FAQ – Infertility Treatment

1. Are there any age limits for the infertility treatment using both own and donor’s oocytes?

There are. Only women not older than 40 can take infertility treatment using their own oocytes, (according to the order of the Ministry of health of Ukraine # 24 from February 4th 1997). If you use donor’s eggs there is no age limit.

2. What are the indications for having donor eggs?

You are recommended to have donor eggs if you are above 40.

If you have high level of follicle-stimulating hormone (FSH) in blood.

If you have no ovaries (aplasia, medical or mechanical castration); premature ovarian failure (POF)

If you have made numerous unsuccessful attempts of IVF and the quality of oocytes was bad or ovarian response to the stimulation was insufficient (even if the maximum FSH doses were used).

If you have benign or malign formations of different locations, including ovaries (increased level of oncomarker CA-125).*

If you have any type of genetic diseases.*

*- If there are no contra-indications to child-bearing.

3. How are the oocyte (sperm) donors matched for the recipients?

They are selected on the basis of the phenotype profile which the patient fills in.

4. How are the recipient’s and donor’s cycles synchronized?

The cycles of the recipient and the donor are synchronized by agonists gonadotrophin-releasing hormones. When donor and the recipient reach down regulation they start the second phase of preparation by valerate (valerianate) estrodiol and progestin.

5. What is “down regulation”?

It is a temporary blocking of lutheinizing hormone (LH) and follicle stimulating hormone (FSH) in order to start preparation for IVF and Embryo Transfer (ET) “on the clear background” (without any ovarian cysts and endometrium thickness less than 4mm).

6. Do they use steroids in standard protocols for preparation in donor cycles? Are there any side effects?

Steroids are not used in the standard protocols.

7. Is there any standard protocol of treatment when using donor eggs? What are the medicines, their active substances and doses?

We have a Standard protocol approved by the Clinic. The medicines we use are: analogues of gonadotropin-releasing hormone, estrogene medications; after the transfer – progesterone medications.

Donors receive menotropines – human menopause gonadotrophin (HMG). The dosage is individual.

8. How many embryos are transferred into the womb cavity?

We transfer 2-3 embryos, depending on the patient's age and medical history.

9. What is the optimal endometrium thickness for the embryo transfer?

According to different sources of information 7-12 mm are optimal.

10. What are the guidelines after the embryo transfer (like food, sex restrictions)?

Our recommendations are:

• taking Progestrone and estrogen medications;
• physical and psychological rest until the test for Human Chorial Gonadotrophin (HCG), (no sex and physical activity and pressures), later on doctor’s recommendation;
• no hot baths, saunas, solariums;
• no alcohol, smoking and spicy food.

11. What day after the transfer is a flight possible?

There is no information concerning flight influence on pregnancy.

12. How long the prescribed drugs should be taken after the embryo transfer?

The medicines are taken until the HCG test.

If the test result is negative the medications are quitted.

If the result is positive, you continue to take medicines till the pregnancy is diagnosed by ultrasound, and if the pregnancy is developing in a normal way (there is no risk of miscarriage) drugs are taken till the 12th week of pregnancy. Then the dosage is gradually reduced till final stopping.

13. What is IVF?

'In vitro Fertilisation' (IVF) involves the retrieval of follicles from a female client followed by fertilisation of the follicle with the husband's (or donor's) sperm. The fertilised follicle is subsequently monitored in our laboratory monitoring for embryo development and as a final step is transferred back into the woman's uterus.

The above IVF method was first successfully used in England in 1978. Presently, thousands of children are born due to this highly successful method.

14. Who should be treated by IVF?

IVF can be successfully used for treatment of almost all forms of infertility. As a rule, IVF is indicated for those couples who can not conceive after one year of regular sexual relations (intercourse) without contraception. In addition, IVF can be successfully used in patients having the following infertility problems:

Blockage of the uterine tubules (the female patient's 'tubes')or commissure process in the small pelvis negatively impact on the anatomy of the uterine tubes and/or the ovaries.

Severe form of spermatogenesis pathology (i.e. abnormal sperm development).

Failure to conceive after 3-6 cycles of ovarian stimulation / intrauterine insemination.

15. How is IVF treatment performed?

Firstly, the client is provided the application form as well as an consent form / agreement which provides information regarding IVF treatment. After discussions with ISIDA-IVF staff regarding all aspects of the IVF procedure(s) , the agreement is signed by the infertile couple and ISIDA-IVF.

As a rule, the woman receives 10-12 days of ovarian stimulation with intramuscular (i.e. into the muscle) or subcutaneous (i.e. under the skin) injection of medications in order to achieve the growth of several follicles (round sacks, filled with liquid, where oocytes reside). From the 8-th day of ovarian stimulation, ISIDA-IVF staff tests the hormonal concentration in the blood every 2 - 3 days. Additionally, ultrasound vaginal monitoring is carried out to monitor for appropriate follicular growth and development.

After obtaining full follicular maturation, the ISIDA-IVF physician uses a special needle to puncture the follicle to withdraw the follicular liquid which contains the oocytes ('eggs'). This procedure is safely and painlessly performed by the ISIDA-IVF team, using anaesthetics to ensure patient comfort. The oocytes that are retrieved are then fertilised using the husband's or donor sperm. In the case of severe abnormalities in donor sperm development, a more advanced technology is used to help compensate for the latter (ICSI program).

The embryos are grown in a special medium (liquid) in the ISIDA-IVF laboratory for 3-5 days. On the 3, 4-th or 5-th day following the procedure for removal of oocytes, the successfully cultivated embryo(s) are transferred into the uterus for implantation and success of the above by the birth of a new baby boy or girl.