Fertility treatment

Dr Richard Murphy

Fertility treatment: what are my options?

If you are looking into fertility treatment options you may have a lot of questions. I believe that you deserve unrushed time with your specialist, to discuss your fertility challenges. On this page I want to guide you through some of the common questions at the start of a fertility treatment journey.
Obstetrics and gynaecology consultations at my private practice in Subiaco.

Fertility consultations at Genea Hollywood

Delivering at the Labour Ward of SJOG Subiaco Hospital

What to expect from your first consultation with a fertility specialist?

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Causes infertility

What is infertility?

Infertility is diagnosed when as a couple you have been actively trying to conceive for 12 months and have not fallen pregnant. If that happens, you may lose confidence and I consider it part of my role to restore your confidence in your capacities. With the overwhelming volume of information that is out there, I am available to help you get a clear picture of what causes infertility and what can be done.

What causes infertility in women?

There are many common causes of infertility in women. These include:

  • irregular periods due to conditions such as PCOS
  • thyroid disease
  • high prolactin levels or other pituitary hormone abnormalities.
  • blocked or damaged fallopian tubes can stop pregnancy and also cause ectopic pregnancy,
  • endometrial pathology such as endometrial polyps, uterine fibroids, Asherman’s syndrome or Mullerian abnormalities.

In addition to these specific conditions, your general health is very important and factors such as smoking, exercise, diet and weight all impact on fertility. So when we work together, we will look at the whole spectrum and I will take the time to discuss every aspect of your lifestyle so we can optimise your chances. I believe this is the role of your fertility specialist: to really take the time to look at all aspects of your fertility journey, and to take an unrushed approach so you are well aware of your options.

What causes infertility in men?

Half of the genetic material needed to build a baby comes from the sperm DNA. A man’s testicular function often reflects his general health. Children of men who smoke, for example, have 2-3 times the rate of childhood leukaemia compared to the children of non-smokers.
So my role is to help you organise the right tests, and to make sure that you have all the information you need, to get clear on what causes any infertility challenges that you may experience.

I work with you as a couple, to optimise your individual reproductive health. The combination of those efforts is what improves your chances of conceiving.

Natural fertility treatment Perth

Can I boost my fertility naturally?

Absolutely! And just as importantly, all the things that help people conceive also help reduce the risks in pregnancy. Good physical and mental health is incredibly important in negotiating the journey to parenthood.

“Any pre-existing health issues should be addressed. Not smoking or using illegal drugs and avoiding alcohol and caffeine when pregnant help conception and reduce the risk of miscarriage and pregnancy loss. For a lot of couples even a modest reduction in weight can significantly improve the chances of conception, and if help is still needed then treatments are more likely to be successful.”

Regular physical activity is important, both for physical and mental health. Pregnancy places a strain on the body and being physically fit means this extra strain is easier to manage.

“With better physical and mental health a couple is likely to have more frequent intercourse. There is good evidence that couples around the developed world are just not as active, in all ways, as they were even 20 years ago!”

Dr Richard MurphyFertility Specialist, Perth
Fertility treatment Perth

Fertility tests Perth

Should my partner and I seek testing for infertility?

The only way to truly see if you are fertile is to start trying. As couples delay starting families until later in life, the window of time where pregnancy usually occurs easily becomes smaller and smaller.

“If you have not conceived within 12 months a consultation to review your situation is likely to be beneficial.”

Dr Richard MurphyFertility Specialist of WA, Perth
For a lot of couples, there will be more specific concerns and in this situation, a review much earlier than 12 months may be best. For instance, if your periods are very irregular you are probably not ovulating often, or if you have had a complicated appendicitis or Chlamydia infection you may well have blocked or damaged tubes.
To review your specific situation, you might be asked to do some fertility tests. I believe that during this whole process (it is often described as a journey), the cornerstone is a relationship of trust with your fertility specialist. To build and nurture that trust, I take the time to listen to your expectations and to inform you about your options.

Female fertility tests

  • Cycle tracking: with blood tests and ultrasounds we look at your cycle health and when and if you are ovulating.
  • Ultrasound: we use pelvic ultrasound to examine your uterus and ovaries to detect fibroids and cysts as well as assess your ovarian reserve.
  • Blood tests: we check your general health with various blood tests. The Anti-Mullerian Hormone (AMH) is a good indicator of your ovarian reserve.
  • Fallopian tubes test to check if you have blocked tubes.

Male fertility tests

  • Semen analysis to check your sperm count, motility, and morphology. We also check for antibodies in your sperm.
  • DNA fragmentation to check abnormal genetic material in your sperm.

Alternative fertility treatment options

Do I need IVF? Are there alternative fertility treatment options?

IVF is a very good treatment for lots of couples trying to conceive. It is safe for both women and the babies produced. For conditions such as very low sperm counts or blocked tubes, IVF is the treatment of choice.

IVF fertility treatment can also be used where an inherited genetic condition is present, such as Cystic Fibrosis or a Breast Cancer gene abnormality, as well as when a structural chromosomal rearrangement exists in a parent. As the safety and effectiveness of IVF have been established its use has grown.

IVF is now used to treat lots of couples with unexplained infertility. In this situation, IVF will often magnify a couple’s chances of conception. For a lot of couples, however, there are other options to help them achieve a successful pregnancy including;

Ovulation Induction: The menstrual cycle involves an intricate interaction of hormones all aimed at releasing an egg just when the vagina, cervix, endometrium and tubes are ready. Various degrees of abnormality with this process can result in poor hormone levels and a thin, less receptive endometrium, less frequent ovulation or even no ovulation. Ovulation induction treatment helps develop a single egg ready for release at the right time and can help overcome these difficulties. In the right couples, it has a high success rate.

Intrauterine Insemination (IUI): can be used for mild or moderate unexplained infertility. Ovarian stimulation is used, aiming for the release of 2 eggs and fresh sperm is prepared for direct introduction into the uterus.

Lipiodol tubal flushing: For couples with mild or moderate unexplained infertility, flushing the tubes with Lipiodol, a poppy seed oil solution, has been shown to significantly improve conception rates over the next 6 months.

IVF and ICSI: IVF involves controlled ovarian stimulation with the surgical collection of multiple eggs, ideally 10-15. Around 75,000 sperm are introduced around each egg and usually 65-75% of eggs will be fertilised. The fertilised eggs become embryos and these are grown in the lab, usually for 5 days. About 40% of embryos reach day 5, when a naturally conceived embryo would be leaving the fallopian tube and implanting in the endometrial cavity, ie in the uterus. ICSI (intracytoplasmic sperm injection) is a specific form of IVF where fertilisation is achieved by an Embryologist selecting one sperm for direct injection into an egg. ICSI is used for very low sperm counts, where there are high levels of sperm DNA damage, where standard IVF fertilisation does not work, and when embryo screening for chromosomal abnormality or genetic conditions is planned.

Fertility Specialist Genea Hollywood

Why Dr Richard Murphy for fertility treatment?

My patients tell me they feel supported on their journey. In fertility, it is not just about ticking the boxes, planning tests and procedures and providing the evidence-based healthcare that I specialise in. It is also about the human aspect of the journey you are on.

"My vision is that if I help build your confidence, in your capacities to conceive, that is also a big part of the process. There is an overwhelming amount of information out there, and part of my role is to make you less prone to doubt. I have an open mind, work with a wide range of patients from around Western Australia and will always respect your lifestyle, orientation and the view you have on what fertility means to you."

That approach, combined with my extensive experience in the wide range of fertility treatments we have available here in Perth, is what allows me to help my patients with passion, enthusiasm and commitment.