Questions

Frequently Asked Questions

General

My practice is a private practice and I recommend that you contact Jill or Leesa for any queries regarding appointments, tests and finances.

Operative procedures

I operate at the Prince of Wales Private Hospital. The hospital is located in Barker Street Randwickm, with ample parking available.

Frequently Asked Egg Questions

Why is female age currently the single most important factor related to female fertility?

The current trend of deferring starting a family from the mid-twenties to the mid-to-late thirties has shown that the older a healthy normal female trying to conceive is the lower her chances are of doing so, the longer it takes and the smaller her family will be. From the patient's point of view it raises the issue of whether the patient or couple are actually fertile i.e. is it an age issue or do they have a fertility problem as well.

Fertility is best thought of as a woman's ability to have a live child.

While tests and treatments for some fertility problems exist, there is no specific test for the natural loss of fertility with advancing age, and neither is there a specific treatment to stop or overcome this natural ageing process.

How do we know we have a fertility problem, or is it merely female age?

The 2 classical guidelines available are: a couple trying to conceive for 12 months and the female is < 36 years old, should get help, and for females 36 and older, the time of trying is reduced to 6 months before seeking help.

Basic testing of the fertility pathway is relatively easy and minimally invasive so if in any doubt seek help sooner than later. My Online Fertility Self Evaluation Guide may help or you could seek a Fertility Evaluation (Free) with my Fertility Coordinator.

What can I do if I my age is progressing, but am not ready to conceive but whose age is progressing?

Discuss this with us and we can undertake basic testing of your fertility system and then recommend one of the following options:

  • Ooctye freezing
  • Generating embryos with partners or donor sperm and storing the
  • Monitoring your ovarian function, which is not a true test of fertility, but can give you a rough guide of your egg supply and pituitary funtion. Neither of these are tests of fertility. Deterioration in these factors would be another reason to become active.
  • Consider the use of donor eggs if fertility is reduced.

What other treatment options exist?

There is medical evidence that obesity, smoking, and to a lesser extent, alcohol will further negatively affect egg quality and number. So attention to good health, a balanced diet and exercise is essential.

Unfortunately, there are no properly conducted studies which show that herbal products, naturopathic/homeopathic or Chinese medical products have any effect. The same applies to acupuncture and other alternate forms of medicine despite unsubstantiated claims by their practitioners.

Are all eggs fertile?

Discussions with patients indicate that there are many women who think that all eggs are fertile. Unfortunately of the 100-200 eggs activated each month only one is selected by your body to ovulate. A normal couple (where the woman is <30 years old) to conceive in one month where the woman is <30 years old is only 25%. This figure will drop to <5% by the time the female crosses 40 years of age. In another words the older you are the less likely you will release/ovulate a fertile egg.

Can doctors determine if this egg will be fertile?

Unless a baby results from this egg no absolute test exits, but certain genetic tests of embryos may partially help in egg/embryo selection.

Why does IVF not work with older eggs?

IVF needs fertile eggs to work with, and the older a woman becomes it is less likely that there will be any fertile eggs in the batch of eggs harvested at an IVF cycle. The exact mechanisms are not understood, but damage to chromosomes as part of ageing and faulty energy production by the mitchondria may partly explain it

How many eggs do I need to cryopreserve (store) to increase my chances of having a live baby?

While the fertility of eggs cannot be tested, programmes using donor eggs of various ages have led to the recommendation that for a to reasonable chance of success, woman <30 years of age, need to store 10-15 eggs, and those >35 much higher number in the order of 50 eggs,

This problem is further compounded by the fact that there is no known medical test to establish fertility as we have just defined it. Therefore, having eggs alone is not a measure of fertility.

Therefore, the best that we as doctors can do- is to recommend that woman either conceive at a young age or store eggs while their eggs are still potentially fertile. Egg storage or cryopreservation needs to be done when women are still young and ideally before the age of 35.

This message from fertility specialists is not to cause fear, but to promote a proactive approach to managing your fertility. While there is no specific test for fertility, certain tests can provide a rough idea of your fertility status, so if in doubt, please seek advice.