This process, named spermatogenesis, is important to understand because what you eat and drink and your general health for up to three months before conception or fertility treatment can make a difference to the quality of the sperm produced on the day. What factors affect sperm quality? The most common factors recognised as having a negative effect on sperm quality are: poor diet; lifestyle choices such as smoking, alcohol and recreational drugs; medical conditions such as obesity and diabetes; environmental factors, including exposure to chemicals, toxins and heat; recent illness (before, during or after 3 months of treatment) resulting in high fevers; body mass index (BMI); advanced age; and genetics. These factors put a large strain on the body, whether they cause changes to the hormone balance in the testes, or filter through the bloodstream, supplying a contaminated food source to developing sperm cells. This can result in harmful free radicals that attack otherwise healthy molecules and can lead to poor-quality sperm being produced. Substandard sperm health has been linked to reduced fertilisation rates, poor embryonic development, miscarriage and birth defects. How do we reduce free radical damage? Positive, healthy changes to diet and lifestyle with the support of antioxidant nutritional supplementation have been proven to increase fertilisation and blastocyst development. Antioxidants have been shown to support the body by helping to neutralise free radicals, preventing them from further damaging the tissues of the body. There are many sperm health supplements on the market containing antioxidants, so look for products with the recommended male fertility antioxidants for best results (see table below). Remember to consult your GP or a specialist for advice and guidance.   Products with the recommended male fertility antioxidants Please note: If you are viewing this table on mobile, please scroll to the right to see entire content.  [cf-table] Supplement, Found Naturally, Count, Motility, DNA Quality, Fertilisation, Anti-Sperm Antibodies Zinc, [attr class=”left”]Shellfish\, oysters\, seafood\, lean meat\, wheatgerm\, spinach\, pumpkin and squash seeds and cashews , Yes, Yes, Yes, No, Yes Vitamin C, [attr class=”left”]Strawberries\, citrus fruits\, acerola cherries\, papaya\, kiwi fruit\, green leafy vegies\, Brussels sprouts\, broccoli\, capsicum and tomatoes , No, Yes, Yes, No, No Vitamin E, [attr class=”left”]Dark leafy greens\, almonds\, shellfish\, sunflower seeds\, broccoli\, avocados\, olive oil\, pumpkin and kiwi fruit , No, Yes, Yes, Yes, No Folic Acid, [attr class=”left”]Dark leafy greens\, asparagus\, broccoli\, citrus fruit\, papaya\, strawberries\, beans\, peas\, lentils\, avocados\, seeds and nuts , Yes, No, Yes, No, No Selenium, [attr class=”left”]Brazil nuts\, oysters\, tuna\, whole-wheat bread\, seeds\, lean meats\, chicken and turkey\, mushrooms\, whole grains such as rye\, oatmeal\, brown rice and quinoa , No, Yes, Yes, Yes, No CoQ10, [attr class=”left”]Fatty fish such as salmon\, tuna and sardines in addition to beef and poultry and spinach , Yes, Yes, No, No, No Vitamin D, [attr class=”left”]Cod liver oil\, fatty fish\, mushrooms\, fortified cereals\, tofu\, caviar\, dairy products and sunshine , Yes, No, Yes, Yes, No Magnesium, [attr class=”left”]Dark leafy greens\, nuts and seeds\, mackerel\, beans and lentils\, whole grains\, brown rice\, avocados\, low-fat dairy\, bananas\, dried fruit (especially figs) and dark chocolate , No, Yes, No, No, No [/cf-table] Making the right choices about your health in the lead-up to conception will help give you a better chance of conceiving and of quality DNA being passed on for generations to come.   Image courtesy of Shutterstock.com

After nearly 18 months of trying to have a baby, Brisbane southside couple Freya and Matthew Young are finally proud parents. Their healthy baby boy, Andrew, came into the world at Sunnybank Private Hospital on March 23 weighing 3.045 kilograms and is the first IVF baby to be born for new fertility clinic City Fertility Centre Southside. Freya, 39, said the couple had sought the help of Dr Neil Astill since 2008 and were pleased when City Fertility Centre opened a clinic at Sunnybank late last year. “We both work in the health sector and would have driven anywhere to see Dr Astill due to his excellent reputation, but being able to see him in Sunnybank and utilise the excellent facilities at City Fertility Southside, instead of having to travel to Wickham Terrace in the city, was an added convenience for us,” Freya said. Freya was 38 and Matthew 42 when they started trying to conceive. The couple were realistic and knew age wasn’t on their side, so after four months of trying sought the help of Dr Astill. “We tried pre-IVF options for six months and then after no success again we moved to IVF,” Freya said. “Our first full IVF cycle was successful and we feel so blessed to now have Andrew.” As is often the case, the 16 months of waiting were emotionally charged for Freya and Matthew but they worked hard at maintaining some balance in their lives. “We tried not to stop our life for IVF and made a conscious effort to do some things just for ourselves, like weekends away and special dinners out,” Freya said. Freya’s advice for other couples going through IVF includes finding a few trusted family members and friends to share the journey with, to continue planning your life, to believe only the evidence-based facts on IVF, to find a doctor and clinic you can trust and, most importantly, not to give up hope. “Dr Astill’s support staff played a big part in our IVF journey and in helping us stay optimistic as well,” Freya said. “They were friendly, informative, discreet, positive and compassionate.” Due to demand, City Fertility Southside now has seven fertility specialists consulting. The clinic is at Level 1, 309 Mains Road, Sunnybank, and has seen nearly 100 patients a month since opening in August last year. Phone 1800 483 483. Other clinic locations are Brisbane City, Capalaba, Chermside, Gold Coast and Melbourne.