INFERTILITY TREATMENT MELBOURNE
Male and Female infertility treatments options
Potential causes of infertility in males and females
What do I look for
I look to find out the underling issues that are causing your infertility. In most cases both you and your partner are involved in this process.
To find the potential problem I’ll look into many health and fertility related factors that may potentially include your:
General health and lifestyle
Previous pregnancy problems
Ovulation cycle and fertility window
How long you have been trying to conceive
Pre-pregnancy screening tests
Female infertility treatments
I have dedicated my life to being able to offer my patients a very broad rage of treatments dependant on the underlying cause. As an Infertility Specialist I aim to find out if your situation is nature needing a helping hand or is significant scientific help required. I then analyse and discuss the treatment options available/suitable for your situation.
Some of my treatments include:
Ovulation Induction (OI) involves the use of fertility medications to trigger increased hormone levels. This encourages your ovaries to release eggs to help your chances of getting pregnant.
It’s a common treatment if you produce low levels of hormones for ovulation, or are not ovulating at all. OI may also be used to regulate ovulation.
Throughout the OI process I will be closely monitor your results. Ultrasounds are conducted to monitor the development of the follicles and the lining of the uterus. By conducting the ultrasound I can make an accurate assessment of your follicles progress and then advise when the optimum time is for you and your partner to have unprotected intercourse or insemination. The OI process may maximise your chances of conceiving successfully.
Other infertility treatments may include medications.
Infertility treatment medications
There are three main types of fertility medications I use and recommend:
1. Clomid (Clomiphone Citrate)
Clomid comes in tablet form and is taken for a certain number of days during or after your menstrual cycle. Clomid is taken to stimulate ovulation. During your Clomid cycle I will monitor your ovarian response to the medication using an ultrasound and in some cases a blood test. This enables me to assess when the optimum time for you and your partner to have unprotected intercourse or insemination.
Clomid is generally used as an initial step into fertility treatment therefore, if you have done previous simple fertility treatments that have involved Clomid I wouldn’t suggest this as an initial form of treatment.
When a patient has done a number of unsuccessful Clomid cycles (this will varies on your response, medical history and my assessment, I may recommend a cycle of Follicle Stimulating Hormone (FSH) injections.
2. Follicle Stimulating Hormone (FSH) – Gonal F and Puregon
Follicle Stimulating Hormones (FSH) is one of the gonadtrophic hormones, the other being luteinizing Hormone (LH).
FSH is one of the essential hormones that stimulates the growth of the ovarian follicles in the ovary before the release of an egg occurs, as a result of one follicle at ovulation.
I may prescribe the medication Gonal F or Puregon, which is administered by injection. I will explain your prescribed treatment plan and how to do the injections. Injections will commence on your second or third day of your menstrual cycle and continue for a number of days until a mature follicle is ready. This is conducted by an ultrasound to monitor your progress and view the growth of your follicle(s).
Once a mature follicle has formed this will mature into an Oocyte (egg). Some patients require assistance for the maturation and release of an egg and in this case, I will administer a “trigger” shot of HCG.
3. HCG (Ovidrel/Pregnyl)
Some patients may require the assistance of fertility medications to help release a mature egg into the uterus for fertilitsation by sperm. In this instance, I will administer or recommend dose of Ovidrel. Ovidrel can be taken in a cycle paired with Gonal F injections or on its own depending on your assessment outcomes.
Once you have had a course of Ovidrel, Dr. Myran’s helpful team will advise you when it is suitable for you and your partner to have unprotected intercourse or arrange the time for your insemination.
We understand that injections can be confronting if you haven’t used this form of treatment before. Rest assured, our office will book you in for a consultation where Dr. Myran will thoroughly explain how to self administer injections. We suggest for this consultation you bring your partner or family member who you would feel comfortable to assist with injections. The injections used are in pen form and are less intimidating then a drawn up needle. To select dosages you click the pen to the directed amount and inject within the fatty tissue of the stomach or upper thigh.
Possible side effects slight bloating, abdominal discomfort, breast tenderness, nausea, muscle aches and tiredness.
Intra-Uterine Insemination (IUI)
IUI usually done in conjuction with horomonal medication (as described above) to help you stimulate ovulation at the right time. After following the recommended treatment cycle of medications the end step (if prescribed) is a Intra-Uterine Insemination (IUI). An IUI is best broken down into these three steps:
Step 1: Semen Collection
On the day of the insemination, your partner will be required to produce a ejaculate into a sterile container provided by Dr. Myran. We recommend abstinence from intercourse for 2-3 days prior to sample being required. The sample will then be required at the clinic within an hour.
Step 2: Sperm preparation
The sample then goes through a process of being “washed” and filtered removing any non-motile sperm. This process basically filters the sperm into its most concentrated sample of active sperm for insemination.
Step 3: Sperm insertion
The concentrated sample of motile sperm is then inserted through the cervix into the uterus. This part of the procedure doesn’t require anaesthetic as it very similar discomfort level you would experience in a pap smear. Dr Palam’s caring and nurturing bedside manner will ensure you are relaxed throughout the procedure and once insemination has occurred, you will be required to remain laying down for 10-15 minutes before you can leave the clinic.
Male infertility treatments
Simple infertility treatments for men involve lifestyle changes such as:
Reducing alcohol intake
Reducing the chance of heat exposure to the testicals
Avoiding other drugs and other substances that may affect male fertility
This approach is a great start but alone may not be enough for most men.
For some men the act of intercourse may be a challenging
This may come in the form of:
- Difficulty maintaining an erection
- Premature ejaculation
- Loss of sex drive
These problems may be resolved with medical or non-medical therapy.
If the signal hormones from the brain to the testis are not being released, then it’s possible to replace these hormones to increase or recommence sperm production.
The pituitary gland in your brain releases hormones called gonadotropins, that stimulate the testicles to produce sperm. In some cases, male infertility is caused by insufficient levels of these hormones. Taking these supplemental hormones as medication may increase sperm production.
Previous injury to the testis from trauma, infections, medications, chemotherapy and radiation may or may not be amendable to treatment.
Receiving sperm from testicular biopsy
Sometimes the outlet tubes that carry sperm are blocked. It’s possible to bypass the blockage by either collecting sperm from the testis or epididymis with a biopsy needle under local anaesthetic. Sometimes the testis may need to be surgically explored to find sperm whilst you are under anaesthetic sleep.
Intra-Uterine Insemination (IUI)
In men with a low sperm count or sperm motility problems, washing the sperm to remove impurities prior to injecting the sperm into the uterine cavity may help couples achieve pregnancy.
In Vitro Fertilisation (IVF)/Intra-Cytoplasmic Sperm Injection (ICSI)
When sperm count and or sperm mobility is very low, then IVF and ICSI procedures may significantly help many couples fall pregnant. IVF is the process where the females eggs are fertilised outside the body with the male’s sperm. The fertilised eggs (the resulting embryos) are then placed into the woman’s uterus in the hope that a successful pregnancy will follow.
In the ICSI procedure, the females eggs are removed from the woman’s ovaries and each egg is injected with a single sperm. This significantly increases the chance of producing a fertilised egg. The fertilised eggs hopefully develop into embryos that are transferred back into the womans uterus at the appropriate time.