Fertility experts give answers:
At Medimall IVF Clinic we recommend that you contact a fertility specialist if after one year of regular unprotected sex, no pregnancy is achieved. When infertility is suspected in women or men, we suggest an initial appointment with one of our doctors, in order to check your fertility with the suitble tests and exams. The appropriate for you treatment will follow the results of this examination.
Most experts define infertility as the inability of a couple to conceive after at least a year of trying. Women who are able to get pregnant but have had multiple miscarriages are also considered infertile.
Pregnancy is the result of a complex chain of events.
To get pregnant:
- the woman must release an egg into one of the ovaries (ovulation).
- this egg must pass from the fallopian tube into the uterus.
- the man’s sperm must fertilize the egg during this journey.
- the fertilized egg must be inside the uterus (implantation).
- infertility can be the result of problems that interfere with any of the above steps.
Of course not. In about one-third of cases, infertility is due to the woman (female factor), while in one-third of cases, it is due to the male (male factor). The remaining one-third is due to both (both male and female) or even unknown factors.
Infertility in men is usually caused by:
Problems in sperm production, ie sperm can have a small number of sperm or low motility or both. This pathological condition of the sperm is called “oligoasthenospermia”. Oligoasthenospermia affects the sperm’s ability to reach the egg and fertilize it. There are also cases where sperm have an abnormality in their morphology and this is called teratospermia and affects sperm ability in the same way.
Sometimes a man is born with problems that can affect his sperm. Other times the problems start later, due to an illness or injury. For example, cystic fibrosis is a cause of infertility in men.
The quantity and quality of a man’s sperm can be affected by his health and lifestyle. Here are some factors that can reduce the amount and/or quality of sperm:
- environmental toxins, including pesticides and lead
- certain health problems
- radiotherapy and chemotherapy
Smoking: It is recommended that you stop smoking before ovarian stimulation begins. It is best to stop smoking at least 3 months before IVF. If you find it difficult to stop, seek the help of your doctor. Tobacco by-products have been shown to be toxic to the egg. Many studies have also shown that smoking during pregnancy results in weight loss in the newborn and exposure to fetal health risks. There is evidence that smoking may also reduce pregnancy rates.
Alcohol: Alcohol is an ingredient that should be avoided during infertility treatment, but also during pregnancy. It is important not to drink alcohol from the time you start taking fertility medications until the pregnancy test.
Medications: If you are taking any medication with or without a prescription, it is imperative that you tell your doctor. Some medications may interfere with fertility medications, while others may not be safe to use before surgery or a medical procedure, some may affect ovulation or embryo transfer. At Medimall IVF Clinic we will also suggest the use of specific vitamin preparations. If you are not taking folic acid vitamin, tell your doctor about your IVF.
Herbal supplements: Do not use herbal supplements during in vitro fertilization.
Stress: An assisted reproductive therapy may already be a stressful process for you and your partner. It may be helpful to talk to someone, such as friends, family, or a psychologist / therapist.
Exercise: Heavy exercise such as aerobics, jogging, weight lifting, etc. are prohibited. during ovarian stimulation and until the results are known
Acupuncture: You can follow your acupuncture treatment before, during and after IVF.
The miscarriage rate is about the same for assisted reproduction as for any other pregnancy. Older women undergoing IVF inevitably have higher rates of miscarriage. Since the pregnancy test is done two weeks after the embryo transfer, there are often unexpected miscarriages in the very early stages of pregnancy. These miscarriages often go unnoticed in a pregnancy whose conception has taken place without the help of a assisted reproduction method.
Your doctor will discuss this with you at the time of signing the consent and will follow the instructions regarding the number of transferred embryos that have been established by the National Assisted Reproduction Authority.
The egg collection lasts 10-15 minutes, it is not painful and it is done under light sedation. At the end of the process you can return to your daily activities.
No, sedation is not needed for the embryo transfer.
We transfer the embryo/-s, 2-5 days after the egg collection.
We transfer 1 or 2 embryos. The number of embryos to be transferred depends on the woman’s age, the cause of infertility, the number of previous attempts and, of course, her desire.
Yes, you can take painkillers after the procedure. There is also no problem taking them before treatment. However, we advise you to take only those with paracetamol.
Moderate exercise is good before egg collecting. After the egg collection, you should be relaxed and avoid swimming, although walking is allowed, as it is a good way to exercise without getting tired. Any form of exercise that causes shortness of breath should be avoided before and immediately after the procedure.
If you had an IVF with ovarian stimulation, you should not start a new stimulation before 3 period cycles.
If you wish an IVF with egg/embryo donation or you have already frozen embryos, you can start in the next period cycle. A key parameter in any decision is your emotional state.
As with any medical procedure, there are some risks involved but complications are rare. Your doctor at Medimall IVF Clinic will explain everything in detail giving you all the relevant information and instructions.
At Medimall IVF Clinic we offer egg/sperm cryopreservation services for those who have a personal or medical reason and need this service. We use the most modern cryopreservation technique in sperm and egg freezing.
AMH or anti-mullerian hormone, as it is widely known, is combined with FSH, to inform us about the ovarian potential of a woman when we want to assess her fertility. It is produced by granular or follicular cells in small ovarian follicles, with the highest amount of them being produced when the diameter of the follicles is less than 4 mm. Hormone production stops when the follicles reach 8 mm.
As women get older, the follicle potential decreases. Respectively, the levels of AMH in the blood and the number of follicles that are visible on the ultrasound are reduced. Women with many small follicles, such as those with polycystic ovaries, have high levels of the hormone AMH, and women who have few remaining follicles and are close to menopause, have low levels of AMH. The amount of follicles that remain in a woman’s ovaries is referred to as “ovarian reserve”. Unfortunately, even if a blood test indicates that the woman has a high level of follicles, this does not necessarily mean that her eggs will be of good quality. Women with high AMH tend to respond better to ovarian stimulation for IVF, thus giving more eggs for fertilization. And that for sure leads to higher pregnancy rates.
Many couples find stressful the assisted reproduction reatments. We would not like to add extra stress to you, imposing additional restrictions on your lifestyle. Your sex life should not change. In case a short period of abstinence is required (2 – 4 days), we will inform you. What you should know is that neither long-term abstinence nor short-term abstinence is recommended for the good sperm quantity and quality.
A healthy lifestyle, a balanced diet, quit smoking and reduced alcohol consumption are factors that can help. Women should also intake folic acid and vitamin D supplements.
You can do the pregnancy test 2 weeks after the date of your embryo transfer. Some women may see blood spots before taking the test, but you should continue with the medication and take the test on the recommended day. The test is done by measuring β HCG in the blood. Urine tests that you can get from the pharmacy are unreliable to detect a pregnancy of a few days. If you are not sure for the result, do not hesitate to contact your doctor at Medimall IVF Clinic.
If you have a positive pregnancy test, you should continue to use your medication daily. You will need to contact Medimall IVF Clinic for more instructions and a new test of your HCG. At this stage it is best to be moderately optimistic. Miscarriages can occur at any stage of pregnancy, although they are much less common after 12 weeks. If you become pregnant, you will need to contact your obstetrician-gynecologist to begin the monitoring your pregnancy.
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