Australian IVF

"At Sydney IVF we explain carefully to patients the chance of conceiving with different typesof treatment" said Dr Bowman. "For couples in their 30s, after 18 months of trying, evenwith no obvious reason for infertility, continuing to do nothing, using clomoiphene orperforming IUI (intrauterine insemination) has less than a five percent chance of success inany one month."

"IVF, however, has success rates of close to 50%" said Dr Bowman."Australian couples are fortunate in that Medicare provides assistance to those couplesrequiring IVF. The cost of having an IVF cycle, after the rebates are received from thegovernment, is approximately $1,500 unlike many countries where IVF is only for those ableto afford tens of thousands of dollars." It is in these countries that couples who cannotafford IVF tend to try with these outdated other treatments that might cost less, but do nothave the success rates of IVF.

Australian fertility specialists and scientists lead the world in fertility research. Advancessuch as the Sydney IVF culture medium (which grows the embryos) and egg freezing topreserve fertility mean that Australian couples are highly advantaged in pursuing their goalsof achieving a healthy family.

Dr Mark Bowman talks on Australian IVF

Dr Mark Bowman, medical director of Sydney IVF talks on the treatment of unexplained fertility and the success rates of common treatments versus standard IVF.What are they most common infertility conditions?

Dr. Mark Bowman: There are a number of problems that can occur on both sides that make it harder to get pregnant. The male could have a poor sperm count or the woman could have a blockage of the fallopian tubes which prevents the sperm and egg combining. Other examples are ovulation disorders andendometriosis. A very common problem is female age, females are born with all their eggs so by their early 40s the eggs they are releasing are old and have a higher rate of chromosome errors.


Are some infertility conditions caused by outside influences? Work environment, food, technology, stress?

Dr. Mark Bowman: Yes. Sometimes it is quite obvious, such as stress, over-exercising or crash dieting causing periods to become irregular, these lifestyle issues can prevent ovulation. The number one environmental problem in both men and women is cigarette smoking, all smoking in fact, but in particular nicotine; this clearly reduces the chance of pregnancy. If a women smokes for most of her life she will damage her eggs over many years and menopause will be brought forward. So don't smoke.


Are there some foods that encourage fertility?

Dr. Mark Bowman: Not really. As long as you are healthy and there is a well balanced diet on both sides you will be fine. Specific things women need, even if they are healthy, are iodine and folic acid as it is difficult to get enough of these agents even from a healthy diet. If a woman uses pre-pregnancy supplements they will usually have all the necessary vitamins and minerals, but it is wise to check which agents are in the supplements you plan to use.


How can we prepare our bodies for fertility? Relaxation, Yoga etc:

Dr. Mark Bowman: Having a happy work life balance is important. Keep yourself healthy and don't smoke. Have a well balanced diet and take pre-pregnancy supplements. You should see your GP to make sure you are up to date with your pre-pregnancy checks, for example to ensure that you are immune to rubella and chicken pox.


What are some of the emotional hurdles couples face before considering IVF?

Dr. Mark Bowman: Well remember IVF is just one treatment for infertility, there are many others. For example, tablets can be used if the woman is not ovulating. Fallopian tube blockages can be repaired with surgery and other benefits can be obtained with lifestyle changes.

Irrespective of the treatment, infertility can become an emotional burden that weighs heavily on the couple. Strength within the relationship is very important, you need to support each other and have a health carer that you both have confidence in, whether it is a practitioner, GP or specialist. This is why some see nutritionists and take herbal supplements, as they have the confidence in that individual and the help they are providing, perhaps this is more important than the supplement itself. The couple's chosen practitioner can explain the basics of fertility, order appropriate tests and can also discuss in an understanding way how best to move forward.

IVF is an overwhelming process for some, which is why all IVF centers have in-house counselors available at any stage and any time.


How do couples find/choose a Doctor for IVF?

Dr. Mark Bowman: Ultimately I think it is word of mouth. The couples GP will often say "I have referred a lot of people to see this specialist; he/she provides good care and gives excellent results". Many couples will choose to see a doctor because they know someone who has been through treatment and recommends a particular doctor or unit. Additionally people are increasingly doing their own Internet research, making their choice that way. I encourage you to do your own research, the Internet is a good resource, but don't do it all day and night!


What is IVF? and what is the process that both parties undergo?

Dr. Mark Bowman: IVF is a treatment where a woman has medications, usually tiny hormone injections under the skin that she administers herself, for a couple of weeks to make more than one egg develop. This process could result in up to about twelve eggs developing, on average. Along the way she has ultrasounds and blood tests every few days. Then the eggs are removed using a simple ultrasound procedure and on the same day, a sperm sample is obtained from the partner. Then the eggs and sperm are put together outside of the body, in special incubators.

Following fertilization, embryos develop and five days later the embryo that is developing the best is put back in the women (a simple procedure that is just like a pap smear). Maybe two to three of the remaining embryos are frozen. The process is described in detail at www.sydneyivf.com.au .

Sometimes IVF is indicated straight away, sometimes it is chosen after simpler treatments for fertility has failed.


How long can you keep embros in storage?

Dr. Mark Bowman: Embryos can remain frozen for many years scientifically, but various laws and regulations state that you can't freeze them for more than 5-10 years.


How much does IVF cost?

Dr. Mark Bowman: Luckily in this country you get a lot of money back from your health fund and from the Medicare safety net, but a couple will be often out of pocket between $1500-2000 per IVF cycle. A frozen embryo cycle ismuch less expensive.


Are there any help or support groups for couples undergoing IVF?

Dr. Mark Bowman: Counseling is available; all accredited IVF units have in-house counseling. There are patient support groups here at Sydney IVF, also there are a lot of web-based patient support chat-rooms were people can talk about their experiences.


What is the success rate of IVF?

Dr. Mark Bowman: It depends on the age of the woman. If a women is up to 36 years of age each cycle of IVF has about a 40% chance of pregnancy. A better way to look at it is that out of the people that did IVF at Sydney IVF and had a baby, almost all of them fell pregnant in the first three attempts. For younger women up to 80% will conceive in those first few attempts. For women above 40, only a small number achieve pregnancy, however the ones most likely to conceive will also achieve success in those first few attempts at Sydney IVF.

IVF from an Egg Donor Perspective

Joni Carnegie an egg donor has answered some important questions, so we can thoroughly understand the process of egg donors:Explain what exactly it is that you are doing?

Joni Carnegie: I am donating my eggs to a couple that are finding it difficult to have child.


Do you know the couple who you are doing this for?

Joni Carnegie: The couple who I am donating my eggs to are good friends of mine.


Did they come and ask you directly?

Joni Carnegie: No they did not. I was talking with my friend one day about children and they said they were trying to have a child. They told me that they are having trouble and have previously gone through IVF. They traveled to America, found the egg donor and underwent the procedure. After all the emotional, physical and financial costs the result was unsuccessful. My friend told me that he was about to try it again. I asked who is going to be the egg donor and they said they would have to find one again. I said I am a healthy young fit girl why not use my eggs. They would have a better chance as I am only 24 and at this age the eggs I have are the most successful for egg donation.


What is your part of the procedure?

Joni Carnegie: I have to go through canceling sessions to see whether I am the right candidate for egg donation. After four sessions I will be going on the pill for a month. I will then go through a week of hormone sprays and then 10 day of hormone injections. After I have produced many eggs I will be put under a general and have my eggs removed.


How long is the process?

Joni Carnegie: The process is a few months.


Why did you choose to do this?

Joni Carnegie: I am doing this because I am helping my friend who has always wanted children. It is one of the greatest gifts I can ever give someone.


You are doing this for free; do you think everyone should do it for free?

Joni Carnegie: I would never take money from donating my eggs. The word donation means to give. I am doing this out of love for a friend. The saying goes you cannot put a price on a life and I truly believe that.


Will you do this in the future if it does, or doesnt work?

Joni Carnegie: I am going through the process now so I cannot really say if I would do it again. Hopefully I will have produced enough eggs for them to use in case it does not work. It is not easy to go through all these things but I am helping a friend so its worth it.


Does your family know? Do they understand?

Joni Carnegie: My family, do not know and I am not sure if they will understand. I really dont think I need to confide in them. I am an adult and it is my decision. I am going to do this no matter what they say and if they do not think it is acceptable then that is stress that I do not need. Everyone has different opinions and beliefs. I believe it is the right thing to do for me and they possibly may not agree.


Have your friends been supportive?

Joni Carnegie: I have told a few friends and they think its amazing what I am doing. They stand by me and said they are here to support me whenever I need them.


Do you have to do anything in particular to your body in this time?Joni Carnegie: I dont really have to do anything but I would like to be in good condition before I go ahead with the pill and hormones. I am a very healthy and active person so I dont think I will have any problems.


What support do you have?

Joni Carnegie: I have support from the couple I am doing this for and I have support from my friends.