Sometimes the hardest part of reaching out for help is saying the words out loud…
I’m worried about not being able to have a baby.
I think my husband needs to see a doctor about his fertility.
I don’t know if I can go through another unsuccessful round of IVF.
When it comes to fertility, every person is unique, each situation is different and there isn’t a one-size-fits-all solution. Whatever the situation, every concern is valid, each question deserves to be answered honestly and there shouldn’t be any shame or embarrassment in asking for help.
That’s exactly why we’ve enlisted Genea fertility specialist Dr Mark Livingstone to answer all the questions posed at our recent ‘A Frank Chat on Fertility’ webinar. Pull up a seat and join us for an insightful and enlightening conversation…
Women’s Agenda: Thanks for offering to answer all the big questions for us Mark. One of our webinar guests wants to know, how long does the process of egg freezing take? Should I bother if I’m over 35?
Dr Mark Livingstone: The egg freezing process takes a maximum of two weeks – and yes, you should bother if you’re over 35. The egg quality does depend on age; the younger you are when you freeze your eggs, the more chance of pregnancy and less chance of miscarriage and chromosome issues. At 35, the chance of pregnancy after embryo transfer is 35%, at 40 it’s 20% and 43 it’s 5%. These are the rates after an embryo has been thawed, an egg fertilised and an embryo created so there are still more steps after the eggs are frozen. In saying that, I had someone at 41 freeze their eggs and she had above average number of follicles, which meant an above average number of eggs and when she used them two years later, she had a baby with the first lot she thawed. Every case is different.
WA: What can women do to better their chances of natural conception after 40?
DML: Have sex! Women should have sex every second day around the time of ovulation, take folic acid and do all the healthy things: not too much caffeine or alcohol and no smoking and normal weight. They’re the main things, the rest is just luck, I’ll be honest.
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WA: How can I find out which IVF clinic gets the best results? They all seem to say the same thing!
DML: The Government has launched a website called yourivfsuccess.com.au and it gives the success rates of IVF clinics. When people are looking at IVF clinics, they need to know what their chances are. I can proudly say Genea has the highest success rate and that really validates our approach and the technology we have.
WA: How can I encourage my husband to seek advice about his fertility? We’ve been trying for a year and my tests are clear.
DML: I would ask him what the reason is behind his reluctance. Is he embarrassed about having to give a sample? Is he worried about performing in a strange environment? Is he scared of the results? If you find out what’s putting him off, you can address that. He needn’t be embarrassed, we have more than 40 men a day giving samples at Genea, it’s very normal for us. He also shouldn’t be scared about the results, because even if there’s an issue, most of the time there’s something we can do about it. Please reassure him. He’s just got to go – there are two parts to the equation.
WA: I’m 30 but my partner and I have been trying for a year and a half to get pregnant. Should I start worrying?
DML: Don’t worry, that’s not productive! But do go and see someone, get some tests done and work out what the next steps are. I’d encourage anyone over 30 who has been trying for a year to see someone and if you’re over 35 and you’ve been trying for six months it’s worth making an appointment. Even if everything is normal, you want the reassurance that you’re doing the right thing and not wasting your time if you’ve got a blocked tube or something you can fix.
WA: How many rounds of IVF should we go through before calling it quits? I’ve gone through 6 rounds now and haven’t been successful. I’m 37 years old.
DML: It really depends on egg numbers, embryo quality and test results. So, if you’ve done over five egg collections at the same clinic and you feel there are still some tests or approaches that have not been tried I’d suggest getting a second opinion from another fertility doctor. I have had someone come in after eight unsuccessful cycles and I discovered fluid in the fallopian tube which was reducing the chance of success and she became pregnant on cycle 9 but this is of course a rare event. If you find something wrong, you can try to fix it. At least you’ll know you’ve done everything if you do decide to call it quits.
WA: Are IVF rates improving?
DML: In the last 10 years, IVF rates have improved with technology – not as much as they’ve improved before [since IVF started in the 1970s], but they are still getting better. When IVF started out, the success rate was in single figures now it’s 50% and 55% for some people.
WA: Why are fertility treatments so expensive? Are there any ways to have this subsidised?
DML: They’re not all expensive and there are ways of doing it subsidised. People can have IVF through the hospital system, but they won’t be able to choose their doctor, have seven-day-a-week care or have their embryos genetically tested. Essentially, not all IVF clinics are the same and you get what you pay for. No matter where you go, the Government pays for every IVF cycle with a Medicare rebate of approximately $5,300. So, if it costs $6,300 through the hospital, the Government will pay about $5,000 so you will be out of pocket around $1,000.
WA: I’ve heard about the Shettles method. Is there any science behind this?
DML: I don’t know what the Shettles method is, let me Google it… Oh, it’s sex selection at home. No! It doesn’t work. People try to do sex selection by having sex before or after ovulation or eating certain foods, none of it has been proven to work. It just lowers your chance of pregnancy if you’re not having sex as frequently as you should be. As an aside, IVF clinics in Australia cannot legally offer sex selection.
WA: Are there risks to your health if you have a baby after 40?
DML: There are risks at any age. The chance of pregnancy complications when you’re older are higher, but that’s not a contra indication to trying.
WA: What are the biggest misconceptions about IVF and can you debunk them for us?
DML: I think we need to remember age is still the most important determiner of success. Even if you feel fantastic at 42 and you’re fit and healthy, your eggs are still 42. That’s hard for a lot of people to accept.
Another misconception is that IVF always works. As a society we expect everything to work and nothing to fail. Unfortunately, that’s not the way it works in biology. There are limits on what we can do. Embarking on IVF improves chances of pregnancy success, but it’s not a guarantee.
WA: What advice can you give to couples who’ve been unsuccessful in their attempts to have a baby?
DML: I think people need to be comfortable that they’ve done everything they can. When they look back years from now, they want to know they tried their best. If it hasn’t worked after five attempts, we may discuss other family building options like egg donation. We also offer counselling to help work through this. I always try to be honest with people and tell them what I would do in their situation. If your doctor says, “If I was you, I probably wouldn’t do any more cycles,” as hard as it may be, it may be time to work on coming to terms with that. I’ve had people say they feel like the pressure has been taken off because they’ve done everything, and they can now get on with their lives and stop living in limbo.
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