Gynaecologist & Fertility Specialist.
work as an experienced team.
ensures you receive expert support throughout your treatment journey.
Dr John Esler is one of Queensland’s most experienced gynaecologists renowned for offering services that are at the forefront of the latest and most significant advances in gynaecology.
Dr Esler is also one of Australia’s leading fertility specialists. His focus is on providing expert treatment based on best practice science to ensure his patients have the best chance of falling pregnant as quickly as possible.
His commitment to the latest scientific advancements and clinical excellence has produced success rates that are amongst the highest in the country. His patient-focused fertility treatments have helped thousands of patients achieve their parenthood goals.
Dr Esler offers a full range of gynaecological services including surgery. His expertise is extensive and he has grown to become one of Queensland’s most experienced gynaecological surgeons, in particular in vaginal surgery – an area of gynaecological surgery shown to deliver a host of benefits to patients (where indicated).
Dr Esler offers a comprehensive range of fertility services including options for the simplest of problems through to the most complex fertility issues, as well as options for singles and same sex couples. His fertility success rates are amongst the highest in the country.
Dr Esler’s boutique-style clinic offers a relaxed and friendly ambience. Free car parking is available (in a secure carpark) for the convenience of patients.
Dr Esler’s practice is located in Toowoomba and patients travel from across the country for a consultation. If travelling is a challenge Dr Esler does offer Skype consultations (a GP referral is required).
Interstate patients are able to book same day direct flights to Toowoomba. Very affordable, high quality accommodation is available in close proximity to Dr Esler’s office and day surgery.
Dr John Esler – Gynaecology & Fertility Services
Dr John Esler & Queensland Fertility Group (QFG) Toowoomba
Dr Esler is one of Queensland’s most experienced gynaecologists and gynaecological surgeons. His services are personal and professional and his experience, knowledge and expertise ensure his patients have the best chance of achieving a positive outcome.
Dr Esler’s fertility practice – Queensland Fertility Group Toowoomba – offers a comprehensive range of services including fertility services for singles and same-sex couples. Dr Esler’s fertility services incorporate all the latest evidence-based, best practice, techniques and treatments (including advanced embryo selection) that are clinically and scientifically proven to give individual patients the best chance of producing a viable pregnancy. Dr Esler understands that patients seeking fertility advice dream of having a baby and his aim is to help them achieve that dream, safely and with minimum anxiety and cost. His success rates are amongst the highest in the country.
Dr Esler’s friendly team members understand that one size does not fit all. They are on hand to provide support every step of the way through your treatment journey. Dr Esler’s fertility team includes experienced nurses, counsellors and locally-based IVF scientists, who deliver personalised care to meet your individual needs and concerns.
Practice Manager Sharlene has been employed by Dr Esler for almost 12years. She has worked in the medical industry for over 27 years and recently completed a Diploma in HR Management. Sharlene manages the day-to-day running of Dr Esler’s practice and she is also his personal assistant.
Susan is a registered nurse and midwife who began working in Queensland Fertility Group Toowoomba as a Clinical Nurse in 2008. Before becoming a fertility nurse, Susan worked throughout Australia in Maternity Services. She holds a certificate of Midwifery from UNE.
Susan’s aim is to ensure patients embark on their IVF journey fully prepared and well informed.
Every woman deserves expert personalised care
Every woman is unique and deserves a personalised approach to her care from an experienced clinician. Dr Esler’s gynaecological expertise is extensive and he has grown to become one of Queensland’s most experienced gynaecological surgeons, in particular in vaginal surgery, which includes treatment of prolapse and incontinence. Evidence shows that vaginal surgery (where indicated) delivers greater benefits to patients than other forms of surgery. Vaginal surgery ensures patients have fewer complications, a faster recovery, a shorter stay in hospital and less pain. Dr Esler also performs all other forms of gynaecological surgery including advanced laparoscopic procedures, complex major surgical procedures involving abdominal pelvic surgery as well as vaginal surgery; pelvic floor reconstruction, prolapse repairs, vaginal and abdominal hysterectomy, and treatment for urinary incontinence.
Hysterectomy – The following information on hysterectomy is a summary of the excellent information about hysterectomy available on the Women’s Health Queensland website, and we thank them for their permission to share it.
For more information please visit https://womhealth.org.au/conditions-and-treatments/hysterectomy-fact-sheet.
Hysterectomy is one of the most common types of elective surgeries for Australian women. It is major surgery, and depending on your condition there are several different types of operations and several different ways the surgeon can perform your operation.
The different types of hysterectomy operations are:
* Hysterectomy with ovarian conservation – removal of the fallopian tubes, uterus and cervix but keeping the ovaries (this is the most common procedure performed).
* Hysterectomy with oophorectomy – removal of the fallopian tubes, uterus and cervix and one or both sets of ovaries.
Your surgeon can perform your hysterectomy in three different ways.
Total abdominal hysterectomy – performed when extensive exploration is required such as in the case of cancer, an enlarged uterus, obesity or if the woman has never had children.
A vaginal hysterectomy – this involves making an incision in the upper portion of the vagina and removing the uterus through the vagina. Evidence shows that a vaginal hysterectomy should be performed in preference to an abdominal hysterectomy, or a laparoscopic approach where possible and where indicated (i.e. for non-cancerous conditions) because it delivers the greatest benefits to patients – less pain, a shorter hospital stay and the absence of a visible scar.
Laparoscopic hysterectomy – three or four small incisions are made in the abdomen. A laparoscope is inserted through one of the incisions into the abdominal cavity enabling the surgeon to view the pelvic organs on a video screen and insert surgical instruments through the remaining incisions.
Disadvantages of a laparoscopic hysterectomy include the possibility of a longer operating time depending on how much of the operation is performed laparoscopically, higher costs and an increased risk of damage to the urinary tract and bowel. Women considering a laparoscopic hysterectomy are advised to ask specific questions about the surgeon’s training and experience in this particular procedure.
The surgical approach to hysterectomy should be decided by the woman in discussion with her surgeon. This discussion should cover the relative benefits and hazards. Before arriving at any decision, the woman also needs to take into consideration the experience of her surgeon, the number of successful procedures they have performed and their complication rates, as all these factors also have the potential to influence the outcomes.
Incontinence – Urinary incontinence occurs more often in women than in men. Pregnancy, childbirth, and menopause may contribute to urinary incontinence in women. Weak bladder muscles, overactive bladder muscles, and nerve damage may also cause urinary incontinence in women. Urinary incontinence in women is common and treatable.
Prolapse repairs – Vaginal prolapse is a common condition where the bladder, uterus and or bowel protrudes into the vagina. This can cause symptoms such as a sensation of a vaginal lump, constipation, difficulty emptying the bowel or bladder or problems with sexual intercourse. Dr Esler does not and never has used vaginal mesh.
Endometriosis – Endometriosis is one of the most common causes of pelvic pain and infertility in women. This condition can cause painful menstrual cramps, abnormal bleeding, pain during intercourse and infertility. Treatment will vary depending on the severity of the condition and the objectives of the patient. In the past surgical intervention was recommended in order to diagnose or treat this condition; however – if treatment is sought for fertility reasons – consensus is that surgery may not be the best approach (surgery can cause scarring and decreased ovarian reserve). Patients should discuss IVF prior to considering surgery.
Polycystic Ovary Syndrome – PCOS affects more than 10% of women. It causes infertility, menstrual irregularity, acne, obesity, high blood pressure and diabetes as well as excessive hair growth.
Half of the women diagnosed with polycystic ovaries will have a substantially elevated BMI, which can not only affect their general health but also affect their fertility. Diagnosis is made using ultrasound, but more specifically with an Anti Mullerian Hormone (AMH) blood test.
Hysteroscopy – This procedure will investigate abnormal bleeding or infertility and is performed as day surgery procedure.
Treatment of abnormal PAP Smears (Colposcopy) – Dr Esler has treated abnormal smears for more than 30 years and is one of Queensland’s most experienced colposcopists.
For more information on any of these procedures please contact our rooms.
Evidence based, best practice, techniques and treatments
Dr Esler established the Toowoomba Fertility Clinic in 1996. This service later became the Queensland Fertility Group (QFG) Toowoomba Clinic and is now widely regarded as delivering world standard fertility services that have helped thousands of couples fulfill their dreams of parenthood. Dr Esler’s practice is ISO:9001 accredited and was the first practice in Australia to obtain this reputable certification.
Dr Esler has one aim – to help his patients achieve a pregnancy. As one of Australia’s leading fertility specialists, Dr Esler has the experience, knowledge, science and technology to give his patients the best chance of success. Dr Esler understands that time is of the essence for those seeking fertility treatments and the services he and his experienced team provide, make the fertility journey easier for patients. There are no delays in accessing treatment.
Dr Esler’s fertility services are based on the most recent evidence and world’s best practice techniques that blend scientific expertise and leadership with patient-focussed care. This approach ensures his patients have the best chance possible of starting or continuing to build their family while sparing them from the stress and expense of undergoing unnecessary cycles.
Widely regarded Australia-wide as a pioneer in “day-five freeze all” cycles, which includes the use of agonist triggers that eliminate the risk of ovarian hyperstimulation syndrome (OHSS), Dr Esler has pioneered techniques that have eliminated Ovarian Hyperstimulation Syndrome (OHSS). His clinic was the first Ovarian Hyperstimulation Syndrome (OHSS) free clinic in Australia.
His extensive experience in the “freeze-all” approach has been recognised with the recent publication of an article he co-authored titled, “Should we still perform fresh embryo transfers in ART?” published in the prestigious international journal Human Reproduction. He has also presented at national and international meetings.
Dr Esler offers a comprehensive range of fertility services including options for the simplest of problems through to the most complex fertility issues as well as options for singles and same-sex couples.
Dr Esler also offers fertility preservation for patients diagnosed with cancer and certain diseases, disorders, and life events that affect fertility. Those who might benefit from fertility preservation include:
– Patients about to undergo treatment for cancer (male and female)
– Patients with medical conditions (auto-immune diseases such as lupus)
– Patients with genetic diseases that affect future fertility
– Women delaying having children (women who cannot see themselves becoming pregnant for a few years).
Low stimulation- low cost cycles
To ensure fertility treatment is more accessible to couples, who would otherwise struggle to meet the costs of a fully stimulated cycle, Dr Esler has introduced a low stimulation – low cost cycle. This new service may also be appropriate for more mature couples. Please contact Dr Esler’s rooms for more information on this new service. A consultation with Dr Esler will be required to determine if a low stimulation cycle is appropriate for you.
Donor eggs, sperm and embryos are available for couples needing to access these services.
Ovarian Hyperstimulation Syndrome (OHSS)
OHSS is a serious complication from IVF, which is completely avoidable. If you have had OHSS but still need IVF and are concerned about it, or if you are simply concerned about OHSS, please contact the office – we will explain how it is avoidable.
What is involved?
The most important step for any patient is to have a thorough medical investigation to identify if there really is an underlying problem that is impacting on their fertility – this includes investigating male factor fertility.
Dr Esler is committed to helping hopeful patients become parents. He will perform a thorough examination (including a series of tests) to identify if and what the problem is that is affecting your fertility. It is Dr Esler’s policy to genetically test all new patients to identify if any chromosomal abnormalities might be affecting their fertility. Once the investigation is complete, Dr Esler will recommend the most suitable treatments that meet your specific needs. Patient preferences for specific treatment modalities are accommodated, to the best of our ability.
Dr Esler’s fertility practice has excellent success rates that are amongst the best in the country. His experience and expertise have helped produce more than 1400 babies (and counting).
At this time in Australia, we are prohibited from promoting our pregnancy rates on a website; however, we are able to discuss these results (which are excellent) with you in person – so for more information please contact the practice, we’ll be happy to discuss our success rates with you.
Call us today.
There will be fees for the initial consultation, which includes a thorough medical assessment and relevant tests (separate fees apply to these), and a follow-up consultation where the results of the tests are presented and treatment recommendations discussed.
1. Initial consultation
An initial fee will be charged for the first consultation which includes a thorough medical assessment of both parties to determine if there are any underlying problems affecting their fertility. Medicare rebates do apply. Further diagnostic tests will be ordered at this appointment. Separate costs are associated with these tests, and you will be informed of the costs of these tests when you make the appointment for the initial consultation.
Test results will be discussed at the follow-up appointment.
2. Follow up appointment
At the follow-up consultation, Dr Esler will discuss the results of the tests ordered during your initial consultation. He will also explain to you the various treatment options he recommends will ensure you have the best chance possible of achieving your dream of starting or expanding your family.
Once these options have been outlined, Dr Esler’s experienced staff will provide a full itemised listing of the costs involved for each of the options discussed. You and your partner can then make an informed decision about which option best suits you and your circumstances.
All costs will be discussed with you BEFORE you commit to a particular treatment.
A GP referral will be required
Your questions answered
Dr Esler is a pioneer of state-of-the-art “day five freeze all” cycles. If IVF is recommended as the treatment that will give you the BEST chance of achieving a pregnancy and having a baby, Dr John Esler and an increasing number of leading international fertility experts will recommend a “day five freeze-all” cycle.
This recommendation is supported by scientific evidence that shows:
1. Embryos frozen after day 2 or 3 have a 70% risk of failure. If they are transferred and fail to produce a viable pregnancy, the patient is required to undergo another transfer cycle.
2. Embryos that survive to day 3 and continue to survive out to day 5 before being frozen have a 50% risk of failure; therefore, embryos frozen at day 5 are the ones more likely to survive to lead onto a viable pregnancy.
As such, Dr Esler recommends “day 5 freeze all” process as the most beneficial for his patients, given the higher likelihood of success and the reduced emotional, physical and financial burden that would be incurred if treatments need to repeated in order to achieve a pregnancy.
The “day five freeze all” IVF technique, is now widely accepted as the gold standard in high quality, patient focussed IVF services that give patients the BEST chance of achieving a pregnancy1. So in short – fresh is not best when it comes to IVF. If you are being advised to have a fresh transfer – ask why?
How long should I keep trying to conceive before I seek medical help?
If you suspect there is a problem – Dr Esler advises you to seek advice early – it is never too early but can often be too late.
Fertility problems are highly distressing for a couple and the sooner a problem is diagnosed the better. Knowing if there is a problem and knowing what the problem is (if there is one) can save you time, money and angst.
Always choose an experienced fertility specialist for that initial consultation – fertility should be treated as a couple. It is vitally important to identify the extent of the medical issues in both parties in order to make appropriate treatment recommendations.
How do I choose a fertility specialist?
Here are some important questions to ask to help you choose your fertility specialist.
1. Are you a recognised fertility specialist and what is your experience, reputation and how much time do they spend in the fertility area.
Dr John Esler has more than 20 years’ experience in IVF. He is widely acknowledged as an Australian leader in “day five freeze-alls” and was the first Australian IVF specialist to use agonist triggers, effectively eliminating ovarian hyperstimulation syndrome (OHSS) in the patients he treats.
His practice offers a comprehensive range of fertility services and the live births from his practice currently stand at 1400 babies.
2. Will you fully investigate us to see if a cause can be found for our infertility that might avoid complicated treatment and advise us on whether waiting longer has a good chance of working?
All patients (and their partner) are thoroughly investigated before treatment
3. What options are open to us other than IVF, and what can we do to avoid treatment or maximise our chances of success?
Once Dr Esler has your results he will discuss with you the range of options available to you.
4. If we undergo IVF, what are our chances of having a single healthy baby from one started treatment cycle?
Fresh is not best when it comes to IVF.
If IVF is the recommended treatment that will give you the BEST chance of achieving a pregnancy; Dr John Esler recommends a “day five freeze-all” process.
International research has found the “day five freeze-all” process is the most efficient and timely A) because the “day five freeze all” produces the highest pregnancy rates, and B) because the higher success rates, spare patients the emotional, physical and financial burden incurred when treatments are repeated in order to achieve a pregnancy.
5. What will the real financial and emotional costs be if I undergo treatment?
Whatever the recommended treatment options are – all costs will be discussed with you BEFORE you commit to a particular treatment.
Why does Dr Esler advocate “day five freeze all” as the best treatment for me?
Dr Esler has one aim – to help his patients achieve a pregnancy.
Dr Esler acknowledges that some specialists prefer freezing embryos at day 2 or day 3; however, he and an increasing number of leading international fertility experts recommend a “day five freeze all” process. These recommendations are supported by scientific evidence that shows:
1. Embryos frozen after day 2 or 3 have a 70% risk of failure. If they are transferred and fail to produce a viable pregnancy, the patient is required to undergo another transfer cycle.
2. Embryos that survive to day 3 and continue to survive out to day 5 before being frozen have a 50% risk of failure; therefore, embryos frozen at day 5 are the ones most likely to survive to lead onto a viable pregnancy.
As such, Dr Esler recommends “day 5 freeze all” process as the most beneficial for his patients, given the higher likelihood of success, and the subsequent emotional, time and financial savings associated with the process.
Is there after-hours support?
Afterhours help and support is available. You will be supported at every step of your fertility journey by one of Dr Esler’s experienced fertility team which includes counsellors, experienced administration staff and fertility nurses who are on call to provide after-hours advice.
Fertility services are supported by an onsite laboratory run by highly experienced locally-based IVF scientists.
What tests should I have done before I visit a fertility specialist?
Dr Esler will perform a thorough medical assessment during your initial consultation – this assessment will include ALL the relevant tests needed to determine if there is an underlying problem that is affecting your fertility – therefore it is not necessary to have any tests done prior to your appointment with Dr Esler.
Do fertility problems only occur in females?
The short answer is no; however, couples should always be examined together so that an accurate assessment of potential problems can be made. Male fertility can be affected by childhood illnesses such as mumps or cancer treatment; injury; steroid use; or simply genetics. Female fertility can be affected by any number of issues, which makes it vitally important for the couple to be checked out by an experienced fertility specialist.
Is surgery indicated if endometriosis is affecting my fertility?
There is no question endometriosis can affect your fertility; however, if you are exploring a surgical treatment option in order to treat your endometriosis to improve your fertility – think again and seek the advice of an EXPERIENCED fertility specialist!
The most recent evidence suggests your best option would be to consider IVF first.
Well the evidence shows that surgical treatment for endometriosis will give you no greater chance of getting pregnant than you would achieve at home (naturally) i.e. the natural rate for pregnancy for women under the age of 38 is approximately 10% per month; a laparoscopy to treat endometriosis will never achieve a pregnancy rate above 10% per month; indeed surgery can diminish your chances.
On the other hand, an IVF cycle will give you up to a 60% chance/embryo transfer of achieving a pregnancy (if you are under the age of 38) … which means your greatest chance of achieving a pregnancy lies with IVF rather than a surgical treatment for endometriosis.
Once you have completed your IVF cycles you can, of course, continue with surgery to treat endometriosis if required (but with no adverse effects on your chances of achieving pregnancy). In short- endometriosis does not negatively impact on IVF success rates!
Does BMI affect my chances of getting pregnant?
The answer is yes and no. Excess weight and abdominal fat can have an adverse effect on your fertility. The good news is that losing weight can improve your chance of getting pregnant. However, if you are concerned your window of opportunity to start a family is closing and you might not be able to lose weight quickly enough – IVF could be an option for you. Depending on your weight, you might be able to undergo an IVF cycle to harvest and freeze your eggs/embryos. You can then pursue your weight loss plans, in preparation for pregnancy with the knowledge your “fertility” has been preserved. For more information, please ask your GP for a referral to Dr Esler, who can make an expert assessment of your situation. We have associations with expert dieticians who specialise in this area and Dr Esler will be happy to refer you for further advice.
Can you help me access donor eggs, donor sperm or donor embryos?
The answer is yes – Dr Esler can organise all the above for you.
Can you help me with surrogacy?
The answer is yes. Dr Esler deals with surrogacy on a regular basis and can help you. Call us!
Dr John Esler has the experience, skills and commitment to excellence to ensure you experience a positive outcome.
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