We asked a fertility doctor all your burning IVF questions
If you've ever wondered which fertility clinic is the best or if the Shettles method works (or even what the Shettles method is), we asked Dr Mark Livingstone of Genea to answer all of these questions and more.
The hardest part of asking for help is sometimes saying the words aloud...
I'm concerned about my inability to have a child.
I believe my husband should see a doctor about his fertility.
I'm not sure if I can go through another failed round of IVF.
When it comes to fertility, each individual is unique, each situation is unique, and there is no one-size-fits-all solution. Whatever the situation, every concern is valid, every question deserves an honest answer, and there should be no shame or embarrassment in seeking assistance.
That's why we've asked Genea fertility specialist Dr Mark Livingstone to respond to all of the questions raised during a recent 'A Frank Chat on Fertility' webinar by Women’s Agenda . Take a seat and join us for an insightful and enlightening discussion...
Dr Mark Livingstone: The egg freezing process takes no more than two weeks – and yes, if you're over 35, you should do it. The quality of your eggs is affected by your age; the younger you are when you freeze your eggs, the greater your chances of pregnancy and the lower your chances of miscarriage and chromosome issues. The chance of pregnancy after embryo transfer is 35% at age 35, 20% at age 40, and 5% at age 43. These are the rates after an embryo has been thawed, an egg fertilised, and an embryo created, so there are still additional steps after the eggs have been frozen. In saying that, I had someone freeze their eggs when they were 41, and she had an above-average number of follicles, which meant an above-average number of eggs, and when she used them two years later, she had a baby with the first lot she thawed. Every case is unique.
Dr Mark Livingstone: Have some sex! Women should have sex every other day around the time of ovulation, take folic acid, and do all the healthy things like not drinking too much caffeine or alcohol, not smoking, and maintaining a healthy weight. They're the most important factors; the rest is just luck, to be honest.
Dr Mark Livingstone: The government has launched a website called yourivfsuccess.com.au, which provides IVF clinic success rates. When looking at IVF clinics, people want to know what their chances are. I am proud to say that Geneahas the highest success rate, which validates our approach and the technology we have.
Dr Mark Livingstone: I'd inquire as to the source of his reluctance. Is he embarrassed to have to provide a sample? Is he concerned about performing in an unfamiliar setting? Is he afraid of the outcome? You'll be able to help him if you figure out what's holding him back. He shouldn't be embarrassed; at Genea, we have more than 40 men giving samples every day; it's completely normal for us. He shouldn't be afraid of the results, either, because even if there is a problem, there is usually something we can do about it. Please comfort him. He just needs to get going – there are two parts to the equation.
Dr Mark Livingstone: Don't be concerned; that is not productive! But go see someone, get some tests done, and figure out what your next steps are. Anyone over the age of 30 who has been trying for a year should see someone, and anyone over the age of 35 who has been trying for six months should make an appointment. Even if everything appears to be normal, you want to know that you're doing the right thing and not wasting your time if you have a blocked tube or something that can be fixed.
Dr Mark Livingstone: It really depends on the number of eggs, the quality of the embryos, and the results of the tests. So, if you've had more than five egg collections at the same clinic and you believe there are still tests or approaches that haven't been tried, I'd recommend seeking a second opinion from another fertility doctor. I had a patient come in after eight unsuccessful cycles, and I discovered fluid in the fallopian tube, which was reducing her chances of success, and she became pregnant on cycle 9, but this is a rare occurrence. If you discover an error, you can try again. If you discover an error, you can attempt to correct it. If you do decide to call it quits, at least you'll know you've done everything.
Dr Mark Livingstone: IVF rates have improved with technology in the last ten years – not as much as they have in the past [since IVF began in the 1970s], but they are still improving. When IVF first became popular, the success rate was in the single digits; now, it ranges between 50 and 55 percent for some people.
Dr Mark Livingstone: They aren't all expensive, and there are ways to get them subsidised. People can have IVF through the hospital system, but they will not be able to select their doctor, receive care seven days a week, or have their embryos genetically tested. In essence, not all IVF clinics are created equal, and you get what you pay for. Every IVF cycle is covered by the government through a Medicare rebate of approximately $5,300, regardless of where you go. So, if the hospital charges $6,300, the government will pay about $5,000, leaving you with around $1,000 out of pocket.
Dr Mark Livingstone: I'm not familiar with the Shettlesmethod; let me look it up... Oh, it's time for sex selection at home. No! It's not going to work. People try to do sex selection by having sex before or after ovulation or by eating specific foods, but none of these methods have been proven to work. It simply reduces your chances of becoming pregnant if you don't have sex as frequently as you should. Aside from that, IVF clinics in Australia are not permitted to provide sex selection.
Dr Mark Livingstone: Risks exist at any age. Pregnancy complications are more likely as you get older, but this isn't a reason not to try.
Dr Mark Livingstone: I believe it is important to remember that age is still the most important determinant of success. Even if you feel great at 42 and are fit and healthy, your eggs will still be 42. Many people find this difficult to accept.
Another common misconception is that IVF is always successful. We as a society expect everything to work and nothing to go wrong. Unfortunately, that is not how biology works. We have limitations in what we can do. IVF increases the chances of a successful pregnancy, but it is not a guarantee.
Dr Mark Livingstone: I believe people need to feel confident that they have done everything possible. They want to know that when they look back in years to come, they did their best. If it doesn't work after five tries, we'll talk about other family-building options, such as egg donation. We also provide counselling to assist you in working through this. I always try to be open and honest with people, telling them what I would do in their shoes. If your doctor says, "If I were you, I probably wouldn't do any more cycles," as difficult as that may be, it may be time to work on accepting that. People have told me that they feel relieved because they've completed all of their tasks and can now move on with their lives instead of living in limbo.