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Q : When should I consider seeing a registered subspecialist in Reproductive Medicine?

 

A : The American Board of Obstetrics and Gynaecology recommend that patients under age thirty-five try to conceive for one year before pursuing infertility treatment. Patients between the ages of thirty-five and thirty-nine should try to conceive for six months and women aged forty and over should wait no more than three months.
There are a few exceptions to these recommendations. Patients who have irregular menstrual periods (cycles that are thirty-five days or longer between periods) or have had previous pelvic infections such as PID should seek advice from their gynaecologist for an earlier referral.


Q : Why should I see a subspecialist in Reproductive Medicine registered with the HPCSA?


A : Subspecialist in Reproductive Medicine registered with the HPCSA has completed specialised training in Reproductive Medicine and would be better equipped to deal with fertility problems. The additional two to three years of training beyond the OB/GYN specialty focuses on assisted reproductive techniques, advanced microsurgery of the pelvic organs, disorders of the anatomy, which may affect fertility, and disorders of the sperm. This additional training beyond the OB/GYN specialty is invaluable and will increase your probability of conception.


Q : How much does infertility treatment cost?

 

A : The cost involved with creating a successful pregnancy depends upon the nature of the disorder causing the infertility, the age of the female partner, and if a male factor is involved. Costs can range from R6 000 for AI, to R47 000 for IVF or for ICSI. * Fees are subject to change without notice but not during a treatment cycle.


Q : Will infertility therapy be covered by my insurance plan?

 

A : The majority of insurance plans in South Africa do not cover infertility treatment.


Q : How successful are infertility treatments?

 

A : Improvements in medication, microsurgery, and in Assisted Reproductive Technologies (ART) make pregnancy possible for the majority of the couples pursuing treatment. Over two thirds of infertile couples will be able to make their dreams of having a child come true. In particular, success rates have dramatically improved for couples who require ART. The pregnancy rate for an ART cycle approaches the monthly fertility rate for most couples. After an initial consultation and a review of diagnostic tests we can better determine your probability as success rates vary from patient to patient and from situation to situation.


Q : What are my chances of having twins, triplets or higher multiple births?

 

A : Most cases of successful treatments with either ovulation induction with IUI or IVF will result in a single birth. Worldwide the rate of twin pregnancy averages approximately 3.5 per 1000 births and less than 1 per 1000 births for triplets or more. The rate of twins with the use of clomiphene citrate is approximately 5-10%. The number of embryos or zygotes transferred following assisted reproductive techniques (ART) directly correlates with the risk of multiple pregnancy, increasing from 1.4% with a single embryo transfer with in vitro fertilisation (IVF), to 17.9% following the transfer of two embryos, and 24.1% with the transfer of four embryos.


Q : Is it safe for me to have a baby in my late 30s or early 40s?

 

A : Many women well into their 40s will have healthy children. The risk of birth defects such as Down's syndrome do increase as you age, as do the risks of developing complications during pregnancy such as gestational diabetes (diabetes during pregnancy) or hypertension (high blood pressure). Early genetic screening can be used to detect certain defects like Down's syndrome. Maintaining a healthy diet and exercise pattern will help reduce the possible health complications. Your physician can help you evaluate your individual risks based on your age and overall health.


Q : How long should I remain on Clomid/Serophene/Clomiphene Citrate therapy?

 

A : The majority of patients who respond to Clomiphene Citrate do so during the first month of therapy. Three ovulatory courses constitute an adequate therapeutic trial. If pregnancy has not been achieved after three ovulatory responses other treatment options should be considered.

 
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