Sometimes patients are unable to conceive even after full investigation and no medical cause has been found. This does not mean that the cause is psychological or that the couple is trying too hard. While psychological issues may contribute to some infertility, we believe that in some cases of unexplained or poorly explained infertility, investigations may not be sensitive enough to diagnose the problem.
Cervical Mucus Hostility
This occurs when there is an excess in acidity in the mucus (pH<6) or when the mucus secreting cells have been destroyed by surgery, such as for abnormal pap smears or prolapse surgery. Rarely, sperm cannot penetrate the mucus because of sperm antibodies in the mucus.
What is the treatment?
Intrauterine Insemination (IUI) where the mucus is bypassed by placing the sperm directly into the uterus.
What is the success rate?
15% to 18% per month.
What is the treatment?
Intrauterine Insemination (IUI) where the mucus is bypassed by placing the sperm directly into the uterus.
What is the success rate?
15% to 18% per month.
Endometriosis
This occurs when cells from the lining of the uterus develop in areas outside the uterus. There are several implications:
• it may damage some of 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
Endometriosis is diagnosed by performing an operative laparoscopy. Your fertility specialist may also suggest that endometriosis might be present after an examination and pelvic ultrasound. 50% of women who present with fertility problems have endometriosis.
What is the treatment?
Laparoscopic surgery with removal 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.ballaratendoclinic.com.au
• it may damage some of 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
Endometriosis is diagnosed by performing an operative laparoscopy. Your fertility specialist may also suggest that endometriosis might be present after an examination and pelvic ultrasound. 50% of women who present with fertility problems have endometriosis.
What is the treatment?
Laparoscopic surgery with removal 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.ballaratendoclinic.com.au
Ovulation Disorders
This means the ovary does not release an egg regularly and the woman may experience absence of periods (Amenorrhoea) or infrequent periods (Oligomenorrhoea). Rarely, women with regular cycles may not be ovulating regularly.
What is the treatment?
Phase 1 – Ballarat IVF's preferred fertility drug is Letrozole and is effective in most cases.
What is the success rate?
80% of pregnancies on this treatment occur within the first 3 months of ovulating.
If conception does not occur after 3 months the treatment should be reviewed.
This treatment is normally not given for more than 6 months.
Phase 2 – using ovulation stimulation, Follicle Stimulating Hormones (eg Gonal-F, Puregon) by daily injection.
What is the success rate?
Up to 90% within 9 months – 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.
What is the treatment?
Phase 1 – Ballarat IVF's preferred fertility drug is Letrozole and is effective in most cases.
What is the success rate?
80% of pregnancies on this treatment occur within the first 3 months of ovulating.
If conception does not occur after 3 months the treatment should be reviewed.
This treatment is normally not given for more than 6 months.
Phase 2 – using ovulation stimulation, Follicle Stimulating Hormones (eg Gonal-F, Puregon) by daily injection.
What is the success rate?
Up to 90% within 9 months – 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.
Tubal Blockage
This can occur as a result of prior sterilisation, abdominal or pelvic surgery, or from a pelvic infection. 80% of women with blocked tubes have no obvious underlying cause for this in their history.
What is the treatment?
Surgery remains the best treatment for women over 40 years of age who have had a tubal sterilization using clips.
What is the success rate?
60% to 90% for clip sterilisation.
20% to 50% for burnt tubes.
15% to 20% for cut and tied tubes.
10% for blocked tubes due to a prior infection within a year of the infection.
All of these conditions have a risk of up to 20% of an ectopic tubal pregnancy. That is where the embryo implants in the fallopian tube instead of in the uterus. It is reassuring to know that IVF is a highly effective way of treating infertility caused by tubal blockage.
What is the treatment?
Surgery remains the best treatment for women over 40 years of age who have had a tubal sterilization using clips.
What is the success rate?
60% to 90% for clip sterilisation.
20% to 50% for burnt tubes.
15% to 20% for cut and tied tubes.
10% for blocked tubes due to a prior infection within a year of the infection.
All of these conditions have a risk of up to 20% of an ectopic tubal pregnancy. That is where the embryo implants in the fallopian tube instead of in the uterus. It is reassuring to know that IVF is a highly effective way of treating infertility caused by tubal blockage.
Uterine Causes
The following can all lead to failure of the embryo to implant – forgotten IUDs, scar tissue in the uterus following multiple curettes, polyps, fibroids in the cavity of the uterus and tissue from a previous pregnancy loss or termination.
What is the treatment?
These conditions are diagnosed by hysteroscopy and treated operatively, depending on the problem.
What is the success rate?
This will depend on the cause of the uterine problem.
What is the treatment?
These conditions are diagnosed by hysteroscopy and treated operatively, depending on the problem.
What is the success rate?
This will depend on the cause of the uterine problem.
