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Effectiveness of programs up to 80,52%
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Answers to questions from the reproductologist Azhder Irina Anatolyevna

Is it wise to get pregnant during the epidemic?

Unfortunately, we have very little information about pregnant women who have become infected with Covid-19. Avoid getting sick! But, from the small amount of information that we possess, we know that pregnant women suffer from Covid-19 no more severely than non-pregnant women of the same age. Women with concomitant diseases, namely respiratory diseases, arterial hypertension, diabetes mellitus or HIV infection, are more likely to get a more severe form.

Is it mandatory to be officially married in order to be able to do IVF?

No, it is not necessary to be officially married. In order to sign an agreement on in vitro fertilization (IVF), it is enough not to be officially married to third parties (or there must be a divorce certificate / court decision). It is not necessary to officially register a marriage specifically for starting an IVF program, with the exception of surrogacy cycles, in such an IVF cycle, official registration of marriage is mandatory!

Follicle-stimulating hormone 12.2, norm 11.3, what does this mean, I have menopause? I am 33 years old.

With the advent of AMH (antimuller hormone), the value of FSH has somewhat decreased. Nevertheless, it is believed that the norm for FSH on the 2-5th day of the menstrual cycle, for women who plan a pregnancy of no more than 9. A figure of FSH of 10 or more indicates a possible decrease in ovarian reserve. We recommend that you consult a reproductologist for the correct interpretation of your result. Perhaps the reproductologist will ask you to repeat the ultrasound of OMT (with counting of antral follicles) on the 2-3rd day of the menstrual cycle, after which it will give recommendations on the scope of the examination.

Teratozoospermia, is pregnancy realistic without IVF? What is the percentage of empty follicles after a puncture?

With teratozoospermia, the likelihood of becoming pregnant naturally depends on the severity (moderate, severe or severe), and the presence of additional factors that prevent pregnancy. You can contact our reproductologists for an additional examination and to decide on further tactics of pregnancy planning.

With progesterone deficiency, with what attempt is the probability to endure?

Progesterone deficiency, today, is not a problem for planning pregnancy, especially if you know about this dysfunction in advance. In the arsenal of doctors there are highly effective drugs with a different route of administration, and their combination allows to achieve a positive result, as a rule, already at the first attempt.

How to avoid OHSS in spk?

I would like to immediately note that doctors around the world have long ceased to be afraid of ovarian hyperstimulation. Today, in our arsenal there are enough preparations to cope with this task. If you are at risk for ovarian hyperstimulation syndrome, follow the simple rules and appointments prescribed by your doctor. You need to follow such simple but very important rules as: physical and sexual rest, abundant water regime, high-protein diet. Take seriously the IVF protocol and doctor’s prescriptions and then in 5-7 days you will be able to cope with this condition.

In PCOS, which program is suitable, doesn’t an independent pregnancy occur?

We recommend that you first go through a survey of a married couple with a reproductologist to diagnose infertility factor. If it turns out that you need an IVF program for pregnancy, it is very likely that this will be a short ovarian stimulation protocol. Our Personal 1 or 2 program may be suitable for you. Sign up to our reproductologist in order to get more detailed information. https://ladaclinic.ua/service/ekstrakorporalnoe-oplodotvorenie-eko

Can PCOS get pregnant without IVF by simply stimulating the ovulation in the natural cycle?

Indeed, many patients become pregnant on their own with such a diagnosis. For the correct diagnosis and planning of pregnancy with PCOS, it is necessary to undergo an examination of both spouses, as there are some nuances that must be taken into account when planning pregnancy with PCOS.

How to prepare for an initial visit to a reproductologist? Is it possible to do some kind of analysis first?

There is no special preparation for the first visit. For the initial consultation of the reproductologist, it is necessary to take all available extracts from outpatient monitoring, extracts from hospitals (if any), as well as all analyzes. Of particular importance are surveys conducted over the past year. After the reproductologist acquaints himself with your anamnesis, performs an ultrasound examination of the pelvic organs, he will determine the plan for examining your couple.

Do IVFs with AMH less than 1?

Yes, IVF can be performed with AMH less than 1. Features of the choice of stimulation protocol are in the number of antral follicles. As you know, not every follicle can contain an egg, and with an AMH of less than 1, an egg can be of poor quality and may carry chromosomal abnormalities. For this reason, many clinics recommend in such cases to immediately start the IVF program with donor eggs, as the chances of getting pregnant are much higher in the donor protocol.

What are the chances of getting pregnant with a single tube during intrauterine insemination?

The chances of pregnancy with intrauterine insemination do not so much depend on the number of fallopian tubes, but on the quality of the seminal fluid, the condition of the fallopian tube (the severity of the ciliary epithelium, the ability to contract to capture the egg, and then push the embryo into the uterine cavity), the patient’s age (known that with age the egg shell becomes denser and becomes impermeable to the sperm), depending on the thickness and quality of the endometrium.

After what time does an hCG injection come out, which can show a false positive 2 strip?

It is believed that the first 10 days after injection of an hCG-containing drug is determined in the circulating blood and excreted in the urine in different concentrations. For this reason, it is not advisable to conduct a pregnancy test or determine the level of hCG in the first 10 days after injection of an hCG-containing drug.

What percentage get pregnant the first time?

Most IVF protocols end in pregnancy after the first transfer. In our clinic, this is approximately 60-70% of transfers. It all depends on the age of the patients, the ovarian reserve and the infertility factor, because, as you know, the effectiveness and efficiency of the IVF program depends on the quality and quantity of eggs and sperm. Do not waste precious time!

How to determine if ICSI is needed or not?

For a long time, advanced clinics all over the world switched exclusively to the ICSI fertilization technique. So we were able to increase the efficiency of IVF protocols up to 70-80%. In some cases, for example, male infertility factor, woman’s age is more than 37 years old, smoking – ICSI is mandatory.

There are no both fallopian tubes, is there a chance of pregnancy?
In the absence of both fallopian tubes, there are absolute indications for an IVF program. With natural conception, fertilization and development of the embryo in the first 5 days occurs precisely in the fallopian tube. In their absence, natural conception and the onset of pregnancy is impossible. IVF protocols allow fertilization and development of the embryo outside the body of the expectant mother, then to plant the embryo directly into the uterine cavity for further development of pregnancy. A reproductive doctor evaluates the ovarian reserve and selects an IVF program that is right for your couple.

What are your statistics for successful protocols?

When evaluating the effectiveness of IVF programs, various parameters must be considered. First of all, these are the factors of infertility and the age of patients (couples), the type of protocol. You can find more details about clinic statistics in our report. https://ladaclinic.ua/landing

How much does the human factor (the quality of the work of the doctor-reproductologist) at all stages affect the likelihood of a successful conception?

50% of the success of the IVF protocol depends on the quality of work of the doctor – reproductologist. The second half of success depends on many factors, namely:

– From the choice of the protocol by the doctor (each patient is selected individually, long or short protocol), for the patient they will proceed almost identically, and the result may be different.

– From the choice of drug for stimulation (groups of drugs are different). The answer and the number of eggs received depend on this choice.

– Next, I want to note the work of an experienced embryologist and equipping the embryoblock with the most modern equipment.

– Well, and not least, attentiveness and return of patients. Sometimes patients take the recommendations lightly, skip injections or take medications, which is very important and can result in a negative result for all of us. We strongly recommend that you pay great attention to the choice of not only the clinic, but also the doctor – reproductologist, because only in team work can you achieve a positive result.

Features of stimulation of girls with sleep?

When planning a stimulation protocol for patients with polycystic ovary syndrome, you need to follow a few simple rules, namely:

– An EXCLUSIVELY short stimulation protocol using an antagonist (to avoid ovarian hyperstimulation syndrome).

– trigger agonist (with the goal of preventing OHSS).

– frezze all, that is, freezing of all embryos and delayed transfer of embryos in another menstrual cycle (with the goal of preventing severe forms of OHSS, especially secondary ovarian hypnostimulation syndrome during pregnancy).

Types of phenotypes in PCOS

Doctors of the Lada Clinic, however, like doctors around the world, identify 4 main phenotypes of patients with PCOS based on these criteria, according to ESHRE / ASRM, 2007, Consensus on women’s aspect of PCOS, 2012,2013,2014. Namely: the main, ovulatory, nonandrogenic and anovulatory.

Due to the fact that with PCOS, in addition to the main ones, there are hidden systemic disorders, we pay special attention to the majority of patients with a “non-classical” manifestation of PCOS.

Dear patients, we urge you not to self-medicate, but to seek advice from a reproductologist at the Lada Clinic and assure you that a positive result will not take long!

If possible, I would like to hear a few words about donor fertilization.

Everything is very simple, according to the order of the Ministry of Health of Ukraine, the donor undergoes a full examination (blood tests, smears, ultrasounds, everything that a woman usually gives up before starting ovarian stimulation). At the end of the examination phase, the therapist gives permission to start stimulation, and we confidently begin the IVF program. On the day of the follicle puncture, the donor’s eggs are fertilized with the husband’s sperm using the ICSI technique and placed in the incubator for 5-6 days for further cultivation. If the donor and recipient cycles were synchronized, then on the fifth day of cultivation, 1-2 embryos can be transferred to the uterine cavity of the recipient (the remaining embryos are frozen), or all embryos are frozen and the recipient is prepared for transfer taking into account the individual characteristics of the formation of the implantation window.

I was diagnosed with PCOS, is it possible to become a mother with such a syndrome?

No need to be afraid of your diagnosis, many women become pregnant on their own with such a diagnosis. The fact is that there are various options for this disease and a comprehensive examination of a married couple will enable the reproductologist to determine the management and planning of pregnancy. Do not waste time, sign up to our reproductologist and perhaps soon you will see the treasured two strips.

Can you say a few words about the percentage guarantee of donor protocols?

The IVF program with donor eggs is highly effective. Everything is very individual, but, as a rule, the effectiveness exceeds 50% and can reach 70-80%. It depends on whether the cause of infertility in the eggs only or whether there are other factors, such as: a severe male factor, endometrial factor, and many others.

Do I need to do a testicular puncture twice to my husband?

In our clinic, a man undergoes an examination, after which it is recommended to do a test biopsy in order to assess the chances of the possibility of fertilization of oocytes on the day of follicle puncture. If we get sperm, we suggest freezing and storing them (they can be used on the day of the follicle puncture if there are a large number of eggs for fertilization and there are not enough morphologically normal and active motile sperm from a fresh testis biopsy for ICSI). If spermatozoa are not found in the tissue of the testis, we are talking about the need to choose a sperm donor.

Our clinic uses a unique technique for working with a biopsy sample of testicular tissue. The effectiveness of these programs, despite the difficult male factor, in previous years is above 90%.

My husband had varicocele testicles, a year ago they did the operation there is no result. Will IVF help get pregnant?

Yes, the question speaks for itself. If within a year after the operation, the long-awaited pregnancy did not occur, you should contact our specialist for advice. Perhaps they missed something, did not take into account, perhaps there are other factors that impede the onset of pregnancy. Our experts will help you figure it out.

Is it true that IVF luck is better in cryoprotocol and what is the reason for this?

In the last few years, with the beginning of the widespread use of vitrification (rapid freezing of embryos), indeed, the efficiency in cryoprotocols has increased significantly. But, still very individual. In some cases, where it is justified, we continue to carry out fresh transfers, and get high results.

Most likely, the cryoprotocol gives high performance where a fresh transfer does not make sense, namely:

– endometrium thinner than 7 mm

– at increased risk of hyperstimulation

– progesterone over 1.5 per day trigger (in a short protocol!)

And many other indications …

Is IVF done with anesthesia?

The IVF program consists of several parts:

– Survey. Patients donate blood, smears, undergo a series of ultrasound examinations in order to make sure that there are no contraindications to the IVF program, or if there is no need to undergo treatment (so to speak, prepare for the IVF program).

– Stimulation of the ovaries. This stage consists of several injections (on average 10-12 days), under ultrasound monitoring of follicular growth.

– Puncture of the follicles, the procedure during which you need to take the eggs. It is somewhat unpleasant, so we always carry it under intravenous anesthesia. This means that the patient is given an intravenous injection, during which she falls asleep for 5-10 minutes so that there are no unpleasant sensations at this stage. I draw your attention to the fact that this is a deep medical sleep, and not anesthesia.

– Then the eggs are transferred to the embryologist. He selects the best sperm and, using the ICSI technique, injects one sperm into each mature egg and places them in the incubator for 5-6 days.

– The final stage is the transfer of the embryo, it is performed on a gynecological chair without anesthesia, it is absolutely painless (except in rare cases when there were operations on the cervix and there are difficulties with the passage of the cervical canal and anesthesia is necessary).

Our clinic has developed a unique technique in which, before each transfer, we show the patient embryos before transferring them to the uterine cavity.

Big chances for successful IVF with a long or short protocol?

The INDIVIDUAL question depends on many factors, such as: ovarian reserve, age, body weight, associated gynecological diseases, and much more.

Tell us about the implantation window.

The period of maximum receptivity of the endometrium is called the “implantation window”. The opening of the implantation window occurs in the natural menstrual cycle on the 6-10th day, after ovulation. It remains open for about 2 days. During this period, the conditions for embryo transfer are as good as possible. The opening of the implantation window is accompanied by the appearance of pinopodia – these are smooth protrusions of the surface epithelial cells of the endometrium. It is assumed that they contribute to the occurrence of close contact between the blastocyst and the surface of the uterus.

In what cases does the implantation window shift?

If the formation of pinopodia is disturbed, the “implantation window” may shift in time. If pinopodia is not enough, the “implantation window” will be inferior. All this can lead to a negative IVF result. The causes of such phenomena can be hormonal imbalance, the infectious process of the genital area, and surgical interventions.

The process of implantation of an embryo (from the moment of its attachment to the uterine mucosa and until complete immersion in it) takes about 40 hours. During implantation, a biochemical “dialogue” occurs between the embryo and the endometrium. The blastocyst produces substances that allow the uterus to “feel” its presence. By the quality of biochemical impulses sent by the embryo, the endometrium determines its quality. A full blastocyst must be morphologically normal and have the correct set of chromosomes. Such a pinopodia embryo is beginning to attract, in every way contributing to its implantation. If the blastocyst is genetically defective or with external defects, the endometrium can reject it.

Is it possible to get pregnant with endometriosis or treatment first?

Everything depends on the form (genital – which is divided into external and internal, or extragenitoid) and the severity of this disease. In most cases, a preliminary examination and preparation for pregnancy are required, because it may turn out that this is not the only factor in infertility. And if you know your diagnosis, this once again indicates that you need to contact a specialist in the treatment of infertility.

Tell us about age and IVF.

Today, women get married only at 30, then live for themselves or build a career, and the first pregnancy often occurs at 35. The second child is already closer to 40 years. This trend is characteristic of the whole world, which is one of the predisposing factors of congenital malformations of the fetus and various complications during pregnancy.

Experts say that the birth of children in adulthood is associated with certain risks for newborns. The older the expectant mother, the higher the probability of having a baby with Down syndrome or a miscarriage.

The researchers found that the optimal age for the birth of children is a period from 20 to 35 years. They noted that after 30 years in the female body, egg production decreases, which reduces fertility – the likelihood of becoming a mother.

What are the risks / complications of hyperstimulation?

Possible complications during ART:

– OHSS (ovarian hyperstimulation syndrome)

Allergic reactions associated with the introduction of drugs to stimulate ovulation.

-bleeding

multiple uterine and ectopic pregnancy

torsion of the ovary

ovarian apoplexy

If you do not follow the regimen, diet, and medication prescribed by your doctor, OHSS can be complicated by ovarian torsion, rupture of ovarian tissue, and bleeding.

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Клиника репродуктивного здоровья "Лада"
ул. Среднефонтанская, 19В, ЖК «Чудо-город» 65039 Украина, г.Одесса
(0482) 373747, [email protected]