IRML Consulting Room
28 Mercury Street - Wollongong - NSW - 2500
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Frequently Asked Questions

Click on any of the questions or glossary of terms below to receive an answer to the question or meaning of the word or term. Click on the item again to close it.

Difficulties in getting pregnant?

Infertility affects one couple in five.
Luckily, most of the time, it is just a matter of waiting a few more months that will help you achieving your project. If you have been trying to get pregnant unsuccessfully for more than 12 months, there might be something wrong. Especially if you have irregular cycles, or if yourself or your partner have a previous history that could interfere with fertility, it is probably time to seek some advice.
If you are aged over 35 years old, or if you have a known history of gynaecological or endocrinological problems, you may seek advice after 6 months of regular intercourse.
What is regular intercourse? It depends on every couple, but 2 to 3 times a week would usually be good.
You can help yourself with several iPhone applications to find the most fertile period of the month, but remember not to put too much pressure on yourself and your partner. Making love should remain fun, and not only directed by your iPad or thermometer.

Additional ressources

The pharmaceutical company Merck Serono has edited a series of very useful patient booklets dealing with infertility, IVF, ICSI, PCOS, endometriosis, etc…. The quality of the information is excellent and I don’t find it biased. I am very happy to host a link towards those PDF files on my own website.

irml.fertilityportal.com.au/

 

What is involved in a first consultation?

We will take a complete history of the two partners, perform a complete clinical examination and depending on the case order simple tests (sperm count for him, pelvic ultrasound and blood tests for her). Sometimes after a reassuring primary assessment, we will decide to wait a few more months depending on the age and the context.

What happens at the second consultation?

It is time to draw conclusions and a plan.

Roughly, 30 % of the infertility cases are female related, 30% male related, 30% involve both partners and 10% are unexplained. If no obvious cause is detected and the couple is happy to keep on trying for a few more  months, GENEA offers a service of ovulation tracking, which is bulk billed. It could give you some reassurance that you are doing the right thing at the right time...

Depending on the cause, I can offer some medication or lifestyle management (lose some weight, quit smoking for instance) to enhance fertility and restore ovulation. A good example is polycystic ovary syndrome PCOS.

If the female patient has obstructed tubes , a big fibroid or if I suspect endometriosis, I will suggest an operation to make a diagnosis and treat the potential causes of infertility. If the tubes are obstructed beyond any chance of repair, we will proceed to In Vitro fertilization IVF, and if the male patient has a very low sperm count and motility, most likely I will offer Intracytoplasmic spermatozoid injection ICSI. If there are associated mild factors, IUI could be an option.

If you can fall pregnant, but have experienced recurrent miscarriages.

Depending on your age and previous history, I usually trigger a complete miscarriage work up after 2 or 3 accidents. We will check the uterus, the ovarian status, the fluidity of the blood, the absence of genital infection and the karyotype of both partners. It takes more than 1 month to have all the results.

If here is something that we can cure, we will find it and treat it, to support the next pregnancy. Anticoagulant, vitamins, antibiotics are simple ways to correct the problem. if there is chromosomal imbalance, we will refer you to Genea Sydney to perform a pre implantation genetic diagnosis PGD. Sometimes, unfortunately we do not find a cause but I will not let you down, and will provide some empathic support all through the first trimester with frequent consultations and ultrasound (“TLC”).

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Glossary of Terms

Below are some of the meanings of terms you may hear talked about in relation to your visit or when researching fertility and the associated fields.

AMH (Anti Mullerian Hormone)

 

Anti-Mullerian Hormone (AMH) measurement in the female is directly related to her ovarian reserve. The relationship of AMH to ovarian reserve in the normal female population follows the fertility profile with advancing age. The clinical usefulness of AMH is in assessing whether the patient’s AMH result is outside the normal limits for her age. This provides insight as to whether your patient is aligned to their fertility age and how different the AMH result is from the norm. It is not a marker of quality of the eggs, you can have a very low level of AMH and still be fertile.


Karyotype

A Karyotype is the number and appearance of chromosomes in the nucleus of a cell. The term is also used for the complete set of chromosomes in an individual organism.

Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is one of the most common female endocrine disorders. PCOS is a complex, heterogeneous disorder of uncertain etiology. PCOS produces symptoms in approximately 5% to 10% of women of reproductive age (12–45 years old). It is thought to be one of the leading causes of female subfertility and the most frequent most frequent endocrine problem in women of reproductive age. The principal features are anovulation, resulting in irregular menstruation, ovulation-related infertility, polycystic ovaries on the ultrasound and excessive amounts or effects of masculinizing hormones, resulting in acne and hirsutism. Insulin resistance, often associated with obesity, type 2 diabetes and high cholesterol levels can be associated.

Additional ressources

The pharmaceutical company Merck Serono has edited a series of very useful patient booklets dealing with infertility, IVF, ICSI, PCOS, endometriosis, etc…. The quality of the information is excellent and I don’t find it biased. I am very happy to host a link towards those PDF files on my own website.

irml.fertilityportal.com.au/

 

Endometriosis

Endometriosis is a gynecological medical condition in which cells from the lining of the uterus (endometrium) appear and flourish outside the uterine cavity, most commonly on the ovaries. Symptoms often worsen with the menstrual cycle and may depend on the site of active endometriosis. Its main but not universal symptom is pelvic pain in various manifestations. Endometriosis is typically seen during the reproductive years; it has been estimated that endometriosis occurs in roughly 5–10% of women. Endometriosis is a common finding in women with infertility.

Additional ressources

The pharmaceutical company Merck Serono has edited a series of very useful patient booklets dealing with infertility, IVF, ICSI, PCOS, endometriosis, etc…. The quality of the information is excellent and I don’t find it biased. I am very happy to host a link towards those PDF files on my own website.

irml.fertilityportal.com.au/

 

Pre-Implantation Genetic Diagnosis

Pre-implantation genetic diagnosis refers to procedures that are performed on embryos prior to implantation. When used to screen for a specific genetic disease, its main advantage is that it avoids selective pregnancy termination as the method makes it highly likely that the baby will be free of the disease under consideration. PGD thus is an adjunct to assisted reproductive technology, and requires in vitro fertilization (IVF) to obtain oocytes or embryos for evaluation.
Genea offers a very sophisticated PGD program, called GeneSure

In Vitro Fertilisation (IVF)

In vitro fertilisation (IVF) is a process by which egg cells are fertilized by sperm outside the body: in vitro. IVF is a major treatment in infertility when other methods of assisted reproductive technology have failed.

Additional ressources

The pharmaceutical company Merck Serono has edited a series of very useful patient booklets dealing with infertility, IVF, ICSI, PCOS, endometriosis, etc…. The quality of the information is excellent and I don’t find it biased. I am very happy to host a link towards those PDF files on my own website.

irml.fertilityportal.com.au/

 

Intracytoplasmic Sperm Injection

Intracytoplasmic sperm injection is an in vitro fertilization procedure in which a single sperm is injected directly into an egg.

Additional ressources

The pharmaceutical company Merck Serono has edited a series of very useful patient booklets dealing with infertility, IVF, ICSI, PCOS, endometriosis, etc…. The quality of the information is excellent and I don’t find it biased. I am very happy to host a link towards those PDF files on my own website.

irml.fertilityportal.com.au/

 

Intra Uterine Insemination

Intra uterine insemination is a process by which sperm are injected in the uterus after having been washed and selected; Fertilization occurs inside the body. IUI is a first line of assisted reproductive technology. 
Additional ressources

The pharmaceutical company Merck Serono has edited a series of very useful patient booklets dealing with infertility, IVF, ICSI, PCOS, endometriosis, etc…. The quality of the information is excellent and I don’t find it biased. I am very happy to host a link towards those PDF files on my own website.

irml.fertilityportal.com.au/

 

end faq






 

Genea Accredited



Dr Reyftmann is a Genea Accredited Surgeon.
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