Pathways to parenthood

Medical Director of Fertility Associates Christchurch, DR SARAH WAKEMAN explains the different causes of infertility and the various options for treatment.

For many, falling pregnant and creating a family is relatively easy. For others it feels like an uphill journey, and the longer the struggle without a positive outcome, the greater the stress and growing sense of hopelessness.

There are many causes of infertility, explains Sarah – from not ovulating regularly, or at all, to tubal damage and endometriosis in women, and low sperm count or motility (movement) in men. And, having had a child is no guarantee of being able to have another one easily – with secondary infertility occurring for a myriad of reasons. ‘The first step is always finding out what the problem is.’

Depending on the causes of infertility and patients’ preferences, there are various treatment options available. ‘Many prefer to start with the simplest one and move on from there’, says Sarah.

Clomiphene & Letrozole treatment
For women who are not ovulating or have irregular cycles, Clomiphene or Letrozole medication is a scientifically-proven, ‘natural’ treatment – where, Sarah explains, you still have sex to become pregnant.

Intrauterine Insemination (IUI)
IUI involves preparing sperm in the lab, then putting the best sperm in the uterus. The treatment is usually combined with medication like Clomiphene to boost the number of eggs from one, to two or three.

In Vitro Fertilisation (IVF)
Almost every cause of infertility can be successfully treated with IVF, says Sarah. First, medication is taken to increase the number of eggs available. Next, the eggs are removed, and sperm is added to the eggs in the lab. The embryologist then selects the embryo they consider has the best chance of a pregnancy and this is transferred into the uterus. Any other good quality embryos can be frozen for another chance of pregnancy.

Public funding covers two cycles of IVF and can be accessed through any Fertility Associates clinic in the South Island. Fertility Cover is also available through Fertility Associates
and includes three cycles of IVF and a refund of 70% if unsuccessful. Criteria applies.

Preimplantation Genetic Screening (PGS)
For women aged over 35, or for those who have had recurrent miscarriages or not become pregnant despite the transfer of several embryos, PGS offers a powerful tool for selecting the best embryo for transfer, by checking the number of chromosomes in each embryo and so reducing the likelihood of a miscarriage or failed IVF cycles.

At Fertility Associates, patients are allocated a doctor who ensures they understand and feel comfortable through each step of diagnosis and treatment, and the nursing team supports them through every stage. A specialist fertility counsellor is accessible at all times, says Sarah. ‘Infertility can be very stressful on relationships, and individuals can handle the process very differently. It is vital that people are supported emotionally and psychologically along the way.’

While reproductive endocrinology is a specialty and passion for Sarah, at the end of the day ‘one of the best parts of the job is seeing people return with a baby’.

0800 712 342 / fertilityassociates.co.nz