Ask Our Fertility Doctors

IVF

Issues pertaining to infertility and fertility treatments are complex and certainly create a lot of questions in the minds of individuals who are either undergoing fertility treatments or seriously considering those. Since it would be impossible for us to provide answers to all the questions we receive on our website, we decided to set up a more appropriate venue for questions our clients may have. This is how this blog was born. Our fertility doctors (e.g. reproductive endocrinologists, OB/GYN doctors, embryologists, etc.) agreed to answer questions pertaining to infertility and fertility treatments.

In case you are wondering about qualifications of our doctors, during the selection process of our IVF clinics, we went an extra mile to ensure our clients will receive the same high quality IVF advice and/or treatments as those available in the U.S. Our partner clinics follow the standards of the American Society for Reproductive Medicine (ASRM) and are accredited in the U.S. Our partner doctors are board certified and often hold Ph.D. on top of their M.D. degrees.

Our hope is that this blog will serve as a professional, discrete environment where one can ask questions and hopefully find answers pertaining to fertility treatments. Our doctors agreed to answer questions concerning:

• General questions about infertility
• Questions in regards to effectiveness of Assisted Reproductive Technology (ART)
• Questions pertaining to tests (e.g. blood work, genetic testing, PGD etc.)
• Questions about the IVF process and what happens during specific treatments
• And of course questions pertaining to symptoms and problems during the course of the treatment

We hope we can answer most of your questions and in the process help you with starting or expanding your family. Feel free to email me with your questions (Darya.Mikhailova@theMedVacation.com).

Darya Mikhailova, MD

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I am concerned that my eggs may be of poor quality. How can one determine the quality of her eggs?

We can have some basic notion about the quality of eggs by examining the size of the follicle and the level of Estradiol in the middle of the cycle. However, as the woman ages, we often deal with such factors as thickening of the external wall/skin of the egg, which in turn makes it harder for sperm to penetrate the egg.

In reality, it is impossible to determine the quality of one’s eggs until we extract those from the follicles, examine them under the microscope and see the stage of their development. There are some easier methods of testing the ovarian reserve and the quality of eggs. These are chlomiphenom test, and the tests to determine the level of Follicle Stimulating Hormone (FSH) and Inhibin B. All these tests although helpful, are still not as effective as examining eggs under the microscope.

Do ovarian cysts affect my chances of getting pregnant?

The research shows that any ovarian cysts of 10 mm or larger reduce one’s chances of getting pregnant. For instance, studies show that women who underwent IVF treatments while they had 10 mm cyst in the beginning of the cycle were twice as unlikely to get pregnant as women who didn’t have cysts (all other factors being equal). Therefore, cysts will not prevent one from getting pregnant but will significantly reduce woman’s changes of doing so.

Can I fly and how long can I be in the air, after embryo transfer?
 
Yes, you may travel by plane. Air travel does not pose any danger to pregnancy as long as constant air pressure is maintained. Modern airplanes……….. as a rule…….. don’t have sudden air pressure changes.

We received a couple of inquiries about reversing tied tubes and getting pregnant after that.

Our doctors recommend IVF treatments, if you have your tubes tied and are thinking about getting pregnant. You may have heard this already from doctors in the U.S. or from research you’ve done. Getting pregnant a traditional way after reversing tied tubes may be a dangerous endeavor.

First, our IVF doctors say that reversing tide tubes is typically not an effective procedure. Moreover, even if the reversing tied tubes procedure is done, chances of having tubal pregnancy (situation when the fertilize egg implants itself outside uterus) are very high for that person. That is the reason why doctors recommend to have IVF in this case.

To summarize the recommended treatment course for women with tied tubes, our doctors would perform ovulation induction and egg extraction without reversing tied tubes for the patient.

Several individuals asked us how many eggs are typically harvested from a donor and what happens to the unused eggs.

On average, our clinics harvest 10 to 18 eggs per donor. As a rule, we fertilize all of the retrieved eggs with sperm. Certain number of fertilized eggs grow to become embryos. Our doctors transfer 1-2 embryos (more often two) in the transfer stage of the IVF process. In rare cases, in the situation of severe infertility, the doctors may recommend transferring 3 embryos.

The embryos which are left after the IVF cycle can be frozen. Our clinics use the latest cryopreservation approach, which dramatically increase cryosurvival (percentage of eggs/embryos that are alive after thawing) of embryos. Traditionally, IVF clinics used the slow freezing method that has been used since the 1980’s. Our clinics use rapid freezing technique recently developed in Japan called Vitrification. With Vitrification, the temperature is lowered at 23,000 degrees C° per minute. That is 70,000 times faster than in traditional approach. Such rapid cooling coupled with cryoprotactant fluids prevents formation of ice crystals in embryos.

You may be wondering why it is important to have as little ice crystal formation as possible. It is important in the embryology, because ice crystal formation is very damaging to frozen eggs and embryos. In other words, eggs do not fertilize well after thawing. The slow freezing approach produces disruption in the membrane, which causes a block to the conventional fusion and penetration of sperm with the egg surface.

Our IVF clinics do all of their embryo freezing at the blastocyst stage. Upon request from our clients, our clinics can also freeze eggs rather than embryos. We freeze embryos, because statistics show that pregnancy rates are just as high in properly frozen embryos as in fresh embryos which have never been frozen. The same cannot be said for frozen eggs; pregnancy rates for frozen eggs are 15-20 lower than those for frozen embryos.
You can email us your questions to info@theMedVacation.com

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3 Responses

  1. We have several people asked us whether bed rest is a requiment for patients after their embryo transfers. If it is a requirment, how many days of bed rest do our doctors recommend?

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    First, there is no difference between instructions for patients who have frozen embryos and those with fresh embryos. Here is what our doctors recommend. The most important thing for the patient after the transfer is to abstain from physical activities for at least a day or two. Moreover, our doctors recommend not to get overheated. That is, do not use hot baths, saunas, hot tubs or anything of that nature so that your body temperature does not go up. Do not walk to long or be up during the first day or two. If you have to be up, take 10-15 minute breaks after every hour. Lastly, when you are in bed, assume a comfortable position and change positions periodically. You don’t want to have your body to go numb. If you need to travel, traveling is allowed after two days.

  2. We’ve been recently asked by several clients whether somebody could choose their own carrier, gestational mother.

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    It is indeed possible to select your own surrogate mother who will be gestational mother of your child. In the event you choose to use your own carrier, the future surrogate mother will have to provide us with the test results for the following tests: HIV, syphilis, Hepatitis B, Hepatitis C, and embryo/egg/sperm analysis before it was frozen. Moreover, you will have to provide us with the description of the method used to freeze embryos, sperm, or eggs.

    As far as legal documents are concerned, you will have to provide us with the executed contract and the signed agreement. These documents must be original; no copies will be accepted. Furthermore, the couple must submit copies of their passports, a copy of the marriage certificate, and a medical note from a doctor. The note shall state that the wife is unable to become pregnant or has a medical condition that makes pregnancy or child delivery dangerous to her health.

  3. We were told that my husband’s sperm may be the cause of our inability to conceive a baby. Is it possible to use my husband’s sperm and donor sperm in the same IVF cycle?

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    Yes, it is possible and actually quite a few couples in our clinics ask us for such arrangements. Male infertility is the single cause or one of the causes of couples’ infertility in nearly 50% of cases.

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