Fertility Treatment

How can we help you?

Aevitas Fertility Clinic is dedicated to help individuals and couples realise their dream of having a family. We offer a full range of fertility services, tailored to each patient’s needs.

Heterosexual couples:

Your fertility specialist will address medical conditions affecting your health. The following fertility treatment options may also be discussed:

Ovulation induction

Artificial Insemination (AI)

In Vitro Fertilisation (IVF)

Intra Cytoplasmic Injection (ICSI)

LGBT couples:

Aevitas Fertility Clinic welcomes LGBT couples. We look forward to helping you build your family!

Same sex female couples:
Same sex female couples can make use of one partner’s eggs and donor sperm for conception through either Artificial Insemination or Invitro Fertilisation. Many same sex female couples prefer IVF / ICSI with the one partner’s eggs and allowing the other partner to carry the baby.

Same sex male couples:
To start your family, you would need to find a suitable surrogate mother willing to carry your baby. Sperm from one partner can then be used for Artificial Insemination or In Vitro Fertilisation .

Transgender:
If you have not begun hormone medications or gender confirmation procedures, it is a good idea to see a fertility specialist to discuss fertility preservation options, such as egg freezing and sperm freezing.

If you have already started hormone treatment, we recommend that you consult with a fertility specialist to help you decide which is the best options for you.

Single women:

The option of egg freezing exists for women in their reproductive years who want to preserve their fertility.

There are also a growing number of single women choosing the path of single parenthood. Fertility options for these women include using donor sperm for Artificial Insemination or In Vitro Fertilisation .

Ovulation Induction

Ovulation induction is a fertility treatment which uses fertility medication to:

Induce ovulation
Increase the number of eggs released per ovulation cycle.

Ovulation induction is recommended for:

Women with unexplained infertility
Women with abnormal cycles
Women who do not ovulate spontaneously

Treatment Process

Stimulation. Medication is taken in the form of oral drugs or injections to promote the growth of the follicles (fluid-filled pockets containing the eggs).

Egg release/ovulation. When the follicles are mature (16 – 20mm in diameter) you may be prescribed an intramuscular injection of HCG in preparation for intercourse/ artificial insemination.

Artificial Insemination

Artificial Insemination (AI) is also known as Intrauterine Insemination (IUI). The female partner follows the same process as with Ovulation Induction . Leading up to ovulation, the partner’s best sperm or donor sperm is concentrated through a laboratory procedure. The sperm is introduced into the woman’s cervix or uterine cavity through a soft plastic catheter. This is a simple procedure performed in the doctor’s rooms.

Artificial Insemination is recommended for:

mild sperm disorders
poor quality of female cervical mucus
impotence or premature ejaculation (sperm cannot be introduced through sexual intercourse)
unexplained infertility
Single women or lesbian couples making use of donor sperm

In-Vitro Fertilisation

In Vitro fertilisation (IVF) is the most commonly used of the assisted reproductive technologies (ART). IVF literally means “fertilisation in glass” (referring to the test tube, which is where the term “test tube baby” comes from).

During IVF, eggs are collected from the ovaries and fertilised in the laboratory with sperm. After a few days, the fertilised eggs (embryos) are transferred to the female patient’s womb to develop and grow.

Aevitas fertility specialist’ Professor Thinus Kruger and his team’s research and treatment resulted in the birth of South Africa and Africa’s first “test tube” (IVF) baby in 1984. This event opened a new era in reproductive medicine in Southern Africa.

Treatment Process

Our team of fertility specialists and nursing sisters will work with you to plan your treatment cycle.

For Women

Step 1: Hormone treatment

Hormone treatment is used to boost the development of several follicles containing eggs. With more fertilised eggs, there may be a greater selection of embryos.

Step 2: Ultrasound scan

Your ovaries will be monitored by vaginal ultrasound scan on certain days of your cycle. Blood tests may also be required. Regular ultrasound scans monitor the progress, as well as the response of your ovaries.

Step 3: Hormone injection

You will receive a final hormone injection about 36 hours before the eggs are retrieved. This injection triggers the final maturation of the eggs.

Step 4: Egg retrieval

Egg retrieval takes place in the privacy of our own day theatre. The eggs are retrieved under ultrasound guidance under deep sedation, administered by an anaesthetist. After the procedure, you will be offered a cup of tea and a sandwich before you go home.

Step 5: Fertilisation

The sperm are introduced to the eggs by being placed in an incubator so that fertilisation can occur overnight. The procedure is performed by an embryologist (scientist) in our IVF laboratory.

Step 6: Record fertilisation

The embryologist monitors the eggs to record fertilisation as well as embryo development.

Step 7: Embryo transfer

Embryo transfer into the uterus is usually done on the third to fifth day after the eggs have been retrieved. The optimum day for embryo transfer is determined according to the number and quality of the embryos. One or more embryos are transferred into the female partner’s womb. No sedation is needed for this procedure, which is similar to Artificial Insemination (AI) or to having a cervical smear taken. A fine catheter is gently threaded into the cervix and the embryo is placed in the cavity of the uterus. Ultrasound is used to confirm the placement of the catheter.

Step 8: Pregnancy test

A pregnancy test by means of a blood sample is done on the 10th day after embryo transfer to confirm the outcome.

Number of visits to clinic: 5 – 7 per cycle.

For Men

On the same day that the eggs are collected, you will be asked to produce a fresh sample of sperm using one of our private facilities. The sperm is then washed, the healthiest and most active sperm are selected.

Donor sperm and donor eggs

IVF / ICSI can also be performed using donor egg or sperm if indicated. Aevitas has a great selection of sperm donors and egg donors . Patients also have the option of making use of fresh or frozen donor eggs .

IVF is recommended for:

If other treatments such as Artificial Insemination (AI) have been unsuccessful.
Male sub-fertility ( ICSI is recommended in more severe cases of male infertility).
Unexplained infertility.
Lesbian couples where one partner donates eggs to the other partner.

Intra-cytoplasmic sperm injection (ICSI)

The procedure is similar to IVF (Step 1 – 4). However, the fertilisation process is slightly different as ICSI involves the selection of the best sperm, which is then injected directly into an egg to fertilise it. This enhances the chances of fertilisation.

Aevitas Fertility Clinic is responsible for the 1st ICSI baby in South Africa (1995)

ICSI is recommended for:

Previous failed IVF cycles.
Male partners with sperm abnormalities. This can include low sperm count; if the sperm are not highly active (low sperm motility); or if a low percentage of sperm have a normal shape (low morphology).
The male partner does not produce sperm (azoospermia) and sperm has been collected from the testicles through a testis biopsy.

Testis Biopsy

Testicular sperm extraction (TESE) is performed through a surgical biopsy of the testis.

A testis biopsy can be performed in the privacy of our day theatre within our clinic under deep sedation. A tiny amount of tissue is removed from the testis. The tissue contains a network of tiny tubes (seminiferous tubules) where sperm are produces. The tissue is processed in the laboratory to check for or extract sperm for fertilisation with ICSI.

Testis biopsy / TESE is recommended for:

Non obstructive Azoospermia (when a man cannot produce enough sperm to have a detectable amount in his semen).

Embryo Freezing

Embryo freezing forms part of fertility preservation and is recommended to couples in a long-term relationship.

During an IVF / ICSI cycle more than one embryo can form. With the guidance of your fertility specialist you may decide how many embryos will be placed back during that cycle’s embryo transfer. You may choose to freeze the remainder of the embryos in case the cycle is unsuccessful or for a future sibling pregnancy.

Sperm Freezing

Our laboratory at Aevitas Sperm Bank has the technology and the expertise which allows males to freeze sperm for future use. Sperm can be stored for an unlimited period. Thawed semen samples have the potential to achieve a pregnancy by assisted reproduction, such as Artificial Insemination (AI) or Invitro Fertilisation (IVF) / Intra-cytoplasmic Injection (ICSI) after any length of storage period.

Sperm freezing is recommended for:

The male partner is unable to attend the clinic during the female partner’s fertility treatment cycle.
The male partner may not be able to produce a sample on demand.
Testicular sperm from a biopsy can be frozen, limiting the number of biopsies required to achieve a pregnancy.
Prior to radiotherapy and chemotherapy or the removal of the testicles due to cancer or other disease.
Prior to male sterilisation (vasectomy).
Social fertility preservation.

Oncofertility

Oncofertility is the discipline that merges oncology and fertility. Over the years advancement in oncology care and treatment has resulted in an increase in the survival rate of cancer patients. However, it is also of great importance to pay attention and enhance the quality of life of cancer survivors.

Many cancer survivors may find themselves in their reproductive years with infertility because of the side-effects of certain cancer treatments. The field of oncofertility strives to raise awareness of the effect of cancer therapy on fertility, as well as to develop strategies that will preserve and restore physiological function for both male and female cancer survivors. The following fertility preservation techniques exist for:

Women

Egg freezing. This is recommended for single women or women who are not in a long-term relationship.

Embryo freezing. This is recommended for women in a long-term relationship.
Ovarian tissue freezing. This is the only option for preserving the fertility of prepubertal patients with cancer. For post pubertal women, this is an option for patients who need immediate chemotherapy or patients who do not want to undergo ovarian stimulation.

Men

Sperm freezing . This is recommended for single men or men who are not in a long-term relationship.

Embryo freezing. This is recommended for women in a long-term relationship.

Surrogacy

Surrogacy agreement between the surrogate and commissioning parents will have to be confirmed and authorised by the High Court before any treatment commences. Chapter 19 of the Children’s Act, which relates to surrogacy, came into effect 1 April 2010. As a result prospective parents and surrogates are required to bring an application to the High Court for an order confirming the surrogacy agreement and ordering that the child/children born of the agreement through assisted reproductive techniques, are those of the intended parents and not that of the surrogate. This alleviates the need to undergo an adoption process.

Surrogacy is recommended for:

Women with no uterus
Women with abnormal uterus preventing her from carrying a baby of her own.

Process:

Step 1: legal and medical criteria

Surrogacy must adhere to certain legal and medical criteria:

The surrogate

The surrogate must have a living child of their own and be in good physical-, emotional- and mental health.

Surrogacy agreement

The application, collated by attorneys include:

An affidavit
A surrogacy agreement between the surrogate and commissioning parents
A medical, psychological- and social worker report of the surrogate and commissioning parents

Step 2: Consultation with the fertility specialist

The intended parents, together with the surrogate mother will consult with the fertility specialist. The health and fertility of both the intended parents, as well as the surrogate mother will be performed.

Step 3: Fertility treatment

Gestational surrogacy. In Vitro Fertilisation (IVF) / Intracytoplasmic Sperm Injection (ICSI) can be used with partner or donor egg and/or sperm.

The surrogate will be compensated for expenses related directly to the surrogacy and may claim for reasonable and appropriate loss of earnings that result from the surrogacy, pregnancy, and birth. The surrogate mother however may not use this as a source of income.

The surrogate and commissioning parents can have as much contact as they choose to, however the surrogate will have no rights to the child after birth and the commissioning parent’s names will be entered directly onto the birth certificate after birth.

Surrogates are women who are medically, emotionally, and psychologically willing and able to carry a baby for someone else. The altruistic gift of being a surrogate is a selfless and loving act. Many couples try to find someone close to them to carry their baby for them (a sister, cousin, or friend). Aevitas Fertility Clinic also collaborates with fertility and surrogacy law attorneys to help you through this process.

Preimplantation Genetic Testing

Preimplantation genetic testing (PGT) is the testing of an embryos (up to 5 days) for genetic abnormalities, before the embryo would naturally implant into the uterus (usually after day 6 of fertilisation). Thus, after fertilisation with IVF / ICSI an embryo biopsy can be performed by our embryologists. The sample is then sent to a genetic laboratory for chromosomal analysis.

PGT includes two types of testing. The one test is aimed at testing for chromosomal abnormalities and the other is aimed at testing for familial genetic conditions. These tests allow us to select the best embryos for your treatment cycle.

Testing for chromosomal abnormalities

Preimplantation genetic testing – Aneuploidies (PGT-A) can be offered to test for chromosomal abnormalities. Abnormal chromosome numbers are associated with either miscarriage or a genetic condition (such as Down Syndrome).

Testing for familial genetic conditions

Preimplantation Genetic Testing – Monogenic (PGT-M) screens embryos for known mutations causing single gene familial genetic conditions, such as Tay Sachs or Cystic Fibrosis. PGT-M therefore allows the selection of embryos unaffected by the familial genetic condition to be transferred.