One in six Australian couples struggle to achieve pregnancy, but what boxes do you need to tick to be considered eligible for in vitro fertilisation?
“In Australia, a fertility specialist has to first assess you as being subfertile,” Associate Professor Warren Chan of Monash IVF said.
“Subfertility is generally defined as not being able to conceive after 12 months of unprotected intercourse, however it depends on multiple factors. A fertility specialist will look at the reasons for this, and see if IVF is the right treatment for you.”
It’s an age thing
“Maternal age has the most significant influence on fertility,” Chan said.
“For a female in her early 30s, generally we would recommend fertility investigations after 12 months of trying to conceive, with strategies to achieve natural conception before considering IVF at 18-24 months. Your chances of conceiving naturally are lower as you get older, so if a woman is in her late 30s or early 40s, we would generally recommend investigations at six months, and consider IVF at nine to 12 months.
“For males, if there is a significant sperm abnormality on semen analysis, we may consider initiating IVF earlier. It’s really important that you see your fertility specialist as a couple so that we get the whole picture.”
The odds of IVF success
“The chance of pregnancy has come a long way since the first IVF baby was born in 1978,” Chan said.
“Today, we can generally help the majority of women under the age of 38 fall pregnant over a number of IVF cycles. Of the couples we are destined to help, most pregnancies will occur within three to four IVF stimulation cycles. However the chance of pregnancy success depends on many factors such as reduced ovarian reserve, endometriosis, PCOS, sperm issues and lifestyle factors such as smoking and obesity, which are all important to assess during consultation with your Fertility Specialist.”
The angst and inconvenience of it all
“IVF can be daunting at the beginning because there’s a lot of information to take in,” Chan said, albeit acknowledging that today’s IVF process is “patient-friendly”.
“You generally need only three to four blood tests during a cycle, and the injection phase only lasts about eight to 12 days in that cycle, so patients usually handle treatment pretty well,” Chan said.
Where he practises, blood tests and ultrasound monitoring are usually carried out in the morning so that the patient can go to work after. “We get the results by about lunchtime, have a meeting with the IVF team, and the team’s nurse usually rings a patient up in the afternoon to tell them what to do next.”
The only time the female would need to take off work is for egg retrieval, a 20-30 minute procedure under sedation or general anaesthetic.
Taking the first step
“Difficulty conceiving is a stressful time in people’s lives,” Chan acknowledged. He said the hardest part of IVF can be “taking that first step” and seeking advice from a fertility specialist before considering the best tailored treatment.
“Patients leave their first appointment feeling reassured that everything that can be done will be done.”
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