FAQ

Why were IVF treatments postponed due to the coronavirus Covid-19 breakout?

All states are vigilant all over the world because of Covid-19. For this reason, to both slowdown and stop the epidemic, we decided to stop IVF treatments by following all international and national rules.

One of the biggest factors in this decision is to prevent transmission of the virus to couples, but there are several important points in terms of reproductive health. Since we do not know everything about the virus, we do not know exactly what the mother candidates will face when they encounter this virus during pregnancy, plus what kind of effects antiviral drugs will on them.

What is infertility?

Infertility is the inability to conceive after 12 months of unprotected intercourse. This means that a couple is not able to become pregnant after a year of trying. However, for women aged 35 and older, the inability to conceive after 6 months is generally considered infertility.

Source: ASRM (American Society For Reproductive Medicine)

What causes infertility?

In rough terms, about one-third of infertility cases can be attributed to male factors and about one-third to factors that affect women. For the remaining one-third of infertile couples, infertility is caused by a combination of problems in both partners or, in about 20 percent of cases, is unexplained.

Source: ASRM (American Society For Reproductive Medicine)

What can cause infertility in women?

A woman’s age can have a big effect on her ability to have a baby, especially as she enters her 30s and 40s. For a healthy woman in her 20s or early 30s, the chances of conceiving each month is 25%-30%. But by the time a woman is 40 years old, the chances are 10% or less.

The most common female infertility factor is an ovulation disorder. Other causes of female infertility include blocked fallopian tubes, which can occur when a woman has had pelvic inflammatory disease or endometriosis (a sometimes painful condition causing adhesions and cysts). Congenital anomalies (birth defects) involving the structure of the uterus and uterine fibroids are associated with repeated miscarriages.

Source: ASRM (American Society for Reproductive Medicine)

What can cause Infertility in men?

The most common male infertility factors include azoospermia (no sperm cells are produced) and oligospermia (few sperm cells are produced). Sometimes, sperm cells are malformed or they die before they can reach the egg. In rare cases, infertility in men is caused by a genetic disease such as cystic fibrosis or a chromosomal abnormality.

Source: ASRM (American Society for Reproductive Medicine)

What can I do about my infertility?

Going to see a fertility specialist may help a couple figure out why they’re not conceiving. Women see a reproductive endocrinologist and men see a urologist who specializes in fertility. In some (10% or more) cases, though, there may not be an obvious reason why a couple can’t conceive. This is known as unexplained infertility. Fertility treatments can often help these couples with unexplained infertility.

Source: ASRM (American Society for Reproductive Medicine)

When should I seek help for infertility?

Couples are generally advised to seek medical help if they are unable to achieve pregnancy after a year of unprotected intercourse. The doctor will conduct a physical examination of both partners to determine their general state of health and to evaluate physical disorders that may be causing infertility. Usually, both partners are interviewed about their sexual habits in order to determine whether intercourse is taking place properly for conception.

If no cause can be determined at this point, more specific tests may be recommended. For women, these include an analysis of body temperature and ovulation, x-ray of the fallopian tubes and uterus, and laparoscopy. For men, initial tests focus on semen analysis.

Source:ASRM (American Society for Reproductive Medicine)

Does Age of female effect the fertility?

Age affects the success rates of infertility treatments as well as the natural ability to get pregnant.

ASRM (American Society for Reproductive Medicine)

When should I begin basic evaluation for infertility?

An evaluation of a woman for infertility is appropriate for women who have not become pregnant after having 12 months of regular, unprotected intercourse. Being evaluated earlier is appropriate after six months for women who are older than age 35 or who have one of the following in their medical history or physical examination:

• History of irregular menstrual cycles (over 35 days apart or no periods at all)

• Known or suspected problems with the uterus (womb), tubes, or other problems in the abdominal cavity (like endometriosis or adhesions)

• Known or suspected male infertility problems

Any evaluation for infertility should be done in a focused and cost-effective way to find all relevant factors and should include the male as well as female partners. The least invasive methods that can detect the most common causes of infertility should be done first. The speed and extent of evaluation should take into account the couple’s preferences, the woman’s age, the duration of infertility, and unique features of the medical history and physical examination.

What is Ovarian Reserve Testing?

When attempting to test for a woman’s ovarian reserve, the clinician is trying to predict whether she can produce an egg or eggs of good quality and how well her ovaries are responding to the hormonal signals from her brain. The most common test to evaluate ovarian reserve is a blood test for follicle stimulating hormone (FSH) drawn on cycle day 3. In addition to the FSH level, your physician may recommend other blood tests, such as estradiol, antimullerian hormone (AMH), and/or inhibin-B, as well as a transvaginal ultrasound to do an antral follicle count (the number of follicles or egg sacs seen during the early part of a menstrual cycle).

Source: ASRM (American Society for Reproductive Medicine)

What are the other blood tests for infetility evaluation?

Thyroid-stimulating hormone (TSH) and prolactin levels are useful to identify thyroid disorders and hyperprolactinemia, which may cause problems with fertility, menstrual irregularities, and repeated miscarriages. In women who are thought to have an increase in hirsutism (including hair on the face and/or down the middle of the chest or abdomen), blood tests for dehydroepiandrosterone sulfate (DHEAS), 17-α hydroxyprogesterone, and total testosterone should be considered. A blood progesterone level drawn in the second half of the menstrual cycle can help document whether ovulation has occurred.

Source: ASRM (American Society for Reproductive Medicine)

What is Hysterosalpingogram (HSG)?

Hysterosalpingogram is an X-ray procedure to see if the fallopian tubes are open and if the shape of the uterine cavity is normal. A catheter is inserted into the opening of the cervix through the vagina. A liquid containing iodine (contrast) is injected through the catheter. The contrast fills the uterus and enters the tubes, outlining the length of the tubes, and spills out their ends if they are open.

Source: ASRM (American Society for Reproductive Medicine)

What is Sonohysterography?

Sonohysterography is a procedure that uses transvaginal ultrasound after filling the uterus with saline (a salt solution). This improves detection of intrauterine problems such as endometrial polyps and fibroids compared with using transvaginal ultrasonography alone. If an abnormality is seen, a hysteroscopy is typically done. This test is often done in place of HSG.

Source: ASRM (American Society for Reproductive Medicine)

What is Transvaginal Ultrasonography?

A Transvaginal Ultrasonography is an ultrasound probe placed in the vagina allows the clinician to check the uterus and ovaries for abnormalities such as fibroids and ovarian cysts.

Source: ASRM (American Society for Reproductive Medicine)

What is Hysteroscopy?

Hysteroscopy is a surgical procedure in which a lighted telescope-like instrument (hysteroscope) is passed through the cervix to view the inside of the uterus. Hysteroscopy can help diagnose and treat abnormalities inside the uterine cavity such as polyps, fibroids, and adhesions (scar tissue).

Source: ASRM (American Society for Reproductive Medicine)

Why is a Laparoscopy performed?

Laparoscopy is a surgical procedure in which a lighted telescope-like instrument (laparoscope) is inserted through the wall of the abdomen into the pelvic cavity. Laparoscopy is useful to evaluate the pelvic cavity for endometriosis, pelvic adhesions, and other abnormalities. Laparoscopy is not a first line option in the evaluation of a female patient. Because of its higher costs and potential surgical risk, it may be recommended depending on the results of other testing and a woman’s history, such as pelvic pain and previous surgeries.

Source: ASRM (American Society for Reproductive Medicine)

How is infertility treated?

Most infertility cases — 85 to 90 percent — are treated with conventional therapies, such as drug treatment or surgical repair of reproductive organs.

ASRM (American Society for Reproductive Medicine)

Why is In Vitro Fertilization (IVF) used?

In infertile couples where women have blocked or absent fallopian tubes, or where men have low sperm counts, in vitro fertilization (IVF) offers a chance at parenthood to couples who until recently would have had no hope of having a “biologically related” child.

ASRM

What does it mean Assisted Reproductive Technologies?

Assisted Reproductive Technologies are all treatments which include the handling of eggs and sperm and/or embryos. Some examples of ART are in vitro fertilization (IVF), gamete intrafallopian transfer (GIFT), pronuclear stage tubal transfer (PROST), tubal embryo transfer (TET), and zygote intrafallopian transfer (ZIFT).

What is the process of In Vitro Fertilization (IVF)?

In IVF, eggs are surgically removed from the ovary and mixed with sperm outside the body in a Petri dish (“in vitro” is Latin for “in glass”). After about 40 hours, the eggs are examined to see if they have become fertilized by the sperm and are dividing into cells. These fertilized eggs (embryos) are then placed in the woman’s uterus, thus bypassing the fallopian tubes.

What is Intracytoplasmic Sperm Injection (ICSI)?

Intracytoplasmic Sperm Injection (ICSI) is a micromanipulation procedure in which a single sperm is injected directly into an egg to attempt fertilization, used with male infertility or couples with prior IVF failure.

ASRM

What are the possible side effects of injectable fertility medicines?

  • Soreness and mild bruising at the injection site.
  • Nausea, mood swings, fatigue.
  • Breast tenderness and increased vaginal discharge.
  • Temporary allergic reactions.
  • Ovarian hyperstimulation syndrome (OHSS)

ASRM

Ovarian Hyperstimulation Syndrome (OHSS)

Ovarian hyperstimulation syndrome is a condition that may result from ovulation induction characterized by enlargement of the ovaries, fluid retention, and weight gain.

ASRM

What is the intrauterine insemination?

Intrauterine insemination (IUI) is an office procedure in which prepared sperm cells are placed directly into a woman’s cervix or uterus to produce pregnancy, with or without ovarian stimulation to produce multiple oocytes.

ASRM

What is ovarian stimulation?

Ovarian stimulation occurs with the administration of hormone medications (ovulation drugs) that stimulate the ovaries to produce multiple eggs. Sometimes called enhanced follicular recruitment or controlled ovarian stimulation.

ASRM

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