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Fertility Treatments

Fertility PLUS offers a full range of fertility treatments. We are proud of our success rates and our caring approach to treatment. Following your initial consultation and investigations, we will guide you towards the treatments that are most appropriate for you. Possible treatment options include:

Ovulation induction

Intra-uterine insemination (IUI) (stimulated with a fertility drug)

In-vitro fertilisation (IVF) and Intracytoplasmic sperm injection (ISCI) if necessary

Egg donation cycles

Donor insemination (DI)

Surrogacy

Embryo donation

Surgery for endometriosis, tubal disease and sterilisation reversal

Preimplantation Genetic Diagnosis (PGD)

Public funding

Public funding is available for most fertility treatments. Your eligibility for funded treatment will depend on both your underlying problem and how long you have been trying to conceive. Learn more about eligibility for publicly-funded treatment here.

Ovulation induction

Irregular or absent periods are often a sign of anovulation (not producing an egg each menstrual cycle). The most common reason for this is polycystic ovarian syndrome. This condition is usually diagnosed by trans-vaginal ultrasound and hormone testing. For many women with polycystic ovaries, the simplest and most effective treatment to restore ovulation is weight loss. For other women with polycystic ovaries a range of therapies might be suggested, including clomiphene, metformin, and laparoscopic ovarian drilling. For women who are not ovulating and have hormone problems other than polycystic ovarian syndrome, other specific therapies will be recommended.

Clomiphene treatment

Clomiphene is the most widely used treatment for women who are not ovulating. It is taken for five days from the second day of a period. Clomiphene cycles at Fertility PLUS are monitored with blood tests and, if needed, ultrasound scanning. This is to ensure that treatment is effective and to minimise the risk of a multiple pregnancy. To learn more read our clomiphene information leaflet.

Clomiphene is also used for some women with irregular periods who do not have polycystic ovaries. In women who are ovulating regularly, clomiphene does not increase pregnancy rates unless combined with intra-uterine insemination treatment. Clomiphene treatment is not funded and there is a charge for each cycle.

Metformin treatment

In some women with polycystic ovaries, metformin is more effective then clomiphene. Metformin is taken every day and many women will ovulate regularly after a couple of months of therapy.

Other treatments

Laparoscopic ovarian drilling is less common, but may be recommended for women who have not responded to clomiphene or metformin.

Intra-uterine insemination (IUI) with stimulation using clomiphene

Intra-uterine insemination (IUI) is a treatment where sperm is inserted into the uterus through the cervix, at the time of ovulation. IUI is only suitable for women with normal fallopian tubes and men with a normal semen analysis (or minor abnormalities). Many couples with unexplained infertility opt for IUI as a simpler option compared to IVF.

Success rates

  • IUI treatment typically doubles a couple’s monthly chance of conception.
  • The treatment cycle can be undertaken every month.
  • Success rates will depend on a woman’s age and the sperm quality, but in appropriately selected couples we would expect half to have conceived over four cycles of treatment.

Preparation

  • Women are usually given clomiphene to encourage the growth of more than one follicle each cycle.
  • The cycle is monitored in the days leading up to ovulation with blood tests to check hormone levels and ultrasound scans to check the number of eggs growing in the ovaries.

Insemination

  • On the day of ovulation, sperm from the male partner is prepared in the laboratory. This process collects the motile sperm from the sample to use for insemination.
  • This is placed into the uterus using a small catheter which is passed through your cervix.

In-vitro fertilisation (IVF)

For many couples with problems conceiving, IVF is the most effective treatment. For some couples it is the only effective treatment. IVF is used for couples with tubal infertility, severe male factor infertility (where the eggs are inseminated by ICSI) and for couples with unexplained infertility. We treat couples eligible for publicly funded treatment and couples seeking private treatment.


Single embryo transfer (SET)

Fertility Plus has a policy of single embryo transfer. The principle of single embryo transfer is to give each single embryo that is transferred its maximum opportunity to implant and develop into a healthy pregnancy and to avoid all 'avoidable' multiple pregnancies. Twin pregnancies carry a much greater risk for pregnant women and for the foetuses/babies than singleton pregnancies. There is also an increased financial risk with a multiple pregnancy.

The only exception to this single embryo transfer policy is patients who request a double embryo transfer and who have had a booked consultation in the clinic with a doctor with whom they have had a chance to discuss the potential hazards of double embryo transfer. The patients then need to consent to double embryo transfer with a counter-signature from the Fertility Plus doctor involved.

Success rates

  • Our IVF programme success rates have consistently been in the top 25% of clinics in Australia and New Zealand.
  • Our frozen embryo treatment programme has one of the best success rates in Australasia.
  • It is important to realise in older women success rates are lower.
  • You can learn more about success rates here.

IVF treatment explained

The prospect of undergoing IVF is a daunting one for many couples but the treatment is entirely clinic based with no overnight stays in hospital or major surgery. Most women carry on working during most of their treatment.

IVF treatment involves several steps, including:
  • Suppressing your natural monthly cycle: This requires a daily injection of a hormone that suppresses your natural cycle and prevents you releasing your eggs before collection.
  • Increasing the number of eggs produced: A second hormone injection is given to increase the number of eggs that are produced. The hormone used (follicle stimulating hormone) is identical to the hormone produced during a natural menstrual cycle.
  • Monitoring your response: Blood tests and trans-vaginal ultrasound scans are used to check that an appropriate number of egg-containing follicles are growing.
  • Egg collection: This is done using vaginal ultrasound probe and a fine needle is used to collect the eggs from the ovaries. Intra-venous sedation and pain relief is given.
  • Fertilisation of the eggs: In the laboratory eggs and sperm are mixed together and fertilisation occurs over the next 24 hours. In couples with male factor problems intra-cytoplasmic sperm injection (ICSI) is used. In this procedure each egg is injected with a single sperm.
  • Embryo transfer: After three to five days the embryos will be transferred. A small tube is containing the embryos is inserted through the cervix into the uterus. Ultrasound scanning is used to confirm that the embryo is placed in the correct part of the uterus. No pain relief is required.
  • Luteal support: In the weeks after embryo transfer and during early pregnancy, daily pessaries of progesterone hormone are given vaginally to help support the lining of the uterus.

Preparation and support

Before you begin IVF treatment you will be seen for an orientation session. You will meet a nurse, an embryologist, a counsellor and a doctor. During this session the proposed treatment will be carefully explained.

Using donor eggs and sperm

Fertility PLUS is able to offer treatment using donor eggs and donor sperm. More information on these treatments can be found below. In 2004 the Human Assisted Reproductive Technology (HART) Act was passed in New Zealand, which requires clinics providing donor treatments to send details to the Registrar of Births Deaths and Marriages when a child is born. These details include the name, address, date and place of birth of the donor and child, and the name and address of the parents or guardians. It is the responsibility of the Department of Internal Affairs to maintain this register. This information can be accessed by the offspring when they are 18 or by their guardians if they are under 18. For more information on the HART Act please contact us.

Egg donation cycles

Fertility PLUS is able to provide egg donation treatment for both private and publicly funded cycles. Using donor eggs may be suggested for couples where the woman has a raised FSH level, has responded poorly to previous IVF treatment or has had her ovaries removed in the past.

Success rates

  • Generally, egg donation cycles are straight forward with success rates very similar to standard IVF.
  • The most important factor determining a recipient couple’s chance of having a baby is the age of the egg donor.

Finding a donor

  • Very few altruistic egg donors come forward in New Zealand and it is not legal to pay an egg donor for their services.
  • If you want to advertise to find an egg donor we can help you do this.
  • Most recipient couples use a ‘known donor’ who might be a sister, cousin, friend or work colleague.
  • There are many emotional and ethical issues associated with egg donation and both the recipient and donor couples are obliged to meet with our counsellors to ensure that all parties understand the treatment, the emotional implications, their rights, and their obligations before treatment can begin.
  • All donors are also seen by a doctor to ensure that they are medically suitable to be a donor and are screened for hepatitis and HIV.

Egg donation cycle process

  • The treatment process requires the donor to undergo IVF stimulation with daily hormone injections and an egg collection.
  • The recipient woman is given hormone tablets to ensure the lining of the uterus is ready for an embryo transfer.
  • Sperm is used from the recipient woman’s partner to fertilise the donor woman’s eggs.

Donor insemination

Donor insemination (DI) treatment is offered by Fertility PLUS to heterosexual couples, same-sex couples and single women. Heterosexual couples may request DI due to poor sperm quality, or a complete absence of sperm.

Publicly-funded treatment is available to women who meet eligibility criteria. Fertility PLUS also provides a private service for DI. For details of treatment costs see our treatment costs page.

Success rates

  • Insemination with donor sperm in a fertile woman usually results in a pregnancy rate of 15% per cycle.
  • Success rates will be less in older women.

Donor insemination process

When a woman undergoes DI treatment, her menstrual cycle is tracked with blood tests and frozen sperm from a screened donor is inseminated at that time.

Preparation and support

Both donors and recipients are required to meet with a clinic counsellor prior to donation or treatment. The emotional, ethical and legal aspects of DI treatment are discussed.

Finding a donor

  • It is not possible to pay donors in New Zealand and couples or women planning DI treatment can use sperm from either a known donor that they recruit themselves or a clinic donor.
  • Donors are required to undergo health screening and complete a checklist for inheritable diseases.
  • In particular, all potential donors are screened for HIV, hepatitis B and hepatitis C before banking sperm and these tests are repeated after a quarantine period to ensure that there is no risk of transmitting these diseases during DI treatment.
  • Donors complete a non-identifying information questionnaire to help with donor selection.
  • We are not able to undertake any treatments using sperm that has not been frozen and quarantined.

Surrogacy

Surrogacy treatment is available at Fertility Plus. This treatment might be recommended for a woman with an abnormality of her uterus or who has no uterus.

There is publicly-funded treatment available for some couples.
  • To be eligible for public treatment there must be a medical reason for surrogacy.
  • All surrogacy treatments require ethics committee approval before treatment can commence.

Embryo Donation

Couples who have embryos remaining frozen in storage after they have completed their families are able to donate these embryos to another infertile couple. For more information on this program contact Fertility PLUS at fertlab@adhb.govt.nz

Surgery for endometriosis, tubal disease and sterilisation reversal

Many women will have laparoscopy as part of their infertility investigations. If endometriosis or tubal problems are present there may be a role for further laproscopic surgery.

Endometriosis

Removing mild or moderately severe endometriosis may increase the chances of natural conception in the months after surgery. For women with more extensive endometriosis, surgery may be needed to remove ovarian endometriosis.

Tubal disease

Tubal surgery is usually only recommended for women with relatively mild disease. Most women with fallopian tubes that have been severely damaged or blocked by infection will be advised to have IVF treatment.

Sterilisation reversal

We are able to offer sterilisation reversal at Fertility PLUS. This may be a more effective option for some women than IVF. Public funding is available for some eligible couples. The chances of sterilisation reversal being successful depend on the type of sterilisation procedure, a woman’s age and the presence of any additional problems in either partner affecting fertility.

Preimplantation Genetic Diagnosis (PGD)

PGD is available for couples where there is a risk to any offspring of a serious inherited medical condition or chromosome abnormality. It is necessary for couple to have an IVF cycle and the resulting embryos have a cell(s) biopsied after three days of development. These cells are sent to Monash, Melbourne for genetic testing. An unaffected embryo can then be transferred on day 5 and any other unaffected embryos can be frozen.

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