Fertility Treatment Options
Treatments for infertility
- Treatments for fertility problems are many and varied. Some common treatments include medications to improve the production of eggs, surgery on the fallopian tubes to fix damage, insemination of the woman with either the partner’s sperm or with donor sperm, in vitro fertilisation (IVF) or IVF with intra cytoplasmic sperm injection (ICSI).
- Though success rates vary, treatment does not carry any guarantee of success.
- There is no treatment for egg quality (due to age) – egg donation is sometimes the only option for women with poor ovarian reserve.
- Some people try natural treatments such as acupuncture and naturopathic treatments.
- Some couples choose not to seek treatment; infertility treatment can be emotionally draining, and although some publicly funded treatment is available in New Zealand, specific eligibility criteria must be met, and there may be a wait to access treatment.
- A small number of New Zealanders will adopt children (around 60 non-relative adoptions per year), while others will remain without children.
If you’ve been trying to conceive for a while with no luck, or have a medical condition which impacts fertility, you might want to look at the next options for making a baby. This can be incredibly daunting and stressful. Often, coming to terms with the reality that making a baby isn’t as easy as you imagined has its own grief attached.
- We recommend that you take as much control as possible, and have a plan
- Ideally you should be able to check all the lifestyle boxes (weight, alcohol, stress, an understanding of your age, etc) described here. Learn to identify the fertile window and you feel confident about your general health. Even if you are years into a fertility journey, it's important to know this information
- If you have been trying to conceive for 12 months (9 months if the woman is over 35, and 6 months if the woman is over 40), see your GP for preliminary tests
- If you meet the eligibility criteria, your GP can refer you for a consultation with a fertility specialist, or you can make a private appointment
- A couple where the woman is aged 30 has around a 47% chance of a baby from one IVF cycle. If the woman is aged 40, this drops to 23
Ovarian Hyperstimulation Syndrome (OHSS) is the most serious ‘potential’ complication that can arise from IVF treatment - Egg freezing may become an option for those wishing to delay parenthood, but it is expensive. In women aged 35 or younger, one egg freezing cycle may give up to a 50% chance of a child from using frozen eggs later (this varies depending on the number of eggs obtained)
Treatment options in New Zealand
|
OPTION |
DESCRIPTION |
SUITABLE FOR |
|
Trying naturally for a further number of months |
There is no diagnosed cause for infertility The woman is relatively young |
|
|
Clomiphene citrate |
Drug which promotes egg production No injections Have sex to become pregnant May or may not be part of a monitored cycle |
Women who don’t ovulate Women with short cycles Women with short duration of unexplained infertility |
|
Intra-uterine Insemination (IUI) |
Preparing sperm in lab Selecting best sperm for implantation in uterus May be combined with fertility drugs such as Clomiphene to increase the number of eggs available Can be conducted over course of several cycles |
Mild male factor infertility Short duration of unexplained infertility |
|
Drugs to increase number of eggs that mature Eggs collected Sperm added in lab Best embryo selected to replace any additional can be frozen for later use |
Nearly any cause of infertility - tubal damage, endometriosis, unexplained infertility, ovulation problems |
|
|
IVF as per the above, with an extra step of the best sperm being selected by an embryologist and injected directly into an egg |
Sperm defect has been identified or where there has been poor fertilisation with ordinary IVF (although ICSI is widely used now) |
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|
When clinics refer to PGS (Pre-implantation Genetic Screening) or PGT-A (Pre-implantation Genetic Testing – Aneuploidy) they are talking about the checking suitable embryos to see if they have the correct genetic make-up. To really understand this though we first need to understand a little more about human genetics.
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It will depend on each patient’s fertility journey and family genetic history. It is generally recommended to any patients that have a known genetic condition or Recurrent Implantation Failure (RIF). Genetic testing of embryos can help identify and eliminate one aspect that could be causing the failure of embryos to implant. |
Funding
Requirements for publicly funded treatment differ slightly by District Health Board, but these criteria include:
- The couple have been trying to conceive for at least twelve months (for single people and same-sex couples, refer to ‘Making Babies with Donors and Surrogates’)
- If there is no diagnosed reason for infertility (‘unexplained infertility’), the couple must have been trying to conceive for four years
- Woman’s age 39 or less at time of consultation
- Woman’s BMI 32 or less
- Woman must be a non-smoker (at least three months prior to application)
- NZ citizenship, residency or visa of at least two years’ in duration (for both partners)
