Recent questions from patients asked during live online events
Can a patient select a donor from photographs?
No, because donors are anonymous and if we show you a picture is not anonymous anymore. That’s why we will provide you with as much information as possible about the donor’s hobbies, education, job, hair/eye colour, height, but not a photo.
I am preparing for a second egg donation cycle as the first one was unsuccessful. Will the transfer of 2 embryos maximise my chance of success this time?
When transferring the embryos, the chances of success depend mainly on the quality of these embryos rather than their quantity. It’s true that when we’re looking at the figures for transferring 2 embryos, there’s a slightly higher likelihood of achieving a pregnancy. However, there’s also a risk of having a twin pregnancy. Our policy is to try to minimise the risk of having twins in general. So our general recommendation is to transfer one embryo at a time. And if you do not achieve a pregnancy with one embryo transfer, we can always do another embryo transfer. That, of course, has to be individualised and it mainly depends on the quality of the remaining embryos that you have. So if you have embryos that are frozen, it’s important that you discuss with your doctor the quality of those embryos and he or she makes the assessment with you. If it’s a brand new cycle, it will also depend on the quality of the embryos. Similarly, if you’re having any other risk factors for having any complications with the pregnancy – like previous uterine surgery or a problem with a Pap smear – or other contraindications for having twins. So my recommendation generally is to do a single embryo transfer and avoid transferring two embryos, except if the embryos are of poor quality or the chances of pregnancy are not very good.
Would you recommend PGT testing for IVF with donor eggs? / Is it necessary to perform PGT on donor egg blastocysts?
If you actually look at the euploidy rate described for egg donors, I think it was 60%. So not 100% necessary but it will save time up to pregnancy. You have to think how important is it for you, how hard is it for you to go through the disappointment of an unsuccessful transfer? How much time, money and mental energy do you waste on this?
What’s the ideal time duration of taking estrogen and progesterone before the embryo transfer?
The ideal duration of estrogen supplementation is approximately 12 to 15 days. It is a hormone that helps to build up the lining of the womb. There are some women who respond quite quickly to it and on day 8 or 9 of the estrogen supplementation they develop the lining of 9 millimetres. But there are other women whose response is not that quick – they might develop this type of lining on day 15. Sometimes we give it up to 20 days until we build up the lining. In case of progesterone, the duration depends on the sort of embryos you have to transfer. If you have to transfer a blastocyst, then you have to take 5 days of progesterone. If you have to transfer day 1 or day 2 embryos, then you need to start taking progesterone for two days. So it depends on the age of the embryo.
Is it possible that the intended parents are the very first people to touch the baby right after the birth?
Yes, this can be arranged.
Why do most of the clinics—I would say 99%—provide information about success rates as pregnancy per transfer. I mean, the IVF with own eggs program, and not the pregnancy per cycle or would it be better to show live births per cycle?
I totally agree with you but the problem is that sometimes the follow-up of these patients in Clinica Tambre we usually do a very individual control of our patients and we call them back if they are in other countries when the pregnancy test must be done and then we do a follow-up for all pregnancies in the first three months, at 20 weeks and also after the delivery. The problem is that sometimes there are patients who do not answer our questions or do not answer our emails so we cannot provide data about our delivery rates. I would say that you should decrease the rate that the clinics offer by at least 10% — at least 10 to 15% of the live births per cycle.
Do you test couples before they go onto surrogacy? What if you can’t help them?
Normally, we ask our couples to come to the clinic with their test results because, as you understand, surrogacy is often the last resort, and couples have normally undergone all kinds of pre-treatments. But, if needed, or where there are no test results available, our clinic provides the possibility to test everything from head to toe.
I have multiple polyps in the uterus. Would it be enough just to remove them via hysteroscopy procedure right before implantation? Or the biopsy needs to be done in advance?
I definitely agree the polyps is like having a foreign body inside your uterus. It’s like a coil, it’s something that will definitely reduce the success rate. Usually in our practice, when a woman has polyps, we would like to remove them one month before going ahead with any IVF treatment. Because by removing them with hysteroscopy and gently scratching the lining of the womb, we usually make the uterus more receptive. We have noticed that after removing polyps with a hysteroscopy or doing cervix curettage, success rates are a little higher because the lining of the womb becomes more receptive. We can reset some cells that live in the area called uterine natural killers and make them work within the normal range again. So my advice would be as follows: do a hysteroscopy a month before doing the embryo transfer, then remove the polyps and ask your doctor to perform gentle curettage in the lining of the womb to help the implantation.
Can we use different Rh factor of donor eggs? Hypothetical situation: I am Rh+ and possible egg donor is Rh-?
Yes, I think we already had that question. Of course, it’s possible. It doesn’t influence the IVF success rate. But with the Rh factor, I would suggest using donor eggs with Rh+. It’s not because of the IVF success rate. It’s for your pregnancy because we can have a pathological situation with the Rhesus conflict – that’s why it is better to use the same Rh factor, but it’s not so important with blood group.
Do you think is best to start with ICSI right away (we are having mobility problem) or give it a try in a ‘natural’ way with IVF?
For sure it’s always better to try the natural way. In our clinic what we choose first is the IVF. But sometimes if we see the sperm motility is very poor, we would recommend ICSI. IVF can only be done if we have enough sperm and if they are motile. Sometimes the day the test analysis is performed, the semen is worse but on the day of the fertilisation, we have better sperm out of the blue. We can say that if we have better sperm concentration and motility, we can try IVF. In my opinion, if it is possible, IVF should be used. But if it’s not possible, then it’s better to use ICSI. But it has to be decided on a case-by-case basis.
Is it possible to send sound samples to the surrogate mother during the pregnancy to let the baby hear some sounds from the intended parents for example voices or music?
This is actually a recommendation from our psychologists and is part of the surrogate’s work after week 18. Our psychologists say that, after week 18, the child starts to recognise sounds from the outside world, so we ask our parents to send some recordings of them reading fairytales, singing songs and so on. It’s a really good idea.
Can you comment on my husband’s semen analysis? We will be using his 42-year old frozen semen: Ejaculate Volume: 5.2 mln; Sample Viscosity: normal; Liquefaction: incomplete, Sperm Clumping: 15%; Aggregate Debris: normal; Round Cells: few; pH: 8.2; Sperm Concentration: 67.3 million/ml; Total Sperm Count: 349.96 million/ ejaculate; Progressive Motility: 69% progressive; Total Motility: 73% progressive; Progression Rating: 3/4; Sperm Vitality: not required; Normal Forms: 4% of normal forms; Isotypes: not done. Other significant findings: Patient Result: SFA freeze for assisted conception.
Do you know how, according to WHO criteria, I define sperm results as normal? Volume: more than 1 ml – here we have 5. Concentration: I’m happy with 15 million – here we have 67 million. Motility: I’m happy with 30% – here 73%. Morphology: 4% – and I have 4 %. So this sperm looks perfect to me – even for fertilisation with frozen sperm.
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What #IVFWEBINARS attendees say
#IVFWEBINARS presenters' opinions
Being a presenter of #IVFWBEINARS is a very good way to spread very important message for all the people that struglle with infertility and who might have some questions. I think that it’s great opportunity for people and patients to interact with us (doctors) and have some engagement and address their concersns. So I like to do it, I have to say 🙂
International Medical Director| Fertty International
It was better than I’d expected. I hadn’t done anything like that before and was a little nervous. I’m sure I can learn more and improve but it was a good first try! Questions were great. Really interesting and clear that participants were very engaged.
Foubder Director Donor conception network
A new experience that I feel really happy about. I enjoy presenting scientific data in a patient-friendly way and also contacting them directly, for example to answer their questions. Me 2nd webinar felt more comfortable than the first, obviously.
Dr Stavros Natsis
FERTILITy specialist | gennima IVF
In the world where all the information seems to be just a click away, it is more and more difficult to differentiate between valuable and useless content. This is especially true for IVF patients who are literally bombarded with knowledge that – unfortunately – they are rarely able to verify. Nowadays anyone can share any information online and finding a reliable source of expertise may become a challenge. And as we all know, verified and educational content is what all fertility patients need the most – at every stage of their treatment.
With the above in mind, we have decided to launch a project that would highlight the importance of sharing valuable IVF knowledge and expertise with those who struggle to become parents. IVF Patients’ Supporter is a recognition we give to all the clinics and IVF experts who provide fertility patients with answers to their most crucial questions. Thus, they are making patients’ IVF journey much easier and – at least partially – more predictable.
But how do they do this? The answer is simple: they share their knowledge via webinars and patient meetings at MyIVFanswers.com! The aim of our interactive videos is to assist patients in making well- informed decisions when selecting the right country and clinic for their fertility treatment, as well as to give them the chance to learn more about available treatment options. That’s why we turn to the most renowned specialists in the field of assisted reproductive technologies and we are always very happy when they agree to share their expertise with all of us. Our viewers highly appreciate the insight into all aspects of IVF procedures they gain thanks to our webinars. It is enough to read their enthusiastic comments and shout-outs to understand how much such support means to them!