IVF: Embryos are created in a lab using the eggs and sperm of the prospective parents or donors.Embryo Biopsy: A few cells are taken from each embryo at the blastocyst stage (day 5 or 6 after fertilisation).Genetic Testing: The extracted cells are analysed for genetic abnormalities.Embryo Selection: Only embryos without identified genetic abnormalities are considered suitable for transfer to the woman’s uterus.

Assisted Reproductive Technology (ART)

ASSISTED REPRODUCTIVE TECHNOLOGY (ART)

Infertility can be caused by a complex collection of different factors, and thus one treatment does not suit all.

Great advances have been achieved in the field of assisted reproductive technology, and while IVF may be the best treatment for many patients, there are other fertility treatments that may be more appropriate for some patients.

What are the ART options?

1 in 12 couples may encounter difficulties conceiving after one year of actively trying for pregnancy. 1 in 6 couples may require some assistance to conceive. When that happens there are numerous treatment options available.

Ovulation Induction

This involves taking medication in the form of tablets or injections to induce ovulation. Then you will be advised of the optimal time to have intercourse. This is an appropriate treatment for women who do not regularly ovulate. It is of minimal benefit to women who already naturally ovulate each month.

Intrauterine Insemination (IUI)

This involves pinpointing the day of ovulation, and then concentrating the moving proportion of sperm (motile sperm) and injecting it directly into the uterine cavity. This helps the sperm bypass the cervical canal. This treatment is less effective if the sperm is very abnormal or with advancing age of the woman. It is often the first treatment of choice when using donor sperm in single women and female same sex couples trying for conception.

In Vitro Fertilisation (IVF) and Intracytoplasmic Sperm Injection (ICSI)

This involves stimulating the ovaries to release more than one egg for the treatment month with fertility medication. Then right before ovulation, the eggs are collected under sedation anaesthesia via a small procedure involving a fine needle through the vagina. The eggs are then fertilised with the sperm by either immersing them in the sperm (IVF), or by selecting the sperm and injecting it into the egg (ICSI). The fertilised egg (embryo) is then cultured in the laboratory and then inserted back into the uterus 5 days later, to await implantation (attachment to the uterus).

Operative Laparoscopy or Hysteroscopy

This is a day procedure under general anaesthesia where pelvic pathology that may compromise fertility (such as endometriosis, polyps, or fibroids) are treated.

Other Fertility Treatment Options

Egg and Sperm Donation

For individuals unable to use their own eggs or sperm, donated eggs or sperm represent a profound gift. Egg and sperm donation open the door to parenthood for those facing genetic concerns, premature ovarian failure, azoospermia, or same-sex couples wishing to start a family.

Surrogacy

Surrogacy is an arrangement where a woman (the gestational carrier) carries and delivers a child for another person or couple. This option is particularly relevant for women unable to carry a pregnancy, same-sex male couples, or when pregnancy poses a significant health risk to the woman.

Fertility preservation

Fertility preservation is the process of freezing eggs, sperm, or embryos for future use, preserving reproductive potential. These treatments are essential for individuals who are considering delaying childbearing or are undergoing medical treatments that may impair future fertility, such as chemotherapy. Fertilitiy preservation can offer hope and flexibility.

Genetic Testing and ART

Genetic testing in the fertility setting encompasses a range of procedures designed to identify genetic disorders, chromosomal abnormalities, and potential hereditary conditions that might affect fertility or the health of future offspring.

Knowing if there is an increased risk of your baby inheriting a significant genetic disease is important to allow informed decision about fertility planning and fertility treatment. Genetic testing in ART, such as IVF, plays a crucial role in modern fertility treatments, as it can avoid passing on known genetic conditions to your offspring, or reduce the chance of miscarriages for individuals and couples facing fertility challenges.

Reproductive Genetic Carrier Screening (RGCS)

Reproductive Genetic carrier screening tests for genetic conditions you or your reproductive partner may carry which can impact your babies health. The primary goal is to assess the risk of having a child with genetic conditions such as cystic fibrosis, sickle cell anaemia, Tay-Sachs disease, and many others. Carrier screening can provide vital information for making informed decisions about family planning and managing the risk of genetic diseases in offspring. Options include antenatal screening of your baby in pregnancy or Assisted Reproductive Technology such as IVF to prevent passing on the genetic condition to your offspring before pregnancy.

Reproductive Genetic Carrier Screening (RGCS)

Options for RGCS range from screening for 3 diseases up to 1,000+ genetic conditions.

Click here to download Dr Huang’s summary on Reproductive Genetic Carrier Screening.

The Process

Sample Collection: Some laboratories offer posting a saliva sampling pack for you to do testing in comfort of your home. Other laboratories offer on-site blood or saliva collection.
Genetic Analysis: The sample is analysed in a laboratory to identify mutations or changes in specific genes known to cause genetic disorders. The results can take 1-3 months to be reported.
Counselling and Results: Genetic counselling is available to help you understand your results and discuss your report if you and your reproductive partner have an increased risk of your child being affected by the genetic condition.

Preimplantation Genetic Testing (PGT)

Preimplantation Genetic Testing (PGT) is an additional testing option within an Vitro Fertilisation (IVF) treatment cycle. It is used to identify genetic abnormalities in embryos created through In IVF before pregnancy.

PGT allows couples and individuals to make informed decisions about their embryos, increasing the chances of a healthy pregnancy.

This technology is particularly useful for those with known genetic disorders, a couple identified at reproductive genetic carrier screening as having an increased risk of offspring with a genetic disease , recurrent pregnancy loss, or multiple failed fertility treatments. PGT is divided into three main categories, each serving a specific purpose:

PGT-A (PGT for Aneuploidy)

PGT-A screens embryos for aneuploidy, which are abnormalities in the number of chromosomes. These abnormalities can lead to miscarriage, failed IVF cycles, or conditions such as Down syndrome. PGT-A is approriate for individuals with recurrent miscarriages, those of advanced maternal age and so have a higher chance of pregnancies with abnormal chromosome number, or couples with repeated unexplained IVF failure.

PGT-M (PGT for Monogenic/Single Gene Disorders)

PGT-M is used when there’s a known risk of passing on a specific genetic disorder to the child. This test looks for single-gene disorders, such as cystic fibrosis, sickle cell anaemia, or Huntington’s disease, allowing only embryos without the genetic disorder to be selected for transfer to the uterus.

PGT-SR (PGT for Structural Rearrangements)

PGT-SR is designed for individuals or couples where one or both partners have chromosomal structural rearrangements, such as translocations or inversions. These rearrangements can increase the risk of infertility, miscarriages, or the birth of a child with a genetic disorder. PGT-SR helps identify embryos least likely to be affected by these rearrangements.

The Process

IVF: Embryos are created in a lab using the eggs and sperm of the prospective parents or donors.
Embryo Biopsy: A few cells are taken from each embryo at the blastocyst stage (day 5 or 6 after fertilisation).
Genetic Testing: The extracted cells are analysed for genetic abnormalities.
Embryo Selection: Only embryos without identified genetic abnormalities are considered suitable for transfer to the woman’s uterus.

I offer ART treatment through Genea Mebourne City which is affiliated with Genea. Genea provides a world leading PGT and genetic screening program, offering advanced technological services for all medically indicated genetic testing.

An Emotional and Physical Journey

Embarking on an ART journey is both an emotional and physical experience. Couples and individuals may face emotional ups and downs, from the hope of successful treatment to the stress and disappointment of setbacks, such as a miscarriage.

Physically, the process can be demanding, with hormone treatments, medical procedures, and the waiting periods associated with each cycle. Remember, you are not alone and services and support are available.

Your Next Steps

Assisted Reproductive Technologies have transformed the landscape of fertility treatment, offering hope and possibilities where none existed before.

Whether it’s through IVF, IUI, ICSI, egg or sperm donation, or surrogacy, ART provides a pathway to parenthood for many.

I’ll be there to guide you every step of the way – from our initial consultation to crafting your personalized treatment plan, I’m dedicated to helping you navigate your fertility journey to a health baby.

START YOUR JOURNEY

Compassionate, Holistic care and treatment.

Our friendly and dedicated team will be able to assist you with regards to appointments and enquires over the phone or in person.

Dr Alice Huang

About

Fertility Medicine

Early Pregnancy

Gynaecology

Treatment and Procedures

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(03) 9417 1088

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