At Wijnland Fertiltiy, we offer a plethora of fertility treatments as well as gentle support along the way. If you haven’t been able to fall pregnant after trying for 12 months (or if you’re older than 37) it could be time to seek advice. Our fertility specialists will be able to tell you more about the routine tests and procedures as well as our assisted conception treatments. Infertility is relatively common in South Africa and can be caused by many reasons. These reasons could be attributed to a female factor, male factor or combination thereof. At Wijnland Fertility we aim to treat couples holistically and we strive to optimise all your avenues for chances of success.
Along with the various fertility treatments we have to offer, we also offer the full range of fertility surgery, including laparoscopic myomectomy, laparoscopic treatment of all grades of endometriosis, hysteroscopic removal of fibroids/polyps and re-anastomoses of Fallopian tubes after sterilisation.
As part of our general gynaecological surgery we also offer total laparoscopic hysterectomy, as well as endometrial resection/ablation.
- Endoscopic surgery and advanced endoscopy
- Laparoscopic diagnosis of endometriosis
- Gynaecological endocrinology
The fertility treatments that we offer include:
The process & what to expect
There are different expectations for the various treatment options that we offer at Wijnland Fertility. To make the expectation process simple, we can divide the different treatment options into in vivo (where the eggs stay in the body) and in vitro (where the eggs are removed from the body).
In vivo:
- Home plan
A home plan cycles is considered as the least complex and cheapest fertility treatment option. For the home plan treatment option, the female is mildly stimulated to aim to create 2 mature eggs. Timed intercourse around ovulation during the stimulated cycle is then recommended in the hopes for a higher chance of conception than in an unstimulated cycle.
- Artificial insemination (AI) / intrauterine insemination (IUI)
Similar to the home plan induction cycle, but sperm are artificially inserted into the uterus. The female partner will undergo the insemination of the prepared sperm sample at the doctor’s rooms. The AI procedure is similar to a routine gynaecological examination for a Pap smear. The pregnancy test is normally performed 12 days after the AI procedure. A blood beta-hCG test is the most accurate. A home pregnancy test is less accurate and can be done 15 days after the AI. We will contact you as soon as we receive your test result.
In vitro
- Standard IVF
- ICSI
- IMSI
For all ‘in vitro’ procedures, the patient’s process is the same for all procedures. The differences between the procedures only occur within the laboratory.
Female patients will be stimulated in order to produce a number of eggs for aspiration around day 12 – 14 of your stimulation cycle. 36 hours prior to your procedure, a very important hormone trigger is administered in order for us to control exactly when to retrieve the eggs (before you ovulate).
On the day:
You will be admitted into the day ward at Wijnland Fertility. The aspiration procedure is very short and makes use of anaesthesia, which means that you need to be prepared prior to the day of the procedure (no eating after midnight). The aspiration procedure is so short (generally), that the process of the anaesthetist putting you ‘to sleep’ takes longer than the actual egg retrieval. Once your procedure is finished, you will be wheeled out of theatre and be placed back into your warm recovery bed where you will be woken up with some tea or coffee and a scone. Thereafter, an embryologist will let you know how many eggs where retrieved. This information is only given to you once you have fully woken up from your drowsy sleep and are relaxed and ready to receive the much awaited information.
Following the egg retrieval:
The eggs will be evaluated the next day to see how many have been fertilised (Day 1).
We will call you to inform you of the results. Fertilised eggs are now known as zygotes and can start to develop into embryos.
Not all fertilised eggs develop into embryos, but most do. The quality of the embryo development will be evaluated by a scientific grading system, which will guide us to select the embryos with the greatest implantation potential to place into the uterus. The embryologist will inform you of embryo development.
Embryo Transfer:
The embryo transfer procedure will be done on Day 5 (in standard cost option Day 3), depending mainly on how many good-quality embryos have developed. Our clinic’s protocol is to transfer only one embryo per cycle. In exceptional cases, two embryos may be transferred at the discretion of the treating doctor and attending embryologist. It will depend largely on the quality of the embryos. If any surplus high-quality blastocysts remain in culture after the transfer, they can either be frozen and stored for future use, or donated or discarded.
Please talk to the doctor and/or embryologist about the freezing, discarding or donation of surplus embryos before starting fertility treatment to ensure you and your partner have enough time to think about these options and make a well-informed decision. The nursing sister or embryologist will call you to inform you when the transfer procedure is going to take place.
You will be given information about preparing for the transfer procedure. This will also include having a full bladder. You will be conscious, and your husband/partner can be with you in the procedure room. Your uterus will be visualised by doing a trans-abdominal scan and the doctor will use a speculum to visualise the cervix. The embryos will be drawn into a thin catheter and will be placed into the uterus.
The embryos will be released slowly into the uterus – you and your partner will be able to see this on the ultrasound screen! Your bladder will then be emptied by the doctor with the use of a catheter. You may lie down and rest for 20 to 40 minutes after the transfer. If you have any surplus embryos in the laboratory, the embryologist will talk to you about your decision and/or instructions on the handling of your surplus embryos. The embryologist will give you the applicable consent forms to be signed by you.
You will also receive forms showing a summary of the number of eggs retrieved, the number fertilised, how many embryos were transferred, how many were left in culture and when pregnancy tests can be done. You can then go home and continue with your daily activities. We advise you to take it easy on the day of the transfer. You may drive a car if needed. The embryologist will phone you a few days after the transfer to give you feedback on the further development and/or freezing of your surplus embryos, where applicable.
When should you start considering fertility treatment?
Home plan:
- Usually the first-line treatment for ‘good prognosis’ patients
AI / IUI:
(Female)
- Mild Endometriosis
- Unexplained Infertility
- Irregular Menstrual Cycles
(Male)
- Mild Male Factor
- Sexual Dysfunction (e.g. Premature Ejaculation)
- Frozen Sperm (e.g. If husband is away at time of insemination or if donor sperm is needed.)
IVF:
- >3 failed AI’s / IUI’s
- Tubal factor
- HIV
ICSI:
- Failed IVF Fertilisation
- Poor Sperm Parameters
- Sperm Extracted from the Testis
- Low Oocyte Count
- Spinal Injury in Men
- Women Older than 38
IMSI:
- Severe male factor infertility (poor morphology)
- Recurrent failed ICSI cycles
- Failed blastulation
- Poor fertilization within previous ICSI cycles