Most of us take our fertility for granted but the process of reproduction is complex, so some people may experience difficulties when trying for a baby. There are a range of factors that can affect fertility. Taking care of your preconception health by modifying your lifestyle can improve your chance of a pregnancy and the health of your future child.
Medical conditions such as polycystic ovary syndrome PCOS and endometriosis can reduce fertility, however it may just take longer to get pregnant. In some cases, medical procedures can be used to preserve fertility. Fertility preservation freezing of gametes for later use is used by people who are not ready to have a baby during their most fertile years or for those facing medical treatment that might impair their fertility. Understanding reproduction It is useful to understand how eggs and sperm are normally formed, and how conception occurs to understand the causes of infertility and how they are targeted in fertility treatment.
The hormones which control the production of sperm and eggs are called gonadotrophins. In men, they stimulate the testicles to produce sperm and testosterone. In women, they act on the ovaries where the eggs develop. The female sex hormones, oestrogen and progesterone, are produced by the ovaries when eggs mature and are released ovulation.
For women, the production of sex hormones and the release of an egg is known as the menstrual cycle. It is counted from the first day of the period until the day before the start of the next period. In an average cycle of 28 days, ovulation happens on day However, cycle length varies between women, and it is important to note that ovulation occurs earlier in women with shorter cycles and later in women with longer cycles.
Sperm are produced at the rate of about million per day. They take some 80 days to mature. Each sperm has a head, which contains the genetic material, and a tail, which propels it up through the vagina, uterus, and fallopian tubes where the egg is fertilised. Conception occurs when an egg and a sperm come together. At ovulation, an egg is released from the ovary into the fallopian tube.
If sperm is present at that time, the egg can be fertilised. The fertilised egg then starts to divide and becomes an embryo. After ovulation, the ovary produces progesterone which prepares the lining of the uterus - the endometrium - for the growing embryo. A few days after implantation, the embryo starts to produce human chorionic gonadotrophins HCG - the hormone that gives a positive pregnancy test reading. If an embryo does not form or attach to the endometrium implantation , the level of progesterone drops and the next period starts.
What is fertility preservation? Fertility preservation is used to increase the chance of somebody having children in future. It can be used for medical reasons and personal circumstances. It is sometimes used before medical procedures and treatments that may cause infertility, such as cancer treatment and gender transitioning.
Freezing eggs, embryos or ovarian tissue Egg freezing Egg freezing is a way of trying to preserve your fertility so you can attempt a pregnancy with IVF in future.
Egg freezing offers the potential to preserve fertility but there is no guarantee of a baby, so it is important that you are well-informed about all aspects of egg freezing before you proceed. In Victoria, egg freezing and thawing are increasing, but the total number of women using these services is still small.
There were 4, women with eggs in storage at the end of , compared with 3, women the previous year — a 30 per cent increase. But use of frozen eggs is still uncommon. In , less than one per cent of all IVF cycles involved the use of thawed eggs, and 34 babies were born to women who used their own thawed eggs.
Why should I freeze my eggs? You may consider freezing your eggs because you are: facing medical treatment that may affect your fertility, such as some forms of cancer treatment or gender transitioning not ready to have a child during your most fertile years for personal reasons concerned about your fertility declining as you get older and feel you are not currently in a position to have a child at risk of premature menopause or have endometriosis.
What is the process? Your fertility specialist will come up with a plan for your treatment and prescribe medication to stimulate your ovaries. You will then have an egg collection procedure and your eggs will be frozen and stored. Risks A small proportion of women have an excessive response to the fertility drugs that are used to stimulate the ovaries. In rare cases this causes ovarian hyperstimulation syndrome OHSS , a potentially serious condition.
Bleeding and infection are very rare complications of the egg retrieval procedure. Egg freezing is still a relatively new technique and the long-term health of babies born as a result is not known. However, it is reassuring that their health at birth appears to be similar to that of other children. Financial considerations The cost of egg freezing varies between fertility clinics.
In most cases there is only a Medicare rebate provided for egg freezing for medical reasons, which means that women who choose to freeze their eggs for other reasons may have considerable out-of-pocket expenses.
Fertility clinics usually charge for: management of the hormone stimulation of your ovaries devising a plan for your treatment and prescribing medication the drugs used to stimulate the ovaries the egg collection procedure which may include admission to a private hospital and fees for an anaesthetist freezing and storage of the eggs.
Medicare does not cover the storage of frozen eggs, regardless of whether they are stored for medical or other reasons. This may cost hundreds of dollars for each year of storage.
Additionally, once you decide to use the eggs to try to conceive through IVF, the process of thawing the eggs, fertilising them with sperm, and growing embryos for transfer into the uterus can cost thousands of dollars in out-of-pocket expenses not covered by Medicare. Questions to ask your fertility specialist Information about egg freezing, success rates and costs on fertility clinic websites varies. It is important that you are well-informed about all aspects of egg freezing before you decide to proceed.
How many eggs have been thawed at this clinic and how many live births have resulted from these thawed eggs? What is my chance of having a baby from frozen eggs, considering my personal circumstances such as my age and estimated ovarian reserve a measure of how many eggs you are likely to produce?
How many eggs should I store to have a reasonable chance of having a baby? You might require more than one stimulated cycle to retrieve enough eggs to give you an acceptable chance of success further down the track What is the approximate total cost, bearing in mind that I may need more than one stimulation and egg retrieval procedure to yield enough eggs?
Freezing embryos Freezing embryos can also be used for fertility preservation as part of fertility treatment. Read more about fertility treatment here. Freezing ovarian tissue Freezing ovarian tissue ovarian tissue cryopreservation is a relatively new approach used to help women undergoing chemotherapy preserve their fertility. It is a surgical procedure in which a small amount of ovarian tissue is collected, cut into slices, frozen and stored. These tissue slices can be thawed and transplanted back at a later date.
The aim is for the woman to start producing hormones and release eggs. Freezing sperm or testicular tissue There are two methods used to preserve fertility in men. Sperm freezing You produce a semen or sperm sample through masturbation in a private room in the fertility clinic. A lubricant is not used as this can damage the sperm.
Small amounts of sperm are placed in straws which are carefully labelled. These straws are then frozen and stored in a tank with liquid nitrogen at the clinic. If possible, several samples are stored to make sure there is enough sperm to conceive one or several children. While the freezing process usually affects the quality of the sperm, in most cases plenty of good quality sperm survive.
This method is also used for men before they begin cancer treatment or gender transitioning. Once you are ready to try for a baby, you can undergo fertility treatments such as IVF or artificial insemination with thawed sperm.
Testicular biopsy Sometimes it is not possible to get a good sample of sperm through masturbation. In such cases your doctor will talk to you about testicular biopsy in which sperm are harvested directly from the testes.
Cancer and fertility Some cancer treatments can affect your fertility. If you have been diagnosed with cancer, fertility preservation is an important consideration. Depending on the type of cancer and its treatment, your fertility may recover, but the treatment may also cause temporary or permanent infertility. Cancer and its treatment can affect: ovarian function and the production of sperm the ability to carry a pregnancy the ability to have sexual intercourse emotions and feelings, which can impact on relationships.
Some factors may reduce fertility including: The type of cancer. The type of treatment. This may be upsetting, but it's normal. Most couples about 84 out of every will get pregnant within a year if they have regular sex and don't use contraception. But women become less fertile as they get older. One study found that among couples having regular unprotected sex:. Some of these factors affect either women or men.
The most common cause is ovulation failure which can be caused by lots of different things and sperm disorders. Read more detailed information about the causes of infertility.
Page last reviewed: 4 September Next review due: 4 September Each egg and sperm cell contains half the chromosomes needed to make a complete embryo. These chromosomes are time-vulnerable. When asked to do their share in creating the embryo, they no longer do so satisfactorily. They break, collapse or go to the wrong place. There are things you can do to make the most of every cycle:. Time intercourse properly An egg is ready for fertilization during ovulation, or 14 days before your period.
If your cycle is short, you may ovulate even if you are still bleeding. You should be having intercourse during ovulation. Start early, not late Because sperm can live for a week inside your cervix waiting to fertilize an egg, start trying to conceive before you ovulate. You can start trying on day 10, repeating every day or two. See your gynecologist if your cycle is shorter than 21 or longer than 35 days.
You may not be ovulating. Your BBT is the temperature of your body at rest.
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