Fertility Solutions for the Single Woman

1. Fertility Solutions for the Single Woman Single and wanting a baby?

2. Why a Fertility Clinic? EFT gives you the best chance and the safest way of fulfilling your dream by your own choice.

3. Why Canberra Fertility Centre? Australia’s leading experts in Fertility Options for Single Women

4. Two basic choices CHOICE 1 CHOICE 2 (Well Established) (Still Developing)

5. Good News! Medicare recognise the Single Woman as eligible for fertility treatment and subject to the same benefits as for all item numbered fertility treatments. This includes donor sperm treatment cycles as well as egg freezing.

6. Why am I here?

7. Few topics arouse such anxiety and confusion as the effect of aging on female fertility and ultimately pregnancy. If defer pregnancy to mid 30s one third will have fertility problems. If defer pregnancy to 40+ 50% will seek infertility treatment. What is the Biological Clock?

8. Egg Numbers: natural attrition Fertility starts to decline after age 35: the number of eggs reduces naturally until menopause. The eggs have a predetermined life span that cannot be altered. Using oral contraceptives does not preserve egg numbers Unlike sperm there is no new production of fresh healthy eggs in women. 400 eggs are ovulated in a lifetime.

9. Ageing and Fertility Fertility starts to decline after age 35: the number of eggs reduces naturally until menopause Increased menstrual irregularity and shortened follicular phase Increased miscarriage rates Increased fetal abnormalities

10. Choices start now

11. 3 Questions to be answered Am I fertile? What options are available? How do I start?

12. Am I Fertile? Fertility depends upon 3 major factors: Eggs Sperm Pathway

13. For pregnancy to Occur Regular menstrual cycle and ovulation Patent fallopian tubes Normal uterine cavity Adequate sperm Timing

14. Cycle Tracking Can be both diagnostic and a treatment Confirms cycle length and regularity Pinpoints ovulation Identifies ovulatory problems Identifies luteal insufficiency Bulk Billed

15. Where do I start? Seek specialist referral Relevant investigations Counselling Pre pregnancy preparation General health check Immunisations PAP smear Weight loss vitamins Treatment

16. Fertility Options CHOICE 1 CHOICE 2 • Oocyte Freezing • Young <35yrs • ‘Untried’ 1000 births worldwide • At best still a low chance • Donor Sperm • Insemination • Create embryos • Store or Use the Embryos

17. Take Home Message THERE IS CURRENTLY NO TEST TO DETERMINE WHETHER A PARTICULAR EGG OR EMBRYO WILL MAKE A BABY Currently the only test of your Fertility is the birth of a live child.

18. Donor

19. Donor Gametes Gametes include sperm, eggs. Providers (Canberra Fertility Centre and donors) and recipients (patients) all governed by law. “Known Donors” allowed and all governed by law An Australian shortage of donor gametes CANBERRA FERTILITY CENTRE HAS DONOR SPERM AVAILABLE

20. Choice 1: Donor Sperm Types of donor Donor provided by Canberra Fertility Centre Donor provided by overseas Sperm Bank Own Donor Background & Legal Aspects Treatment Options Counselling & Ethics Process

21. Sperm Donation Facts & Background • Current legal in ACT covered by the Parentage Act • Clinic also governed by federal laws, NHMRC guidelines • Clinic has two levels of accreditation RTAC and NATA. • 2010 Sperm excluded from the Human Tissue Regulation • Gay donors acceptable • Canberra Fertility Centre has strong commitment to maintaining supply of donor sperm guaranteed for your plans now and in the future • Strong commitment to recruit LOCAL sperm donors.

22. Sperm Donation Facts & Background Donor identifying information placed on a register at birth of offspring When a child reaches 18 years and if desired can obtain identifying information of the register at CFC One donor can have offspring up to 5 families in the ACT

23. Sperm Donors (3 types) Provided by Canberra Fertility Centre sperm bank 1. Local ACT compliant Comprehensive history 2. Imported from USA or Denmark US company Xytex: www.xytex.com Californian Cryo Bank European Sperm Bank Denmark ACT compliant Comprehensive history

24. 3. Known Donors (A known donor can be your closest male friend ) Legally acceptable Must be fertile Comply with medical testing & counselling 6 Months quarantine Governed by ACT laws Altruistic donation Always identifiable to offspring (≥ 18 yrs) Sperm Donors (3 types)

25. Choosing a Donor Information may include the following: • Ethnicity of donor • Ethnicity of parents- maternal/paternal • Age at donation • Blood type • Height • Weight • Eye colour • Hair colour/type eg brown,wavy • Skin colour • Education • Occupation • Interests/activities • Religion • Some donors have photos • Medical history • Medical screening

26. Choosing a Donor from www.xytec.com • Patient Section tab includes information on: • Semen Donor Screening Guide – includes blood screens for certain diseases eg HIV, Hepatitis and other diseases • FAQs • Fees Most information is free but some information such as photos may require a payment to view. If you have any queries about using this website or the websites for European Sperm Bank Denmark or the Californian Cryo Bank, you may contact our donor coordinator, Fiona by email fiona@cfc.net.au or Ph:02 6282 5458

27. Choosing a Donor Appointment with our Donor coordinator, Fiona at CFC You choose a donor from Xytex, European Sperm Bank Denmark, or Californian Cryo Bank or from CFC local donors If you choose an imported donor, Fiona arranges the purchase, transportation and storage at CFC of the frozen (cryopreserved) donor sperm from the company. You pay the company directly for the donor sperm. If you choose a local donor from CFC, you make payment for your selected cryopreserved straws of donor sperm which are already in storage at CFC. Donor sperm is stored in individually labelled vials or straws in cryopreservation tanks at CFC. Each patient’s donor sperm straws/vials are stored separately from other stored sperm.

28. Treatment Options IUI Insemination OI & IUI Ovulation Induction IVF & ICSI

29. Treatment Options: IVF/ICSI v IUI • IVF/ICSI Advantage: • 6 x more likely to achieve pregnancy per straw/vial than with IUI ie better use of donor sperm.  • One straw/vial of donor sperm usually covers more than one cycle. • IVF/ICSI Disadvantage: • More invasive treatment (medications and egg retrieval operation) • (CFC local donors are only to be used for IVF cycles as there is a higher success rate with IVF and we have a limited number of CFC local donor straws.) • IUI Advantage: • Less invasive and less costly • IUI Disadvantage: • 6 x less likely to achieve pregnancy per straw/vial because a whole straw/vial is used in a treatment cycle • (Imported donors can be used for IUI treatment.)

30. Prepare yourself Weight (30%) Exercise Alcohol Smoking Recreational Drugs Folic Acid and Multivitamins Get to know your cycle with Ovulation Tracking

31. Counselling Patients considering using or donating gametes attend compulsory counselling prior to commencement Both recipient and donor – separate with partners Focus on consequences of the donation Legal considerations Parenting roles Effects on family members/ dynamics especially non biological parent and grandparents Issues of self identity for the child

32. Counselling (continued) Openness / secrecy (when and how to tell the child and others) Future relationships especially with known donors (establishing boundaries and legal rights) Single women and consideration of male role/influence Effect of the donor’s future family No coercion – illegal to be paid for donating Rights of the child are paramount – our society says child has right biological information

33. Choice 2: Egg Freezing (Only viable under 35 years of age)

34. 3. How do I start?

35. What does it cost? • Fees are dependant upon treatment • Fees Information Booklet available at seminar, from CFC, and also on website www.cfc.net.au • Please ring Merran at Canberra Fertility Centre to discuss fees for your individual treatment PH: 02 6282 5458

36. FINAL TAKE HOME MESSAGE OUR TEAM IS COMMITTED TO HELP YOU ACHIEVE A BABY!