Which tests will you require for treatment?

We require a series of tests for fertility assessment / fitness for pregnancy as well as infectious disease screening. Each and every test that we order serves a different purpose and each one of these tests will have an implication for your treatment.

For assessment of fertility, we ask each female patient to have the following testing done on day 2 or day 3 of their menstrual cycle: FSH, LH, Estradiol, Prolactin, TSH and AMH hormone tests. The AMH test is independent from your menstrual cycle and can be done at any time, but our patients find it easier to have all the tests done on the same day during their visit to their doctor. It will also be important to have a base line pelvic ultrasound scan during this visit for antral follicle count in the ovaries and to check that there are no major visible problems in the uterus that can interfere with a successful pregnancy.

The male patient is required to have a semen analysis done. Especially if he has not had a child in the near past, it will be important to observe sperm parameters such as count/volume/motility/morphology/pH level and round cell count. In some cases, a small infection in sperm can compromise the whole process, therefore, it is important to be prepared for possible precautions that we may need to take.

All patients undergoing treatment at our practice are required to undergo infectious disease screening. This includes patients undergoing donor treatments as well. There are three main reasons for infectious disease screening:

1- To protect the spread of infectious diseases at our lab and to avoid exposing other patients to these diseases.

2- To avoid exposing embryos to infectious diseases that might come from their parents.

3- To protect lab personnel from exposure to infectious diseases when handling egg and sperm cells.

The validity of infectious disease testing is six (6) months. As long as patients have their testing done within the 6 month period prior to their treatment time, we do not require a repeat test. However,if patients do not have current test results, then we will administer these tests here at our practice prior to handling any samples.

Only the test results from reputable clinics and hospitals will be accepted, and original test results will need to be presented at the time of your first visit.  Photocopies and scanned email attachments are only accepted as temporary proof of testing until we see the originals.

The infectious disease tests required by our practice are as follows:

For female patient: Anti-HIV, Anti-HCV, HbsAg, VDRL, Rubella IgG, CMV IgG, and Toxoplasmosis IgG

For male patient: Anti-HIV, Anti-HCV, HbsAg, VDRL.

www.donasyon.net
www.lowcostivf.net
www.gender-selection-ivf.co.uk
www.egg-donor-ivf.co.uk

Fertility Drugs

An IVF Medication cycle consists of different medications or fertility drugs that stimulate the body to promote pregnancy using IVF. The particulars of the cycle are decided by a specialist physician, below are some of the most widely used medications.

GnRH Agonists - Allow for improved control of ovarian stimulation during the administration of exogenous FSH. Exogenous FSH is given to stimulate ovarian follicle, followed by human chorionic gonadotropins (hCG) to trigger ovulation. Some GnRH agonists are: Buserelin, Leuprorelin, Nafarelin, Lupron (Prostap), Triptorelin, Decapeptyl and Synarel. Some are injected just under the skin others are applied as a nasal spray. They allow the body to produce a higher number of improved quality eggs during the treatment cycle. Midcycle hormonal surge caused by a cancellation of a cycle can also be minimised using these.

Antagonists - Cetrotide, Ganirelix and Antagon are IVF medications that are given by injection usually for three or four days they are antagonists of gonadotropin releasing hormones (GnRH) and are used to prevent premature ovulation.

Gonadotropin preparations - are medications that simulate the physiological effects of gonadotropins. They are taken as subcutaneous injections that provide stimulation to the follicles that contain the eggs during the stimulation phase. Gonal F, Menopur, Merional, Fostimon, Puregon, Bravelle, Follistim, Pergonal and Repronex are the most commonly used gonadotropins.

Human Chorionic Gonadotrophin (hCG) - The administration of hCG in the presence of one or more mature ovarian follicles can trigger ovulation to aid egg retrievel and it can also be used to stimulate the production of progesterone. The most commonly used hCGs are Pregnyl, Ovitrelle, Profasi and Novarel.

Prednisolone / Medrol - Generic name is Methylprednisolone and is a cortisteroid based hormone. It is normally given for a period of four days during the IVF cycle, to assist pre-embryo implantation.

Doxycycline - an antibiotic also know by the brand names Vibramycin, Monodox, Microdox, Periostat, Vibra-Tabs, Oracea, Doryx, Vibrox, Adoxa, Doxyhexal, Doxylin, Doxoral and Atridox. It is administered in pill form and is given to the male partner during the wife's stimulation IVF cycle to reduce the minute levels of bacteria found in the semen. This bacteria can compromise the performance and quality of the sperm during an IVF cycle. It is also sometimes given to the female to reduce the risk of infection following aspiration of the follicles during the egg retrieval period.

Progesterone - Natural Progesterone can be taken as a daily intramuscular injection called Gestone, starting two days after egg retrieval and continuing until the placenta is making adequate amounts of Progesterone. It can be given in the form of a pessary or suppository called Cyclogest. It is given in the dose of 400 mg twice daily rectally until embryo transfer and rectally or vaginally after embryo transfer. Progesterone can also be given in the form of a vaginal gel Crinone or Capsules called Utrogestan. It is essential to prepare the endometrium for implantation of an embryo, ovulation induction or sometimes to induce a period in a woman who hasn't ovulated.

Source - http://goo.gl/ICugOW

www.donasyon.net 
www.lowcostivf.net 
www.gender-selection-ivf.co.uk 
www.egg-donor-ivf.co.uk

ACERCA DE SELECCIÓN DE GÉNERO FIV

La selección del género a través PGD funciona igual que la FIV convencional, donde los huevos y el esperma son fertilizados en el entorno de laboratorio. Luego, los embriones se colocan en una incubadora para un crecimiento óptimo. Una vez que los embriones de llegar a la etapa de crecimiento de 8 celdas (por lo general de 3 días después de la fecundación), la biopsia se realiza en una sola célula se recupera de cada embrión para el diagnóstico. Esta biopsia nos permite probar determinadas condiciones genéticas y determinar el sexo. Aparte del sexo del bebé, que prueba de cromosomas X, Y, 13, 18 y 21, que son las causas de casi el 90% de todas las anomalías genéticas vinculadas, como el síndrome de Down.

¿Por dónde empezar?

El primer paso del tratamiento es ver a su ginecólogo para una ecografía (ultrasonido). Esto es para asegurarse de que la pareja femenina tiene n los fibromas, pólipos grandes en el útero o quistes en los ovarios, o nada, en general, que potencialmente puede interferir con un embarazo exitoso.
           
El tratamiento inicial se lleva a cabo muy fácilmente con un plan de tratamiento que se le proporcionan en base a sus credenciales.Hay algunas pruebas que he mencionado más adelante, que nos ayudarán a identificar su propio perfil hormonal único y nos permite llegar a un plan de tratamiento, que se adapta a su propio perfil.Este plan de tratamiento incluirá el uso de medicamentos todos los días, así como un calendario de citas con su médico. Todo se aclarará una vez que sabemos qué tipo de un protocolo a seguir.Una vez que son capaces de proporcionarle una tabla, entonces podemos llevar a cabo el trabajo preliminar a través de correo electrónico y comunicación telefónica, tanto con usted y su ginecólogo. Una vez que el trabajo preliminar se lleva a cabo, tendrá que venir a Chipre durante una semana. Si usted es capaz de quedarse un poco más, digamos 10-12 días, sería más conveniente para que pudiéramos hacer algunas de las ecografías aquí y para supervisar su evolución más de cerca.

Para los pacientes que han concebido los niños antes, que no requieren pruebas de infertilidad. Sin embargo, tendremos resultados de las pruebas de enfermedades infecciosas antes de que podamos realizar la transferencia de embriones aquí. Puede que los hagan por allá o aquí, una vez que llegan a nuestra clínica.Esto es sólo para asegurarse de que no se pasa ningún enfermedades infecciosas sobre los recién nacidos.

Estas pruebas de enfermedades infecciosas son las siguientes:

Para el socio de Mujer Para el socio de Mujer
Anti-VIH de Lucha contra el VIH
Anti-HCV Anti-HCV
HBsAg HBsAg
VDRL VDRL
Rubéola IgG
CMV IgG
La clamidia

Sin embargo, incluso si no tiene algún antecedente de infertilidad, seremos capaces de tomar una decisión más informada con respecto a su uso de la medicación y la dosis de la medicación

será administrado por la observación de los resultados de las pruebas hormonales que se realiza en el 3er día del período menstrual (FSH, LH, E2 y las pruebas de PRL). Esto es especialmente importante para los pacientes por encima de la edad de 32 años.


La obtención de la medicación y el tratamiento inicial

Vamos a ser capaces de enviar una copia escaneada de su receta una vez que veamos algunos resultados de las pruebas y determinar el modo correcto de tratamiento. Usted puede utilizar esta receta en la farmacia internacional que trabajamos. La farmacia es capaz de ofrecer en todo el mundo, y tiene precios razonables. La dirección de la farmacia es la siguiente:
Sitio Web: http://www.fertility2u.com
E-mail: info@fertility2u.com
Nombre de contacto: Bushra Sheikh

Con la medicación que usted compra, usted será capaz de hacer que su trabajo previo a nivel local bajo nuestra supervisión y con la orientación de su ginecólogo. Al final de este proceso, se le requiere para viajar a Chipre por 7 días.


Administrar el medicamento

Las inyecciones son todos los sub-cutáneo, y son administrados por el área de la panza. El siguiente video ofrece información sobre el ajuste de la mezcla y dosis.
http://www.youtube.com/watch?v=OMklbInsQGk

Después de ver el vídeo en el enlace de arriba, por favor ver el video en el enlace de abajo sobre la administración de la inyección:
http://www.youtube.com/watch?v=AHEyyB0IKNY


Viajar a Chipre

Nuestra clínica está ubicada en Nicosia, Chipre del Norte. El aeropuerto más cercano a nuestra clínica es el aeropuerto de Ercan. Todos los vuelos en el aeropuerto de Ercan pasan por una de las ciudades en Turquía, así que no hay vuelos directos. La ruta más directa hacia Ercan sería volar a través de Estambul.

Otra alternativa es el aeropuerto de Larnaca en el Sur. Se encuentra a unos 60 km al sur de nuestra clínica, y dura aproximadamente una hora de viajar. A veces, los vuelos a Larnaca puede ser mucho más barato dependiendo de la temporada, por lo que la comprobación hacia fuera los dos aeropuertos tiene sentido antes de reservar sus vuelos.


www.donasyon.net 
www.lowcostivf.net 
www.northcyprusivf.com 
www.gender-selection-ivf.co.uk 
www.egg-donor-ivf.co.uk

Repeated IVF Failures

IVF failures are one of the most depressing experiences a couple can go through in their IVF journey. Having experienced several failed attempts can be very depressing and frustrating, especially when there is no explanation provided for them. At North Cyprus IVF, we make sure our patients are thoroughly analyzed before attempting another IVF cycle so that some known possibilities can be ruled out. Once a couple go through the standard testing procedures and these tests are inconclusive of the factors of infertility, then additional factors need to be taken into consideration. Some of the possibilities which need to be taken into consideration are as follows:

Uterine infection
The inside of the uterine cavity is normally considered to be a sterile environment. It has been strongly suspected that infection of the uterine cavity with bacteria may cause an inhospitable environment that would lead to failure of embryos to implant. In cases where there is a reason to suspect a uterine infection, an endometrial biopsy procedure may be called for in order to make an effective assessment. Normally, infections can be treated with antibiotic use. There are also other infectious diseases that can be considered during this investigation such as CMV IgG, Chlamydia and more.

Immune factors as a cause for IVF implantation failure
The immune system is designed to protect individuals from infection with microorganisms and to fight off abnormal processes in the body like cancer. In the areas of IVF, infertility and recurrent pregnancy loss, there has been an extensive amount of investigation as to the role of immune factors in the implantation process of the embryos. In some cases, the immune system is believed to see the embryo as a foreign object and reject its implantation.

Thrombophilias
Thrombophilias are conditions that result in an increased chance for blood clotting. There have been many studies showing an association between the presence of thrombophilias in women and the risk for miscarriage. Some studies also indicate that thrombophilias can also be associated with implantation failures. Certain genetic tests help identify the existence of thrombophilias in the female partner.

www.donasyon.net 
www.lowcostivf.net 
www.northcyprusivf.com 
www.gender-selection-ivf.co.uk 
www.egg-donor-ivf.co.uk

7 Tips for Success in IVF Treatment

Even though each IVF treatment is different in itself, there are a number of measures that can be taken in order to maximize your chances of success. In some cases, things that might sound small could make a world of difference in IVF treatment. So let’s be on the safe side and do our part:

1- INITIAL SCAN: Have an ultrasound scan at your gynecologist’s office. This is to make sure there are no fibroids or polyps in the uterus that could jeopardize your chances of success. Also, women who are not undergoing egg donor IVF treatment should make sure there are no cysts in the ovaries that could potentially affect their egg count/quality.

2- INVESTIGATION: If you have previously had a number of miscarriages (with or without IVF), it makes sense to investigate the cause. In most cases where women have repeated miscarriages, there is a genetic reason behind it. Some gene mutations affect your blood circulation and cause you to have a miscarriage (especially up to 12 weeks). These genetic tests include testing for mutations in MTHFR C677T, MTHFR A1298C, Factor V Leiden (G1691A), Factor II (G20210A), and PAI I 4G/5G.

3- VITAMINS: It is important that your take essential vitamins and nutrients prior to and during pregnancy. A supplement such as “pregnacare” includes Folic Acid, B6, B12 and Zinc supplements, which are proven to reduce the likelihood of a miscarriage and support healthy development of your baby. It makes sense to start using such a supplement at least a few feeks prior to your embryo transfer stage.

4- HORMONE TESTING: For women undergoing IVF treatment using their own eggs, it is important that certain hormone tests are done prior to using any IVF medication. These hormone tests include:

FSH, LH, Estradiol and Prolactine. Based on these hormone test results, we will be able to assess your ovarian reserves and egg quality. Also, it these results will be important in identifying your treatment protocol and the dose of medication that needs to be administered.

5- IVF FAILURES: For patients who have had several failed IVF attempts, with no history of pregnancy, it makes sense to have an endometrial biopsy around days 18-21 of menstrual period. An endometrial biopsy will tell whether there is any condition that might prevent implantation and a successful pregnancy. There are also other infections that need to be checked for in this case.

6- INFECTIOUS DISEASES: Prior to embryo transfer, it is vital that certain infectious disease tests are done on both parents. The purpose of these tests is to make sure the newborn does not receive any infection from his/her parents. Some of these test are routine tests, which most of you do not have, such as Anti-HIV, Anti-HCV. These can be done at our clinic prior to embryo transfer. However, some other test results, such ac CMV IgG and Chlamidia might require the use of antibiotics for a certain amount of time prior to emrbyo transfer, therefore, it is important for the female patient to have tested for CMV IgG and Chlamidia once the IVF decision has been made.

7- AVOID STRESS: One of the biggest enemies of IVF treatment is stress. Avoid stress as much as you can when going through IVF treatment. You can take up yoga classes, or join the gym or start a book club, anything that will help you avoid stress will add a couple of percentages to your chances of success.

www.donasyon.net 
www.lowcostivf.net 
www.northcyprusivf.com 
www.gender-selection-ivf.co.uk 
www.egg-donor-ivf.co.uk

Infertility Medications

It is necessary to take certain medications during the IVF cycle in order to prepare the body for the treatment. The instructions for each medication vary from patient to patient. Our Specialists at North Cyprus IVF will analyze your case closely to determine which medications to use, what dosage to take, when to administer the medications and how long to take them.

GnRH Agonists - Lucrin, taken as an injection just below the skin and Synarel, a nasal spray, allow the body to produce a greater number of high quality eggs during the treatment cycle. They also prevent the midcycle hormonal surge that can result in the cancellation of a cycle.

Antagonists - Antagon and Cetrotide are antagonists of gonadotropin releasing hormone (GnRH) and are used to prevent premature ovulation. These medications are given by injection and the duration of treatment is usually three or four days.

Gonadotropins - Gonadotropins are taken as subcutaneous injections that provide stimulation to the follicles that contain the eggs during the stimulation phase. Gonal F, Bravelle, Follistim, Pergonal and Repronex are the most commonly used gonadotropins.

hCG - hCGs are taken as an intramuscular injection and are used to induce the final maturational changes in the eggs and prepare them for retrieval. The most commonly prescribed hCGs are Pregnyl, Ovitrelle and Choriomon.

Doxycycline - Doxycycline, an antibiotic administered in pill form, is given to the male partner during the wife's stimulation cycle to reduce the low levels of bacteria that may be found in the semen and which may compromise the performance of the sperm during an IVF cycle. It is also given to the female partner to reduce the risk of infection following aspiration of the follicles at the time of egg retrieval.

Progesterone - Natural Progesterone may be taken as a daily intramuscular injection beginning two days after egg retrieval and continuing until the placenta is making adequate amounts of Progesterone. Progesterone can also be given in the form of a vaginal gel or vaginal suppositories or pills (Prometrium).

Frequently Asked Question

Frequently Asked Questions

Why do I need to get hormone tests done if I already have children?

The hormone tests are requested in order for the Dr. to better understand the quality and quantity of eggs and provide a personalized and detailed treatment for each individual patient.

Why do I need to have an ultrasound before I begin treatment?

The ultrasound is requested in order to make sure there are no ovarian cysts, polyps or anything else that might stand in the way of a successful IVF cycle.

What is the  HCG trigger injection for?

This shot is for women who are using their own eggs and it helps release the  mature eggs from the follicles and is usually done 35 hours before egg collection. It is the final step in assisting the maturation process and ensure the eggs are released from the follicles.

This is generally done in Cyprus but can be done before traveling in order to shortent the stay.

When do I start using the Cetrotide?

Cetrotide is generally used to block any premature LH surge in women and is generally started when the dominant follicle reaches 14mm.

What does Estradiol Valerate do?

It is a female estrogen hormone and is used for patients undergoing Egg Donation and is used to thicken and prepare the womb before the embryo transfer.

What does Gonal F do?

This is a follicle stimulating hormone (FSH) to help increase the number of growing follicles and their development.

The dosage will be prescribed based on the inital hormone test results and varies from individual to individual.

What does Menopur do?

Menopur is also used for follicle growth and development and contains follicle stimulating hormone as well as luteinising hormone (LH).

Can I travel with the injections?

The injections will need to be checked in your luggage but there should be no problems traveling with them.

Why do I need to have scans?

The scans for Egg Donation patients are requested in order to make sure that the lining of the womb is ready for the embryo transfer.

The scans for women using their own eggs (IVF with ICSI and Gender Seletion/PGD) is to ensure the follicles are developping well before egg collection.

It is important to let us know the results of the scans so that we can adjust your treatment schedule and medication in take if necessary.

What tests can I do if I have recurrig miscarriages?

Here are a list of tests that can be done:

MTHFR C677T

MTHFR A1298C

Factor V Leiden

Factor II

PAI 1

How are the injections done?

The Gonal F injections should be done subcutaneously either in the abdomen/stomach area, naval area or upper thigh where there is excess skin and fatty tissues. It is recommended to vary the injection site.

Please watch the videos below for preparing and administering the medication.

http://www.youtube.com/watch?v=OMklbInsQGk

http://www.youtube.com/watch?v=AHEyyB0IKNY

When are the eggs collected?

The eggs are generally collected on day 15 of the cycle after an ultrasound and the trigger injection.

When is the embryo transfered?

With regular IVF the embryos are generally transfered on day 18 and with PGD on day 20.

This of course might vary from patient to patient.

We can transfer up to 3 embryos at our clinic.

What chromosomes are examined with PGD?

During the PGD biopsy we test chromosomes X, Y, 13, 18 and 21 which are causes of close to 90% of abnormalities.

What happens if we have left over embryos?

Many patients will choose to freeze the embryos in case they need it in the future, other patient will ask for the remaining embryos to be destroyed or used for donation.

When do I do the pregnancy test?

The pregnancy blood test is suggested 12 days after the embryo transfer.

What happens after a postive pregnancy result?

After a postitive result you will continue to take medication for 11 weeks after the embryo transfer. Normally this will be Crinone Gel (Progesterone) and Aspirin.

Do we have to use the accommodation offered in your packages?

Some patients decide they would prefer to select their own accommodation which is no problem for us.

If you would like to still take advantage of the free ground transfers however, it is preferable that your hotel be in Nicosia (Lefkosa) North Cyprus.