How do I administer the medication?

Administering medication is relatively easy given that the injections to be used are sub-cutaneous injections and are administered right under the skin. These injections are painless and easy to self-administer. Please refer to the link below for a complete explanation on how to mix and arrange the dose of your medication as well as how to administer it.

Once you watch this video, please contact us for any questions you may have.

You will notice that once you retrieve the necessary amount of medication from the vial, you will have some left over medication in the vial. You will store this in a refrigerator and use the next day.

For instance, a vial of Gonal-F 450 iu will give you 600 units of medication once mixed. If your daily dose is, say, 300 iu, you will use half of it and store the other half for the next day.

http://www.youtube.com/watch?v=nr6-3vJ4SpA

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Why do I need to use medication if I don’t have any fertility issues?

This is one of the most commonly asked questions from patients undergoing treatment for gender selection. Given that most patients require gender selection for their second or third or even fourth pregnancies, they are mostly fertile individuals who are able to achieve pregnancy through natural means. This raises the question why they need to use fertility medication like other patients who are not able to conceive naturally. The answer is simple. Whether you are able to conceive naturally or not, in any IVF treatment, we will need to obtain multiple eggs and therefore multiple embryos so that we can maximize your chances of success. Without any use of fertility medication, your ovaries are likely to release only one egg in a given menstrual cycle. This single egg may or may not be of optimal quality. Especially in gender selection treatments, we need multiple eggs so that we can have multiple embryos, which will allow us to find at least one embryo that is healthy genetically and that is of desired sex.

Not all the eggs will fertilize into good quality embryos and not all the fertilized embryos will survive until the day of embryo transfer, and not all the embryos that have survived will turn out to be healthy and of desired sex. This is why we need to administer a custom prepared medication protocol which will optimize the number of eggs to be harvested so that we can offer you the highest chance of success possible.

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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

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Male Infertility Problems

 Infertility in men is most often caused by:

1- Problems making sperm, which means producing too few sperm or none at all

2- Problems with the sperm's ability to reach the egg and fertilize it, which could be the case where abnormal sperm shape or structure prevent it from moving correctly

Sometimes a man is born with the problems that affect his sperm. Other times problems start later in life due to illness or injury. For example, cystic fibrosis often causes infertility in men. The number and quality of a man's sperm can also be affected by his overall health and lifestyle. Some things that may reduce sperm number and/or quality include:

- alcohol

- drugs

- environmental toxins, including pesticides and lead

- smoking cigarettes

- health problems

- medicines

-radiation treatment and chemotherapy for cancer

-age

In some cases, even if sperm production is not sufficient enough to produce sperm through ejaculation, minor surgical procedures like TESA and MESA can be used to retrieve the sperm. In the cases where the sperm is unable to reach and fertilize the egg, ICSI is used for assisted fertilization. In other cases where no sperm can be found or the quality is exceptionally low, using donor sperm becomes the only alternative.

Semen Analysis

With the aid of a semen analysis, sperm can  be categorized in the following groups:

Azoospermia: Nearly or no live sperm cells in semen

Oligospermia: Low count of live sperm cells

Asthenospermia: Low motility

Terathospermia: Low morphology

Fertile: No problems with count, motility or morphology

Sub-Fertile: Slight male factor infertility.

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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.