Frequently Asked Questions

Why do I have to take the pill?
If you plan to complete a cycle of standard IVF treatment (with or without ICSI) you should take the oral contraceptive pill for one month only, in the month before you have eggs collected. During this month you will commence treatment with either Lucrin or Synarel. If you are planning to have a "short down-regulation" cycle you do not need to take the pill before beginning the IVF treatment cycle. The main reason you should take the pill in your monthly cycle before the egg-collection cycle, is to allow more accurate planning of the day of your egg collection. We ask you to phone the Fertility Centre on the first day of a cycle to confirm you wish to begin the IVF treatment. On that day you should commence the pill. This allows a reasonably accurate prediction of when your next period will occur and also when you will have egg collection in your next cycle. By taking the pill you should avoid the possibility that the Lucrin or Synarel treatment will alter the day when your next period will occur.

Do I have to keep taking the Lucrin or Synarel when the other medication starts?
Yes, it is very important that you do not stop the Lucrin or Synarel at this time. They should be taken until the day the last injection is given before egg collection. If you stop Lucrin or Synarel treatment before that time you may ovulate and lose your eggs before they can be collected.

What's my blood group?
Your blood group is generally ascertained before you start any form of fertility treatment. It may be important to know your blood group if you have a miscarriage. If you become pregnant and have the Rh-negative blood group type you will be given an injection of gamma globulin after delivery to help prevent you developing Rh antibodies.If present, these antibodies may cause a problem in any future pregnancy.

Why are the Medicare cheques in other people's names?
A large part of the IVF and ICSI treatment is done in the specialised laboratory of the Fertility Centre by embryologists who are highly trained specialist scientists. Some of the Medicare payment is for this laboratory work and it is billed in the name of the pathology provider rather than the doctor who originally organised your treatment. Medicare cheques in the names "Smith" and "Trudinger" can be expected.

Why are we NOT covered by Medicare completely?
The Medicare funding available for assisted reproduction treatment in Australia is more generous than any other country throughout the world. However it is still insufficient to cover the cost of all aspects of your treatment.

Is this a public clinic?
Although the Westmead Fertility Centre is located within a large university-based public hospital it does not receive funds from the NSW state health department. Hence it is not a public clinic. Rather it is the same as other IVF centres who rely on the fees paid by each patient to fund the service. The Westmead Fertility Centre has lower overhead costs hence the cost of treatment to each patient is less than elsewhere. We strive to keep costs down by insisting that all patients make timely payments at the beginning of each treatment cycle.

Why is the treatment not covered by private medical insurance?
Private medical insurance only pays for treatment done on patients admitted to hospital and classed as an "inpatient". As none of the assisted reproduction treatment programmes require hospital admission, they are not covered by private medical insurance.

Do we treat single females?
Mostly WFC treats married or defacto couples as we concur with majority community opinion that this is in the best interests of the potential child. However, we recognise under Commonwealth anti-discrimination regulation single women cannot be refused treatment.

How long is our waiting list?
To see one of our specialist doctors there can be a 1-2 month delay in getting the initial consultation. Treatment should begin soon after this consultation, depending on the time of your monthly cycle.

Why do I need a referral letter to see a doctor (with both partner's names included)?
All forms of assisted reproduction treatment are regarded as specialist medical services. As such Medicare requires that you and your partner be sent to one of the specialist doctors of the Fertility Centre with a letter of referral. This letter may be obtained from any medical practitioner. A referral from another specialist doctor is valid for 3 months only whereas a referral from a general practitioner is valid for 12 months. Without a referral letter the Fertility Centre is unable to claim benefits from Medicare on your behalf. In this situation you will have to cover all cost's incurred for your treatment. Therefore it is important that you have a current referral letter before commencing treatment.

Are our unwanted embryos going to be used for stem cell research?
Your unwanted embryos remain your property and you control their fate. At present no patients of the Westmead Fertility Centre have been asked to donate their embryos for any form of embryo research. All patients with stored embryos have signed a consent form for frozen-storage. This states WFC will store your embryos for up to ten years with an agreement they will be disposed of at that time unless you request otherwise. They may not be used for research without your express written permission.

If I have 10 follicles why didn't I get 10 eggs?
In an ultrasound picture, follicles (containing eggs) and empty cysts have the same appearance. While we hope each large follicle contains a mature egg, we cannot actually see the egg with ultrasound (they are far too small). It is more likely that eggs can be obtained from follicles between 17 and 25 mm in diameter. Eggs may be collected from follicles smaller than 17mm in diameter, however these eggs may be immature and may not fertilize.

Do all my eggs have a chance of fertilising?
Only mature eggs have a chance of fertiliising normally. Before the eggs are collected it is not possible to confirm that all the follicles contain mature eggs. We rely on the size of the follicle and the level of oestrogen in the blood to indicate when the egg within each follicle is mature. However these are not always accurate indicators of the maturity of an egg. The possibility of an egg becoming fertilized can be more carefully assessed after it has been collected and examined under a microscope.

Why didn't all my eggs fertilise?
Eggs will not fertilize if:
- they are immature
- they are abnormally formed
- the sperm are abnormal in number, movement or shape
- there is a high concentration of antisperm antibodies around the egg or sperm

Why didn't all my embryos divide?
After a sperm enters and interacts with an egg, the egg is regarded as being fertilised. The next step is growth of the fertilised egg followed by division into two cells. Sometimes the fertilisation process is not normal. Perhaps more than one sperm or an abnormal sperm enters the egg, or maybe an egg is not normal. In these situations normal division and growth of the embryo may not occur. Sometimes division of the fertilised egg is delayed even though fertilisation is normal. In this case it is just a matter of time before division occurs.

Why weren't of my spare embryos all frozen?
Fertilisation of an egg does not always produce a perfect embryo. Even at the very early stages it is possible to see differences in embryo growth. Embryos which do not have a normal shape and appearance may not survive the processes of freezing and later thawing. These embryos are also unlikely to cause a pregnancy. Specialist embryologists can tell by looking at an embryo if it has any chance of surviving or no chance. If you request it, all embryos with a possibility of surviving a freeze-thaw will be frozen.

Why didn't my embryos survive freezing and thawing?
The process of freezing and thawing subjects embryos to events, which may cause their destruction. Some embryos appear more fragile than others and do not survive the process. At the Westmead Fertility Centre we will freeze all embryos, which have a potential to survive even if this is only a small possibility. Be aware however that only approximately two thirds of all frozen embryos survive the freezing and thawing process.

Should I still be in pain the day after OPU?
Many women experience pain for one or more days after OPU. This may be due to the procedure or the previous hormone stimulation treatment. You should contact the doctor on call for the Westmead Fertility Centre (phone 9845 5555) if you have any concern about pain at this time. It is permitted to take simple pain relieving tablets such as Panadol or Aspirin at this time.

Should I still be bleeding the day after OPU?
It is common to have a small amount of blood loss the day after OPU and this is of no concern. If you have heavy or persistent bleeding at this time you should contact the doctor on call for the Westmead Fertility Centre (phone 9845 5555).