DR RICHARD MURPHY

Perth fertility specialist

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Reasons to see your Perth fertility specialist

Fertility education

Reason 1: Accurate information

You will come across a massive amount of information about fertility when you browse the internet, talk to a friend, or go through books and magazines. Finding information is not a problem for most people.

Finding accurate information which is relevant to you is a different matter. With a thorough look at your fertility history, and a number of routine investigations, we can provide an accurate diagnosis. This combined information helps us calculate how likely you are to conceive naturally.

If treatment is needed this will allow you to then choose your best option. So accuracy is definitely an important reason to see a qualified Perth fertility specialist.

Obstetrics and gynaecology consultations at my private practice in Subiaco.

Fertility consultations at Genea Hollywood

Delivering at the Labour Ward of SJOG Subiaco Hospital

"Finding information is not a problem, finding accurate information is a different matter."

Dr Richard MurphyPerth obstetrician

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Infection & fertility

Reason 2: A history of pelvic infection

If you have any history of infection in your pelvis, then it is worth seeing a fertility specialist – even before you try to conceive. A burst appendix or a Chlamydia or Gonorrhea infection, especially if complicated, can cause damage to your tubes or adhesions around them.

"This can stop pregnancy altogether but also be associated with ectopic pregnancy, a surgical emergency. In this situation an assessment is useful either before you start trying or if there is any delay in conceiving. "

Dr Richard Murphy, Perth fertility specialist

Damaged tubes can form a “hydrosalpinx” where the tube becomes swollen with inflammatory fluid so that even if the other tube is undamaged, pregnancy is much less likely without the hydrosalpinx being treated.

Male infertility test

Reason 3: An abnormal sperm test

If your sperm quality is persistently low the chances of a spontaneous pregnancy can be very low. Thankfully modern IVF treatment can almost always help. Men with a history of testicular trauma, undescended testes, or a history of inguinal hernia as a young baby, for example, may need to see a specialist. Undescended testes are associated with low sperm counts, increasing the risk of fertility problems, but also with an increased risk of testicular cancer.

While every man has probably had a minor testicular injury or 2 growing up, there is the occasional more severe case of a testicular injury. It can result in loss of testicular tissue but also the development of anti-sperm antibodies. This is also commonly seen after a vasectomy where even with a successful surgical reversal producing sperm in the ejaculate, the sperm are so covered with antibodies that pregnancy cannot occur. In these cases, IVF and ICSI may be needed.

Period problems & fertility

Reason 4: Long or irregular periods

This is usually a clear sign you are not ovulating regularly. Common causes for no or irregular ovulation include PCOS, thyroid disease, high prolactin, and hypothalamic dysfunction. The good news is that irregular cycles are usually very easy to treat.

After appropriate investigation and treating any underlying cause, we use Ovulation Induction, stimulating your ovaries carefully to produce a single egg. You can then fall pregnant through normal intercourse with your partner. At the fertility clinic where I work, Genea Hollywood, we are proud of our high rates of success with ovulation induction, producing beautiful babies with a low risk of multiple pregnancy.

low number of eggs & fertility

Reason 5: Low ovarian reserve

A low number of eggs is another typical reason to come and see me as your Perth fertility specialist. This might show through a low AMH blood test or a low number of antral follicles on an ultrasound. One percent of women will, unfortunately, go through menopause before the age of 40, and this is called premature ovarian failure. If you are concerned about your ovarian reserve please contact me and we can discuss your options. Similarly, while it sounds strange, premature ovarian failure does not always stop you from having a baby and it is associated with some ongoing health risks which you should be aware of and which require ongoing management.

Freezing eggs Perth

Reason 6: Egg freezing

If you are in your 30’s and not in a position where you can start a family just yet, then there is the option of freezing some of your unfertilised eggs as a form of “reproductive insurance”. Using IVF treatment we can stimulate your ovaries and collect a number of eggs which can be stored for up to 10 years. When you are in a position later on to start a family your fertility and hence chances of falling pregnant and delivering a baby will be lower. If things do not go smoothly then your stored eggs can be used to give you a good chance of producing a baby.

"Like all forms of insurance, you will hope not to have to use it but egg freezing can give peace of mind and a solid, reassuring fallback position if needed."

Dr Richard MurphyPerth fertility specialist

The reasons for egg freezing vary widely and egg freezing may or may not be relevant for you. Come in and we can discuss your situation.

Recurrent miscarriage & fertility

Reason 7: Two or more miscarriages

This is another reason to look into fertility treatment: You have had 2 or more miscarriages or any second or third-trimester pregnancy loss. The loss of a wanted pregnancy can be devastating to couples. Unfortunately, first-trimester miscarriage is very common, usually due to chromosomal problems intrinsic to a specific pregnancy. The more miscarriages you have had the more likely it is that there is some underlying pathology causing the miscarriages. Often this is not obvious and so specific tests can be very useful to help find not just answers but also evidence-based treatments that can prevent further losses.

Sometimes people have known medical conditions which can increase the risk of miscarriage, like diabetes, autoimmune, or other chronic diseases. In this situation, a preconception review is very important. If this has not been possible for whatever reason then review after even 1 miscarriage is recommended.

Second and third-trimester pregnancy losses are associated with a different spectrum of disease than first-trimester miscarriage. Any second or third-trimester loss should result in a thorough obstetric review before you fall pregnant again. If this is you I would like to help.

Not conceiving after 1 year

Reason 8: Trying for 6 or 12 months

You have been trying for 12 months and are not pregnant, or you are over 35 and have not conceived after 6 months. Some quite simple tests for you and your partner can tell us whether your prognosis for falling pregnant naturally is good or poor. A good prognosis can significantly reduce your stress and hopefully return some fun to the process of making a baby. A poorer prognosis does not usually mean there is no chance of falling pregnant naturally. Either way, with accurate information you will be able to consider all your options and find the best option for you.

Genetic disorders & Fertility

Reason 9: Family history of genetic disease

You have a history of inherited disease in your family. Autosomal dominant genetic conditions are passed on from either the mother or father to children 50% of the time. Examples include Huntington’s disease, polycystic kidney disease, Marfan’s syndrome, Machado-Joseph disease, and neurofibromatosis. Autosomal recessive conditions require both parents to be carriers of the disease, having 1 normal and 1 abnormal “carrier” copy of the gene involved. 25% of babies inherit 2 abnormal genes and then develop the recessive genetic condition. Examples include cystic fibrosis, where 1:25 Caucasians are carriers, and spinal muscular atrophy, where 1:40 Caucasians are carriers. X-linked genetic conditions are caused by having no normal copy of a gene on any of your X chromosomes. Females have two X chromosomes so are rarely affected however males only have X chromosome so these conditions are passed from a normal “carrier” mother to 50% of her sons. Examples include fragile X syndrome and haemophilia.

The good news is that modern IVF treatment allows us to screen embryos for these types of diseases. I know firsthand how devastating these conditions can be within families, being personally a carrier of the BRCA2 breast cancer gene. If you have a family history of genetically inherited disease in your family then please come and see me before you start trying to conceive so that we can discuss your options.

genetic screening perth

Reason 10: Exclude inherited genetic disease

Here’s another reason to come and see me: You do NOT have a family history of inherited genetic disease. “What!” you are thinking. You have not misread this. There are hundreds of rare X-linked and recessive genetic conditions. They are all individually rare, affecting 1:10,000, 1:50,000, or even fewer people. However, when you add all these “rare” diseases together they are anything but, affecting about 1:200 children. You now have the option of a blood test for you and your partner which can screen for hundreds of these conditions in one go. 97% of couples will find they are NOT at risk, providing great reassurance. 3% of couples however will have a 1:4 chance that each and every one of their children has one of these rare diseases.

This recessive and X-linked genetic screening is best done before you start trying to conceive as this allows the option of using IVF to screen embryos, using just those that will be unaffected.

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