IVF FAQs

There are many possible causes for not conceiving. Many women and couples have a number of possible causes. During your consultation, your Ballarat IVF Fertility Specialist will work with you to identify the causes, and provide treatment advice.

How long should I wait before seeking fertility treatment?

Traditionally, it is suggested that women and couples wait 12 months before seeking treatment, but if menstrual cycles are irregular, suggesting ovulation issues, or when the woman is older, we recommend seeking help after 3-6 months

When trying to conceive naturally, a couple should try to have sex for four days, starting the day after the Urinary LH surge, or the day after using a trigger injection. 

How Ovulation Works - video

BIVF is a Doctor-owned fertility service, with a team of specialists, nurses and scientists who understand the needs of people who are trying to have a family. We work really hard to provide excellent individualised fertility care.

Most people start their fertility journey by trying to conceive naturally. If this is not working, a visit to their GP, and a referral to a fertility specialist is the next step. 

There are then a number of treatment pathways, depending on individual circumstances. Some involve laparoscopic surgery, some, simple treatment such as ovulation induction, and others which involve “Assisted Reproduction”, such as IUI, or IVF.

We do not have a waiting list for fertility treatment when a couple have eggs and sperm available. If donor eggs or sperm are needed, there is a waiting list for this treatment. When donor eggs or sperm as required, there may be a further wait, because of the need to quarantine them before use.

You will need to request a referral from your GP to your chosen specialist. You can then either Book an appointment through HotDoc, or call our clinic on 03 5339 8200 If you have had previous surgery or fertility treatment, try to find the records of these, and bring them along on the day of your appointment. 

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You will meet your fertility specialist who will listen to your fertility story, then offer you an examination, and possibly perform an ultrasound scan to assess your pelvic organs. Your specialist may ask you to have some blood tests, then they will discuss your treatment options with you. The advice provided will be individualised. 

More information here

This will depend on many factors, especially your personal choices, based on advice provided by your fertility specialist. A typical pathway might include, ovulation induction for 3-4 months (with proven ovulation) followed by a review appointment. At that stage, laparoscopy is often discussed, as well as moving forward with IUI or IVF. The approach is to use simple treatments, then move through the options as chosen by our patients.

Many people use acupuncture during IVF treatment. The research information supporting its benefit is limited, but it can improve wellbeing and may add to your overall involvement in the treatment plan to improve fertility. Ballarat IVF fertility specialists are fully supportive of patients choosing acupuncture during treatment

The use of natural therapies in fertility is common. Natural therapies are used to make fine changes to hormone balances, and moderate inflammation in situations where a woman or couple cannot or prefer not to use traditional treatments. Your Natural therapist will know you are trying to conceive, and we are happy for you to use these treatments during your IVF treatment.

Maintaining a healthy diet and adequate exercise is recommended. Pre-conception folic acid or multivitamins are also recommended to be taken for all women considering pregnancy. Male vitamins are recommended to support sperm health and fertility for those planning pregnancy.

We strongly recommend you avoid cigarettes and illicit drugs completely and alcohol in excess. Studies have shown these decrease the chance of pregnancy.

Smoking is one of the worst things you can do if trying to conceive. As a general rule, it halves the likelihood of getting pregnant, and doubles the miscarriage rate.

In men, smoking reduces the number and quality of sperm. Sperm DNA is very susceptible to environmental toxins, such as the chemicals in smoke. Smoking damages the DNA in the head of the sperm. This cannot be seen on a normal semen test, and reduces fertility.

Ballarat IVF fertility specialists believe that people should not undertake IVF whilst smoking. We recommend ceasing smoking for at least two months before starting IVF.

Alcohol consumption around the time of conception and early pregnancy is not advised as it can affect the developing baby. Some people accidentally consume alcohol in very early pregnancy or around the time of conception. 

Whilst this is not advisable, there is no evidence that brief exposure to alcohol in early pregnancy is an issue, so if this happens, don’t panic, and speak to your specialist.

If a couple have a healthy diet, including seafood, and a Mediterranean diet, all that is needed is folate. If you wish to take extra multivitamins, you won’t do any harm. When starting IVF, it is a good idea for the male to use antioxidants, as these may reduce (improve) levels of DNA damage in sperm.

Folate (folic acid – one of the Vitamin B groups) supplements have been shown to reduce the occurrence of spinal cord abnormalities in babies. These are called spina bifida,and neural tube defects. Neural tube defects can cause very serious health problems for babies.

It is important to make your fertility specialist aware of any medical conditions you may have before planning IVF. It is always best to optimise your health before conception, as this increases the likelihood of having a healthy baby. There are some rare health conditions which make IVF, or pregnancy, dangerous, and your fertility specialist will be able to help you with your decision making.

As a women becomes older, there are increasing risks of chromosomal abnormalities, such as Down Syndrome, in their babies. At age 40, the risk is 1% of pregnancies. This means that 99% of babies don’t have the condition. General health issues are more common with advancing age, so it is important to optimise these. Once you conceive, your Obstetrician will discuss testing options with you.

People usually choose IVF when more simple treatments haven’t worked, or are not appropriate. It can be stressful and frustrating to realise that IVF is needed, but it can make the difference between having, and not having a family.

It is very important for you to fully understand the treatment offered, and to confirm your request for it. Your fertility specialist will discuss the treatment options, along with the benefits and risks. Signed consent forms are required for all fertility procedures.

Your fertility nurse, or your counsellor, will explain the consent forms to you. They contain important information about the benefits and risks associated with procedures. If you have any concerns, please don’t sign the consents and make a further appointment with your fertility specialist.

We advise the use of ICSI for people where the sperm count is either low, or sperm swimming ability, (motility) is low. ICSI improves the egg fertilization rate in this situation. ICSI is often used when frozen sperm is used, as motility is often low in these sperm samples. We sometimes advise the use of ICSI in unknown cause (idiopathic) infertility, as a proportion of these situations involve poor sperm attachment to the egg.

The trigger injection is a hormone, chorionic gonadotrophin. Using a trigger injection during IVF, IUI or ovulation induction stimulates the final stage of egg (oocyte) development, and usually, causes ovulation (release of the egg). The trigger injection also stimulates the ovary to release progesterone, which supports the implanting embryo.

During an IVF cycle, the trigger injection is typically used 36 hours before the eggs are collected, and otherwise usually leads to ovulation after 40-48 hours.

More information here

Progesterone pessaries are usually used in the second part of the IVF treatment cycle. Progesterone supplements have been shown to improve pregnancy rates in IVF. 

Some women have low progesterone levels during natural, or ovulation induction cycles, and supplementing progesterone can improve the chance of conception.

If you don’t have success after a number of treatment attempts, your specialist may speak to you about adjuvants. These are treatment options which may improve the likelihood of conceiving, but the evidence to support their use is less robust. There are a wide range of adjuvants which may be discussed. Often, it is our patients who bring up their use.

Our general approach is that if an adjuvant is safe, definitely does no harm, has a biologically plausible way of acting, is inexpensive, and has a reasonable body of supporting scientific evidence, Ballarat IVF fertility specialists may bring them up for discussion.

Ballarat IVF Specialists are very experienced in offering DuoStim treatment for women who are undergoing egg freezing, or those who don’t produce many eggs. Duostim can be a great benefit, as it increases the number of eggs collected in a short space of time.

For information on DuoStim, please click here

The timing of embryo transfer is carefully planned, based on the time after egg collection (in a fresh cycle), the uterine lining thickness, and blood tests. The day of embryo transfer is generally between day 4 to day 6 after the egg collection, but we will give you advice about the best time for this.

The Ballarat IVF policy is to only transfer one embryo at a time. If you haven’t conceived after four embryo transfers, a “double embryo” transfer may be discussed with you.

We will suggest that you freeze all embryos created in your IVF stimulation cycle if you have a large number of eggs collected, or if you are assessed as being at risk of ovarian hyperstimulation syndrome. We also advise a “freeze all” cycle if your hormone levels are not perfect, or your uterine lining is thin. In these situations, the chances of getting pregnant are lower. We always assess you carefully, to give your embryo the best chance of developing and leading to pregnancy.

Embryos and eggs (oocytes) are snap frozen (vitrified) and stored in liquid nitrogen. They can be stored indefinitely. There is a fee payable for ongoing storage of eggs, sperm or embryos. In Victoria, you have to make a decision about your embryos every five years. At this, or any other time, you can decide to use, donate or dispose of your embryos.

Some people say that having IVF treatment is a job in itself. During your IVF treatment you will need to have one or two internal ultrasound scans, which you should allow 1 to 1.5 hours for. You will also need a blood test at the time of your scan.

For the egg collection, you will need the day of the procedure, and the next day, off.

The embryo transfer is performed in the middle of the day, so you will be able to work in the morning, have the embryo transfer performed, and then either relax for the afternoon, or go back to work.

In theory, everyone undergoing IVF is at risk of having Ovarian HyperStimulation Syndrome, (OHSS). The Ballarat IVF team are aware of the additional risk factors for developing OHSS. These are, being young, having PCOS, having a high AMH, having a low BMI, and having a “lot” of follicles noted on your ultrasound scan. If we identify risk factors, you can use a lower dose of fertility medications, change the trigger injection, and occasionally “cancel” the IVF stimulation cycler. If your cycle is cancelled, there is no cost to you, and we will make changes to your treatment to further reduce the risk of OHSS on the next occasion.

Fibroids are present in the uterus in 40% of women. Most are small, and don’t impact on fertility. Larger or multiple fibroids can impact on fertility by altering the endometrial cavity (uterine lining), changing the blood supply within the uterus, or changing the uterine contraction patterns. Occasionally, fibroids release locally acting hormones in to the uterus which impact on embryo implantation.

Generally, the larger a fibroid is, and the closer it is to the uterine cavity, the more likely it is that it is contributing to not getting pregnant. It is important to have a detailed conversation with your fertility Specialist, as a personalised approach to fibroid management is essential.

Endometriosis is a very common part of many women’s fertility story. It is uterine lining cells growing in the wrong place, usually in the pelvis. Endo causes inflammation in and around the pelvic organs, with the release of chemicals which reduce the fertilization of eggs, and implantation of embryos. In more severe forms, endometriosis can damage the ovaries, block tubes, and cause damage to other pelvic organs.

More information here

Adenomyosis is similar to endometriosis, in that it is endometrial lining cells in the wrong Place. In this situation, endometrial cells grow in the uterine muscle, causing painful and heavy periods, and inflammation, as well as enlargement of the uterus. Adenomyosis contributes to infertility. The treatment is highly personalised, so you should discuss this with your Ballarat IVF fertility Specialist.

If a pregnancy is in the wrong location, it is called an ectopic pregnancy. It may be in the fallopian tube, sometimes on the ovary, or occasionally in the cervix. Ectopic pregnancy occurs in 1-2% of pregnancies, and unfortunately, can happen with IVF. When you get pregnant, part of your follow up will be to check that the pregnancy test level (HCG) is going up as expected. Our fertility nurses will help you with this and speak to your Specialist as needed. Ectopic pregnancy can be a serious risk to your health, so we will monitor you carefully for this. The follow up can sometimes be drawn out, so be patient, and stay in contact with us.

The main way PCOS impacts on fertility is by making ovulation infrequent. All of the treatments for PCOS such as dietary changes, weight loss, metformin and letrozole can increase the likelihood of ovulation. PCOS can also affect egg quality, and cause changes in the endometrium (uterine lining). Sometimes, IVF is needed to treat PCOS because ovulation induction doesn’t work.

Generally speaking, a higher BMI impacts negatively on fertility, and reducing BMI improves fertility. The younger a woman is, the more benefit she has from reducing BMI.

When a woman reaches the age of 38, changing BMI does nothing to improve fertility, and IVF is the best, immediate option. In some situations, a high BMI can make IVF impossible, and weight loss treatment, which can involve surgery is considered, before IVF.

Your fertility specialist will give you personalised advice about this.

The definition of implantation failure must be considered in the context of a woman’s age.

In the best of situations, the likelihood of conceiving is one out of three. For women in their early 40s, its one in 7. So, a 30-year-old woman who doesn’t conceive after, 4 embryo transfers may be considered having implantation failure, but it can be a completely expected outcome to not conceive after 4 embryo transfers at the age of 40.

If you have had a number of disappointments, your fertility specialist will assess your situation, and discuss follow up treatment options. The older you are, the more likely it is that “not conceiving” is statistical bad luck, rather than recurrent implantation failure, but we still work hard to provide all options to increase your chances of getting pregnant.

You will have constant contact with your fertility nurse during treatment via face to face consultations email, and phone support. 

Supportive counselling with our fertility counsellor is also available for use when necessary