There are a number of infertility treatment options to help you conceive.

Overcoming Infertility

With the advancement of modern medical science, you have a variety of infertility treatment options to choose from. Any one—or a combination of these treatment options—may improve your chances of starting a family. These include:1

  • The male partner’s semen is inserted through the female’s cervix and into the uterus at or near the time of ovulation.
    IUI is also known as artificial insemination.
  • Hormone medications (oral or injection) are used to enhance the production of a female hormone called follicle-stimulating hormone. This encourages follicle, a fluid-filled sac that contains an immature egg, to grow. Once the follicle is large enough, another hormone is introduced to help release the mature egg from the follicle.

There are a number of innovative and advanced fertility options available as well. These are called assisted reproductive technologies (ART), and are used to treat infertility in both men and women.
There are several types of ART:1-3

  • In vitro means ‘outside of the body and in an artificial environment’. IVF is one of the more widely used forms of ART today.

  • Quite simply, if a woman opts for in vitro fertilisation, her eggs and a male partner’s healthy sperm will be collected. The egg and sperm are then left in a culture dish in a laboratory, to allow the egg to be naturally fertilised by one sperm. Once the embryo is formed, it’s put back into the woman’s uterus.

  • If more than one embryo forms, the remaining embryos may be frozen for use in later transfer procedures. Please know that freezing of eggs may not be allowed or practised in some countries. It is best to consult your doctor on this matter.

  • ICSI is quite similar to IVF in that eggs and sperm are collected from each partner, and fertilised outside of the woman’s body.
  • However in ICSI, a single healthy sperm is directly injected into each egg to achieve fertilisation. This is necessary if the sperm is unlikely to fertilise the egg naturally (due to various sperm issues), or if the egg’s outer layer is too thick.
  • Once fertilised, the embryo is transferred back into a woman’s uterus, much like the IVF process.
  • In GIFT, a woman’s eggs are removed from her ovaries and mixed with the man’s sperm, and placed in her fallopian tubes where fertilisation will occur.
  • In ZIFT, the egg and the sperm are mixed together in the laboratory, and given time to fertilise before being placed in the fallopian tubes.

With the huge advancements in infertility treatment options today, it is also possible for couples to test for any genetic impairment as well. Pre-implantation genetic diagnosis (PGD) helps reduce the risk of an individual or couple passing on a specific genetic or chromosomal disease or abnormality to their child.

The IVF Journey
Since the world’s first birth in 1978, IVF has helped more than 8 million babies bring joy into their parents’ lives.4
Typically, an IVF cycle can take from three to six weeks. This includes various appointments with your doctor, tests and examinations, the actual procedures and the waiting time in-between procedures.5
On average, women miss 23 hours of work per IVF cycle.6
IVF procedures are complex, and involve many different stages which can be demanding and emotionally draining.
  1. Suppression7-9
    Goal: To suppress your natural menstrual cycle, and prevent early or unexpected ovulation.

      This step is also called down-regulation.

      You will need to take a daily injection (your doctor will teach you to give it to yourself), or a nasal spray for around two weeks.

    What should I expect:

      Some menopausal side effects, such as hot flashes may occur.

  2. Stimulation7, 9-10
    Goal: To develop multiple eggs rather than the single egg which normally develops each month.

      In order to boost your egg supply, you will be given oral or self-injectable hormonal fertility drugs to take over the course of 8-14 days.

      These hormone drugs will help increase the number of eggs that your ovaries normally produce, so you will have more eggs for collection and fertilisation.

    What should I expect:

      Potential side effects from hormonal fertility drugs may include breast tenderness, swelling, rash and mood swings.

      You will need to visit the clinic often in order to monitor your ovaries via ultrasound scans, and to check your hormone levels through blood tests.

  3. Egg and sperm retrieval7, 9-10
    Goal: To retrieve the eggs from your ovaries.

      Usually, between 34 to 38 hours before your eggs are scheduled to be retrieved from your body, you will be given a hormone injection to help your eggs mature quickly.

      This procedure is usually performed in the outpatient room of your doctor’s office.

      Your mature eggs will be removed from your ovaries using a long needle and ultrasound guidance. You may be sedated to minimise discomfort.

      This procedure takes approximately 20-30 minutes.

      Sperm from the male partner should ideally be extracted on the same day as your egg retrieval.

      Your doctor may start you on a hormone medication called Progesterone, to help the lining of your womb prepare for receiving an embryo in around six days’ time.

    What should I expect:

      You may experience cramps or spotting.

      You may need to fast (for sedation), and your doctor will advise you on what to eat and drink during the approximate 36 hour wait.

      Dress comfortably, arrange for transport so you don’t have to drive to and from the clinic, and take the day off from work, if possible.

  4. Fertilisation7
    Goal: To fertilise your eggs with healthy sperm.

      Your eggs will be combined with your partner’s sperm in the laboratory.

      Sometimes, your doctor may recommend that a single sperm be injected directly into the egg instead. This procedure is called ICSI.

      The embryos (fertilised eggs) should ideally be nurtured in high-tech incubators for up to six days before being transferred back into your uterus.

    What should I expect:

      You will need hormonal medication to help prepare the lining of the womb to implant the embryo.

      Route of administration for the hormonal medication can be vaginal or injection.

  5. Embryo transfer5,10
    Goal: To transfer the embryos (fertilised eggs) into your uterus.

      The doctor will choose the best embryos to transfer back into your uterus using a long, thin tube called a catheter.

      A speculum will help keep the vaginal walls apart as the catheter is passed through the vagina using ultrasound guidance.

    What should I expect:

      The whole transfer usually takes place in the outpatient room at your doctor’s office.

      It takes around 15 minutes and requires no sedation.

The 2-week waiting game:11

For most couples, this is the most stressful part of the treatment process. A woman’s body begins to produce a hormone called human chorionic gonadotropin (hCG) soon after implantation of a fertilised egg inside the uterus. It takes about two weeks for trace levels of hCG to be detected from an early pregnancy. This is why it’s best to wait around two weeks—at least 10 days—before getting tested to find out if you are pregnant.

Patients are often prescribed progesterone to take throughout the two weeks’ wait. During this time, you will need to continue with your hormone medication. Please do not stop taking these medications until you have been advised to do so by your doctor.

After two weeks, your doctor will advise you to take a blood test to confirm your pregnancy.

How to cope with the stress?

Feeling anxious over the outcome of your IVF treatment and upcoming pregnancy test results is understandable. It is important that you talk to your partner, doctor, family and friends about your feelings and anxiety.

Treat yourself to everything you like to do; from cooking delicious healthy meals to curling up with a favourite book – do what makes you feel happy, calm and content.

We recommend you refrain from performing a home pregnancy test as they can render false results, either a false negative or false positive.

  1. Victorian Assisted Reproductive Treatment Authority (VARTA). What is assisted reproductive technology (ART)? Available at: https://www.varta.org.au/sites/default/files/What%20is%20assisted%20reproductive%20treatment%20(ART)%20-%20brochure.pdf Accessed: April 2020.
  2. ReproductiveFacts.org. What is Intracytoplasmic Sperm Injection (ICSI)? Revised 2014. Available at: https://www.reproductivefacts.org/globalassets/rf/news-and-publications/bookletsfact-sheets/english-fact-sheets-and-info-booklets/what_is_intracytoplasmic_sperm_injection_icsi_factsheet.pdf. Accessed: April 2020.
  3. Zhu, Tian. Zygote Intrafallopian Transfer. Embryo Project Encyclopedia (2011-01-31). ISSN:1940-5030.http://embryo.asu.edu/handle/10776/1971.
  4. European Society of Human Reproduction and Embryology. (2018, July 3). More than 8 million babies born from IVF since the world's first in 1978: European IVF pregnancy rates now steady at around 36 percent, according to ESHRE monitoring. ScienceDaily. Retrieved July 26, 2020 from www.sciencedaily.com/releases/2018/07/180703084127
  5. Human Fertilisation and Embryology Authority. In vitro fertilisation (IVF).Available at: https://www.hfea.gov.uk/treatments/explore-all-treatments/in-vitro-fertilisation-ivf/ Accessed: April 2020.
  6. European Society of Human Reproduction and Embryology. Pocket Guideline. Psychosocial care in infertility and mar: how to meet patients’ preferences. Available at: https://www.eshre.eu/Guidelines-and-Legal/Guidelines/Psychosocial-care-guideline Accessed: April 2020.
  7. National Health Service. What Happens. IVF. Available https://www.nhs.uk/conditions/ivf/what-happens/ Accessed: April 2020.
  8. National Institute for Health and Care Excellence. Assessment and treatment for people with fertility problems February 2013. Available at: https://www.nice.org.uk/guidance/cg156/resources/assessment-and-treatment-for-people-with-fertility-problems-pdf-244343771845 Accessed: April 2020.
  9. American Society for Reproductive Medicine (ASRM). Medications for inducing ovulation. Available at: https://www.reproductivefacts.org/globalassets/rf/news-and-publications/bookletsfact-sheets/english-fact-sheets-and-info-booklets/booklet_medications_for_inducing_ovulation.pdf. Accessed: April 2020.
  10. American Society for Reproductive Medicine (ASRM). Assisted Reproductive Technology. A Guide For Patients. Revised 2018. Available at: https://www.reproductivefacts.org/globalassets/rf/news-and-publications/bookletsfact-sheets/english-fact-sheets-and-info-booklets/art-booklet2.pdf Accessed: April 2020.
  11. Healthline. Signs your embryo transfer may have been successful. May 2020. Available at: https://www.healthline.com/health/infertility/positive-signs-after-embryo-transfer Accessed: April 2020