Infertility

Infertility is a medical condition characterised by the inability to conceive a child despite regular, unprotected sexual intercourse for at least 12-months. It is estimated that around 10-15% of couples experience infertility at some point in their reproductive years.

Overview

Infertility can affect both men and women and may be caused by a variety of factors. Dr Wang-Gilchrist specialises in infertility medicine, which is a complex and evolving field that seeks to address the inability to conceive or carry a pregnancy to term.
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Causes of Infertility

Infertility can be caused by a variety of factors, often categorised by gender but many underlying contributors can affect both sexes:

  • Ovulatory Disorders: Conditions like polycystic ovary syndrome (PCOS) and premature ovarian failure.
  • Tubal Factors: Blocked or damaged fallopian tubes due to infections or surgery, which prevent the egg from reaching the uterus.
  • Uterine Factors: Issues like fibroids, polyps, pelvic inflammatory disease (PID) or other uterine anomalies.
  • Endometriosis: A condition where tissue similar to the lining of the uterus grows outside the uterine cavity and can cause pelvic adhesions and inflammation, hindering fertility.
  • Age-Related Factors: Decreased fertility with advancing age, especially after 37.
  • Low Sperm Count / Quality: A low sperm count (oligospermia) or complete absence of sperm (azoospermia), varicocele, poor sperm motility or morphology, infections, or lifestyle factors can affect fertility.
  • Ejaculatory Disorders and Erectile Dysfunction: Issues with delivering sperm effectively.
  • Genetic Disorders: Such as Klinefelter syndrome or cystic fibrosis.
  • Environmental Factors: Exposure to certain chemicals or radiation.
  • Hormonal Imbalances: Affecting reproductive processes.
  • Lifestyle Factors: Such as smoking, alcohol use, obesity, use of anabolic steroids and stress.
  • Environmental Toxins: Pesticides, heavy metals, etc.
  • Medical Treatments and Drugs: Such as chemotherapy.
  • Unexplained Factors (idiopathic infertility): In 10-30% of cases, the exact cause of infertility remains unknown despite thorough evaluation.

Associated Medical Conditions

  • Thyroid Disorders: Both hyperthyroidism and hypothyroidism can impact fertility.
  • Autoimmune Disorders: Conditions like lupus can affect reproductive health.
  • Hypothalamic and Pituitary Disorders: Problems with these glands can disrupt the hormonal regulation of the menstrual cycle.
  • Chronic Diseases: Diabetes, hypertension, and other chronic conditions can interfere with fertility.
  • Genetic Abnormalities: Chromosomal disorders such as Kleinfelter syndrome, cystic fibrosis or sickle cell disease can affect fertility.

Treatment Options

  • Medication: To stimulate ovulation, treat hormonal imbalances, or address specific conditions like PCOS.
  • Surgery: To excise visible endometriotic lesions, remove fibroids or polyps, or correct anatomical issues.
  • Assisted Reproductive Technology (ART):
    • Intrauterine Insemination (IUI): Placing sperm directly in the uterus around the time of ovulation.
    • In Vitro Fertilisation (IVF): Fertilising eggs outside the body and implanting embryos in the uterus.
    • Third-party: Donor eggs, sperm, embryos, or surrogacy.
  • Lifestyle Changes: Improving diet, reducing stress, quitting smoking, etc.
  • Alternative Therapies: Acupuncture or herbal treatments, though more scientific research is needed to confirm efficacy.
  • Genetic Testing: Preimplantation genetic testing for chromosomal abnormalities.
  • Fertility Preservation: Egg or sperm freezing for future use.
  • Personalised Medicine: Tailoring treatments based on individual genetic profiles.

Associated Support

Emotional and psychological support is crucial in managing the stress and emotional impact of infertility. Counselling and support groups can be very helpful. We also provide comprehensive counselling and emotional support service through our in-house counselling service at various locations at IVF Australia.

It is important to note that the choice of treatment depends on the underlying cause of infertility, the couple’s preferences, and their medical history. Consultation with a reproductive specialist or fertility doctor is essential to determine the most appropriate treatment plan. Infertility treatment can be emotionally and financially demanding, and couples may need support throughout the process. Advances in medical science continue to offer new hope and possibilities for couples facing infertility challenges.

Dr Wang-Gilchrist is a Sydney Fertility Specialist, and Obstetrician and Gynaecologist who has significant experience diagnosing, treating, and managing a wide range of conditions related to women’s reproductive health.

Dr Wang-Gilchrist spent four years working as a laboratory and clinical researcher investigating novel infertility treatments and has published several peer-reviewed international papers in reproductive medicine. She holds three separate Master Degrees in the areas of embryology, infertility and reproductive care, and she is a Fellow of Royal Australian and New Zealand College of Obstetricians and Gynaecologists (FRANZCOG).

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