How to manage your IVF treatment?

Ofra Balaban Kasztelanski
Founder and Chair of CHEN – Patient Fertility Association, CHEN – Patient Fertility Association

Failed IVF Cycles, IVF Abroad

IVF treatment and how to manage it.
From this video you will find out:
  • How to have successful communication between a patient and the clinic/doctor?
  • What is CHEN – Patient Fertility Association?
  • Should my doctor in my home country work with my fertility doctor abroad?
  • The fertility doctor doesn’t contact me directly, only via the coordinator. What to do?
  • How to choose the best clinic for my needs?


The importance of communication between your fertility doctor and family doctor

In this webinar, Ofra Balaban Kasztelanski, Founder and the Chair of CHEN – Patient Fertility Association has been discussing the importance of communication between your fertility doctor with your other professional doctors and how your treatment should be managed.

- Questions and Answers

What would you advise me to do if the doctor is not willing to cooperate with my fertility doctor? I don’t want to change him, but he constantly says that he is busy and is postponing it all the time, it seems impossible to kind of connect them at the same time. I am having an IVF cycle abroad.

I would advise you to change your doctor because a doctor that doesn’t want to be with you on your journey is not the doctor you need. Sometimes, people said okay, but he’s very professional, but you need to realize that a good doctor is a doctor that gives you the answers you need, and this is important for your journey. If he doesn’t want to speak and you don’t want to change him, it’s a difficult situation, but as he always says he’s busy, perhaps convince your gynecologist to call him. They need to speak because it’s crucial for you, I don’t know about your condition, but in my opinion, a good doctor is a doctor that answers your questions, cooperates with the other doctor especially, with such a sensitive situation.

What to do in a case of low ovarian reserve with AMH at 0.20? I am 37.

At 37, the egg quality starts declining because we know that the average decline of women’s fertility is 27, but after 35, it’s declining a lot faster. I’m not a doctor, so keep in mind that you have to consult your doctor, but you need to ask your doctor what to do and what will be the right way because low ovarian reserve means that in a year or two, you will not be able to produce good eggs. Maybe the best thing to do is to get as many eggs as you can now and freeze them. Egg freezing, as we know, is a very efficient way of preserving your fertility for the upcoming years, but it’s a medical question, and so, I would advise you to check it with your doctor.

Would you know the likelihood of live birth (or at least a transfer) of 3 x 8 cell 3-day embryos? I am 41. What about those 8 cells embryos? Does that mean that they are of good quality? Or is more information needed? (I will only transfer one at a time).

I don’t know what will be the likelihood of live birth, but the embryo transfer can be about 10 to 15%, however, I am not sure about it. To have a successful IVF treatment, you need good eggs, good sperm, and a good womb with the ability to conceive. Again, you must ask your doctor about it. In Israel, we recommend implementing only one embryo at a time and freeze the other embryos for the next time. It’s also a medical decision, and I don’t want you to be disappointed, but I really want you to ask your doctor because it might be that you have very good embryos and if they have eight cells 3-day, they are probably very good embryos, and I wish you all the success. An embryo with 8 cells means that the embryo has divided well, we don’t know anything about genetics, though. If we want to be sure, you can ask the doctors to take one cell out of the embryo and then to do a genetic test, then you will have the information about the genetics, and you’ll know if they are of good quality. The problem with eggs is that we are born with a certain number of eggs, so if I’m 60, my eggs are 60, as long as we are getting older, our oocytes are getting older too. The problem is that if oocytes are getting older, it means there are mistakes in the genes or chromosomal abnormalities. So have an open discussion with your doctor to get all the details and what your best options are.

The IVF doctor does not talk to me directly during the preparation of cycles, only via an assistant. My hormone levels are not checked during IVF pregnancies. The clinic is abroad, and I have to get all medication from a local doctor too. I have endometriosis, so my gynecologist is once again another doctor. For high blood pressure, one more doctor. Doctors don’t talk to each other. What would you recommend me to do? Is this the right clinic? All IVF failed, most at 5 weeks, even with donor eggs.

Endometriosis is a very difficult disease, it means that the fluid from the womb that usually goes out with our monthly period is not completely out, and if it’s not completely out, it means it remains either in the womb or outside of the womb and makes some kind of problems, and it’s damaging the wall of the womb and of course blocking the tubes. I don’t know your age but what I think you need to do is to ask your doctor the treats you about the endometriosis situation, this is the first thing. The second thing is as your hormone levels are not checked, it’s a bit of a problem because endometriosis is something that reacts to hormones. Actually, if we want to put it that way, the treatment against endometriosis is taking birth control pills, so it’s hormone-dependent, it’s a very delicate situation. It’s a must that the doctor that deals with your endometriosis will speak with the doctor that you are doing IVF with. Regarding high blood pressure, it’s something that has to be dealt with before IVF treatment, so if you have time, first of all, balance your high blood pressure and then balance your endometriosis and then go for IVF treatment. I’ve talked about the link between the patient and the doctor, so you should ask each one of the doctors. You should ask the questions, get from them the answers and send the answer to the other doctor, all the doctor must consult, but if they don’t, you have to circulate all the answers and get to a conclusion. Otherwise, you have to wait and see that high blood pressure is balanced, and of course, endometriosis is in a good condition.

If this first IVF fails, what are the things that we should look at and doing differently for the next cycle? Apart from changing from short to long protocol. I am already eating healthily.

It’s good that you’re eating healthily, first of all, balance your weight. Again, this is a medical question, and you need to ask your doctor about it. You should not do anything about changing your cycle, it’s the doctor to think about what can be the problem and if anything should be changed.

What would be your advice when it comes to choosing a clinic. What are the most important aspects we should look at? There are so many of them, and they seem so similar sometimes. I want to change my clinic after 2 failed attempts with donor eggs, but I am not sure if it’s the right way.

Sometimes, choosing a clinic is a personal choice. Sometimes, it’s better to ask your doctor who is recommending some centers because every doctor has some connections with somebody. I have a feeling that if he sent you to a clinic, he probably may be in touch with them and connect with them during the treatments, so maybe you can ask your doctor which clinic he recommends. As you already had 2 failed attempts, now you do know the feeling and how it is when a doctor is not speaking to you, so you know what you are looking for, you need a doctor that will treat you and communicate, you need a clinic that has a good rate. In every country, you can check on the ministry of health sites, they have some lists of clinics, so it might be a good way to look for a new clinic if it’s in a country that has such things. Try to look for more information than usual, now you have a little bit of experience, so try to listen and ask the questions.
IVF & fertility treatment with own eggs for women over 40 – what are your chances?
Exploring Male Fertility – all you need to know about semen analysis
IVF for women over 40 – options and insights
Creating Fertility Awareness: Navigating Your Journey with Holistic Insights and Medical Know-How
Choosing the right clinic for your treatment: One of the most important decisions you’ll ever make
How will this affect my future child? 40+ intended parents’ concerns (age, donor conception, single motherhood)
Ofra Balaban Kasztelanski

Ofra Balaban Kasztelanski

Ofra Balaban Kasztelanski is the founder and the chair of CHEN – Patient Fertility Association (since 1998), the organization supplying support to infertile couples and persons, distributes information and initiates change in laws regarding egg donation in Israel. Ofra also represents Israel in the international umbrella organizations such as ICSI, AFAM and IAPO. Ofra is an active member in Fertility Europe as well as Deputy to the board in the last 2 years. In Israel, CHEN -patient fertility association is conducting a long term prevention project. She's also an active member in a task force to encourage freedom of research in stem cells, established in Rome 2006, by MEP Marco Cappato and Luca Coscioni Association from Italy and in Israel she is a member of the women council in Holon and member of the board of volunteers council.
Event Moderator
Caroline Kulczycka

Caroline Kulczycka

Caroline Kulczycka is managing MyIVFAnswers.com and has been hosting IVFWEBINARS dedicated to patients struggling with infertility since 2020. She's highly motivated and believes that educating patients so that they can make informed decisions is essential in their IVF journey. In the past, she has been working as an International Patient Coordinator, where she was helping and directing patients on their right path. She also worked in the tourism industry, and dealt with international customers on a daily basis, including working abroad. In her free time, you’ll find her travelling, biking, learning new things, or spending time outdoors.