IVF+ICSI Questions

1- How do I know if IVF treatment is right for me?

This is something that would be decided with an IVF specialist. If you have been trying to get pregnant for at least a year without protection and have been unsuccessful, then it may be time to have some tests done. Infertility can be either caused by a male factor or a female factor or in some cases, caused by both.

For the male partner, it makes sense to have a semen analysis in order to check for sperm quality: sperm count, sperm motility and morphology. The semen analysis will indicate if there is any reason to suspect a male factor infertility.

For the female partner, the first round of testing would involve FSH, LH, Estradiol and Prolactine hormone tests. These tests are the indicators of the ovarian reserves and egg quality.

Even after the first round of testing, there are considerations to be made such as whether further testing would be needed, or whether IUI would be consulted prior to an IVF treatment.

  

2- Which tests do I need to have done prior to IVF treatment?

Your gynecologist will be able to make a better assessment based on your initial consultation. First, an ultrasound scan and a round of hormone testing will be called for. For the male partner, a semen analysis will be required. These are the standard tests. If your doctor believes that further infertility  testing is necessary, then additional tests can be done.

Apart from infertility testing, IVF clinics usually ask for infectious disease testing as well. These are Anti-HIV, Anti-HCV, HbsAg, VDRL, Rubella IgG and sometimes CMV IgG. Some clinics require more tests than others, so it’s best to consult with the clinic which tests to have done prior to your IVF treatment.

3- How do I know if I can use my own eggs in IVF treatment?

Your hormone test results (especially FSH) will be indicative of the ovarian reserves. The hormone tests will allow your doctor to make an assessment of your ovarian reserves and estimate your likely response to a stimulation cycle.

Even though different clinics have different cut-offs for hormone levels, most clinics will not recommend using your own eggs with an FSH level higher than 15. In some cases, where the FSH test is inconclusive, the AMH test might be consulted.

4- What is the age limit for IVF treatment?

The age limit for IVF treatment varies from clinic to clinic and from country to country. Most clinics will not treat patients aged 45 and above while some will have an age limit of 50. Our age limit for IVF treatment is 45.

5- What does a high FSH result suggest?

Women are born with a set number of eggs. As they age the number and quality of eggs decrease. Basically FSH goes up in response to a negative feedback loop. Meaning as a woman's eggs start to diminish in quality or number, her body will in turn make more FSH to compensate for this loss. The egg itself communicates with the women's body to tell it to make certain hormones. So testing a woman's hormone levels can help determine the quantity and quality of eggs a woman has.. Anything higher than 14/15 will put the patient at a disadvantage in her response to stimulation medication. By measuring the amount of FSH, your doctor will be able to suggest specific treatments (such as in-vitro fertilization or intrauterine insemination) that could help you to conceive. 

6- How do I interpret my hormone test results?

Usually, the specialist who asks you to get hormone testing will do the interpretation for you. However, what is important is to get the hormone tests done on day 3 of your menstrual period so that the results are most accurate. Most labs will give you a report with your hormone levels and reference values so that you will know whether your hormone levels are in the normal acceptable range or not.

7- Can I have IVF treatment with PCOS?

Absolutely! In fact, some women can get pregnant naturally even if they have PCOS. Most women change their diets and living styles as a permanent treatment method, and in most cases, these lifestyle changes can have a positive impact of fertility.

Women with PCOS have difficulty ovulating properly, so you may have to use medication to stimulate ovulation and to regulate your menstrual periods. Your doctor may also prescribe injections such as an HCG shot to further stimulate your ovaries. However, if these changes do not allow you to fall pregnant naturally, or if you have not responded well to conventional medication, the IVF might be called for.

8- What is the IVF success rate for women with PCOS?

As long as the patient with PCOS is subjected to a successful stimulation cycle, and as long as some good quality eggs are retrieved, women with PCOS will have no problem falling pregnant. In fact, the rate of success will not be that much different from women without PCOS.

9- How does endometriosis affect IVF treatment?

The most important handicap of women with endometriosis is reduced egg quality. As a consequence, the rate of fertilization is much lower compared to women with no fertility issues. Therefore, the main problem is creating of the embryo rather than implantation. If you have gone through a few IVF cycles without success due to fertilization failures, the most sensible option might be to opt for egg donor IVF.

10- What is the IVF success rate for women with endometriosis?

Endometriosis is a condition in which the tissue endometrium, normally lining the uterus, grows on different organs outside the uterus.

In severe cases, formation of connecting tissues around endometriosis near the Fallopian tubes or ovaries may reduce fertility. Endometriosis can affect egg quality substantially, therefore, reducing the likelihood of a woman of becoming pregnant with her own eggs. In some cases, IVF using an egg donor is the only solution for women with chronic endometriosis.

11- Does IVF medication have any side effects?

There is no consensus on the possible side-effects of IVF medication. For quite a long time, IVF medication were thought of possibly causing ovarian cancer, but recent studies provide evidence that there is no direct link between IVF medication and cancer.

If side effects are experienced, they are usually very mild and short-lasting. Some patients experience feeling emotional and/or bloated. These are directly related to the changing hormone levels within the body.

12- How many eggs are usually retrieved in an IVF cycle?

This depends on your hormone levels, ovarian reserves, and how well you react to stimulation medication. An optimal stimulation cycle should result in an average of 10-12 good quality eggs to be fertilized. This allows the patient to have an optimal number of embryos (depending on sperm quality) to transfer and perhaps to freeze for future cycles.

13- How many embryos are put back in an IVF treatment?

This would depend on the IVF laws of a country. Some countries only allow for a single embryo transfer, while some countries have different numbers for different age groups. At younger ages, you are more likely to succeed with a lower number of embryos transferred; however, as you get older, it might be necessary to transfer multiple embryos in order to achieve pregnancy.

While single embryo transfers reduce the chances of IVF success, multiple embryo transfers increase the likelihood of a multiple pregnancy, therefore, you should plan carefully when you get to that stage in your IVF treatment. At North Cyprus IVF, our embryo transfer limit is 3 embryos.

14- What happens to unused embryos after the treatment?

Most clinics will offer you the option to freeze any unused embryos for future use if you have a sufficient amount of unused embryos of good quality. You will be able to have your unused embryos frozen for future cycles at a small fee. This will give you the opportunity to have future IVF attempts with minimal preparation and costs.

If the clinic does not offer cryopreservation (freezing), or if you do not want to have your embryos frozen, they are usually disposed of, or are used in clinical trials. The IVF specialist would make this clear prior to treatment.

At North Cyprus IVF, we offer our patients the option of freezing any unused embryos they have for future use.

15- Semen analysis shows zero sperm count, can we try IVF?

Even though a semen analysis may indicate a zero sperm count, it might be the case where there are live sperm cells in the testes. This can only be identified through minor surgical procedures like TESE/TESA/Micro-TESE and the like. These procedures are used to surgically remove a piece of tissue containing sperm cells. If there are live sperm cells, they will be used in IVF treatment along with ICSI to assist the sperm with fertilization.

In cases where these surgical procedures yield no results, IVF using a sperm donor becomes the only viable option.

16- I have reduced ovarian reserves, what type of treatment is right for me?

There is no single answer to this question. There are different levels of reduced reserves. You can have sub-optimal reserves, meaning you could be producing sufficient amount and quality of eggs with a good stimulation cycle, or you could be pre-menopausal, suggesting a very low chance of success.

An IVF specialist will typically ask for your hormone test results and make an assessment accordingly. Based on your hormone levels, (s)he will be able to prescribe you the right mode of treatment and the right dose of medication for the most efficient stimulation.

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