Frequently asked questions
Am I infertile?
About 85% of young, healthy heterosexual couples conceive after one year of trying and about 93% are successful after two years. The standard definition of infertility is the inability to conceive after 12 months of unprotected sexual intercourse. Today this has been modified to take into account age, and now women over 35 may be considered infertile if they have failed to conceive after trying for six months. Some specialists half that number to three months for women over 40. If you suspect you are infertile or are at risk of being infertile, speak with a medical professional to discuss your options.
What is the difference between 'sterility' and 'infertility'?
Sterility means that it is impossible for a couple to conceive a child. A diagnosis of sterility is given after a thorough examination concludes that there is no sperm production and ovulation cannot occur.
İnfertility means that a couple is not sterile but for some reason they have not been able to conceive a child. There are three conditions that need to be met for conception to be possible: sperm must be present, the fallopian tubes must be open, and ovulation must occur. If one or more of these conditions is not met, the couple suffers from "true infertility". If all three conditions are met but the couple has failed to conceive, the diagnosis is "sub-fertility".
Once a couple are diagnosed as infertile, the doctor will perform tests to determine the cause or causes. Then treatment can begin. With todays technological advances even truly infertile couples conceive a child , sometimes with the assistance of a third party donor or surragate.
Should I consider seeking professional treatment for infertility?
People who consider undergoing IVF or other assisted reproductive techniques (ART) often do so after they have failed to conceive for 12 months. Others who have known risk factors for infertility seek treatment sooner. Reasons for this include;
- the female partner is over 35 years old
- either partner has received injuries or has been diagnosed with conditions that affect fertility (endometriosis, pelvic infection, polycystic ovarian syndrome, undescended testicles)
- either partner has a family history of genetic disorders (Tay-Sachs disease, thalassemia)
- the couple has not been helped by ovulation induction or infertility treatments
- the femal partner has had multiple unsuccessful pregnancies for other reasons
Single women and lesbian couples may also obtain professional assistance when attempting to conceive a child.
I have been diagnosed as infertile, will I need IVF?
Not necessarily. Most couples find that they can successfully conceive with the help of medications, fertility drugs, or occassionally surgery. Only a small percentage of infertile couples - about 5% - require advanced treatments such as IVF, GIFT (gamate intrafallopian transfer), ZIFT (zygote intrafallopian transfer), ICSI (intracytoplasmic sperm injection) and egg donation.
What exactly is a Hysterosalpingogram? What does it involve and does it involve pain?
Hysterosalpingogram(HSG) is an x-ray study of the uterus that uses a special dye visible on x-rays. A series of x-ray images are taken as the dye flows into the uterus and through the fallopian tubes which helps the doctors evaluate the size and shape of the uterine cavity and determine whether the fallopian tubes are open, and sometimes even if there are adhesions near the tubes.
HSG is best scheduled 2 to 3 days after the last day of menstrual flow. It is important to ensure that you are not pregnant at the time this study is performed, if there is any doubt about whether you are pregnant, of if the flow is light, a pregnancy test should be performed beforehand. You may be prescribed a dose of antibiotics to reduce the risk of infection and a non-steroidal antiinflammatory agent such as Ibuprofen (advil or brufen) or Naproxen (aleve) to minimize cramping.
The doctor begins by inserting a speculum into the vagina. The cervix is wiped with an antiseptic, and a catheter (narrow tube) is inserted into the uterine cavity. There may be mild cramp at this point. The speculum will be removed, and you will be repositioned on the x-ray table. The radiologist will place tension on the uterus to straighten the bend and give a better picture of the uterine cavity. The dye is then injected into the uterus via the catheter. Thls again may cause cramping. If you can try and relax it should help with the cramping. If the dye does not flow through the fallopian tubes, additional presssure may be necessary to see if the tubes are really blocked. This can cause more intense discomfort.
After the x-ray, you will be asked to remain lying down for another 5 - 10 minutes to allow any cramping to subside. If you experience increased pain, fever or heavy bleeding after the procedure you should contact your doctor.
What are the tests I need to have done prior to treatment?
Before a recipient can be matched with an egg donor, the following tests must be carried out:
FEMALE MALE
CMV Hepatitis B
Hepatitis B Hepatitis C
Hepatitis C HIV
HIV Semen Analysis
Syphillis Blood Type
Rubella
Blood Type
Baseline scan or HSG
NB: These tests must be less than 12 months old at the time of treatment.
Who are the donors?
Donors are women of 18 - 30 years of age. Most of them are 21 - 28 years old and often students or graduates. They will have normal body weight, healthy medical and genetic history and will have tested negative for all the infectious disease screening performed. Donors cannot donate more than three times. The ethnic origin of donors is quite diverse: mostly Eastern European Caucasian women (from former Soviet Republics), students and graduates living in Turkey and Northern Cyprus. We have a number of African students studying in North Cyprus who are also donors.
How will the egg donor be selected?
You complete a donor characteristic form in which we document the characteristics you would like the donor to have. We use this information to supply you with a list of donors that match your criteria and blood groups. You select your first choice and a reserve donor. This will allow flexibility and avoids delays in case the first choice donor does not produce enough number of eggs or for any reason, decides to withdraw from the programme.
How can I be sure the donation will be safe?
All egg donors are fullly screened prior to being accepted. Baseline ultrasounds and blood work are carried out to determine hormone levels, absence of substance abuse, sexually transmitted or other diseases, and her physical eligibility to undergo follicle stimulation and egg retrieval. Genetic screening, when indicated, to test whether the individuals carry a genetically transmitted disease is carried out.
The criteria for donor selection includes:
- Age less than 30 years old
- Two ovaries
- FSH level not more than 8IU/L
- BMi not more than 25
- No previous ovarian surgery
- No previous history or family history of genetic of familial illness
- No history of infertility
In addition, all donors are screened and must be completely clear with respect to:
- Chlamydia
- CMV
- Cystic Fibrosis Gene
- Hepatitis B and C
- HIV
- Kıdney function
- Liver function
- Normal Chromosome Analysis
- Syphillis
- Total Blood count
Will the donation be anonymous?
Yes. The rules on annonymity are strict and are in the best interests of all concerned. No identifying information wii be given to you about the donor. Likewise, the donor will not receive any information about you.
Will I be given any information about the donor?
We will provide you with information on:
- Age
- Hair colour
- Body build
- Height
- Weight
- Education
- Eye Colour
- Number of children of their own if applicable
- Country of origin (ethnicity)
How many egg/embryos will I receive?
You will receive between 10 and 16 oocytes(eggs) from your allocated donor. This is a guarantee not matched by any other centre.
What is the drug regimen?
There are two drug regimens
Patients who are menopausal(ie with no periods) Oral Oestradiol Valerate (Progynova) is given for 10-12 days to thicken the uterus lining(endometrium). An ultrasound scan will be performed to check the endometrial thickness. Progesterone support will commence 3-4 days before the embryo transfer.
Patients with naturally occurring periods(ie not thought to be menopausal). In order to control your cycle, you will first need to take oral contraceptive before starting with oral Oestradiol Valerate to thicken the lining of the uterus and progesterone support as above.
In order to sychronise both recipient and donor cycles for fresh embryo transfer it is essential to "switch off" the recipients cycle using a long protocol. The recipient will need to take Nafarelin (Synarel) nasal spray daily, from day 2 or 21 of the menstrual cycle, until the day before the donors egg collection. The endometrium is prepared by giving oral oestradiol valerate (Progynova) and progesterone support as above.
For both sets of clients , the drug regime is continued until a pregnancy test is performed.
Are there any side effects of the medication used during my IVF treatment cycle?
During down regulation you may experience headaches, hot flushes or mood swings. When you start your stimulating injections these side effects should subside, but you may experience "twinges" in your ovaries and feel bloated.
Can I stop my down-regulation eg Buserelin, when I start my stimulating injections eg Menopur, Gonal F?
You must continue using your Buserelin throughout your cycle of IVF treatment. A member of the medical or nursing team will advise you when to stop.
Can I mix the Buserelin and my stimulating injection together?
No you cannot mix your Buserelin and stimulating hormone together in the same syringe, but they can be injected at the same time as single injections.
Can I mix my Menopur/Gonal F the night before use and store in the fridge?
NO. Your menopur/gonal F must be injected immediately after you have mixed it.
Will the drugs make me put on weight?
You will not increase in weight, but once you commence your stimulating injection eg menopur/gonal, you may feel a little bloated and experience lower abdominal swelling.
What can I take for my period pains during down-regulation?
Paracetamol
Do I have to have my stimulating injections at the same time each day?
It is advisable to administer your Menopur/Gonal F at approximately the same time each day. As you may need to attend the clinic for a scan, do not have your stimulating injection before the scan as your injection dose may be changed.
Can I still have intercourse whilst on my drugs?
Intercourse is unrestricted until day nine of your stimulating injections
Why do I have to use barrier form of contraception once I have commenced treatment?
If you should become pregnant naturally, the down regulation drugs may increase the chances of miscarriage.
Following embryo transfer do you recommend I use my cyclogest pessaries rectally or vaginally?
It is your personal choice whether you administer your pessaries rectally or vaginally. When using the pessaries vaginally you may experience a white discharge.
Can I do a pregnancy test earlier than 2 weeks following embryo transfer?
It is advisable to perform a pregnancy test 2 weeks after embryo transfer to avoid false results. We also recommend you test using an early morning sample of urine.
I am due to have a dental filling, can I have this done during treatment?
Yes, but it is advisable to inform your dentist of the possibility of your being pregnant. He will then decide whether dental treatment needs to be postponed or cancelled.
Can I drink alcohol during treatment?
There is evidence that alcohol reduces fertility in both men and women. It is advisable to keep alcohol intake to below the recommended limits eg upt to 5 units per week.
Can I dye my hair/use spray tans while having treatment?
Ask your hairdressers advice about using certain hair products in early pregnancy. A reputable tanning establishment should also be able to advise you.
My doctor has given me antibiotics, can I take them during my treatment?
If your doctor is aware you are having IVF treatment he/she will prescribe antibiotics that are safe to take during pregnancy. If you doctor is not aware inform him/her that you may be pregnant.
Can I have my flu jab during treatment?
No, it is not advisable to have a flu vaccination during treatment.
Can I go swimming during/after treatment?
During treatment it is a good way to keep fit. After treatment we would advise you not to go swimming for at least a week following your egg collection to prevent the chance of infection occurring.
Can I use complementary therapies during treatment?
We have no evidence to say it is harmful, but we would advise you tell your therapist that you may be pregnant as the use of certain aromatherapy oils is NOT advisable during pregnancy.
Do I need to take time off work during treatment?
It is not necessary to take time off work during your treatment.
What is your success rate?
We regularly achieve high pregnancy rates due to a combination of high quality oocytes and the expertise of our team of highly experienced physicians, nurses, embryologists and other laboratory staff. The programme is achieving excellent results - currently pregnancy rates are over 71%. Please see up to date pregnancy rates on the results page of our website.
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