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Endometriosis can recur over time, even after surgery. Long-term management plans are often important.
Yes. Endometriosis can affect fertility in several ways, including inflammation, scarring and distortion of pelvic anatomy.
In some cases severe endometriosis can be identified on ultrasound, however many women require laparoscopic surgery for diagnosis.
Recovery varies depending on the procedure performed, but many women recover more quickly after laparoscopic surgery compared with open surgery.
No. Treatment depends on symptoms, fertility goals and severity. Management may include hormonal treatment, pain management, lifestyle support or surgery.
Following a conversation and diagnosis, fertility doctor Dr Joseph Sgroi will suggest the best course of treatment for you.
Recommendations are based on various things including both the male and female’s age and fertility test results.
While it is not possible to improve the quality of sperm in a man, there are options available. These include surgical options to help sperm movement as well as to remove sperm directly.
Sperm can be fertilised in a test tube, which is called assisted reproductive technology (ART). There are different options available including hormonal therapy, surgery, artificial insemination, in vitro fertilisation (IVF) and Intra-cytoplasmic sperm injection (ICSI).
These options are available to help both men and women become pregnant.
General advice
Women are the most fertile when they are between 20 and 35 years of age. This is when there is an abundance of egg reserves and the eggs are of the best quality.
For healthy couples, if you have been having unprotected sex during your fertile window, and have been unable to conceive for 12 months, then it is time to seek help.
If you are older than 35 and have been unsuccessful in becoming pregnant, then you should make an appointment to see Dr Joseph Sgroi after only 6 months of trying.
Immediate appointments
There are reasons to make an appointment immediately, even if you have not been trying to become pregnant for the prescribed time.
These include a history of irregular periods or painful periods that might be related to either Polycystic Ovarian Syndrome (PCOS) or endometriosis. In addition, if you have experienced any early pregnancy loss, miscarriages or concerns with cervical shortening or insufficiency, that predisposes you to preterm birth.
For men with a history of any testicular surgery, hernia repair or trauma to the testis, then an early appointment is definitely required.
There is no need to delay if you are wishing to freeze your eggs. Emergency appointments are made for women who require urgent Fertility Preservation and egg freezing due to treatments they may be receiving for cancer, such as chemotherapy or radiation.
Yes. PCOS commonly affects ovulation and can make conception more difficult for some women.
Yes. Fertility naturally declines with age, particularly after the mid-30s.
Poor-quality sperm can create poor-quality embryos. Sperm DNA damage and poor embryo development can lead to recurrent IVF failure or an increased risk of miscarriage.
We will start with a conversation to understand your medical history a physical examination. Additionally, we will complete a semen analysis so we can check the number, shape and movement of sperm. The samples will be sent to a laboratory and checked for abnormalities and the presence of antibodies.
In the event that abnormalities in the semen analysis, we may require blood tests to help us assess hormone levels too, which will assist in the final diagnosis. Other things we will consider are a testicular biopsy. This involves a fine needle and microscope being used to check the network of tubes within the testicles. We will also complete ultrasound scans to enable us to look in more detail at organs like the prostate gland.
Before you make this decision, it is important to know that there are steps you can try prior to trying IVF, such as ovulation induction or IUI (intra uterine insemination). Depending on your particular fertility issue, these alternative treatments may be suitable for you, however it is best to speak to a fertility specialist first to verify what steps you should take. When a patient first makes an appointment with Dr Joseph in one of the IVF clinics, he reviews previous investigations, organises any extra relevant tests that may need to be taken and outlines a management plan based on the patient’s condition.
A pre-treatment appointment is also made to discuss this plan. Usually around 80-90% of women under the age of 35 can conceive within a year of trying. If you haven’t become pregnant after this time it is advisable to contact Dr Joseph. For women over 35, if you are not pregnant within six months of trying, please contact Dr Joseph. Other possible reasons for infertility concern include a low sperm count in men, irregular or absent menstrual cycles, painful periods, a history of endometriosis or pelvic inflammatory disease, previous miscarriages, or previous chemotherapy or cancer treatment. Diagnosis and tests are conducted in an IVF clinic in Melbourne via blood tests, biopsies, ovarian reserve testing, imaging studies, laparoscopic evaluation and hysterosalpingography viewing.
There are not a lot of symptoms of male infertility. The biggest one is the inability to conceive a child after 12 months of trying. Some other things to look out for include:
Infertility can affect both men and women and often involves multiple factors. Common causes include ovulation disorders such as PCOS, endometriosis, reduced ovarian reserve, age-related fertility decline, blocked fallopian tubes and male factor infertility. In some cases, no clear cause is identified, which is known as unexplained infertility.
Testing may include hormone blood tests, semen analysis, ultrasound imaging and ovulation assessment depending on your history and symptoms.
Egg freezing involves collecting and freezing eggs for future use. It may be considered for medical, personal or fertility preservation reasons.
IVF (in vitro fertilisation) involves fertilising eggs with sperm in a laboratory before transferring an embryo into the uterus.
The main misconceptions around male infertility are that age, smoking, general health, and alcohol do not affect sperm quality; however, this is untrue, and all of these elements can negatively affect male fertility. On the other hand, losing weight and a diet with plenty of fresh fruit and vegetables can positively affect sperm.
Yes. Fertility concerns can involve male factors, female factors, or a combination of both.
Stress alone is not usually a direct cause of infertility, but it can affect overall wellbeing and may influence factors such as sleep, lifestyle habits and treatment experiences which can have impacts on fertility. Fertility challenges can also be emotionally demanding, making support and self-care an important part of the fertility journey.
Keyhole surgery involves passing a surgical telescope through a small hole in the abdomen usually the belly button. Afterwards, your belly button looks and feels like nothing has happened. There may be three or four smaller incisions on the sides of the abdomen where instruments are passed to perform the surgery. These are usually a centimeter long. This results in very minimal pain, more rapid recovery and very small scars that often fade and are not noticeable several months later.
Before you schedule your gynaecologist appointment, the first step is understanding why you’re going to in the first place. Be prepared with any questions or have notes to review all of your concerns during the appointment. Dr Joseph will spend whatever time is necessary with you to discuss your concerns and ensure you complete peace of mind.
Preparing yourself beforehand can also be of benefit, and we recommend considering the following:
It is important that you do not worry about appearances such as pubic hair, labia length, or any other aspects of your body during your appointment. It is normal to feel self-conscious, and many personal questions will be asked regarding your period and sex life, but Dr Joseph creates a safe, comfortable environment that puts your health as the primary focus. If you wish a chaperone this can be arranged with one of Dr Joseph’s nurses on hand to make you feel comfortable and secure.
Fibroids are non-cancerous growths within the uterus that can cause heavy bleeding, pelvic pain and fertility issues.
Ovarian cysts are fluid-filled sacs on the ovary. Some resolve naturally while others require monitoring or treatment.
A cervical screening test checks for HPV and abnormal cervical cells to help prevent cervical cancer.
Adenomyosis occurs when tissue similar to the uterine lining grows into the muscle of the uterus and may cause painful or heavy periods.
You should consider seeing a gynaecologist if you experience pelvic pain, abnormal bleeding, painful periods, fertility concerns, ovarian cysts or other ongoing symptoms.
Some more common gynaecological procedures include cervical cryosurgery, hysteroscopy, pelvic laparoscopy, and colposcopy. These procedures focus on understanding more about the condition of the uterus, cervix, and vagina, often to take samples for a biopsy or treat certain conditions. Dr Joseph will determine which of these you may require, if any, after a full assessment.
Dr Joseph will discuss all birth options with you, including vaginal birth, assisted birth and caesarean birth, depending on your pregnancy and medical circumstances.
Some pregnancies require closer monitoring due to maternal or baby-related conditions. Additional scans, testing or specialist management may be recommended.
Antenatal care refers to the medical care and monitoring you receive throughout pregnancy to support the health of both mother and baby.
Most women have an early pregnancy ultrasound between 6–8 weeks to confirm dating and viability.
In most pregnancies, regular gentle exercise is encouraged and can support physical and mental wellbeing. Exercise recommendations should always be tailored to your pregnancy.
Please bring any referral letters, ultrasound reports, pathology results, medication information and your private health insurance details if applicable.
Generally, Dr Sgroi will accept only referred patients. This ensures that your family doctor is aware of your appointment with Dr Sgroi, and also because Medicare provides you with a rebate for Dr Sgroi’s specialist services. Overseas patients or those patients without access to Medicare may not require a referral. If you have a query regarding whether a referral is required please contact Dr Sgroi’s rooms.
A Medicare rebate is generally available for specialist consultations when you have a valid referral from your GP or another specialist. Eligibility and rebate amounts may vary depending on the type of consultation and your individual circumstances. Our team can provide further information when booking your appointment.
Your medical file is handled with the utmost respect for your privacy. Our staff are bound by strict confidentiality requirements as a condition of employment regarding your medical records. Your personal information is handled in accordance with federal and state privacy law. his includes complying with the federal Australian Privacy Principles (APPs) forming part of the Privacy Act 1988 (Cth) and the Victorian Health Privacy Principles (HPPs) forming part of the Health Records Act 2001 (Vic). More information about the APPs and HPPs can be found on the Australian Information Commissioner’s website www.oaic.gov.au or in hard copy on request from our Practice reception. Your personal information will only be used or disclosed for purposes directly related to providing you with quality health care, or in ways you would reasonably expect us to use it in order to provide you with this service.
Before seeing Dr Sgroi, it is always preferable to talk to your own family doctor, who can discuss your condition with you and advice on whether any specialist care is appropriate. If it is, he or she can help refer you to Dr Sgroi. Dr Sgroi will liaise with your family doctor regarding your medical condition so that they can both provide you with optimal care.
During your initial visit, Dr Sgroi will ask you questions about your medical history and perform any necessary examination or ultrasound. Apart from your Medicare and insurance information, you will need to prepare for your first visit and bring the following documents:
Dr Sgroi will organise all the relevant investigations required. You will meet with him after these are done so that together you can go through your management plan.