Who needs ART?
It is a staggering fact that up to one in ten couples find that at some time during their life they need assistance to become pregnant. Not all couples need to embark on an IVF procedure. Many simply need to establish their fertile periods or have artificial insemination, or sometimes use hormonal support. Initially couples may seek the advice of their own GP, who may then refer them to the infertility specialists at the Canberra Fertility Centre.

In a natural pregnancy the egg and the sperm meet in the fallopian tube where fertilisation takes place and the resulting embryo implants in the uterine lining. But for those women with blocked fallopian tubes or whose tubes have been damaged by infection, surgery or endometriosis, the blockage is by-passed by IVF. The IVF procedure is also used with success where the male partner's sperm count is too low for normal fertilisation to occur.

Couples who have "idiopathic" or unexplained infertility, often find help from GIFT/IVF programmes and other programmes to time ovulation so that intercourse can be undertaken at the correct time.

Programmes
Canberra Fertility Centre provides a comprehensive range of programmes for infertility including the following:

• IVF (In Vitro Fertilisation)

• FET (Frozen Embryo Transfer)

• ICSI (Intra Cytoplasmic Sperm Injection)

• MESA (Micro Epididymal Sperm Aspiration)

• TESA (Testicular Sperm Aspiration)

• PESA (Percutaneous Epididymal Sperm Aspiration)

• Assisted Hatching

• Extended Culture of Embryos (Blastocyst Culture)

• Embryo cryopreservation

• Oocyte donation

• Embryo donation

• Ovulation monitoring

• Hormone evaluation

• Semen evaluation

• Infertility counselling

• Intra-uterine sperm insemination (AIH)

• Donor sperm bank

• Semen storage

• Ultrasound follicle tracking

• Surrogacy

Patients will usually be referred to a Canberra Fertility Centre gynaecologist from either general practitioners or a gynaecologist for evaluation as to the best course of treatment under a fertility specialist. We are a team of specialists attached to the Canberra Fertility Centre (see Introduction > Specialists).

During your treatment cycle you will meet a number of people who together, make up the team of professionals interested in your welfare. They are available for your support and care whilst you are undergoing the treatment, especially when it is not always possible to contact your doctor. If you have any problem that you wish to discuss about your treatment or need reassurance about a nagging question, do not hesitate to call Canberra Fertility Centre and discuss it with the Nurse Coordinator.

Emotional, physical and financial stresses
There are emotional and physical strains placed on both you and your partner. These stresses can come from many areas such as how to deal with questions from family and friends. You should not hesitate to seek advice from the counsellor in dealing with such stresses. We all acknowledge that undergoing treatment and placing all your hopes on one treatment cycle can be very stressful. A phone call can minimise some of this stress and can put your mind at ease.

There are some procedures which are physically invasive such as daily blood tests, the injections, ultrasound and of course an IVF egg pick up and embryo transfer, all of which takes a physical toll. Apart from the financial cost, there is the time factor which is often overlooked. Taking time off work for injections, tests and procedures often leaves employees in a quandary as to what to tell their employer. Most employers, if you feel that you can tell them, will treat your situation with sympathy and understanding.

Infertility is a highly emotional issue and is sometimes associated with frustration, anger and guilt. Despair and often a lack of self esteem or confidence can be felt by the couple involved. To assist in coping with some of these issues and to discuss the impact the treatment will have on your life, you are welcome to meet with our counsellor before commencing a treatment cycle at Canberra Fertility Centre

Some treatments can be expensive. However, from statistical pregnancy rates particularly with IVF and GIFT, a minimum of 3-4 treatments should be considered to maximise your achievement of a successful outcome.

Information
In order for you to undertake any ART procedure, you must be fully aware of the options for treatment, the risks and side effects, the success rates and details of the procedures you are likely to undertake. Your specialist will discuss a treatment plan for your cycle and you will also attend an information session at the Canberra Fertility Centre to further consolidate your understanding of your treatment plan.

You will also be required to sign Consent Forms prior to each treatment cycle so that you and the Canberra Fertility Centre concur on the procedures to be undertaken. You may place any specific conditions into these Consents as long as they are within the Policies of Canberra Fertility Centre. You may also vary or withdraw from these Consents at any time prior to enacting the specified procedures.

All data concerning your procedure will be kept in strict confidence. From time to time non-identifying treatment data will be made available for studies into the long term effects of ART procedures.

Patient cooperation
Your cooperation in all aspects mentioned is vital to the success and smooth running of the program. Please do not lose this information booklet - it has been provided for instant reference. Further enquires regarding cycle management are best directed through the Nurse Coordinator.

Preparing yourself for ART treatment
Dramatic changes or alterations to your normal lifestyle are not recommended as they add unnecessary stress to what is already a very stressful time. However, it is recommended that you: endeavour to maintain a healthy lifestyle; maintain a sensible weight for your height and build; make modifications such as reducing your intake of alcohol to a social glass or so; and reduce the number of cigarettes smoked. Ideally you should quit smoking altogether.

Being conscious of a healthy diet and leading an active lifestyle will certainly enhance your achievement of a successful healthy pregnancy.

Ensure that you have immunity to rubella (German Measles). This is important whether you are undertaking ART procedures or attempting to become pregnant under natural conditions. All women planning a pregnancy should be taking a folic acid supplement. Increasing the intake of folic acid has been shown to reduce the risk of foetal abnormalities including neural tube defects. Your GP/Specialist can advise you on the dose recommended, but usually a supplement of at least 500 micrograms of folic acid a day is advised. This supplement should be continued for at least the first three months of pregnancy, where increased folic acid is needed by both the foetus and the mother.

Finally, the treatment programs that you may undertake will often be very confusing and you may feel, in some instances, out of control. It is essential that the period of your treatment remain as stress-free as possible for both partners. There is information available about yoga, meditation techniques, relaxation tapes and books from Canberra Fertility Centre for your use and our counsellor can also help you in this area.

Please make sure you ask if you have any questions - we are all here to help you in any way we can.