With 20,400 babies born every year through IVF, it can be difficult to know at what point you should consult an IVF specialist – and how to increase your chances of conception. IVF Australia provides some guidelines.
In the process of trying to conceive, many people reach the point where IVF becomes a recommended next step. With approximately 20,400 (one in every 16) babies born annually in Australia through IVF, medical intervention has helped many achieve their dream of having children.
“IVF is powerful in improving the probability of pregnancy and also shortening the time to pregnancy,” says IVF Australia fertility specialist Dave Listijono. “The benefit IVF has over time is that we’re increasing the odds of collecting a higher number of eggs (per cycle), having those eggs fertilised, and having those fertilised eggs grow into good quality embryos,” Dr Listijono adds.
Statistically, the chances of having a baby after three complete IVF cycles depends on age: 70.7 per cent at 30 to 34 years, 64 per cent at 35 to 39 years, 22.9 per cent at 40 to 44 years and 2.7 per cent for 45 and above.
Before seeking help through IVF, Dr Listijono recommends people optimise timing by understanding the basics of conception. “It would save a lot of time and anxiety, if (people) are aware of the basic menstrual period and fertile window and try and maximise efforts around that fertile window,” he says.
Once you have been timing sex correctly, allow a little time. Dr Listijono says the general consensus for those under 35 who have been trying without success for 12 months, is to seek the advice of a fertility specialist. If you are over the age of 35, allow six months before seeking help.
So what else can people do to help increase their chance of success?
Dr Dave Listijono
Optimising preconception health
Dr Listijono suggests improving health by avoiding a sedentary lifestyle, excess weight, chronic stress, smoking, vaping or drug use, and minimising alcohol. Additionally, he recommends improving diet and nutrition by reducing processed food and eating lots of vegetables, fibre, legumes and omega-3 rich fish.
Adopting this Mediterranean-style diet can promote a healthy gut microbiome, which can in turn help balance hormones, he says.
Then there are the environmental factors. “There’s also a growing body of evidence that fertility health can be negatively impacted by certain chemicals found in our environment, known as endocrine disrupting chemicals (EDCs),” says Dr Listijono. EDCs exist in our day-to-day lives, in our clothing, food, water and air and are a serious issue, he says. These chemicals may mimic, block or interfere with the body’s hormones and are associated with a wide array of health issues including infertility.
“The aim of the game is to minimise exposure where possible,” he says.
Apart from considering modifications to lifestyle, pre-conception fertility testing can be helpful to identify any potential barriers to conception. “Helping to ensure that any underlying health issues are addressed sooner supports not only fertility but pregnancy outcomes,” Dr Listijono explains.
Testing usually includes a semen analysis for men and the AMH blood test for women which measures the level of anti-malarian hormone in her blood in order to estimate her ovarian reserve. “An AMH test on its own is not a predictor of fertility, but is a very important part of broader fertility assessments,” says Dr Listijono.
“Everyone’s got a different underlying cause for infertility,” says Dr Listijono. Age is the primary driving factor for egg quality and is the key factor for why people usually fail to conceive.
While female factor infertility has long been top of mind, male factor infertility is now becoming more widely recognised. “Historically, we used to focus on the female, but there’s an increasing incidence of male factor infertility,” says Dr Listijono.
Once female and male factor infertility have been considered, another cause of infertility can be the combination of those two factors.
What to expect with IVF
By the time people come to see Dr Listijono, they usually have a mix of emotions. “There’s an element of anxiety. (But) there’s always hope,” he says. “For the most part, they’re a bit tired from having tried for many, many months, sometimes a few years, and always getting that negative test or having their period come every month,” he adds.
While the process of IVF takes a physical and emotional toll, Dr Listijono believes the emotional outweighs the physical. “Physically, you’ll be looking at about 10 to 12 days of daily injections, which most women don’t find too burdensome,” he says. “It’s more the emotional roller coaster that everyone finds difficult.”
Each cycle is an involved process of testing and waiting, which starts with cycle monitoring, hormone results and ultrasound. Then egg retrieval, with doctors then deciding how many to fertilise. Following this there are hopefully some which become embryos after fertilisation – and doctors then determine how many of those are good quality embryos, suitable for transfer.
Finally, there is a 10-day wait after transfer to see whether or not a pregnancy is achieved.
While Dr Listijono acknowledges that IVF is not a ‘miracle cure’ that can improve egg quality, it does typically increase the chance per cycle to conceive (if you are under 45 years old). Understanding the basics of conceiving, knowing when to seek fertility advice and using pre-conception fertility testing before trying to conceive, can have the greatest impact on what ultimately matters, says Dr Listijono: holding that healthy baby in your arms.