Assisted Reproductive Technologies

What is infertility?

Infertility is defined as the inability to conceive or carry a pregnancy after a year of unprotected sex. The causes may relate to production of the sperm or eggs, function of the male or female reproductive systems, other health issues or be unexplainable.

About one in six Australian couples of reproductive age experience fertility problems.

How can infertility be treated?

Many couples suffering infertility problems can be successfully treated with lifestyle changes or medical intervention. With the trend towards having children later in life, one in seven women over 37 years use assisted reproductive technologies to help them achieve a pregnancy.

ART procedures include:

• In-vitro fertilisation (IVF) – an egg (or eggs) is retrieved from the woman and combined with sperm outside the body to achieve fertilisation. The resulting embryo is transferred back into the uterus.
• Frozen embryo transfer (FET) – is where a frozen embryo from a previous IVF cycle is thawed and transferred back into the uterus.
• Intracytoplasmic sperm injection (ICSI) – often used in cases of male-factor infertility, a single sperm is injected into each egg to assist fertilisation.
• Blastocyst transfer - an embryo that has been cultured to the blastocyst stage (around 100-150 cells or five to six days after fertilisation) is transferred to the uterus.

ART procedures sometimes involve the use of donor eggs, sperm or embryos. The success rate varies considerably between fertility clinics and depends on a number of factors, including the woman’s age and cause of infertility.

*You may wish to seek fertility assistance if you have been trying to conceive for 12 months, or after six months if you are over the age of 35.

Our research impact

With substantial changes to ART practices in the past decade, researchers have been keen to track child health outcomes, which can then be used to outline risks to prospective parents.

The Australian and New Zealand Assisted Reproduction Database (ANZARD) was established to monitor perinatal outcomes for all ART births and to assess the effectiveness of treatments. However, this register does not report information about birth defect risks or monitor longer-term health outcomes in ART children. Western Australia is the only State with a statutory ART register that includes information about all IVF treatment in the State. This information can be linked to other population-based registers to track health outcomes for the children born.

While there have been encouraging improvements in perinatal outcomes for ART-conceived children over time (such as fewer ART babies being born preterm or of low birthweight), the information about birth defect risk is very out of date – relating to births from 1993-2002.

A current study is aimed at addressing this gap and will examine all births in WA from 2003-2014 and compare foetal growth, birth defects and cerebral palsy in children born following ART, natural conception, and conception using ovulation induction drugs outside the ART clinic setting.

The study will also compare health outcomes within the ART group for children born following a range of different treatment procedures such as fresh vs frozen-thawed embryo transfer, rapid vs slow freezing techniques and standard IVF vs ICSI.

The research will also examine how different causes of underlying infertility contribute to child health outcomes.