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Pregnancy Planning & Fertility
Around 20% of women giving birth in Australia are over 35 years old. However, female fertility declines from 35 years of age at a faster rate than it does before this time. This means that women need to think proactively and in advance of conception in order to maximise the chances of conception. 1
Our services include:
- Pregnancy planning
- Fertility Health Check
- Fertility Treatment Options
- Fertility Support
Your Evoca doctor can provide comprehensive and clear information about what’s to be expected with each option, and ensure you are truly empowered in making the right contraceptive choice for you.
In this consultation your GP will discuss with you your plans for conception, your timeline, how many children you would like to plan, and even explore genetic carrier testing for you and your partner to identify if either of you carry genes for significant genetic disorders. This is accompanied by a review of your menstrual cycle and current and past contraceptive choices. Your GP will advise and investigate as needed, as well as incorporating any contraceptive or lifestyle changes necessary to enable optimal readiness for conception.
Fertility health check
An optimal fertility health check may involve an assessment of the individual or, in some cases, both partners.
In women, a fertility health check involves reviewing the menstrual cycle, conducting a full STI check, conducting a pelvic scan to check for ovarian follicle count, as well as checking hormones including the AMH. These tests are conducted over the course of several weeks as some of these tests need to be done at particular times in your cycle. Depending on findings, your Evoca doctor will be able to arrange some additional and more in depth investigations where required.
In men, the fertility check involves hormone tests as well as semen analysis, alongside a full review of past medical history and lifestyle habits. As with women, more in depth testing can be arranged if required based on the preliminary findings.
Fertility treatment options
Once the fertility health check is complete, your GP will be able to summarise the findings and suggest a strategy going forward. For those where there are identifiable limitations in fertility, we can offer advice and referrals in the following areas of fertility treatment:
- Ovulation induction and tracking
- Intrauerine insemination (IUI)
- Intracytoplasmic sperm injection
- In vitro fertilisation (IVF)
How to prepare for your visit:
Come with a menstrual diary of the last 3-6 months
Advise us of your most recent contraceptive choices
Explore goals and timelines for your family planning in advance of your appointment
Critically, come and see us in advance of when you would like to start trying for a baby
Up to 50% of couples will take 6 months to conceive naturally1, so it’s worth remembering that half will actually take longer than this. Patience and persistence is key, while also being aware of limiting factors such as age or co-existing medical conditions which may make it harder for fall pregnant
1. 80-90% of couples will fall pregnant within one year of trying. The rest will take longer or require some help to conceive.
AMH is commonly misunderstood. AMH (Anti Mullerian Hormone) is a hormone released by ovarian follicles (potential eggs). As such it can be used as an indicator of egg count but is not absolute in this regard. Furthermore, it doesn’t tell us the quality or calibre of the eggs released and as such only gives one part of the story. Additionally, multiple factors contribute to overall fertility, so while AMH measurement is very useful, there are many components which make up your fertility picture.
1 Reference: https://www.ivf.com.au/planning-for-pregnancy/female-fertility/ovarian-reserve-amh-test
Egg freezing was once an option out of reach for many women, and often isolated for use in women post chemotherapy, or who have other medical conditions or receive treatment which may affect fertility. Now, egg freezing is more accessible and more affordable, and thus is an option to women who may want children in the future, but not be in a position to start trying to conceive. Critically, age at the time of egg collection for freezing is important. We know that egg quality declines with age, and studies have shown us that optimal egg thawing for fertility treatment occurs with eggs retrieved from women under the age of 35 years old. 1
1 Reference: https://www.pregnancybirthbaby.org.au/trying-for-pregnancy-after-35#fertility