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FERTILITY TREATMENT

INITIAL CONSULTATION

 

The best place to start on your fertility journey would be to make an appointment with one of our Doctors. It is advisable that you come to this consultation with your partner, as both male and female factors will be investigated.

WE SPECIALIZE IN

 Ovulation Induction

Artificial Insemination (AI)

 In Vitro Fertilization  (IVF)

 Testis Biopsy  

 Embryo Freezing 

 Egg Freezing

 Sperm Freezing  

 Oncofertility  

 Surrogacy 

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Ovulation induction is a fertility treatment that uses fertility medication to:

  • Induce ovulation

  • Increase the number of eggs released per ovulation cycle.

 

Ovulation induction is recommended for:

  • Women with unexplained infertility

  • Women with abnormal cycles

  • Women who do not ovulate spontaneously

 

Treatment Process

Stimulation. Medication is taken in the form of oral drugs or injections to promote the growth of the follicles (fluid-filled pockets containing the eggs).

 

Egg release/ovulation. When the follicles are mature (16 – 20mm in diameter) you may be prescribed an intramuscular injection of HCG in preparation for intercourse/ artificial insemination.

OVULATION INDUCTION

ARTIFICIAL INSEMINATION (AI)

Artificial Insemination (AI) is also known as Intrauterine Insemination (IUI). The female partner follows the same process as with Ovulation Induction . Leading up to ovulation, the partner’s best sperm or donor sperm is concentrated through a laboratory procedure. The sperm is introduced into the woman’s cervix or uterine cavity through a soft plastic catheter. This is a simple procedure performed in the doctor’s rooms.

 

Artificial Insemination is recommended for:

  • mild sperm disorders

  • poor quality of female cervical mucus

  • impotence or premature ejaculation (sperm cannot be introduced through sexual intercourse)

  • unexplained infertility

  • Single women or lesbian couples making use of donor sperm

IN VITRO FERTILIZATION (IVF)

In Vitro fertilisation (IVF) is the most commonly used of the assisted reproductive technologies (ART). IVF literally means “fertilisation in glass” (referring to the test tube, which is where the term “test-tube baby” comes from).

During IVF, eggs are collected from the ovaries and fertilised in the laboratory with sperm. After a few days, the fertilised eggs (embryos) are transferred to the female patient’s womb to develop and grow.

Aevitas fertility specialist’ Professor Thinus Kruger and his team’s research and treatment resulted in the birth of South Africa and Africa’s first “test-tube” (IVF) baby in 1984. This event opened a new era in reproductive medicine in Southern Africa. 

 

Treatment Process

Our team of fertility specialists and nursing sisters will work with you to plan your treatment cycle.

 

For Women

Step 1: Hormone treatment

Hormone treatment is used to boost the development of several follicles containing eggs. With more fertilised eggs, there may be a greater selection of embryos.

 

Step 2: Ultrasound scan

Your ovaries will be monitored by vaginal ultrasound scan on certain days of your cycle. Blood tests may also be required. Regular ultrasound scans monitor the progress, as well as the response of your ovaries.

 

Step 3: Hormone injection

You will receive a final hormone injection about 36 hours before the eggs are retrieved. This injection triggers the final maturation of the eggs.

 

Step 4: Egg retrieval

Egg retrieval takes place in the privacy of a specialized theatre at George Surgical Centre. The eggs are retrieved under ultrasound guidance under deep sedation, administered by an anaesthetist. After the procedure, you will be offered a cup of tea and a sandwich before you go home.

 

Step 5: Fertilisation

The sperm are introduced to the eggs by being placed in an incubator so that fertilisation can occur overnight. The procedure is performed by an embryologist (scientist) in our IVF laboratory.

 

Step 6: Record fertilisation

The embryologist monitors the eggs to record fertilisation as well as embryo development.

 

Step 7: Embryo transfer

Embryo transfer into the uterus is usually done on the third to fifth day after the eggs have been retrieved. The optimum day for embryo transfer is determined according to the number and quality of the embryos. One or more embryos are transferred into the female partner’s womb. No sedation is needed for this procedure, which is similar to Artificial Insemination (AI) or to having a cervical smear taken. A fine catheter is gently threaded into the cervix and the embryo is placed in the cavity of the uterus. Ultrasound is used to confirm the placement of the catheter.

 

Step 8: Pregnancy test

A pregnancy test by means of a blood sample is done on the 10th day after embryo transfer to confirm the outcome.

Number of visits to clinic: 5 – 7 per cycle.

 

For Men

On the same day that the eggs are collected, you will be asked to produce a fresh sample of sperm using one of our private facilities. The sperm is then washed, the healthiest and most active sperm are selected.

 

Donor sperm and donor eggs

IVF / ICSI can also be performed using donor egg or sperm if indicated. Aevitas has a great selection of sperm donors and egg donors . Patients also have the option of making use of fresh or frozen donor eggs .

 

IVF is recommended for:

  • If other treatments such as Artificial Insemination (AI) have been unsuccessful.

  • Male sub-fertility ( ICSI is recommended in more severe cases of male infertility).

  • Unexplained infertility.

  • Lesbian couples where one partner donates eggs to the other partner.

TESTIS BIOPSY

Testicular sperm extraction (TESE) is performed through a surgical biopsy of the testis.

 

A testis biopsy can be performed under deep sedation. A tiny amount of tissue is removed from the testis. The tissue contains a network of tiny tubes (seminiferous tubules) where sperm are produced. The tissue is processed in the laboratory to check for or extract sperm for fertilisation with ICSI.

 

Testis biopsy / TESE is recommended for:

Non-obstructive Azoospermia (when a man cannot produce enough sperm to have a detectable amount in his semen).

EMBRIO FREEZING

Embryo freezing forms part of fertility preservation and is recommended to couples in a long-term relationship.

 

During an IVF / ICSI cycle more than one embryo can form. With the guidance of your fertility specialist you may decide how many embryos will be placed back during that cycle’s embryo transfer. You may choose to freeze the remainder of the embryos in case the cycle is unsuccessful or for a future sibling pregnancy.

EGG FREEZING

Recent technological breakthroughs enable us to preserve female fertility for later use, through egg freezing.

Fertility is known to decline with age as the quality of the ovary and eggs decline. This means that freezing your eggs at an early reproductive age, ideally before the age of 38 years, will enhance your chances of a successful pregnancy in the future. By preserving younger eggs now, you increase your chances of starting a family later in life, using your own eggs.

 

Why do women consider freezing their eggs?

Women consider freezing their eggs for any condition/circumstance that might affect their fertility and family planning.

 

Egg freezing widens the fertility options available to women for a variety of reasons:

  • Women who are not yet ready to start a family due to study/career demands, financial insecurity or single women who have not yet found a partner by the age of 35.

  • Women due to undergo medical treatment, such as chemotherapy/radiotherapy or cancer-related surgery, that might put their fertility at risk.

  • Women who have a family history of ovarian failure before the age of 40.

  • Circumventing ethical-, religious- and legal issues associated with embryo freezing or the fertilisation of multiple eggs.

 

When should you freeze your eggs?

A woman in her prime reproductive years (20 -30 years) has the advantage of premium egg quality and quantity. It is best to preserve eggs while in your prime reproductive years, ideally before the age of 38 years. This being said, you are the youngest today that you will ever be. The older you are when you freeze your eggs, the more eggs you need to freeze to increase your chances of a successful pregnancy.

 

Treatment process

Before proceeding with egg preservation, your fertility specialist will advise basic fertility testing to assess your ovary’s ability to release high-quality eggs. The test results, together with the guidance of your fertility specialists, will assist you to make an informed decision on how to proceed with egg preservation.

 

To retrieve and freeze your eggs, you will self-administer a series of drugs and hormonal injections, for approximately 10 days, under the guidance of George Fertility physicians and nursing staff, until the ovaries are sufficiently stimulated to produce as many healthy, good-sized eggs as possible. During this stage, you will have to visit the clinic about three times for bloodwork and ultra-sound scans to be performed. Once egg development is satisfactory, ovulation is triggered by injection and retrieval is scheduled for 36 hours later.

 

Retrieval is performed under light sedation at George Surgical Centre day theatre. Using a needle attached to a catheter, the mature eggs are extracted. Your eggs are stored in tubes and freezing takes place by our highly skilled embryologists. The aim is to develop and harvest approximately 15 – 20 eggs.

 

The procedure of egg retrieval is not painful and takes 10 – 15 minutes. After the procedure, you will recover in our recovery room for an hour or two, before being discharged. From the start of administering medication to retrieval is approximately a two-week process.

 

Benefits of egg freezing 

George Fertility Clinic is FDA approved for oocyte retrieval, freezing and distribution. Our embryologists have been trained by the best in the world, to refine our laboratory techniques, as evident by our outstanding success rates.

 

What happens after I have frozen my eggs?

Eggs are stored in liquid nitrogen tanks and can be stored indefinitely. Gas mixtures, temperatures and liquid nitrogen levels are checked daily and emergency plans are in place in the case of equipment failures. Your eggs will be safe with us!

 

Once you are ready, you can return to our clinic to use your eggs. Your eggs will be thawed and fertilised through an IVF procedure. Alternatively, your eggs can be shipped to a clinic of your choice.

SPERM FREEZING

Our laboratory has the technology and the expertise which allows males to freeze sperm for future use. Sperm can be stored for an unlimited period. Thawed semen samples have the potential to achieve a pregnancy by assisted reproduction, such as Artificial Insemination (AI) or Invitro Fertilisation (IVF) / Intra-cytoplasmic Injection (ICSI) after any length of storage period.

 

Sperm freezing is recommended for:

  • The male partner is unable to attend the clinic during the female partner’s fertility treatment cycle.

  • The male partner may not be able to produce a sample on demand.

  • Testicular sperm from a biopsy can be frozen, limiting the number of biopsies required to achieve a pregnancy.

  • Prior to radiotherapy and chemotherapy or the removal of the testicles due to cancer or other diseases.

  • Prior to male sterilisation (vasectomy).

  • Social fertility preservation.

ONCOFERTILITY

Oncofertility is the discipline that merges oncology and fertility. Over the years advancement in oncology care and treatment has resulted in an increase in the survival rate of cancer patients. However, it is also of great importance to pay attention and enhance the quality of life of cancer survivors.  

Many cancer survivors may find themselves in their reproductive years with infertility because of the side effects of certain cancer treatments. The field of oncofertility strives to raise awareness of the effect of cancer therapy on fertility, as well as to develop strategies that will preserve and restore physiological function for both male and female cancer survivors. The following fertility preservation techniques exist for:

 

Women

Egg freezing.  This is recommended for single women or women who are not in a long-term relationship.

Embryo freezing. This is recommended for women in a long-term relationship.
Ovarian tissue freezing. This is the only option for preserving the fertility of prepubertal patients with cancer. For postpubertal women, this is an option for patients who need immediate chemotherapy or patients who do not want to undergo ovarian stimulation.

 

Men

Sperm freezing . This is recommended for single men or men who are not in a long-term relationship.

Embryo freezing. This is recommended for women in a long-term relationship.

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Surrogacy agreement between the surrogate and commissioning parents will have to be confirmed and authorised by the High Court before any treatment commences. Chapter 19 of the Children’s Act, which relates to surrogacy, came into effect on 1 April 2010. As a result, prospective parents and surrogates are required to bring an application to the High Court for an order confirming the surrogacy agreement and ordering that the child/children born of the agreement through assisted reproductive techniques are those of the intended parents and not that of the surrogate. This alleviates the need to undergo an adoption process.

 

Surrogacy is recommended for:

  • Women with no uterus

  • Women with abnormal uterus preventing her from carrying a baby of her own.

 

Process:

Step 1: legal and medical criteria

Surrogacy must adhere to certain legal and medical criteria:

 

The surrogate

The surrogate must have a living child of their own and be in good physical-, emotional- and mental health.

 

Surrogacy agreement

Surrogacy agreement between the surrogate and commissioning parents will have to be confirmed and authorised by the High Court before any treatment commences. Chapter 19 of the Children’s Act, which relates to surrogacy, came into effect 1 April 2010. As a result prospective parents and surrogates are required to bring an application to the High Court for an order confirming the surrogacy agreement and ordering that the child/children born of the agreement through assisted reproductive techniques, are those of the intended parents and not that of the surrogate. This alleviates the need to undergo an adoption process.

 

The application, collated by attorneys include:

  1. An affidavit

  2. A surrogacy agreement between the surrogate and commissioning parents

  3. A medical, psychological- and social worker report of the surrogate and commissioning parents

 

Step 2: Consultation with the fertility specialist

The intended parents, together with the surrogate mother will consult with the fertility specialist. The health and fertility of both the intended parents, as well as the surrogate mother will be performed.

 

Step 3: Fertility treatment

Gestational surrogacy. In Vitro Fertilisation (IVF) / Intracytoplasmic Sperm Injection (ICSI) can be used with partner or donor egg and/or sperm.

 

The surrogate will be compensated for expenses related directly to the surrogacy and may claim for reasonable and appropriate loss of earnings that result from the surrogacy, pregnancy, and birth. The surrogate mother however may not use this as a source of income.

 

The surrogate and commissioning parents can have as much contact as they choose to, however, the surrogate will have no rights to the child after birth and the commissioning parent’s names will be entered directly onto the birth certificate after birth.

 

Surrogates are women who are medically, emotionally, and psychologically willing and able to carry a baby for someone else. The altruistic gift of being a surrogate is a selfless and loving act. Many couples try to find someone close to them to carry their baby for them (a sister, cousin, or friend). George Fertility Clinic also collaborates with fertility and surrogacy law attorneys to help you through this process.

SURROGACY

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