There can be many reasons why a couple fail to conceive spontaneously or have recurrent miscarriages and in some cases can remain unexplained once all investigations are complete. Couples should seek help after 6-12 months of infertility, or sooner if the woman is over 35.

Other reasons to seek help earlier may be irregular or absent periods, painful periods, a previous history of infertility or a history of gynaecological problems such as endometriosis, fibroids or pelvic infection. A thorough history will be taken and then appropriate tests ordered. This will involve blood tests to assess ovulation and egg reserve, assessment of the fallopian tubes and a semen analysis. Sometimes an operation involving a laparoscopy and hysteroscopy to assess the pelvis and uterus further may be indicated. Other tests would be based on the information gathered at the consultation. A management plan would then be discussed. All our gynaecologists can start the process of investigation and potential treatment for some kinds of infertility If further fertility treatments are indicated then both Drs Fiona Cowell and Vanessa King are affiliated with Monash IVF.

All of our doctors at Sage Womens Specialists are fully trained and can perform a wide range of procedures. Dr Kristina Cvach has further qualifications as a Urogynaeocologist, offering patients even more highly specialized care in bladder and prolapse problems. Dr Vanessa King and Dr Fiona Cowell are fertility specialists associated with Monash IVF.

Gynaecological conditions treated include:
- Abnormal bleeding and difficult periods
- Period and pelvic pain
- Ovarian cysts and fibroids
- Menopause
- Abnormal cervical screening tests and colposcopy
- Fertility issues
- Pre-pregnancy counseling and checks

We are qualified to manage all pregnancies – in healthy and well women as well as those who are high risk in their pregnancy. All Sage Obstetricians are highly skilled in all types of birth, with many years of teaching hospital and overseas experience.

Your first visit will normally be at around 8-10 weeks of pregnancy. It is a longer appointment and gives the opportunity for your doctor to take a full medical history, arrange tests and discuss your questions and concerns. A pregnancy ultrasound will usually be performed.

In uncomplicated pregnancies you will usually have an appointment each month until 30 weeks, then every 2 weeks until the last month, when your visits are weekly. Extra appointments are easily scheduled for women with high risk or complicated pregnancies, and for emergencies.

We choose to look after our own patients. This means that your routine visits and usually your labour and birth or caesarean will be with the obstetrician of your choice.

As part of safe modern day care we do have scheduled time off, and work together (with one other female obstetrician) to ensure our patients always have excellent cover 24 hours a day, by a Melbourne obstetrician. If we have any planned holidays or study leave of more than a few days, you will be informed of this when you ring to book in for pregnancy care.

We are all working mums, dedicated to the wellbeing of you and your baby, but also offering lots of life experience in juggling careers, home and motherhood.

Your GP may refer you to a gynaecologist for a colposcopy due to an abnormal CST. Specialist gynaecologists require additional certification to perform these procedures. Both Dr Vanessa King and Dr Miranda Robinson are accredited to perform colposcopy and manage abnormal-CST’s.

A Cervical Screening Test is where a plastic brush is swept over the cervix and a sample obtained. It is a screening test to detect the presence of high risk HPV (Human Papilloma Virus) DNA . If no HPV is present the recommendation is to rescreen in 5 years. If a high risk HPV is present then the cervical cells in the same sample are tested. Depending on the type of HPV and result of the cervical cell assessment you be recommended to have either a repeat CST in 1 year or a colposcopy.

A colposcopy further evaluates the cervix. A speculum examination (the same as when a CST is taken) is performed with the woman on a special gynaecological chair. Fluid is applied to the cervix that highlights changes when looked at with a microscope (the colposcope). If changes are seen a small biopsy (a few mm only) is taken. Some women feel this as a pinch and others feel nothing. Some spotting or discharge may occur in the following few days.

Results will be back within a week and observation or treatment of the changes planned. Treatment usually involves a LLETZ procedure which removes the abnormal cells. This is performed in an operating theatre under general anesthetic as a day case. Usual follow up after a LLETZ is a CST one year later looking at both HPV and cells.