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Great advances have been achieved in the field of assisted reproductive technology, with IVF now contributing to 1 in 18 births in Australia.
Infertility can be caused by a complex combination of different factors. While one single treatment does not suit all, IVF and ICSI have demonstrated their ability to help many couples facing different fertility challenges to conceive.
IVF is an approach to assisted reproduction that involves fertilising a woman’s egg with a man’s sperm in a laboratory (in vitro indicating the process occurs outside the body). This technique gives us more control over the conception process, allows us to observe the fertilisation and embryo development to offer valuable insight into possible factors that were stopping conception from happening naturally, and bypasses many of the barriers to fertility that may be found during natural conception via intercourse.
IVF insemination is where the sperm and egg are allowed to fertilise naturally in the same dish. ICSI is a more advanced form of insemination where a single sperm can be selected out and injected directly into the egg to facilitate fertilisation.
In both cases, the fertilised egg is cultured into an embryo inside Genea’s exclusive time-lapse GeriⓇ incubator before being transferred to the uterus of the female partner or surrogate.
Determining whether IVF with or without ICSI is right for you starts with a comprehensive fertility assessment. During this consultation, Dr Huang will investigate any underlying causes of infertility in both yourself and your partner, as well as review your overall health.
If you have a gynaecological condition that’s interfering with your fertility, such as endometriosis or polycystic ovary syndrome (PCOS), sometimes managing these conditions first may be effective at allowing you to conceive naturally.
IVF can also offer a special option for same-sex female couples who want both partners to be biologically involved in starting a family, where one partner contributes the eggs whilst the other partner carries the pregnancy (termed reciprocal IVF).
As a more intensive assisted reproductive technology, ICSI is usually reserved for more advanced cases of infertility or if other factors mean you are not likely to be successful with conventional IVF.
IVF with ICSI is also an important option for couples or women who are undergoing preimplantation genetic testing (PGT). This is a genetic analysis on your embryos created through IVF with ICSI to identify which, if any, are affected by a genetic abnormality and should not be considered for the transfer stage.
Dr Huang will prescribe a course of hormone injection medications that you’ll be shown to administer at home. These hormones stimulate your ovaries to release more than one egg for the treatment month, and Dr Huang will monitor the process of your ovaries and eggs using ultrasound and sometimes blood tests.
Once your ovarian follicles have reached a certain size, you will self-administer a “trigger” injection of another hormone to prompt final maturation. Your egg retrieval is scheduled for approximately 35-36 hours after this trigger shot, which involves a 20-30 minute day procedure under general anaesthesia. A very fine needle guided by ultrasound is used to extract the eggs from your ovaries. Your partner will typically provide his sperm sample on the same day. If you’re using frozen or donor sperm, this will be thawed on the same day.
Fertilisation for the IVF procedure involves combining the processed sperm sample with your egg in Genea’s embryology laboratory. For IVF insemination, the sperm are placed with the eggs in the same dish where the sperm can naturally bind to the outer shell of the eggs and burrow through to fertilise it. If you’re having ICSI, an embryologist will select the best sperm to inject into each egg. These fertilised eggs are grown for 5-6 days in a closely monitored incubator, and nourished by specialised growth solution in a stable controlled environment.
If you are planning for this, an embryo biopsy will be undertaken on the embryos when they have developed to the blastocyst stage before the embryos are frozen. The biopsy will then be sent for further genetic testing.
An embryo that has developed normally to the blastocyst stage (day 5 or day 6) will be selected to be transferred into your uterus. The embryo transfer process involves passing a long, thin tube through your cervix and into your uterus to deposit the embryo, where we will wait for implantation within the next 2-3 days. We will be able to confirm the pregnancy with a blood test 10 days after your embryo transfer and begin your journey through pregnancy.
Any extra embryos that have developed normally to the blastocyst stage (day 5 or day 6) that are not planned for immediate transfer will be frozen, to offer additional chances for pregnancy from future transfers.
Dr Huang is affiliated with Genea Fertility, a world-leading group of Australian fertility clinics. Genea success rates are consistently higher than the national average.
Your individual IVF success can be influenced by various factors. Fertility specialists often refer to a metric known as “cumulative birth rate”, which refers to your likelihood of having a baby from all the embryos created in one completed egg collection cycle.
National average from YourIVFSuccess website funded by the Australian Government shows cumulative live birth rate:
It’s important to note that the above statistics cannot account for all variables. For example, an older woman may have had a baby using IVF and donated eggs from a younger woman, which gives her the same chances of success for the age of the egg donor.
Though IVF and ICSI are associated with good success rates for many couples facing fertility problems, you may prefer a less invasive and more natural approach to assisted reproduction.
Intrauterine insemination (IUI) involves collecting your partner’s sperm sample and introducing it into your uterus, where the sperm must swim to the egg and fertilise it of their own accord.
Ovulation induction involves taking medications to stimulate ovulation with ultrasound to track follicle development, to ensure you ovulate that month and making it easier to time intercourse for when you’re most likely to conceive.
Depending on your fertility, IUI and ovulation induction can be good first-line options to consider before proceeding with the more invasive and more costly IVF and ICSI. However, if you are affected by significant infertility factors, the likelihood of success with these treatments may be minimal. Dr Huang will discuss all viable fertility treatment options with you during your consultation.
Collaborating with the world-class technology and innovative research of fertility network Genea, Dr Alice Huang offers comprehensive fertility care for individuals and couples at all stages of their family-building journey.
Her Melbourne fertility clinic is easily accessible at Epworth Freemasons Hospital in East Melbourne.
Contact Dr Huang’s rooms today to take your first step towards parenthood.
