With a passion for exploring and fully supporting complex fertility cases, Dr Maree searches deeper to find insights when treatments haven't worked and difficulties can't be explained.
Sometimes fertility treatments just don’t work the way they are expected to, and when it comes to knowing why, the answers aren’t easy to find.
But no definitive reason shouldn’t mean no information to work from at all.
From secondary infertility and diminished ovarian reserve, to recurrent implantation failure and other unexplained infertility issues, Dr Maree will work to understand your situation.
She will examine your history, current health, treatment paths and any potential contributing factors.
Complex fertility care insights
Difficult fertility cases often share a common challenge: standard fertility testing may identify no known cause, or standard fertility treatments may not achieve a pregnancy, meaning specialised investigation and treatment is needed.
Unexplained infertility accounts for around 30% of couples assessed and is a diagnosis of exclusion, reached when common examinations return no useful result. The proportion labelled unexplained rises or falls with how far testing is taken, but ‘no findings’ does not rule out problems, only that standard testing has not found a cause.
Secondary infertility means difficulty conceiving after an initial pregnancy. A prior birth is often taken as reassurance, but age, the interval since, and newly present factors can each change the outcome.
Diminished ovarian reserve is a measurable factor, assessed through AMH testing and antral follicle counts. These indicate how the ovaries may respond to IVF stimulation, but do not rule out pregnancy or indicate the likelihood of natural conception.
Recurrent implantation failure describes repeated unsuccessful transfers of good-quality embryos. Much of this is now understood to reflect embryo chromosomal status rather than the uterus. Where embryos are screened for chromosomal abnormalities before transfer, more than 95% of women become pregnant within three euploid transfers. True recurrent implantation failure is thought to affect fewer than 2% of patients.
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Around 30% of investigated couples are diagnosed with unexplained infertility.
At least 40 to 60 % of human embryos are abnormal, increasing to 80 % in women 40 years or older.
Around 1 in 10 women with a previous birth experience secondary infertility.
Diminished ovarian reserve (DOR) affects 10% of women seeking fertility treatment.
Half of women with primary or secondary infertility report psychological distress.
Dr Maree starts with a conversation, working through your history, past treatments, and your goals.
Existing test results, treatment cycles and outcomes are reviewed comprehensively, as the answer can often be in the the details when reviewed closely, reducing the need to start again.
If there’s a test that hasn’t been tried yet, and the evidence supports it, Dr Maree will discuss it with you, including what it can and can’t tell you, and ensure every avenue for finding a reason has been fully assessed.
This might mean a different protocol, a different diagnosis to consider, or just a clearer explanation of where you really stand. Your approach to treatment is personalised, and innovative options are considered with rigour and care.
Complex fertility care isn’t often a quick and easy path, but it is a process you will undertake with a compassionate expert with you every step of the way.
Some infertility situations are more challenging than others. Dr Maree is a specialist who is curious, committed and genuinely invested in helping you find the right approach to achieve pregnancy.
Complex fertility care comes with a lot of questions, and at Dr Maree’s practice, we are all about delivering the answers. Here are some of the most common queries we receive.
No referral is needed to get an appointment with Dr Maree, and you’re welcome to book directly, but note that a referral may be required to claim appointments and treatments on Medicare.
It means standard testing hasn’t identified a cause, not that nothing can be done. It often points to a more individualised approach rather than a generic one, and more detailed review to learn as much as we can before proceeding to next stages.
Secondary infertility is difficulty conceiving after a previous pregnancy. It’s examined much like any fertility difficulty, with your history taken into account, and can occur in any person, as past success is not an indication of current conditions.
No. It can affect IVF timelines and expectations, but many people with diminished ovarian reserve still go on to have successful pregnancies.
Current evidence doesn’t support routine use, but Dr Maree will discuss all existing and emerging tests with you so you receive the right investigations to guide your future treatment.
That history is useful information but it does not necessarily indicate there’s nothing that can be done. Dr Maree will review what’s been tried and use it to inform what happens next.
The Waiting Room is the perfect place to take a few minutes and read through the latest research, emerging practices, and insights shared by Dr Maree. The more you know, the more effectively you can consider and discuss your options and make informed decisions that are right for you.
Male factor affects around half of couples trying to conceive, yet the man is often the last to be tested. Dr Maree Lee explains what a semen analysis really tells you and why both partners should be investigated from the start.
Age is information, not a verdict. Dr Maree Lee explains what fertility decline after 35 really means, why AMH doesn’t tell the whole story, and when to investigate.
An evidence-based guide to elective egg freezing by fertility specialist Dr Maree Lee: what it preserves, success rates by age, the process and the Australian rules.
A complete picture of your reproductive health, so you understand your options before you start trying.
Deep, compassionate investigation for one of the most difficult experiences in fertility care.
Skilled surgical care for the conditions that can affect fertility and gynaecological health.
If your fertility situation hasn’t fit a simple explanation, or treatments haven’t worked, Dr Maree is committed to looking deeper.
