Counseling offers you a forum for discussion, which may assist you in making decisions about treatments and help you explore all options available. Talk to a counselor about your concerns, and find out how others cope and how normal your reactions are.

Counseling at Women's Hospital International & Fertility Centre

For some patients, counseling is mandatory, for example, those donating or receiving donated gametes or embryos during fertility treatment. For most patients, it is service, which we highly recommend to assist you to understand the range of emotions you and your partner may typically experience.

“It is important not to wait until you are overwhelmed before seeking counseling support.”

It is important not to wait until you are overwhelmed before seeking counseling support. Our team of fertility specialists, nurses and scientists all provide counsel to patients. However our specifically trained fertility counselors can help at any time to:

  • Provide independent, confidential support and someone to talk to about how you or your partner may be feeling;
  • Prepare you for your fertility treatments and discuss the options available when making decisions about changing or stopping treatments;
    • Work on your relationship with your partner to support your treatment;
    • Support you through the emotions involved in trying to achieve a pregnancy;
  • Cope with other people’s pregnancies and births by providing protective (self preservation) strategies for couples when faced with emotional settings;
  • Discuss reactions of families, friends and work colleagues; 
explore some strategies to help you feel more in control;
  • Cope with unsuccessful treatment cycles and/or miscarriage; 
discuss the anxieties of pregnancy and preparation for parenthood;
  • Deal with the specific issues related to donor treatment cycles.

For those patients undergoing donor cycles or surrogacy counseling, a number of counseling sessions are required for all parties involved in prior to commencing any form of treatment.

Women’s Hospital International offers professional counseling services to our patients before and after major procedures are undertaken. Our counselors offer a professional service to people who want to talk about their experiences. Seeing a counselor doesn’t mean that you are weak, mentally ill or not coping well. It is an opportunity to talk to someone in private and to get help with coping with difficult feelings. It can be a positive step at a very difficult time. Please contact us for an appointment with our counselors.

Family Planning

Family planning is the planning of when to have children, and the use of birth control and other techniques to implement such plans. Other techniques commonly used include sexuality education, prevention and management of sexually transmitted infections, pre-conception counseling and management, and infertility management.

Family planning is sometimes used in the wrong way also as a synonym for the use of birth control, though it often includes more. It is most usually applied to a female-male couple who wish to limit the number of children they have and/or to control the timing of pregnancy (also known as spacing children). Family planning may encompass sterilization, as well as pregnancy termination.

Family planning services are defined as “educational, comprehensive medical or social activities, which enable individuals, including minors, to determine freely the number and spacing of their children and to select the means by which this may be achieved.”

Sex Selection/PGD

Sex selection is the attempt to control the sex of the offspring to achieve a desired sex. It can be accomplished in several ways, both pre- and post-implantation of an embryo, as well as at birth.

Preimplantation genetic diagnosis (PGD)

After ovarian stimulation, multiple eggs are removed from the mother. The eggs are fertilized in the laboratory using the father’s sperm in a technique called in vitro fertilization (IVF). “In vitro” is Latin for “within glass”. Fertilized eggs are called embryos. As the embryos develop through mitosis, they are separated by sex. Embryos of the desired gender are implanted back in the mother’s uterus.

Prior to fertilization with IVF, the fertilized eggs can be genetically biopsied with preimplantation genetic diagnosis (PGD) to increase fertilization success. Once an embryo grows to a 6-8 cell size, a small laser incision in the egg membrane (zona pellucida) allows safe removal of one of the cells. Every cell in the embryo contains an identical copy of the genome of the entire person. Removal of one of these cells does not harm the developing embryo. An embryologist then studies the chromosomes in the extracted cells for genetic defects and for a definite analysis of the embryo’s gender. Embryos of the desired sex and with acceptable genetics are then placed back into the mother.

The IVF/PGD technique is favored over the Ericsson method because of the stricter control of the offspring gender in the laboratory. Since only embryos of the desired sex are transferred to the mother, IVF/PGD avoids the small likelihood present in the Ericsson method of an undesired sperm fertilizing the egg. Gender selection success rates for IVF/PGD are very high. The technique is recommended for couples who will not accept a child of the undesired gender.

Antenatal Care

Antenatal care monitors your health during pregnancy, as well as the health and development of your baby. It can help predict possible problems with your pregnancy or the birth, so action can be taken to avoid or treat them.

Your first antenatal appointment will probably be your booking-in appointment and usually happens at about eight to 12 weeks. You can expect to have appointments every four weeks after week 12, every two weeks from week 32, and every week during the last three or four weeks.

You’ll be asked a number of questions about your health, family history and any previous pregnancies. The aim is to get a basic picture of your health and your pregnancy so far. The midwife might discuss issues such as diet, smoking and work; she may also ask about your thoughts on breast or bottle-feeding and give you information on these. You don’t have to make up your mind on this or on any other matter, but it’s a good chance to ask questions and clear up anything you’re worried about.

Routine checks at appointments are likely to include:

  • Blood pressure
  • Weight
  • Palpation – feeling your tummy
  • Listening to your baby’s heart
  • Questions about your baby’s movements
  • Urine tests
  • Checking for any swelling in your legs, arms or face
  • Questions about how you feel

Labour and Delivery

Women who feel able to do so are encouraged to walk during the early stages of labor, which can make them more comfortable. One support person may be present during labor and delivery.

Cesarean birth

There are many reasons why the decision may be made to perform a cesarean section. Sometimes, the cesarean is planned in advance because of an existing medical condition or because there will be more than two babies born. Other times, a cesarean section is performed after labor fails to progress and there is some concern about the health of the baby or mother.

Maternity Services at Women's Hospital International & Fertility Centre

Anesthesia provided before and during a cesarean section allows women to remain comfortable during the procedure. Most remain awake during the birth. Husbands are invited to be present in the cesarean section room. After giving birth, women who have had a cesarean are encouraged to hold their baby, breastfeed and bond.

Recovery from a cesarean section will take longer than a vaginal birth. However, women who have had cesarean sections will generally be up and out of bed within 24 hours, with the help of their nurse, and are encouraged to walk and move around. They stay in the hospital a few extra days. In addition, new moms who have had a c-section should plan on some extra help for when they leave the hospital.

Post-birth Care

Our private recovery rooms are equipped with color televisions, telephones, lavatories and comfortable birthing beds.

After the baby is born, new mothers are encouraged to initiate breastfeeding to encourage bonding during this period. Husbands are invited to be present in both the recovery room.

Right after birth, your baby will be evaluated by a Womens’ Hospital International & Fertility centre health career (obstetrician, nurse practitioner and/or neonatologist), who checks your baby’s vital signs, such as blood pressure and heart rate. This is a judgment of the baby’s activity, pulse, grimace, appearance and color.

Babies are weighed and given treatment to prevent eye infection. Identification bands are placed on the baby and both parents, and the baby’s footprints and mother’s thumbprint are obtained to ensure proper identification.

Surrogacy Programmes

Surrogacy is an arrangement in which a woman carries and delivers a child for another couple or person. This woman may be the child’s genetic mother (called traditional surrogacy), or she may carry the pregnancy to delivery after having an embryo, to which she has no genetic relationship, transferred to her uterus (called gestational surrogacy).

Our surrogacy program gives you the opportunity to make dreams come true for yourself and for couples and singles, who can’t have their own children.

Surrogacy Programmes at the Women's Hospital International & Fertility Centre

While not biologically related to the baby they carry, Surrogates play the most critical role in the process—carrying and delivering the baby created through eggs donated by the mother or an egg donor and sperm from a sperm donor or father.

For the intended parents you’ll be working with, you provide something that no one else can—a miracle for their family. But, what you can provide for your own family is equally important. Your family will see the amazing contribution you have made to others while receiving a generous compensation package that can change the future for you and your loved one.

Our program strongly believes in supporting surrogates during each step of the process. Our exceptional team of accomplished professionals will guide you through the entire journey while providing constant, personal support for you and your intended parents. When you contact us, our first goal is to provide you with information about our surrogacy programs and to understand your expectations of the surrogacy process. We will thoughtfully match you with intended parents who desire the same experiences you do.

HIV Sperm Washing

Sperm washing is a process, which has been developed for couples who wish to have a child, where the male is HIV-positive and the female is HIV-negative. The procedure reduces the risk of HIV transmission to the female partner and subsequently the unborn child.

Sperm washing rests on the premise that HIV infected material is carried primarily in the seminal fluid rather than in the sperm itself. There remains a very small theoretical risk to the woman of HIV transmission. Sperm washing is safer than having unprotected sex, but if a couple is certain that they don’t want to take any risk, no matter how minimal, sperm washing would not be a suitable method for them. These couples may prefer to find out more about artificial insemination by donor, which is a risk free alternative.

A couple’s first step on this programme is to visit our counselor, (both individually and as a couple) to get further information and support, and to explore some of the issues involved. Deciding to embark on this treatment may not be a easy decision. Although the risk of the female partner becoming infected is minimal, it still exists, and for one or both partners it may be felt that this risk is too much. There is also an opportunity to discuss issues concerning parenting itself and facing the reality that treatment does not guarantee pregnancy.

During the first visit, couples will also need to have a full sexual health screen, which includes an HIV test for both partners. Over the following few weeks, tests including various blood tests along with an ultra-sound scan and an x-ray for the female partner, and a semen analysis for the male partner will be performed. These tests indicate whether insemination would be a realistic option. If either partner was to have sub-optimal fertility, IVF may be a consideration after all avenues have been explored. All preliminary investigations and appointments can take two to three months.

Egg Donations

You do not need to spend time and money on an outside egg donation agency. We do it all here.

Who should be treated with egg donation?

  • Egg donation can be used as an effective treatment for infertility of all causes except for women with infertility caused by an anatomic problem with the uterus, such as severe intrauterine adhesions.
  • Pregnancy rates with egg donation are high, particularly as compared to pregnancy rates in women with poor egg quality and quantity.
  • Donor ovum IVF is generally used only in women with significantly diminished egg quantity and quality (poor ovarian reserve). This includes women with:
  • Premature ovarian failure (menopause)
Very poor egg quality
  • Poor response to ovarian stimulation
  • Significantly elevated day 3 follicle stimulating hormone (FSH) level
  • Advanced female age, such as over about 39-40

How is egg donation performed?

An appropriate egg donor is chosen by the infertile couple and thoroughly screened for infectious diseases and genetically transmissible conditions.

Consents are signed by all parties.

The donor is stimulated with injected medications to develop multiple egg development. This allows us to perform in vitro fertilization with her eggs and the sperm of the infertile woman’s male partner.

Intra-Cytoplasmic Sperm Injection (ICSI)

ICSI (intra-cytoplasmic sperm injection) is an assisted conception technique, which may be, used where a male has only a few live sperm or where sperm quality is poor or lacking motility

It can overcome problems in which a sperm cannot drill a hole through the egg to fertilise it (for example, because of abnormalities affecting the sac of enzymes on the sperm head), and where anti-sperm antibodies are present. It can also be used where a male undergoing cancer treatment has previously frozen a sample of his sperm, and wants to maximise their potential use. ICSI has been used where there is a blockage preventing release of sperm, as the sperm can be obtained from the epididymis (the tube leading from a testis) or from the testis itself using a fine needle.

During ICSI, a single sperm is injected directly into the white (cytoplasm) of a mature egg using an ultra-fine glass needle (pipette). The fertilised egg is then observed until it has undergone a certain number of divisions before being transferred into the woman’s reproductive tract.

A fertilisation rate of 50 per cent is usual, with 80 per cent or more fertilised eggs starting to divide as normal. Factors such as the woman’s age (and therefore the age of her eggs) affect the success rate. The average live birth rate is 22 per cent, per embryo transfer, but the success of ICSI depends on the skill and experience of its practitioners

Egg/Sperm freezing and storage

Both egg and embryo freezing are available at Womens’ Hospital International and Fertility Centre.

Why freeze and store your eggs and embryos?


You may wish to store your eggs for future use in treatment for a number of reasons, including if you: are about to undergo chemotherapy or radiotherapy require surgical removal of your ovarie face early menopause

You may wish to store your eggs for future use in treatment for a number of reasons, including if you:

  • Are about to undergo chemotherapy or radiotherapy
  • Require surgical removal of your ovaries
  • Face early menopause
  • Wish to postpone childbearing age until after 35

On rare occasions eggs can be frozen in an emergency, for example, when a semen sample can not be produced.

The main advantages of egg freezing are that partner or donor sperm is not required at this stage, so freezing can help preserve fertility in single women, and certain ethical issues relating to the storage and potential disposal of embryos are avoided.

However, there are several disadvantages too. Freezing human eggs is still a relatively new technique and therefore may involve as yet unidentified risks, such as increased risk of a congenitally abnormal baby. What’s more, thawing cryopreserved eggs is more expensive than thawing embryos because after thawing, eggs require fertilisation using ICSI.


At WHI&FC, surplus embryos may be frozen after IVF treatment for use at a later date to create more siblings or if the treatment cycle was unsuccessful. Frozen-thawed embryos have a lower viability rate compared to ‘fresh’ cycles. However, the frozen embryo transfer (FET) is much less invasive.

What does egg freezing involve?

You will be required to have screening tests performed for HIV and hepatitis B and C before freezing and storage of your eggs. You must also attend a counselling session at the centreto discuss the implications of treatment. You will also be required to complete consent forms for freezing and storage of your eggs. These consent forms allow you to specify:

  • What should happen to your eggs if you were to die or become unable to make decisions for yourself
  • Whether the eggs are to be used for your own treatment only, or whether they can be donated for someone else’s treatment or for training
  • Other conditions you may have for the use of your eggs

You may change or withdraw consent at any time, either before treatment or before the eggs are used in training.If this happens, your eggs will not be used. The process is similar to going through an IVF cycle, as you will have to take fertility drugs to stimulate the ovaries to produce follicles (which contain the eggs). The developing follicles are monitored and when they are large enough you will be required to go through the egg recovery procedure, where the follicles are carefully emptied to collect the eggs. For further information please refer to our IVF treatment page.

How are eggs and embryos frozen?

Only mature eggs will be frozen. At WHI&FC, eggs and embryos are frozen by vitrification – a process whereby the solution containing the eggs is cooled so quickly that the structure of the water molecules doesn’t have time to form ice crystals and instantaneously solidifies into a glass-like structure.

How long can my eggs and embryos be stored for?

The standard storage period for eggs and embryos is ten years from the date of freeze, up to a maximum of 55 years. If you have frozen eggs or embryos at the centre it is your responsibility to keep in touch and notify the centre of any changes in your contact details. There will be an annual fee for storage of eggs and embryos at our centre. If you fail to pay the storage charges, or if we are unable to contact you when the storage period is coming to an end, we may remove your eggs/embryos from storage and allow them to perish. Further details are set out in our terms and conditions of storage, and you will be asked to complete a ‘Consent to the preservation and storage of eggs by freezing’ form.

What is my chance of having a baby with frozen eggsand embryos?


It is difficult to assess the chances of a successful pregnancy using frozen-thawed eggs.

Vitrification has shown to yield potentially far more successful results in the freezing of eggs. It has also been suggested that vitrification may be less traumatic for eggs and may have less effect on their physiology.


As with egg freezing, at EHI&FC, embryos are cryopreserved using vitrification. Vitrification of embryos is starting to become more common worldwide as more IVF laboratories start to implement this technique. Although the number of frozen embryos is still low, there seems to be a marked increase in the survival rate of vitrified-thawed embryos compared to that of embryos cryopreserved using the slow freeze method.

What are the risks of egg freezing and storage?

It is important that you are fully aware of all the potential problems involved prior to going ahead with treatment.The centre staff will explain the risks and you willbe given an opportunity to ask questions. Egg freezing is still a relatively new technique and not all eggs will survive the freezing and thawing process orbecome fertilised.

Intra Uterine Insemination (IUI)

In an IUI procedure, the practitioner inserts specially treated sperm through the cervix into the woman’s uterus. IUI increases the likelihood of fertilization. This procedure is performed around the time of ovulation. In some cases, particularly if low sperm count is a concern, two IUI procedures can be performed several hours apart. IUI may use the partner’s sperm, or if indicated, sperm from a donor.

Intrauterine insemination with partner’s sperm can be used as a potentially effective treatment for infertility of all causes in women under about age 45 except for cases with tubal blockage, severe tubal damage, very poor egg quantity and quality, ovarian failure (menopause), and severe male factor infertility. In vitro fertilization with the woman’s eggs or IVF with donor eggs are alternatives for couples that are not candidates for artificial insemination.

It is most commonly used for infertility associated with endometriosis, unexplained infertility, anovulatory infertility, very mild degrees of male factor infertility, cervical infertility and for some couples with immunological abnormalities.

It is a reasonable initial treatment that should be utilized for a maximum of about 3-6 months in women who are ovulating (releasing eggs) on their own. It can be reasonable to use it for somewhat longer than this in women with anovulation that has been stimulated to ovulate.

It should not be used in women with blocked fallopian tubes. Tubal patency should be demonstrated prior to performing insemination. This is usually done with an x-ray study called a hysterosalpingogram.

It has very little chance of working in women that are over 40 years old, or in younger women with a significantly elevated day 3 FSH level, or other indications of significantly reduced ovarian reserve.

If the sperm count, motility or morphology is slightly low, insemination is quite unlikely to be successful. In that situation, IVF with ICSI is indicated and has high success rates.

How is insemination performed?

  • The woman usually is stimulated with medication to stimulate multiple egg development and the insemination is timed to coincide with ovulation.
  • A semen specimen is either produced at home or in the office by masturbation after 2-5 days of abstinence from ejaculation.
  • The semen is “washed” in the laboratory (called sperm processing or sperm washing). By this process, the sperm is separated from the other components of the semen and concentrated in a small volume. Various media and techniques can be used to perform the washing and separation, depending on the specifics of the individual case and preferences of the laboratory. The sperm processing takes about 20-60 minutes, depending on the technique utilized.
  • The separated and washed specimen consisting of a purified fraction of highly motile sperm is placed either in the cervix or high in the uterine cavity using a very thin, soft catheter.

Most programs have the woman remain lying down for 5 minutes following the procedure, although this has not been shown to improve pregnancy rates. Since the sperm is above the level of the vagina, it will not leak out when she stands up.

This procedure, if done properly, usually seems similar to a pap smear for the woman. There should be little or no discomfort.

Pregnancy rates

Success rates for intrauterine insemination vary considerably and depend on the age of the woman, type of ovarian stimulation (if any) used, duration of infertility, cause of infertility, number and quality of motile sperm in the washed specimen, and other factors. Rates for women over 35 drop off, and for women over 40 are much lower. For this reason, we are more aggressive in “older” women.

Pregnancy rates are lower when insemination is used:

  • in women over 40
  • in women with poor with poor quality sperm in women with moderate or severe endometriosis
  • in women with any degree of tubal damage or pelvic scar tissue
  • in couples with a long duration of infertility (over 3 years)p

The rates are slightly higher for women that do not ovulate on their own (anovulation) that are stimulated to ovulate with medication and then inseminated. This is because it is likely that the sole cause of their infertility is their ovulation disorder – which is overcome with the use of the ovulation stimulating medicine.

For a couple with unexplained infertility, the female age 35, trying for 2 years, and normal sperm – we would generally expect about:

  • 5% chance per month of conceiving and delivering with clomiphene and intrauterine insemination for up to about 3 cycles (lower after 3 attempts)
  • 8% chance per month of conceiving and delivering with injectable FSH (e.g. Follistim, or Pergonal) and insemination for up to about 3 cycles (lower after 3 attempts) 

  • 50% chance of conceiving and delivering with one cycle (month) of IVF treatment (at our center – pregnancy rates vary greatly between IVF clinics)

Our IVF pregnancy and delivery rates

Ovarian stimulation with clomiphene citrate versus stimulation with injectable gonadotropins (Pergonal or Follistim)

Although there is not universal agreement in published studies or among infertility experts, intrauterine insemination with partner’s sperm in conjunction with ovarian stimulation seems to provide higher pregnancy rates than insemination in natural menstrual cycles (without ovarian stimulation).

Insemination combined with ovarian stimulation with injectable gonadotropins provides better pregnancy rates (and higher multiple pregnancy rates) as compared to insemination combined with clomiphene. Injectable gonadotropins usually stimulate more mature eggs to develop than does clomiphene. More mature follicles and eggs lead to more chance for a pregnancy. However, more follicles and eggs also entail more risk for multiple pregnancy. It is a double-edged sword…

How many insemination cycles should be done?

Most pregnancies with insemination using partner’s sperm occur in the first 3-4 attempts. The chances for success per month drop off after about 3 attempts and considerably more after about 4-6 unsuccessful attempts. Therefore, this therapy is not usually recommended for more than a maximum of 4-6 cycles. If the reason for infertility is lack of ovulation (anovulation) then it may be more reasonable to try several more cycles (6-12 cycles total). In vitro fertilization is the next step in treatment after inseminations – and has a much higher success rate per cycle.