Fertility

Infertility is a common condition that can often dishearten couples in their goals to have children. In Vitro Fertilisation (IVF) is used to overcome a range of fertility issues, including women with ovulation disorders, men experiencing male factor infertility or other unexplained infertility issues.

It can also be a potential solution for cancer patients who are looking to preserve their fertility for the future. Whatever your reason, undergoing fertility treatment is a major decision. It’s important to speak to a fertility specialist that you trust.

Dr Joseph Sgroi is a highly qualified obstetrician and gynaecologist with extensive experience in each area. He is also a Fertility Specialist in Melbourne, providing IVF treatment at Epworth Freemason’s clinic and Melbourne IVF Clinic. His number one priority is providing patients with personalised fertility management using state-of-the-art fertility treatment within a compassionate, confidential and supportive environment.

Generally speaking, 80-90% of women under the age of 35 years will conceive within one year of trying. You can also find out more information regarding age and fertility via BetterHealth Channel.

If you are over 35 years of age, then seeking the advice of Dr Joseph Sgroi is recommended after 6 months of not being able to conceive.

As an experienced fertility specialist in Melbourne, Dr Joseph Sgroi will discuss all the options that are available to you. There are several options, including conducting a fertility test. Undergoing fertility testing will aid in understanding the next steps in your journey.

If you are concerned about your fertility, then seeking advice from Dr Joseph Sgroi is advisable.

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.

Causes in women

Causes of infertility for either men or women can be present at birth or be acquired with age.

One of the most common causes of infertility in females is due to problems with ovulation. This is because when a woman doesn’t ovulate she does not produce any eggs. Without eggs, pregnancy cannot occur.

Having irregular periods or not having a period at all may be a sign that you are not ovulation normally.

Polycystic ovarian syndrome (PCOS) which is a hormonal imbalance, can be one of the major causes of ovulation problems and is the most common cause of infertility in women.

Other things that may cause infertility are:

• Fallopian tube problems including blockages.
• Endometriosis.
• Age of the woman.
• Structural abnormalities with the uterus including fibroids and polyps.
• Premature menopause – this is when menstruation occurs before 40 in a woman.
• Scar tissue – known as adhesions which can form in the pelvis after certain types of surgery or an infection.
• Medications – while there are certain medications that may cause temporary infertility, we find that stopping these usually restores fertility.

Cause in men

Approximately 30% of fertility problems originate with the male.

The main causes are:

• Obstructions to the passage of sperm. This can be due to a blockage or even an absence of one of the tubes, including the vas deferens. This could be due to an injury or a vasectomy.
• Sperm numbers:
  • A male’s ejaculate doesn’t contain any sperm, known as azoospermia.
  • Low sperm count. Known as oligospermia, it is when not enough sperm is ejaculated to create a pregnancy.
  • Sperm shape. Normal sperm should be tadpole-shaped, and when it’s not shaped properly, it has problems penetrating the egg.
• Function can also impact fertility including:
  • Erectile dysfunction.
  • Problems ejaculating which includes premature ejaculation.

Female infertility can be confirmed with the following fertility tests:

• Blood tests to measure your hormone levels and determine if you are ovulating.
• Biopsies may be obtained to evaluate the inner lining of your uterus.
• Ovarian reserve testing may be performed in order to determine the number and quality of eggs ready for ovulation.
• Imaging studies such as a pelvic ultrasound or hysterosonography may be performed to obtain a detailed view of your fallopian tubes and uterus.
• Hysterosalpingography involves obtaining an x-ray image after injecting a contrast material into your cervix which travels up to your fallopian tubes. This can help identify any blockages in your fallopian tubes.
• Laparoscopic evaluation involves inserting a thin tube fitted with a camera through an incision in your abdomen, in order to detect any abnormalities in your reproductive organs, such as the ovaries, uterus, and fallopian tubes.

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.

Infertility can be of a variety of causes, and the treatment may differ accordingly. Dealing with infertility can be difficult, stressful and very emotional, but there is hope – about two-thirds of the couples treated for infertility conceive successfully. Dr Joseph Sgroi, a leading fertility doctor in Melbourne, will be the best person to address your concerns.