Recent questions from patients asked during live online events
Can adenomyosis be a cause for concern?
In my opinion, adenomyosis is an important factor and should be considered. In order to explore, to rule out or to confirm adenomyosis, a 3d scan is mandatory because this will give us the correct diagnosis. It’s very accurate in diagnosing adenomyosis, which can negatively impact assisted reproductive technique outcomes. This negative impact is seen in own gametes IVF, but also in egg donation IVF. If we are talking about own eggs IVF, adenomyosis can impair implantation rates, decrease implantation rates, and can increase the miscarriage rate. If we are talking about egg donation, there is a very nice publication coming from Spain, exclusively focused on egg donation treatment cycles in patients with adenomyosis and they clearly showed that in these patients, it can the rate of miscarriages. So, yes, we consider this an important topic. Adenomyosis, especially a severe degree of adenomyosis, may negatively impact the subsequent success of these treatments, including egg donation cycles. The correct treatment, in this case, is a prolonged blockage of the variant function for at least three months before proceeding with the actual treatment cycle.
My IVF history and treatments are in German. Are the staff at the IVF clinic fluent in German?
Yes. We have an international department. All patients have a patient care assistant assigned and we do have native German speakers at the clinic as well. We have Dutch, Russian, Italian, and French: nine languages at the moment.
What do you think is the best solution, to do NGS on our own embryo when adoption embryo already has NGS?
An adoption embryo does not have your genes and if you have another adopted embryo, NGS will be better for chromosomes. If you want the child to have your genes, it would be better to check your own embryo with NGS.
Is the window of a patient measured from the first day of the cycle, or the first day of progesterone?
I’ll measure the window of implantation from the first day of the progesterone.
What is the link between morphological quality and likely genetic quality e.g. is a 5AA more likely to be genetically normal than, say, a 4BC?
Sometimes we’re surprised because we have embryos which are AA-quality and they look perfectly fine and however they are the embryos of the pool which are not genetically normal. So there is not always a correlation. If it is a very severe chromosome problem and a lot of chromosomes are altered, this will show in the early embryo development. But if for example, you have had trisomy of chromosome 21, even when you have a fetus in the sixth month of development it will be difficult to detect. So imagine an embryo which is just 5 days old. It will not show so easily on the outer side.
It’s a follow up to my first question regarding the use of alternate lab techniques instead of ICSI. I have had three failed IUIs and now a complete failed fertilisation of eggs with ICSI this month. I used donor sperm which was good, so sperm is not the issue.
Well, it could be a failure of egg activation and this is not always due to the sperm. So calcium ionophore could be an alternative. It can also be due to bad egg quality. Right now I think that the only thing that could solve it is the calcium ionophore. Or otherwise the egg quality is so bad that it’s preventing the fertilisation.
I would like to try an adoption but my husband doesn’t want it. Should I try to convince him?
It’s hard. It has to be a joint decision for the sake of your relationship. You both need to be fully engaged in it and have made that decision together. From what I believe, the adoption process is not an easy process to go through so you would need to be fully engaged in that. I think it’d be worth trying to work out what the reasons are that he’s reluctant to it. It’d be good to know if he would be willing to look into it and – at least – do more research on it and find out more information just so that he’s not ruling it out straight away. Would he be willing to look into the different options? What would it mean? How would it affect you? What does the process involve? A good idea could be speaking to other people and hearing stories from people who’ve adopted. How did they find the process and how are they finding it now, living with an adopted child? It’s very difficult if one of you wants one thing and the other one doesn’t. So I’d say, it’s just about the communication and asking the questions. The reason he might not want to try it might be something that’s quite easy to answer – or, on the other hand, it might be a really deep-seated reason. You could maybe work it through. If he’s willing to start looking into it, then he might be able to make a decision and you’ll both feel like you’ve made the effort to consider it as an option. So I’d say: yes, encourage him to at least hear more about it so that you can rule it in or out. Tell him that you just would like to have more information so that you can make a decision and ask whether he will support you in researching it. You might find out that he’s more open to it once he knows more. When we were going through it, my husband wouldn’t even want to adopt. But I know somebody who’s a foster parent and when we went out somewhere together, she had one of her fostered children with her. After he’d seen this child and realised that it was a little boy who just needed somebody to love him, he changed his mind and his view on why he would adopt. I think he probably had ruled out adoption at the start, without really thinking about it. So when he actually realised that there are children there who do need loving parents and support, it changed his mind a bit. So it might just be that he doesn’t know enough about it. Just ask him if he will support you in researching it. Hopefully, that helps.
How does the paperwork look, and what kind of documents would I have to sign to proceed? Would it be possible to sign them without a personal visit to the clinic?
We can send you all the documents that are necessary for us. However, you will have to come to us for the first visit on your own, so that we can also sign all those documents.
What is the stem cell treatment you can offer? I’m 42 and have had one pregnancy after 9 failed cycles. I’ve just tried for a sibling and had another failed cycle. The feedback is that my eggs are poor quality due to my age. Would this stem cell treatment help me with an own eggs cycle?
Autologous stem cell treatment using stem cells from the period blood is an innovative and promising treatment but is still experimental. We have seen some good outcomes in many female patients, but we have to wait to have more results in the future. Egg donation is, in this case, the most promising option at the moment.
What is the difference between endometriosis and adenomyosis and their implications in egg donation outcome?
Endometriosis is a disease that is causing painful periods, pain during intercourse and is usually in the pelvis, in the ovaries, and inside the womb. Adenomyosis means “thick wall” of the womb – it can be related to fibroid tissue as well as endometriosis. Both of them can play a role in egg donation outcomes – if we are talking about severe endometriosis, then this can affect the chances of pregnancy, as well as adenomyosis – if it affects the endometrium, then it can play a big role, but if it is restricted to the muscle of the womb, they shouldn’t really affect chances of pregnancy unless it co-exists with endometriosis.
What is the success rate of embryo adoption? If I want to choose this treatment, what should I consider?
Regarding the embryo adoption, it is around 45-50% pregnancy rate. What is more important is to consider also if you can ask for blastocyst stage because many embryos in our banks are day 2 or day 3 embryos so not all the clinics have blastocysts to do the embryo adoption.
We are planning to travel to Cyprus for IVF. Can I start the process locally before we travel for the embryo transfer?
Yes. The process, from beginning to end, is approximately 17 to 20 days and not all patients are able to stay in Cyprus for so long. Generally, patients start their treatment in their own country or city and come here for the final days, for ovulation induction or for egg collection, and wait until the egg transfer.
Upcoming online live events
05jun6:00 pmMiscarriages and embryo implantation failures vs. PGT-AAlsu Saifitdinova, PhD, Embryologist & Molecular Biologist, International Centre for Reproductive MedicineEvent Type :Online Patient Meetings
05jun8:00 pmHow repeated stimulation (COS) influences the number of oocytes obtained in a consecutive cycle?Dr. Yuliya Blazhko, fertility specialist, obstetrician-gynecologist at Gryshchenko Clinic-IVF, UkraineEvent Type :#IVFWEBINAR
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