Ballarat IVF - Fertility Clinic

Female Infertility

Many women and couples are told that there is no cause for their fertility concerns. In some cases of unexplained or poorly explained infertility, careful and thorough investigation can help to find the  underlying problem.

Issues with the cervix

Cervical narrowing ( stenosis)



Narrowing or scarring of the external opening of the cervix can occur following treatment for abnormal cells. It is a consequence of healing, and not indicative of poor-quality treatment. Some women are born with a small external cervical opening. If the external opening is narrow, this can reduce the movement of sperm into the uterus.


Cervical Mucus Hostility

This is thought to occur when there is an excess in acidity in the mucus (pH<6) Rarely, sperm cannot penetrate the mucus because of sperm antibodies in the mucus.


The significance of cervical mucus hostility in causing fertility issues is debated amongst experts, but all accept that it is factor for some women.


What is the treatment?

Treatment for cervical narrowing or mucus hostility is Intrauterine Insemination (IUI) The mucus is bypassed by placing concentrated sperm directly into the uterus.


What is the success rate?

The success rate for IUI is 15% to 18% per month, and is influenced by the woman’s age.

Post Caesarean section cervical scar defect

When a caesarean section is performed, it is the cervix which is opened, not the uterus. Despite expert care and careful repair, the cervix sometimes does not heal properly, forming a “scar defect”. It is widely agreed that a cervical scar defect can contribute to fertility problems following the first, and often easy, conception.


Menstrual fluid and other material accumulate in the defect, causing inflammation and preventing implantation.


What is the treatment?

The repair of a cervical scar defect needs to be carefully considered, as many women will have a small defect and still conceive, and the surgery to repair the defect is challenging. Ballarat IVF specialists have the expertise to discuss and perform cervical scar excision and repair for women who need it.


Endometriosis

This occurs when cells from the lining of the uterus develop in areas outside the uterus. There are several implications:


  • it may damage the pelvic organs
  • in severe cases, the ovaries and tubes may be stuck to each other and to other structures in the pelvis, such as the bowel, uterus and bladder
  • the ovaries may contain cysts with old chocolate-like altered blood in them, adversely impacting egg quality, and the overall ovarian function.

 

Endometriosis can also adversely impact on the endometrial environment, affecting implantation of embryos.



Endometriosis is diagnosed by performing a laparoscopy. Your specialist may also suggest that endometriosis might be present after an examination and pelvic ultrasound. More than 50% of women who present with fertility problems have endometriosis.


What is the treatment?

Laparoscopic surgery with excision of endometriosis is the best treatment option. Hormone treatment may be required following this. Either IUI or IVF may also be offered soon after surgery for Endometriosis.


What is the success rate?

This will depend on the individual patient’s age, history and the type of operative treatment required. However, the chance of success of any fertility treatment is greater after laparoscopic surgery.


For more information on Endometriosis visit www.ogballarat.com.au

Ovulation Disorders

This means the ovary does not release an egg regularly, leading to absence or infrequent periods.


Some women with regular cycles may not be ovulating regularly.

 

Common causes of not ovulating:


  • Having Polycystic Ovary Syndrome (PCOS) - For more information click here
  • Being over or under your ideal bodyweight
  • Stress
  • Smoking
  • Having under or overactive thyroid function.
  • Intensive high-level exercise.
  • Having Low ovarian function or reserve.


What is the treatment?

If you are trying to conceive, and not ovulating, Improving your health, and Ovulation induction can help. 

Ballarat IVF is proud to offer Ovunet, our Ovulation online service, or face to face Ovulation Induction


What is the success rate?

About 16 % per treatment cycle. After 4 completes cycles. 35% of women achieve a pregnancy

 

One in 6 women need to use Follicle Stimulating Hormone (eg Gonal-F, Puregon) by daily injection in addition to Letrozole.

 

What is the success rate with FSH?

Up to 90% within 9 months

 

Risks of FSH ovulation induction 

20% of pregnancies result in twins; 5% in triplets; 2% in quads or more.


This treatment requires careful monitoring by ultrasound. We will advise you against trying to conceive if there are more than 2 eggs expected to be released in a treatment cycle.

 

Some women choose to move to IVF treatment to improve the chances of conception, and to ensure a single pregnancy



Visit OVUNET

Tubal Blockage

This can occur as a result of, abdominal or pelvic surgery, from a pelvic infection, or prior sterilisation. 80% of women with blocked tubes have no obvious underlying cause for this in their history. 


A blocked tube can also be filled with fluid, and is called a hydrosalpinx.


What is the treatment?

The best treatment for blocked tubes is IVF.


Surgery to reverse tubal sterilization using clips can be effective in opening up the fallopian tubes. The procedure can be performed laparoscopically, or as an open procedure.


If a hydrosalpinx is present, it is very important to remove it, because the fluid can slowly leak into the uterus, preventing embryo implantation. If the opposite tube is open, removing a hydrosalpinx can result in a natural pregnancy.

 

If the fallopian tubes are blocked or damaged, there may a 10%-15% chance of having an ectopic pregnancy. Your fertility Specialist will provide more information about these risks.


What is the success rate?

60% to 90% for clip sterilisation.

20% to 50% for burnt tubes.

 

Following tubal surgey there is a 20% chance of an ectopic tubal pregnancy, where the embryo implants in the fallopian tube instead of in the uterus. 

Uterine Causes

The following can all lead to failure of the embryo to implant:

 

  • Polyps

Polyps are soft, benign  growths which occur in the uterine cavity, and impede implantation. They are detected by ultrasound, and removed with hysteroscopic surgery. They are very common.

 

  • Fibroids

Fibroids are firm, lumps of muscle which grow in the uterus. Most fibroids are small, and don’t impact on fertility. However, the larger a fibroid is, and the closer it is to the uterine lining, the more likely it is to be affecting fertility. If needed, fibroids are removed with hysteroscopic or laparoscopic surgery

 

  • Abnormal Uterine shape

The shape of the uterus can impact on fertility. Most women with an abnormal shaped uterus will be able to conceive. If a uterine septum is detected, if necessary, it can be treated with hysteroscopic surgery

 

  • Thin endometrium

The lining of the uterus (endometrium) is crucial for conception. It should be more than 7mm thick around the time of implantation. The endometrium can be thin, for no obvious reason, or following miscarriage or following retained tissue from a previous pregnancy

The treatment is complex, and requires an individualised approach.

 

  • Adenomyosis

Adenomyosis is a common condition where the lining of the uterus moves into it’s muscular wall . Adenomyosis causes heavy and painful periods. It results in inflammation in the uterine wall, and this is the accepted reason for it being associated with fertility problems.

Most women with adenomyosis will be able to conceive, but some require treatment of it to achieve a pregnancy


What is the treatment?

These conditions are diagnosed by Ultrasound, or hysteroscopy and treated surgically, or with medications depending on the problem. 


What is the success rate?

This will depend on the cause of the uterine problem, it severity, and the age of the woman and her partner.

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