Family planning, preconception advice and gynaecological conditions
At Newtown Fertility Centre, we provide general gynaecology care, along with fertility treatment using a holistic approach.
An important part of our Sydney fertility clinic is to educate everyone about reproductive, sexual health and gynaecological issues. We help patients reach optimal health. We are known for our empathetic, confidential and non-judgemental approach.
Family planning and contraception
Gynaecological Conditions (Factsheets)
Dr Andreadis does not manage:
– Abnormal pap smears / cervical abnormalities / colposcopy
– Gynaecological cancers
– Pelvic floor disorders / prolapse
– Urological issues
Family planning and Preconception
The complexity of ovaries, uterus, Fallopian tubes etc, and the interaction of estrogen and progesterone can influence a variety of diseases such as heart attack, depression, anxiety, sexually transmitted diseases (STD), osteoarthritis, and urinary tract problems.
These problems necessitate them to visit their doctor in timely intervals in order to screen for various diseases. Screening tests can assess the risk for future illnesses and help in their early detection.
What are common tests for Women's Health and Screening?
- Pap Smears – Dr Natasha performs these but does not manage abnormal pap smears
- Breast checks – Dr Natasha performs these and can teach her patients how to do them
- Blood Pressure Check
- Cholesterol Screening
- Diabetes Screening
- Colon Cancer Screening
- Bone Density
- Dental Examination
- Eye Examination
Nearly 50% of cases of difficulty in conceiving are sperm-related. Common conditions such as stress and obesity can have a negative impact on sexuality and sperm production, and an increased attention to lifestyle factors can significantly improve sperm health.
At times, infertility can be due to more complicated issues such as blockage of sperm production or genetic conditions that require more involved treatment such as a testicular sperm extraction or pre-implantation genetic diagnosis.
Preconception Advice & Support
The formation of mature sperm takes about two months, while the maturation of eggs occurs at about one hundred days prior to ovulation. As you can see, your reproductive health at the time you start to attempt conception is actually largely dependent on parental health, environment, diet and lifestyle a few months earlier. This makes preconception and the pre-pregnancy period vital in optimising the chances of successful conception.
To find out more about preconception advice, please book an appointment with Dr Andreadis.
What is a preconception check-up?
A preconception or pre-pregnancy check-up with your obstetrician or gynaecologist is advised for people attempting conception. At this appointment, your doctor may order blood tests to check vitamin and mineral levels or seroconversion levels against particular infections.
Some potential parents may have conditions such as diabetes, epilepsy or reduced thyroid function or have a family history of neural tube defects that needs special monitoring, genetic screening or further investigation.
What is a healthy preconception lifestyle?
Nutrition is a significant part of optimal preconception health. A well balanced diet including fresh vegetables and plenty of fibre is key to maintaining pre-pregnancy wellbeing. It is important that people attempting conception are getting plenty of nutrients, including vitamins and some minerals, from their diet.
Regular non-contact exercise is an essential part of a healthy lifestyle during the pre-pregnancy and pregnancy periods. People that smoke, use illicit drugs or are heavy consumers of alcohol should also speak to their gynaecologist in order to reduce or abstain from consumption two to three months prior to conception.
Do I need supplements?
In some cases, it may be advisable to supplement certain elements during the preconception period. For example, it is recommended that people considering carrying a child supplement folic acid. This is true of the pre-pregnancy period and during the pregnancy itself. Folic acid reduces the risk of some birth defects, so it is essential that folate levels are maintained at this time.
Do I need vaccinations?
Some people may not develop immunity to chicken pox or rubella despite being vaccinated; both of these can be harmful to a foetus during pregnancy, so further vaccination may be required at preconception.
Exposure to cats and cat litter can also put women at risk of toxoplasmosis, but immunity levels can be checked prior to conception. Like listeria, (a disease transmitted via contaminated food) the infection can cause foetal death.
Other infections are also potentially dangerous to pregnant people and their unborn babies, including syphilis, cytomegalovirus and HIV. There are tests to screen for these illnesses and methods of managing their effects, so people that are at risk should speak to their gynaecologist or obstetrician in a preconception appointment.
Screening may also include a blood type analysis to check for Rhesus factor, as people wanting to become pregnant who are Rhesus Negative will require medical attention.
Family planning is the method of planning your family in terms of the desired number of children, and comfortably spacing your pregnancies. Family planning is achieved with the use of contraceptives. Traditional methods of contraception involve the withdrawal method, where ejaculation occurs outside the vagina, and the calendar-based method, where intercourse is avoided during the fertile days of a menstrual cycle. However, there are more modern methods of contraception, which include:
- Oral contraceptive pills
- Implants containing progesterone hormone
- Injections of hormones
- Intrauterine devices
- Male and female sterilisation
Family planning has several benefits such as prevention of pregnancy-related health risks, sexually transmitted diseases (such as syphilis and HIV) and pregnancies in adolescents, slowing the growth of population and decreasing the rate of infant deaths.
Dr Tash welcomes everyone to her clinic including the LGBTQ community. She understands that traditional gynaecology and reproductive clinics can be tricky spaces for LGBTQ people to feel included. LGBTQ patients are welcome and supported for their individual needs.
Everyone needs advice and access to safe, reliable and affordable contraception. The decision to use specific types of contraception is influenced by a age, health, frequency and type of sexual activity, number and gender of sexual partners, desire for future pregnancy and certain medical conditions.
We firmly believe that patients should be well informed about their options and feel comfortable discussing different contraceptive methods.
To find out more about our fertility treatments, please book an appointment with Dr Andreadis.
What contraceptive methods are available?
A vast array of contraceptive methods is available, including:
- hormonal treatments such as pills, implants, vaginal rings and some intrauterine devices (IUD)
- barrier methods such as condoms, cervical caps and diaphragms, and
- tubal ligation or tubal blockage
A good relationship with your gynaecologist is essential in selecting the best contraceptive methods for your sexual and general health.
What is hormonal contraception?
Hormonal contraceptive methods prevent pregnancy by regulating or ceasing ovulation, thickening cervical mucus thereby preventing the sperm from reaching the egg, or thinning the lining of the uterus. It is important that hormonal contraceptive methods are prescribed, administered and monitored by a gynaecologist in order to maintain optimal reproductive and general health.
For example, Mirena IUD releases progestin once inserted into the uterus, which makes the cervical mucous thicker, the endometrium thinner and suppresses ovulation. Mirena has a lower risk of pelvic diseases and endometrial cancer than oestrogen-based contraceptive methods, and menstrual bleeding and pain are reduced within 3 to 6 months of insertion.
Some methods of hormonal contraception may be contraindicated for particular populations. For example, the combined oral contraceptive pills (the pill) is not recommended for people that smoke and are over 35 years old or for any those who have with a history of blood clots, breast, liver or endometrial cancer or high blood pressure.
Similarly, injectable hormonal birth control may cause bone density loss in some patients, and may either require supplementation of Vitamin D and calcium or cessation of use.
What is barrier contraception?
Barrier contraceptive methods work by preventing sperm from entering the uterus and therefore fertilising an egg. They are removable, and are often a good alternative for people that are not able to use hormonal contraceptive methods. Some products are disposable (such as condoms, dams, gloves etc which are discarded after one use), while some are reusable (such as diaphragms, cervical caps and contraceptive sponges).
Diaphragms, for example, need to be fitted and are discarded after 1-2 years. They should be refitted after pregnancy, dramatic weight gain or loss or pelvic surgery. Additionally, some barrier methods such as lamb skin condoms and spermicides do not protect from sexually transmitted infections (STIs). Occasionally, barrier products may cause irritation to some patients which may require the attention of a doctor. Therefore, it is important that patients understand the risks and challenges associated with each contraceptive method.
What is tubal ligation?
A more permanent contraceptive method is tubal ligation. This is a surgical procedure whereby the fallopian tubes are cut and tied, blocking the path between the ovaries and the uterus. This stops the sperm from reaching the egg and therefore prevents fertilisation. Alternatively, the fallopian tubes can be blocked with an implant causing a tubal blockage which has a similar effect.
Both tubal ligation and tubal blockage procedures may be reversible, but it is not always a successful procedure. For this reason, these contraceptive methods are usually performed after significant consultation, investigation and discussion with a physician.
Factors affecting the success of a reversal include age of the patient, number of previous abdominal surgeries and other medical history, the length of the tubes at the time of the procedure and the type of sterilisation procedure used. The chances of falling pregnant after a reversal procedure are about 60% with full term pregnancies achieved in about 50% of patients.
Mirena is a contraceptive intrauterine device used to prevent unwanted pregnancy. Mirena offers a long-term contraception, for up to 5 years after insertion. Mirena is T-shaped plastic frame with plastic strings attached. When placed in the uterus, it releases the hormone progestin that makes the cervical mucus more viscous and the endometrium thinner so as to avoid the entry of sperms into the fallopian tubes. Mirena is also considered to partially suppress ovulation.
What are the benefits of a Mirena?
Mirena has several benefits over the other contraceptive methods. It can be removed at any point of time ensuring immediate return to fertility. It reduces menstrual bleeding and decreases menstrual pain in about 3-6 months of its insertion. The risk of diseases such as pelvic inflammatory disease, and endometrial cancer is decreased and adverse effects associated with other contraceptive methods containing oestrogen are eliminated.
The use of Mirena may be contraindicated if you have cancers in breast, uterus, cervix and liver or have uterine abnormalities such as fibroids, pelvic infection or pelvic inflammatory disease, abnormal vaginal bleeding, vaginal inflammation, or a lower genital tract infection.
What does the procedure involve?
Dr Andreadis inserts Mirenas in her office. During the procedure, she will first insert speculum into your vagina, there is the opportunity to self insert speculum. The vagina and cervix is cleansed with an antiseptic solution followed by alignment of cervical canal and the uterine cavity using appropriate instruments. After this, the depth of your uterine cavity is measured with a tool. The IUD is then inserted. The strings of the device are then trimmed.
What are the risks and complications?
Mirena insertion is a quite safe procedure, but some people feel giddiness, experience low blood pressure or slow heart rate. Mirena prevents unwanted pregnancy but do not offer any protection towards sexually transmitted diseases.
So please talk to Dr Natasha for more information on use of Mirena before choosing the device for contraception.
Copper (non-hormonal) IUD
Natasha also inserts Copper IUD’s. Patients requiring an IUD insertion are generally seen across 2 visits to the clinic. The first visit will be a consultation and assessment only. Natasha will discuss the pros and cons of the IUD with you at this visit and also other contraceptive options that may suitable to you. Most IUD insertions take place in our office however there may be some cases where an insertion would be better performed in an operating theatre under anaesthetic.
Hysteroscopy & Excision of Fibroids and Polyps
Hysteroscopy is a minor and fairly safe surgical procedure used for diagnosis and/or treatment of various conditions of the uterus. It involves a general anaesthetic.
A thin magnifying instrument called a hysteroscope is inserted into the uterus through the vagina to view the internal aspect of the uterus. The camera in the hysteroscope displays the images on to the monitor thereby helping the surgeon to view the internal structures. This procedure allows the treatment of conditions, such as the removal of uterine polyps or fibroids.
Patients go home on the same day as the procedure.