Female fertility testing and treatment with compassion and sensitivity for women and gender diverse individuals with a uterus.
If you and your partner are taking longer than expected to fall pregnant, know that you’re not alone. One in six Australian couples have experienced the distress and frustration that comes with infertility. Female fertility problems contribute to at least a third of these situations, but fortunately, with specialist guidance and treatment, you may still be able to have a successful pregnancy and healthy baby.
Women and those assigned female at birth are born with all the eggs they will ever have. These eggs are stored in the ovaries and released gradually throughout your reproductive years during ovulation.
Healthy female fertility encompasses not only regular ovulation with high-quality eggs, but also your body’s ability to facilitate fertilisation of the egg by sperm, which occurs in the fallopian tubes, and to carry a pregnancy through to full term.
Many factors can influence female fertility, from your general health and hormone balance to the health of your reproductive organs and your age. Whether you’re pursuing parenthood in a same-sex couple, as a solo parent, or in a couple affected by infertility, Dr Anna is committed to walking this journey with you.
Not only does your body produce half the DNA needed to create a baby in each egg, but is also where the processes of fertilisation, conception, and pregnancy take place, not to mention delivering the incredible effort required during labour and birth.
Age is the most significant factor in determining your fertility. Female fertility naturally declines with age, particularly from the mid-30s onwards, as both the number and quality of your eggs gradually decrease. This makes conception more difficult and can also increase the risk of miscarriage and pregnancy complications.
Unfortunately, there may not always be an identifiable cause for women having trouble falling pregnant, known as unexplained infertility. For other women and those with a uterus, comprehensive fertility testing may uncover:
Ovulation is the release of an egg from the ovary each month. Irregular or absent ovulation can make conception difficult. Conditions such as polyendocrine metabolic ovarian syndrome (PMOS, formerly known as polycystic ovary syndrome or PCOS), thyroid disorders, or hormonal imbalances may affect ovulation.
Endometriosis occurs when glandular tissue similar to the lining of the uterus grows outside the uterus. In addition to debilitating pain for some people, this condition can cause inflammation and scarring around the ovaries, fallopian tubes, and surrounding organs, impacting the function of these organs and contributing to or causing infertility.
Structural issues affecting your uterus, cervix, or fallopian tubes can interfere with conception or implantation. Examples include uterine fibroids and polyps, scar tissue and adhesions inside the uterine cavity (Asherman’s syndrome), or blocked or absent fallopian tubes.
Certain health conditions may impact fertility, including autoimmune conditions, diabetes, pelvic infections, or previous surgery involving the reproductive organs. Chronic illness may also affect hormone function and ovulation.
Some medications and medical treatments can affect fertility. Chemotherapy, radiation treatment, and certain medications used to manage chronic illness may impact egg quality, ovulation, or ovarian reserve.
Lifestyle and environmental factors can also influence fertility. Smoking, excessive alcohol intake, high BMI, poor sleep/night shift, and recreational drug use may all affect your reproductive health, contributing to infertility, increasing miscarriage risk and maternal/foetal risks in pregnancy.
Options are available for most women and those assigned female at birth facing fertility challenges, whether you have been trying to conceive unsuccessfully for some time or you are pursuing parenthood without a male reproductive partner.
After a comprehensive fertility assessment, Dr Anna can guide you through your treatment options, including managing underlying infertility causes, or conception through assisted reproduction or with the help of a donor.
Blood tests assess important reproductive hormones involved in ovulation and ovarian function. These may include follicle-stimulating hormone (FSH), luteinising hormone (LH), oestrogen, progesterone, anti-Müllerian hormone (AMH), and thyroid hormones. Genetic testing, including karyotyping or assessment for inherited conditions, can also be performed via blood tests.
A self-collected vaginal swab or first pass urine test can help exclude STIs that can cause damage to the reproductive tract.
A pelvic ultrasound is commonly used to assess the ovaries, uterus, and reproductive organs for abnormalities. If needed, more specialised imaging techniques such as hysterosalpingo-contrast-sonography (HyCoSy) can be used to assess your uterine cavity shape and the patency of the fallopian tubes.
Ovarian reserve refers to how many eggs you have remaining in your ovaries. Ovarian reserve testing includes assessing your anti-Müllerian hormone (AMH) levels with a blood test and antral follicle count via ultrasound.
Hysteroscopy and laparoscopy are minimally invasive techniques to assess your uterus and pelvic area respectively. In addition to aiding accurate diagnosis of various conditions such as endometriosis, polyps, and fibroids, treatment can often be performed at the same time as diagnosis.
Improving your overall health may improve your chances of conception and prepare your body if you intend to carry the pregnancy. Dr Anna may recommend:
If you are not ovulating regularly, medication may be used to help stimulate ovulation and improve the timing of egg release during your cycle.
Conditions such as endometriosis, fibroids, hormone disorders, or blocked fallopian tubes may be treated with medication or surgery if they are determined to be interfering with your fertility.
Assisted reproductive treatments can help overcome a range of fertility challenges and may be recommended depending on your age, reproductive health, and fertility goals. Options may include:
Dr Anna will explain your options clearly and work with you to develop a treatment plan that ensures you feel informed, supported, and is evidence-based and appropriate for your circumstances.
