In-Vitro Fertilization (IVF) with ICSI

In Vitro Fertilization (IVF) is the process by which an egg is fertilised by sperm outside the body. Subsequently, the embryos considered to be the best are placed into the woman’s womb with the use of a plastic catheter.

At North Cyprus IVF, this process is followed through five basic steps;

1) Fertility testing and identifying the right type of treatment as well as the precise dose of medication.
2) Hormone supplements and stimulation of healthy egg(s) in the ovaries.
3) Collecting the eggs.
4) ICSI (Intracytoplasmic Sperm Injection); Combining the eggs and sperm in the laboratory for fertilization and embryo growth.
5) Embryo Transfer.

At North Cyprus IVF, we guarantee the highest quality treatment with the best quality standards at low cost.

For any more information including cost of our IVF ICSI treatment and medical details, please do not hesitate to contact us.

Source : http://goo.gl/kyMexH

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Treatment Options

Going through a complete assessment of your personal fertility has a great importance on choosing the right treatment option since each treatment is suitable for a specific patient group regarding their fertility requirements.

Initial testing process is the first step infertility assessment. Detailed information where we describe some basics can be found in our "Infertility Testing and Interpretation of Test Results" section. Next, on the ; "Choosing the Right Treatment" section, you can come across some treatment suitable to some patient groups regarding factors such as; age, fertility assessment, previous obstetric history as well as history of fertility.

Together with the treatment, patient's lifestyle has also a great effect on the outcome of the treatment. Therefore, please do not forget to check our "Boost your Fertility".

Deciding on the clinic for your treatment might be challenging for you as you may have many choices around. However, be aware not to choose a clinic that is willing to proceed any treatment without a thorough evaluation of your personal needs. Please note that IVF is a personal, unique treatment and there isn't a single prescription applicable for everyone.

Some treatment options offered by the North Cyprus IVF Clinic is listed below. For more information, please do not hesitate to get in touch with us. We will be more than happy to assist you.

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Sickle Cell Disease

Sickle cell anemia is caused by an abnormal type hemoglobin called hemoglobin S and is a case where the red blood cells are sickle shaped.

The job of these hemoglobin molecules is to bind and carry oxygen to the tissues but in the presence of abnormal hemoglobin molecules, this delivery is less optimal and can cause problems. 

HBB gene mutation is the cause for sickle cell disorder however with our PGD (Pre-Implantation Genetic Diagnosis) treatment you can prevent passing this gene onto your children. 

If you are at risk for passing sickle cell please visit the link below for further information about our PGD IVF treatment for genetic disorders. 

http://www.lowcostivf.net/sickle-cell-anemia-disease-prevention-treatment.htm#.U0BlnVG1Zck

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Infertility Testing & Interpreting Test Results

Infertility testing can be very different for different patient groups. For instance, if you have been trying to conceive for some time without success and have had no prior testing and/or investigation done, then the starting point will be the following:

For female partner:

- A sonogram will need to be performed on day 2 or day 3 of her menstrual period. This sonogram will be indicative of the number of antral follicle count (potential eggs for ovulation) and it will give your gynecologist a chance to observe if there are any problems such as cysts in the ovaries, or polyps/fibroids in the uterus/cervix that can possibly interfere with a successful pregnancy process.

- On the very same day, FSH, LH, Estradiol, Prolactin, TSH and AMH hormone tests will need to be administered to make an assessment of the ovarian function. Each of these hormones reflect a different aspect of your fertility. Our specialists at North Cyprus IVF will evaluate your test results and provide a comprehensive feedback on your test results.

For male partner:

- A semen analysis will need to be performed according to WHO 2010 Criteria, as explained in the "Causes of Male Infertility" section.

For couples who have had their initial testing and perhaps have been through a round of fertility treatment will need further investigation. Based on the problems or the lack of problems that may have been observed in initial testing, the following will be investigated:

- A hysterosalpingography for a thorough investigation into the tubes and the uterus

- Infectious disease screening for both partners including Toxoplasmosis, CMV and Chlamydia for the female partner. Sometimes a small infection can cause your body to reject embryo implantation and therefore prevent you from getting pregnant. A short cure of antibiotherapy can sometimes be a solution to a long-suffered infertility problem.

- A karyotype analysis for chromosome testing. If one of the partners suffers from an abnormal karyotype, a genetic problem may be transferred to the offspring. The nature and the severity of the problem will be indicative of what types of measures should be taken.

For couples with repeated IVF failures and/or repeated miscarriages, in addition to the tests mentioned above, female thrombophilia testing will be in order including the following:

MTHFR C677T

MTHFR A1298C

Factor II

Factor V Leiden

PAI 1

Thrombophilia defects can potentially cause blood clotting problems, where blood clots can get into the placental circulation and stop your baby's heart, therefore, resulting in a miscarriage. Thrombophilia defects have also been identified with implantation failures.

This is not a comprehensive list of infertility testing and we may ask for different tests depending on your unique history of infertility.

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How do I begin treatment?

The first step in treatment is to gather all the necessary information, i.e. the test results mentioned above. One we have all the test results, we are able to identify the right treatment protocol as well as the precise dose of medication to be administered. Once you send us your test results, we will be able to provide our feedback and lay down all the options based on your unique fertility assessment.

At this point, we are able to map out your treatment calendar and issue your prescription. We work with an international pharmacy in the UK which delivers worldwide, so you will be able to order your medication online and receive them at your door. There are clear instructions on how to administer the medication as well as daily instructions of what you need to do on your treatment calendar.

Once you begin with the preliminary treatment, you will begin using your medication locally and you will need to visit your local gynecologist in order to observe your response to medication and reassess the dose of medication if necessary. These local scans can be done at your local gynecologist or scanning clinic. We work with a number of places in the United States, United Kingdom, Sweden, Turkey, Germany, France, Holland and Spain for scans. Therefore, should you not have a local doctor, we may be able to recommend a place or two.

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Required Tests - IVF

Certain tests are required before we can proceed with IVF treatment. Some of these tests are common to every IVF patient regardless of the treatment option they choose. These are the infectious contagious disease tests including:

HbsAg, Anti-HCV and Anti-HIV tests both for the male and the female partner.

We also require further testing forVDRL and Rubella IgG of the female partner.

The aim of infectious disease testing is to make sure that these diseases are not passed onto the newborn (or the surrogate in the case of gestational surrogacy). These tests can be done prior to your arrival at our clinic in Cyprus or once you arrive at our clinic. It is, however, required that we see these test results before the embryo transfer stage.

We also require certain tests for patients undergoing conventional IVF, Sperm Donation IVF or Gender Selection IVF. These are the hormone tests to be done on the 3rd day of the menstrual cycle of the female patient. The aim of the hormone tests is to identify egg quality and quantity produced by the female patient. These test results will tell us about the usability of the female patient's eggs in the IVF procedure. You should keep in mind that age is also a very important factor. A female above the age of 40 with acceptable test results may still have a very low chance of IVF due to older age. The hormone tests we require include:

FSH: Follicle stimulating hormone (FSH) is one of the most important hormones involved in the natural menstrual cycle as well as in pharmacological (drug-induced) stimulation of the ovaries. It is the main hormone involved in producing mature eggs in the ovaries. We consider normal FSH level to be anything less than 9. As levels go above 9 we often see a reduction in response to ovarian stimulating drugs

LH: The Luitenizing Hormone (LH) test is used for a variety of reasons. It is typically used to detect when a woman is ovulating, so that eggs can be retrieved for an IVF procedure. On Day 3, normal LH values are between 3 and 10 mIU/mL. LH levels can also be artificially raised by ovulation inducing drugs such as clomiphene citrate ( clomid).

E2: Performed on Day 3 of your menstrual cycle, the estradiol test is one of the most common fertility testing procedures. Most women undergoing fertility treatments will receive the estradiol test. Women have particular levels of estradiol during different stages of their menstrual cycle. By analyzing these levels on Day 3, your reproductive endocrinologist can determine your ovarian reserve. Normal Day 3 estradiol levels tend to be around 80 pg/mL or lower. If your estradiol levels are higher than this, than this could indicate a problem with your ovulation

PRL: Prolactin is the “milk producing hormone” secreted by the pituitary gland. Elevated prolactin levels must be reduced for successful conception to occur.

Patients undergoing conventional IVF, Gender Selection IVF or Egg Donation IVF are also asked to provide a semen analysis report including sperm count, motility and morphology. This is to make sure that the male partner is able to produce healthy sperm and can be used in the IVF procedure.

Additional testing might be required in a case specific manner. For more information on your specific fertility treatment and testing, please contact us using the web contact form.


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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.

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Infertility Investigation

Infertility is often defined as inability to conceive naturally after trying for one year without any contraception. Women who are able to get pregnant but who are unable to carry pregnancy to full term are also considered to be infertile. About 10% of the US population, and around 9% of the European population between the ages of 15-44 have either difficulty conceiving or carrying pregnancy to full term.

Even though infertility is often perceived as a women's problem due to its direct link to pregnancy, female and male infertility have about the same level of prevalence within the society. About one-third of the causes of infertility are associated with female factor infertility and another one-third is associated with male factor infertility when the rest is either due to a combined male-female factor or unexplained infertility.

If you have been trying to get pregnant for the past one year and have not been able to get pregnant, then you might belong in either one of these groups. For partners who have not been successful at achieving pregnancy for a full year, a series of tests is in order. Infertility investigation works in a dual manner where both partners undergo a testing process. The starting point of infertility testing would be as follows:

- For male partner, a semen analysis is required. Krueger's semen analysis

provides information on sperm count, volume, motility, morphology and

a few more factors. This would be the starting point of infertility investigation.

- For female partner, hormone testing is in order. If the female partner has

regular menstrual periods, then hormone tests such as FSH, LH, Estradiol,

Prolactine and TSH. If the female partner is young, but does not have regular

menstrual periods, then apart from the hormone tests, further investigation

may be necessary to see into the ovarian function and the uterus. Irregular

periods could be due to Poly Cystic Ovarian Syndrome (PCOS) or any other

problems.

When standard hormone testing and sonogram investigations fail to provide an answer, more invasive testing process will be in order. Female partner might be required to have a hysteroscopy as well as certain infectious disease tests such as Chlamydia, CMV IgG and Toxoplasmosis.

When all the above testing processes fail to yield and answer, then thrombophilia defects and immune system problems are to be investigated. Especially for women with repeated miscarriages, thrombophilia is one of the main suspects.

Sometimes, patients who complete their first round of testing can be offered fertility treatment before attempting the more in-depth and invasive tests. This is simply because, the likelihood of belonging in the unexplained infertility group is very high and the expensive testing procedures can be very overwhelming. Therefore, before attempting these tests, an IVF treatment can be attempted first and if the result is negative, then further tests can be performed. In most cases, partners are able to achieve pregnancy without consulting the invasive testing processes.

At North Cyprus IVF, we take into consideration every single factor that can potentially be contributing to your infertility problems. When we ask you to have a series of tests, it is merely due to the fact that we are trying hard to make sure we are able to offer you the most effective type of treatment that is unique and suitable for your specific needs.

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Accommodation Options

We have 3 options to offer for accommodation while you are in Cyprus for your IVF Treatment.

The first option which is the most economically friendly would be our guest house.

The guest house is a newly finished and furnished 4 bedroom villa located in Gunyeli. Each bedroom has a TV and mini-bar. Two of the bedrooms have their own bathrooms and the remaining two share a bathroom. Transfers to and from the clinic are included.

The second option is the 3-Star City Royal Hotel in Nicosia (http://www.city-royal.com) Facilities at the hotel include an Entertainment Center, Sun Terrace,  3 Restaurants, Casino and Bar as well as 24 hour Room Service.

The third and most prefered option is the 5-Star Luxurious Golden Tulip Hotel (http://www.goldentulipnicosia.com). The hotel is a 5 minute walk from the clinic and offers the following amenities: Swimming Pool,  Fine Dining Restaurant, Spa and Wellness Center, Turkish Bath, Sauna, 24 hour Room Service and Casino.

**Please note that pricing and availability are subject to change during national and religious holidays. **

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Talk about Success Rates!

Talk about Success Rates!

It is important to remember that every single IVF patient is individual and different.

Realistic success rates for treatment can only be provided after the individual couple has been evaluated closely.

Our success rates are based clinical pregnancies with a 3 embryo transfer.

Unfotunately since we have many patients from abroad, it is often hard to keep track of each one. It is common for International patients to lose touch once the treatment is complete and they have returned to their home country. 

Of course we are always available to answer any of your questions pre and post treatment.

There are several reasons for failed attempts and here are a few of them:

embryo arrest

tubal disease

low sperm count/ sperm defects

reduced endometrial receptivity

embryonic defects

thin endometrium

immunological factors

genetic abnormalities

endometriosis 

hydrosalpinge

thrombophilia

difficult embryo transfer

high estradiol levels

poor ovarian response

Quote from the San Diego Fertility Center : 

Another problem with infertility treatment success statistics is the way in which they are reported. Should we report pregnancies based on each attempted cycle or overall success after 3 months or 6 months of infertility treatment? Should "success" be defined as a (+) pregnancy test or a live born child delivered 9 months later? Even the fertility experts can't agree and the organizations that collate success rates have changed their definitions over time. The most commonly reported success rate is a "clinical pregnancy"

Since this is a medical procedure unfortunately there is no way of knowing in advance what the reason for failure could be.

Please do not hesitate to contact us with any questions, comments or concerns you might have at info@northcyprusivf.net

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