Stem Cell Therapy for Sperm Production?
Non-obstructive azoospermia involves a group of problems, which produce a similar outcome: Lack of sperm production/maturation. Spermatogenesis, which is a term used for the sum of all of the processes involved in production and maturation of a sperm cell, has multiple steps. Any malfunction during any of these steps can cause problems in obtaining a mature sperm cell in the ejaculate. These stages can be roughly categorized as Mitosis (making copies of the germ cells), meiosis 1, meiosis 2 and final differentiation. The whole process takes about 65-70 days to complete and results in a mature sperm cell.
Depending on the stage where sperm production/maturation comes to a halt is important for determining success with stem cell therapy. Sperm maturation problems could be attributed to intrinsic germ cell defects or extrinsic somatic and/or endocrine problems. Knowing the difference can be the key to identify the precise targeting of the problem. However, such targeted therapy is currently not available in the human model. The following picture helps with visualization of the spermatogenesis process:
Mitosis is the stage where the germ cell line multiples and grows in number. Differentiation comes in during the later stages. For instance, if spermatogenesis can reach the stage where it results in spermatids, then the main issue rests with final differentiation into the sperm cell as we know it. This is probably one of the most suitable cases for stem cell therapy as only one stage in the process of spermatogenesis is problematic and the likelihood of successfully addressing the problem is higher.
If the problem is in the earlier stages and there are no immature sperm cells being produced, then the task becomes more challenging. Therefore, the further down the process of spermatogenesis we run into problems, the higher the chance of success with any intervention we use.
"Sertoli cell only" syndrome refers to a condition where the testicular structures have nor germ cells and only sertoli cells are present. Sertoli cell only syndrome can be congenital or acquired. In congenital sertoli cell only syndrome, given that there are no germ cells present, there are currently no treatment modalities which can be offered. However, if the condition is acquired (klinefelter syndrome, mumps, radiation exposure to name a few), then the condition can be reversible and stem cell therapy can be administered.
As part of the stem cell therapy at North Cyprus IVF, we isolate stem cells from the patient’s own adipose tissue to be obtained from abdominal liposuction. This is a small-scale surgery, which is performed by a surgeon. Standard surgical procedures apply, which means food and drink restriction to be observed starting at a certain time before the surgery. We also perform a number of tests to confirm suitability for surgery. These are rather standard procedures.
Adipose tissue obtained via the liposuction process is then subjected to enzymal dissociation and several other procedures so that the stem cells can be successfully isolated. In the meanwhile, patient's platelet rich plasma (PRP) to be obtained from peripheral blood sample is also isolated separately. After the stem cells are subjected to culture media and seeding and once all the procedures are carried out, the combination of PRP with stem cell population is injected into testes at various different locations.
Afte the procedure, you are discharged from the hospital either on the same day or the next day, depending on recovery process. A semen analysis is required three months after the stem cell therapy to see the effects. In patients with intact spermatogenesis with the problems in later stages, we expect to observe live sperm cells in the ejaculate approximately three months after the procedure. If we do not observe live sperm cells in the ejaculate, a TESE/TESA procedure is scheduled to look for maturing sperm cells which can be used for fertilization. The entire treatment takes about 2-3 days (pre-testing, procedure itself and recovery time). This means you will only be required to stay in Cyprus for 2-3 days in total. The cost of this procedure is 6,000 Euros, which includes the pretests before surgery, all the laboratory work involved and injection of the stem cells as well as your stay at the hospital for one night. The tests required before planning your treatment are ideally done in your local country and are not included in this fee. You will find more information on our "Stem Cell Therapy for Non-Obstructive Azoospermia" page.
Please contact our patient coordinators for more information!
Spontaneous Intracranial Hypotension Presenting with Frontotemporal Dementia, Narcolepsy and Chorea: A Case Study
Our Clinical coordinator and senior clinical embryologist, Asst. Prof. Dr. Ahmet Ozyigit, has recently published an article in one of the most prestigious journals in Neurology: Frontiers in Neurology! This publication is a case report he wrote during his medical studies. Dr. Ozyigit comes from an eclectic background with a PhD in Economics, master's degree in Clinical Embryology and an ongoing MD degree. The full text for the article can be accessed on Frontiers Website.
At North Cyprus IVF Center, we offer comprehensive fertility care for both married and single prospective parents. This includes single mothers and fathers to be. In this blog post, we discuss fertility treatment options for prospective single mothers. Regardless of your marital status, the most important part of any fertility treatment is testing and assessment. We will first want to assess your ovarian function, review your previous reproductive/gynecological history and formulate a treatment plan accordingly. After a thorough assessment, the most suitable treatment option can be chosen and we can then move forward with treatment planning. The following important steps outline how your fertility treatment planning is approached at North Cyprus IVF Center.
Before any fertility treatment, a thorough assessment is key to formulating the most optimal course of treatment. For women in their 20s and 30s, using own eggs is usually a viable option. However, for women over 40 years of age, a thorough ovarian assessment is made before a conclusion can be made whether own eggs can be used. Every woman is born with a finite set of ovarian reserves and these reserves decline with each menstrual cycle over time. By the time a woman reaches 40 years of age, a great majority of her egg reserves will have been depleted. While pregnancy over 40 can be achieved, success depends on whether viable eggs can be obtained or not. If a woman's ovarian function is still within acceptable levels and viable eggs can be obtained, then IVF treatment with own eggs can yield a desired outcome. The first step, therefore, is Fertility Testing.
Deciding on a Suitable Treatment Option
If your ovarian reserves are found within acceptable levels, then IUI or IVF treatment can be planned using donor sperm. If you are in your 20s or early 30s, and would like to opt for a non-invasive method of fertility treatment, then IUI treatment can be right for you. As mentioned above, your ovarian function will be an important determinant prior to deciding on a suitable treatment option. However, if you are found to be in the "optimal level of fertility", then IUI treatment can be one of your options.
If you are in slightly older age brackets (30 and above), and/or your ovarian function is also slightly reduced, then chances of success with the non-invasive IUI treatment will be very low. In these cases, we recommend considering IVF Treatment using donor sperm.
If your ovarian reserves have been depleted and test results indicate no ovarian function, then achieving pregnancy with your own eggs will be very unlikely. In such cases, you may need to consider using donor eggs for a successful pregnancy. You will find more information here on IVF Treatment with Egg and Sperm Donation.
Now, with improved IVF techniques and technologies, certain applications such as "Ovarian rejuvenation via PRP injection" can possibly help women in older age brackets to initiate egg development in their ovaries. While this is still in early clinical trial stage, the preliminary results look very promising.
Treatment Planning and Preparation
Once the optimal treatment method is chosen, the next step is to prepare for treatment. Once we have effectively reviewed your test results, we will be able to draft a treatment program that is customized for you specifically. Your treatment program will include a very detailed account of what needs to be done on a daily basis prior to your arrival in Cyprus. Please see the following pages for more information on "How to Obtain and use IVF Medication" and "Traveling to Cyprus".
Arrival in Cyprus and Finalization of Your Treatment
Once you arrive in Cyprus, you will have a scheduled appointment before finalizing the IVF procedure. Your final scans and mock transfer will take place on your "First Appointment in Cyprus". Prior to your arrival, you will be able to choose your accommodation from a variety of "Accommodation Options" offered by North Cyprus IVF Center.
Your patient coordinators will be guiding you throughout your treatment program from start to finish, ensuring a comfortable and stress-free treatment. Please contact us for more information.
Associate Professor Dr. Savas Ozyigit, a pioneer in the field of assisted reproductive treatments in Cyprus, and the director of North Cyprus IVF Center receives a "Lifetime Achievement Award" for his contributions to the field of medicine over the course of his career. Adding one more trophy to his collection of many, Dr. Savas Ozyigit gave a short speech at his award acception ceremony.
During his speech, Prof. Ozyigit said "It was twenty years ago when I first mentioned it to colleagues that it was a shame couples with infertility problems could not be helped in North Cyprus and had to travel to other countries to seek help. People said it was not a good idea to invest in such a big project for such a small population. They said it would not be profitable and they said I might as well throw my money into a trash can. It wasn't the smallness of population that was the problem. It was the small faith they had in medicine. Today, I stand here holding an award for my work and accomplishment. This is the field of medicine thanking me for believing and taking that first step that no other person was willing to take just because they did not think it was financially viable. Not only it has been financially viable, it has allowed me to train many others to go into this field and become my competitors! There are now ten IVF clinics in North Cyprus! Thank you medicine, for being such a rewarding field. I would have chosen you all over if I were to come to this world again..."
Dr. Savas Ozyigit is the founder of North Cyprus IVF Center, the very first IVF clinic in Northern Cyprus, which was established in 1998. Almost all of the current IVF specialists in Northern Cyprus have been his students at one point during their medical training. As a medical innovator, he has always introduced many firsts in the field of medicine on the island. The first bone densitometry, the first mammogram, the first radical hysterectomy operation, the first IVF clinic and the first genetics laboratory are just a few examples.
We are sure that Dr. Savas Ozyigit still has many awards ahead of him. To contact North Cyprus IVF Center and schedule an appointment with Dr. Savas Ozyigit for your consult/fertility treatment, please use http://www.lowcostivf.net/contact.html or call/text/whatsapp +90 548 882 8000 / +90548 828 9955.
We frequently receive requests from women who would like to plan a pregnancy because their ovarian reserves have declined and they are afraid waiting will further impair their chances of parenting their own biological children if pregnancy is further delayed. As North Cyprus IVF Clinic, we wanted to write this blog post and let you know that if you are a single woman who is not ready to have a child just yet, you do have a number of options and we are ready to assist you with these options.
1- Getting pregnant using donor sperm- You could undergo an IVF treatment using donor sperm and plan a pregnancy accordingly. However, this would be a rushed decision. With today's technological advancements in assisted reproduction, we are able to preserve your fertility for a future date in a number of ways. Therefore, we would not recommend rushing to get pregnant only because your biological clock is ticking. You should be a mother when you are ready.
2- Freezing embryos using donor sperm- In this option, you would prepare very much like in an IVF cycle, we would collect the eggs, use donor sperm to fertilize your eggs and create embryos. Instead of transferring these embryos into the uterus for an immediate pregnancy, we would freeze them so that your embryos would be ready for transfer at a future date. This is a good option considering that freezing embryos gives you a higher chance of success compared to freezing eggs when the egg quality is not optimal. An egg is just a single cell, so it is more likely to be affected by the freeze/thaw procedures. However, an embryo is incubated into a certain stage of development before it is frozen so that it has a higher number of cells and a higher success with the freeze/thaw process.
3- Freezing eggs as eggs without using any sperm- This is the best method for a young woman who is not yet ready to start a family. It helps preserve your fertility, allowing you to have your own biological children in the future. This option is also good in the sense that there is no sperm donor involvement, therefore, if you do meet someone in the future who would be a good candidate to co-parent, then you can use his sperm instead of a donor, or you can still use a donor but it would give you more options when the time comes. However, if your ovarian reserves have declined, then it is likely that egg quality has also started going down. When the egg quality is poor, eggs are less likely to survive the freeze/thaw procedures. Therefore, if you are freezing eggs, it will make sense to freeze a certain number of eggs so that you can have multiple attempts at IVF treatment with them in the future. Our recommendation would be undergoing a couple of cycles of ovarian stimulation so that we can get a certain number of eggs on each attempt and freeze as many eggs as we can so that we can offer you a good chance of success in the future considering that some of the eggs will not survive the freeze/thaw process when their quality is not optimal.
We just wanted you to know that you have options and we are here to assist with these options...
We all know that ovarian function and the level of fertility decline with age and we might just need that extra help to conceive as we age. While standard IVF/ICSI treatments can be a solution for some, some other patients may need to explore added benefits of technology and innovation as well as "outside the box" treatments to achieve pregnancy.
At North Cyprus IVF Clinic, we have been offering "outside the box" treatment options for our patients when offering assisted reproductive treatments. Our new treatment option "Cytoplasmic Tandem IVF" is one such treatment option for patients with lowered ovarian reserves and poor egg quality. Cytoplasmic Tandem IVF combines the benefits of a "Tandem IVF Cycle" with "Cytoplasmic IVF Transfer" to give you the best of two worlds!
A Tandem IVF cycle means using your own eggs as well as donor eggs in a single IVF treatment cycle. This allows women to have a chance of pregnancy using their own eggs by also having donor eggs as their back-up plan should their own eggs do not provide good quality embryos, sufficient for an embryo transfer.
A Cytoplasmic IVF transfer also uses an egg donor and own eggs in a single cycle. But with cytoplasmic IVF, it is not the eggs of the egg donor that we are interested in but rather the cytoplasmic content of the eggs. We retrieve the cytoplasmic content of the egg donor's eggs and inject it into the eggs of the patient, thus, providing our patient's eggs with a better host environment for cellular growth and development and giving them a higher chance of success with their own eggs.
By combining the two treatments, we not only improve your chances of IVF success using your own eggs, but we also allow you to fertilize the rest of the donor eggs (the ones that are not used for their cytoplasm) with your partner's sperm sample. The embryos created by donor eggs can be frozen and preserved for a future date in case your treatment cycle fails and you decide to use donor eggs in the future. This way, you can have an IVF treatment where your personal success likelihood is maximized using your own eggs and where you are also given a back-up plan with donor eggs in a future IVF cycle should things don't work out as planned - All for a single cost of treatment!
Please contact us for more information!
Challenges faced by 40+ women when trying to get pregnant are twofold:
1- Every woman is born with a finite set of ovarian reserves. Starting with puberty, these reserves start to decline every month with the menstrual cycle. Around the age of 37, the number of follicles (cysts which contain the eggs) drop down to less than one percent of what it was at birth. Therefore, the ovarian reserves will have declined to very low levels by the time a woman turns 40 years of age.
2- Just like any other cell in our bodies, egg cells also age. The aging oocyte (egg) is associated with several problems including mitochondrial dysfunctions, aneuploidy and epigenetic changes. Mitochondria is the power source of any cell. Any dysfunction in mitochondria is going to affect cellular energy and development. Aneuploidy refers to chromosomal problems, which is the main factor explainign why women in older age brackets are more likely to have miscarriages or deliver babies with chromosomal abnormalities such as down's syndrome (Also see our Cytoplasmic Transfer page for more information on how we can use donor cytoplasm in order to improve IVF success in older age brackets).
In summary, both the quality and the quantity of eggs decline to very low levels by the time a woman reaches 40 years of age and this affects both her ability to become pregnant and to become pregnant with a healthy baby.
One of our recommendations for patients in 40+ age bracket is embryo banking. Embryo banking refers to undergoing a number of IVF cycles with one embryo transfer scheduled at the end of the last cycle. For instance, a patient can have one IVF cycle where we collect her eggs, fertilize with the partner's sperm sample and freeze the resulting embryos. Once ther patient undergoes a second cycle, we repeat the same process and obtain more embryos. This can be repeated 2 or 3 times until a desired number of embryos have been reached.
Once the ideal number of embryos has been reached, the embryos can be incubated to the blastocyst stage and the ones that reach this stage can either be transferred into the uterus for pregnancy, or, they can be screened via pre-implantation genetic screening (PGS) method in order to check the chromosomal integrity of the embryos. Once PGS has been performed, the healthy and chromosomally euploid embryos can be selected for embryo transfer.
Embryo banking allows us to increase the number of embryos available for embryo transfer. This coupled with PGS will also allow us to make sure the embryos being transferred do not have chromosomal problems.
For more information, please contact us.
One of the main problems facing IVF patients over 40 years of age is the decline in ovarian reserves. Every woman is born with a finite number of ovarian follicles and while a very small number of these follicles succeed in becoming a mature egg, majority of the rest of the follicles never reach ovulation and are disposed with every menstrual cycle. Around the age of 37, the decline in ovarian reserves becomes very sharp.
As a woman gets older, declining ovarian reserves is not the only problem faced in fertility. As age gets older, so do the follicles in the ovaries. Therefore, another problem called "oocyte aging" becomes more pronounced. This is in fact one of the main reasons why women above the age of 40 are more likely to experience a miscarriage- An aging oocyte will be associated with a number of genetic problems, causing the baby to have genetic mutations, thus leading to a miscarriage.
At North Cyprus IVF Center, we offer a comprehensive treatment approach for 40+ patients, which combines a number of important considerations in terms of ovarian reserves and oocyte aging. Patients who still ovulate, and who still have a minimal level of ovarian activity are ideal candidates for our 40+ treatment program. It is important that the female patient still has at least 1/2 pre-antral follicles to be recruited via controlled ovarian hyperstimulation so that we can offer a chance of success with own eggs. For patients with no ovarian function, then using an Egg Donor becomes the only option.
#1- Cytoplasmic IVF Treatment: Patients who still have a few oocytes, but cannot get pregnancy with those oocytes due to oocyte aging can possibly benefit from our cytoplasmic IVF treatment. The principle here is, we use the genetic material from the patient, but we provide the non-genetic parts of the egg from an egg donor so that the patient's own eggs have a friendlier host for optimal growth. It is a known fact that the mitochondria found in the cell's cytoplasm is responsible for cellular energy production and cell growth. By providing the patient's eggs with donor mitochondria, we allow the eggs to grow more optimally and become more viable.
#2- PGS for Genetic Screening: While Cytoplasmic IVF Treatment will allow your eggs to be more viable with higher fertilization potential, it will not be able to eliminate potential genetic risks associated with the age of the patient. Therefore, pre-implantation genetic screening is a good idea to make sure only the genetically correct embryos are transferred into the uterus. Keep in mind that we are not aiming for just any pregnancy. We are aiming for a healthy and viable pregnancy.
#3- Embryo Batching: Given that IVF treatment after a certain age will only allow us to have just a few eggs, any method that will allow us to get more eggs will increase our chances of success. Therefore, while we will be providing your eggs with a better host for optimal growth via cytoplasmic transfer, we still need a certain number of eggs so that we can make sure in the end we have at least one well-grown, genetically correct embryo to transfer. Embryo batching is the key component of success in this age bracket. Combining two rounds of IVF cycles into one allows us to get double the number of eggs- Essentially, what we do is, we prepare you for one round of IVF cycle where we collect the eggs, infuse them with donor cytoplasm, fertilize into embryos and freeze. Once you are ready for the second round, we collect another set of eggs, repeat the same procedures and make a new batch of embryos. With the two sets of embryos at hand, we proceed with pre-implantation genetic screening (PGS) and select a chromosomally normal embryo for transfer, thus giving you the maximum chance of success possible using your own eggs.
We give your eggs the maximum chance of survival through cytoplasmic transfer - we collect two rounds of eggs to increase your likelihood of success by creating multiple embryos - We make sure the embryos to be transferred are chromosomally euploid through PGS testing. This is how we are able to offer you the maximum chance of success possible with your own eggs.
Contact us for more information.
IVF with egg donation is the type of IVF treatment where patient undegoes IVF treatment using donor eggs. When using donor eggs in an IVF treatment, one of the decisions patients make is whether to use a known or an anonymous egg donor. While there are pros and cons of each option and the decision to use a known or an anonymous egg donor depends mainly on the recipients' own perspective, we wanted to discuss both options here in this article so that our patients who would like to consider the option of using an egg donor can make an informed decision.
Our laws in North Cyprus only allow egg donor matching in an anonymous fashion. This does not mean that you can only use anonymous egg donors. It means, we, as the clinic, can only match you with an egg donor anonymously. However, if you would like to use a known donor, then we would need to involve an external egg donor agency for the matching process so that you can be matched via the agency, and not the clinic.
Using an Anonymous Egg Donor:
If you are to use one of North Cyprus IVF Clinic's egg donors, then donation needs to be done anonymously. For donor mathcing, we ask that you fill out a donor/recipient form and return it to us. Using your information and matching criteria, our donor coordinator will match you with suitable egg donors and we will be able to send you these matching profiles so that you can make your own choice. Since our donor coordinator will have your information as well as the donors' information, she will make sure that you are only matched with donors who are compatible with your criteria.
However, we are able to provide you with a profile page for your egg donor with basic information such as age, height, weight, eye, skin and hair color, education, occupation, hobbies etc. What we cannot share is a picture of your egg donor. Anonymous egg donors remain anonymous at all times and so do you. Therefore, your egg donor will not receive your contact information and will never see your pictures.
One of the main benefits of using a clinic egg donor is that we screen our egg donors very closely and we mainly recruit donors with proven pregnancies. Therefore, when you select an anonymous egg donor at our clinic, you will know that the donor has donated before and contributed to a positive pregnancy or has her own child, making her a fertility proven egg donor.
Using a Known Egg Donor:
Some patients prefer to see a picture of their egg donor or even meet them. This is made possible by our overseas egg donor agency. While we are not able to match you up with a "known" clinic donor, we can offer you the option of choosing an agency donor so that the agency can match you up with a known donor and your egg donor can fly out to Cyprus to donate for you. While this gives you the freedom of seeing your donor, meeting her in person and possibly contact via skype or the phone, considering the involvement of another agency and the travel aspects, using a known egg donor will be much more costly compared to using one of clinic's donors.
The additional cost of using a known egg donor from our overseas agency runs between 8,500 - 11,000 USD depending on the egg donor.
Please visit the following link for more information on our "IVF Treatment using Donor Eggs".
Gender selection is a treatment option offered by North Cyprus IVF Center, which makes it possible for patients to select the sex of their unborn baby before pregnancy. Some patients would like to select the sex of their next child purely for family balancing purposes while other patients opt for sex selection as a way of reducing the likelihood of a sex-linked disease in their offspring. Regardless of your reason, gender selection is legally offered in Cyprus by Assoc. Prof. Dr. Savas Ozyigit and his experienced team.
While there are a few alternative methods for gender selection at North Cyprus IVF Center, one of the methods has become very popular among younger couples due to its non-invasive nature. MicroSort IUI offers couples the ability to become pregnant with a baby of certain sex without any invasive methods used in IVF treatments.
MicroSort, which is a patented sperm selection technology, is only available at North Cyprus IVF Center in all of Europe and the Middle Eastern region. This technology allows us to separate X and Y bearing cells in a sperm sample. Once the desired sperm cells are separated, they are injected intra-uterine for pregnancy to occur. Below are some of the frequently asked questions about this method of gender selection:
- What is the percentage success rate of pregnancy following MicroSort and Artificial Insemination (AI) only? Success with IUI (same as AI) is lower than IVF protocols. In younger age brackets, success on the first attempt with IUI is around 30-32%. For some people, the low success rate is offset by the fact that IUI is a non-invasive procedure and the fact that it's cheaper. However, some patients care more about the likelihood of success on the first attempt, so they opt for IVF instead. This is something that you would need to decide for yourself, but we are here to equip you with the necessary information so that you can make that decision.
- What is the percentage chance of having a girl with Microsort? MicroSort has a 90% accuracy rate for selection of sperm cells bearing X cells (girls). Therefore, if you are pregnant after the IUI procedure, there will be a 90% chance that your child will be a girl. The accuracy of selection of a baby boy is around 75%.
- What is the percentage chance of having twins? Not likely with IUI, but it has happened before. It would probably be less than 3% given that IUI cycles are well-monitored and the ovaries are only very mildly stimulated.
- What is the name of the medication I will need to take and what does it do? We usually prescribe a low dosage Gonal-F, which is an FSH supplementation. It contains the hormone FSH, which is normally released by the pituitary gland located in your brain- triggered by follicle development. So we would try and mimic the natural physiology of reproductive events and supplement you with the hormones externally in order to get your ovaries to recruit more follicles for growth. That way, we can increase the chances of sperm fertilizing an egg.
- What happens if I don't take it? If you don't take any medication, we can still work with your natural cycle and use the one egg that will be released by the ovaries. Since you will only have the one egg, we will only have that one egg to work with, so that will reduce the likelihood of success, but it is possible to get a pregnancy after a natural cycle as we have had many patients in such cases. But if you ask us, using a mild medication protocol will increase your chances.
- When do I need to take it? And for how long? We would give you a treatment protocol which will specify everything in detail.
- How much does it cost? The cost is 2,800 Euros for MicroSort IUI.
For more information about our gender selection program and different treatment options suited for different patient groups, please visit our "Gender Selection at North Cyprus IVF Center" link.
So you are interested in gestational surrogacy and are looking for an affordable yet reliable program. Cyprus America Surrogacy Services (CASS) has been offering a low cost alternative to the US surrogacy program while offering you all the legal coverage of a US program.
Our unique surrogacy program offers a state of the art treatment facilities at our clinic in the beautiful island of Cyprus while dealing with all the legal work, surrogate recruitment, child birth and registration in the US in accordance with the US legal system. Our program combines the low cost of IVF treatment with the solid legal framework of the United States surrogacy laws in order to offer you a perfect surrogacy program.
While cost is a large concern when it comes to surrogacy programs, success rates and legal coverage are the most important factors to keep in mind when selecting your surrogacy program. North Cyprus IVF Center and International Surrogacy Partners, joined together offer you Cyprus America Surrogacy Services (CASS), a successful low cost program with the legal coverage that offers full protection for you as the legal parents of your child whether you are a heterosexual couple, a gay couple or a single parent to be.
For more information on our surrogacy services, please view our Gestational Surrogacy Program page as well as our Same-Sex Gay Surrogacy Program page.
Maximizing success rates in more biologically advanced age brackets has always been a challenge in IVF treatments. Patients above the age of 35 start facing a sharp decline in their ovarian function and this decline becomes much sharper after the age of 40. Over the past couple of decades, we have witnessed introduction of several new "methods" and "strategies" in an attempt to increase pregnancy rates in patients over 40. While some of these methods contribute to success, some others seem to have no significant effect.
One of the promising modifications of IVF treatments was to use the human growth hormone (HGH) as part of an IVF medication regimen. While the industry had high hopes for the impact of HGH on IVF outcomes, the initial results were rather disappointing. After a series of dose adjustments and many other attempts, the results were still not as well as what scientists had originally planned.
In theory, growth hormone should contribute positively to IVF outcomes in terms of oocyte count and quality. However, evidence from the preliminary work suggests that rather than increasing the dosage, administration of the human growth hormone should be done in consideration of folliculogenesis. Previous studies introudced HGH during or immediately before an IVF cycle. The hypothesis with this modified version rests on the fact that follicles are more sensitized at different phases of development and the precise length of folliculogenesis contains the necessary information on when follicles containing oocytes can be best manipulated through external means.
At North Cyprus IVF, we have now started offering this modified and excelled version of human growth hormone administration for patients over the age of 40. Expected benefits of this protocol is as follows:
- Decreased aneuploidy rates in embryos created in vitro
- Increased implantation and pregnancy rates with oocytes subjected to HGH
While we do not expect much increase with the actual oocyte count, our expectation is that the oocytes obtained via our new modified therapy will generate chromosomally euploid embryos which will improve pregnancy outcomes significantly for the 40+ age group.
While this is being run as a clinical trial in the United States, which won't finalize until 2017, North Cyprus IVF Center is proud to offer this modified protocol starting in December 2015. For more information, please contact us.
Some clinics have cut-off age for accepting patients into their IVF program. While the age may vary from one IVF program to the other, most European clinics will have an age limit between 43 and 47. There are two main reasons for having a cut-off age.
1- Each woman is born with a certain set of ovarian reserves and starting with puberty, hundreds of potential oocytes are lost during a menstrual cycle. The reserves keep declining as the age of the woman advances and eventually the reserve finishes once the woman reaches menopause. The ovarian function tends to fall below 20-25% of its starting numbers at the age of 35, and beyond the age of 40, chances of pregnancy with own eggs become very slim. Having a cut-off age for IVF treatment where the patient uses her own eggs avoids a very high risk of a negative treatment outcome and disappointment.
2- Having a cut-off age means not admitting patients who are not likely to succeed, which means the fertility clinic can keep its success rates high.
Whether we agree with this or not is not the main point. The main point is, should there be a cut-off age for trying with your own eggs? The answer is not so simple. Patients may not be willing to give up on their eggs just yet regardless of what the statistics might be saying. If there is a 1% chance, it means 1 in every 100 women will achieve success with treatment. While unfortunately 99 others won't be so lucky.
When it comes to using your own eggs, our clinic does not subscribe into age limitations. However, we make sure that you are well-informed about likely outcomes so that you can make your decision accordingly. For maximizing success wheh using your own eggs beyond a certain age, we have additional methods such as "Cytoplasmic IVF Treatment" that can potentially add a few percentages to your success statistics.
While we do not have an advertised age limit, we do not recommend IVF treatment using own eggs after the age of 47, which is the age of the oldest reported IVF pregnancy worldwide.
For more information on our recommendations for patients over 50 years of age, using donor eggs, please see our "IVF over 50" section.
Endometriosis is a gynecological condition which has been estimated to affect about 10% of the female population of reproductive age. Endometriosis is a condition where the endometrium grows outside of the uterus, frequently on the fallopian tubes, ovaries, bowel or the pelvic tissues. The specific cause of endometriosis is still unknown, but there is a tendency for endometriosis to run in the families. While studies have shown certain biochemical and immunological differences between endometriosis and non-endometriosis cases, the specific cause and effect relationships are yet to be established. In other words, it is still unknown whether these differences cause endometriosis or if they are a result of it.
Endometrium is the collection of cells that make up the internal lining of the uterine cavity. It is the precise location where the embryo will implant upon fertilization and grow as a fetus. By definition, endometriosis is a condition where this accumulation of cells is not located where it is supposed to be, but is spread outside of the uterus. In the ovaries, cysts known as endometriomas may form. These are generally referred to as the “chocolate cysts”. Implants of endometriosis may grow on the peritoneum (the lining of the abdomen and pelvis), which is mostly associated with blockage of the fallopian tubes. In some instances, endometriosis can grow underneath the peritoneal lining, causing other problems. Therefore, endometriosis is a condition which can be directly related with infertility.
In a given menstrual cycle, the patient’s hormonal cycle affects the endometrial lining. This lining thickens throughout the menstrual cycle and then empties its contents of its superficial layer- known as a menstrual period (menstrual bleed). However, if a woman suffers from endometriosis, the endometrial lining will take the form of an extra-uterine growth in the peritoneal cavity. Just like the endometrial lining of the endometrial cavity, this extra-uterine growth is also influenced by the monthly hormonal cycle and behaves very much in a same manner- by bleeding every month. The difference between this bleed and a menstrual bleed is that, a bleeding in the peritoneal cavity does not have an exit route and is perceived by the body as an “internal bleeding”. This internal bleeding can cause severe pain.
The body’s immune mechanism perceives the bleeding as if there is an “open wound” inside the body and tries to rectify it. Every month a similar healing process is in order and the peritoneal cavity becomes home to many scar tissues. Over time, accumulation of more and more scar tissue leads to adhesions. Depending on in which direction endometriosis is growing, these adhesions can have negative implications for fertility.
While endometriosis affects about 10% of the female population, not every woman with this condition will have an infertility problem. It has been estimated that only about 35-40% of women with endometriosis will have a negative implication on their ability to conceive naturally. The rest of the patients with impaired fertility will still be able to benefit from assisted reproductive technologies such as IVF treatment.
Sometimes, certain symptoms can point to the existence of endometriosis. These symptoms include painful menstrual cycles, pain during intercourse, observations during physical examination or ultrasound scan. However, there is only one way to effectively assess whether a woman suffers from endometriosis and that is through a minor surgical procedure called laparoscopy. Laparoscopy allows the observing doctor to look inside the abdominal cavity with a laparoscope for an effective visualization.
Endometriosis can be categorized as “Mild”, “Moderate” or “Severe” depending on how advanced it is. While mild to moderate forms of endometriosis are believed not to interfere with fertility and ability to conceive naturally, this does not reflect the truth. Women with mild endometriosis can sometimes have impaired fertility and may need assistance. Though it is true that more advanced stages of endometriosis are likely to impair ability to conceive by affecting the ovaries and the fallopian tubes. In advanced stages of endometriosis, surgical treatment may be required in order to improve fertility even when IVF treatment is considered.
While this article aims to provide general information on endometriosis, there are different stages and growth patterns of endometriosis, which will require a different course of action for different patients. It is important that we make a careful assessment of your case before we can assist you with your treatment options. However, when considering assisted reproductive treatment for endometriosis, it should be kept in mind that IVF/ICSI treatments will yield much higher success compared to IUI treatments. It has been shown via various clinical studies that IVF/ICSI treatments can yield success in majority of endometriosis cases despite the fact that both oocyte quality and response to ovarian stimulation may be lower compared to non-endometriosis cases.
For more information, please feel free to contact North Cyprus IVF Specialists.
PCOS, Infertility and IVF Treatment
Polycystic ovarian syndrome, abbreviated as PCOS, is one of the main causes of ovulatory problems and female infertility for women at the childbearing age. PCOS is a very common problem. It has been estimated that 1 in 10 women (approximately 10% of women) at the childbearing age is affected.
It has been suggested that the main factor contributing to PCOS and its symptoms is insulin resistance. People who are resistant to insulin have an ineffective transport of glucose from blood to the cells and muscles where the glucose is used for energy. Instead, it is built up in blood, causing the body to produce higher and higher levles of insulin in an attempt to lower the level of glucose accumulated. Excess insulin production does not only lead to storage of fat, causing weight gain and obesity, it can also interfere with the reproductive pathways.
Some experts believe that insulin resistance is not to blame for PCOS but rather we should focus on hormonal dysregulation of the hypothalamus of the brain. This is the region responsible for production of hormones and stimulation of the pituitary gland, which has a substantial amount of influence in the female reproductive system.
Symptoms of polycystic ovarian syndrome
The following symptoms are the most frequently observed sympotms by women who have polycystic ovarian syndrome (PCOS):
-Oligomenorrhea, which is defined as having irregular menstrual cycles. Some PCOS patients may also experience amenorrhea, which corresponds to having no menstrual cycles. In such cases, patients are often prescribed appropriate medication so that their cycles can be regulated.
-Some patients with PCOS will also experience an onset of excess hair growth, which is known as hirsutism. Excess growth of hair can be on the face, on breasts or on other parts of the body.
-Patients whose PCOS may have been contrinbuted by insulin resistance are also likely to experience weight gain and difficulty in managing their weight even though various weight loss plans may have been attempted.
Symptoms can vary across women depending on how polycystic the ovaries are and many other factors that might be at interplay.
What is the relationship between PCOS and Infertility?
Patients affected by PCOS are highly likely to have infertility problems. This is due to the ovulatory problems that are associated with PCOS. While some women are still able to ovulate despite having PCOS, some women will not ovulate at all, making it impossible for natural conception to occur. In order for natural conception to take place, an egg should mature and should be released from the ovaries so that fertilization with sperm can take place. However, if there is no ovulation, the eggs will not receive maturity.
It is possible that some patients with PCOS will have naturally regular menstrual cycles and will conceive without any problems, and may not even realize that they have the condition. On the other hand, some patients will exhibit eveyr single symptom in the book and will have a very difficult time achieving pregnancy. This means that PCOS is not a condition that can be managed with a single prescription. Each case will require a unique approach and attention for effective management.
Can I conceive with PCOS?
Absolutely! While PCOS is a condition which is closely associated with female infertility, the chance of achieving and maintaining a successful pregnancy with women who have polycystic ovarian syndrome using fertility treatments is very high. Majority of women with PCOS will be able to achieve and carry a pregnancy to a full term with the use of fertility treatments.
However, it is important that the fertility treatment program of a woman with PCOS is very carefully planned by an IVF specialist. Designing a suitable treatment program will necessitate that your IVF specialist is informed about your hormone levels and your antral follicle count (AFC) so that the dosage of your medication can be adjusted accordingly. For more information on these tests, please visit our “Infertility Testing” Section. The good news is, women with PCOS respond very well to ovarian stimulation medication, therefore, even mild doses of medication will allow us to obtain many oocytes from your ovaries. The bad news is, if you are receiving assistance from an inexperienced clinic, you will be running the risk of a severe case of ovarian hyperstimulation, which can be a very unpleasant side-effect of controlled ovarian hyperstimulation (COH).
At North Cyprus IVF Centre, we make sure that our IVF specialists work with specialist endocrinologists in optimal management of your PCOS.
There are various reasons why people travel abroad for treatment. One of the most popular treatments for which patients travel abroad is In Vitro Fertilization (IVF). Several factors play a crucial role in patients' decision to travel abroad for treatment of infertility:
-Low cost treatment options: At North Cyprus IVF Clinic, we offer a variety of fertility treatments at a cost which is fraction of the costs offered in the UK or the US. However, this does not come with a sacrifice of quality. At North Cyprus IVF, we are able to keep our costs much lower compared to our US and UK competitors as a result of lower licence fees, lower general wage rate, less bureaucratic requirements, considerably lower cost of donor compensation, and the use of advanced technology to keep our overall costs down.
-Flexibility of IVF laws which allow treatment for older women as well as availabilty of many treatment options which are not locally available. At North Cyprus IVF Centre, while we have a "recommended" age limit for treatments, it is at the initiative of our IVF specialists to offer treatment to women above the age of 50 in consideration with the patient's overall health and fitness for pregnancy. Also, at North Cyprus IVF Centre, our favorable laws allow us to adopt treatments and research practices that may not be permitted due to bureaucracy in countries where laws are very rigid.
-Long waiting lines at local clinics for receiving treatment under the NHS or at private clinics. This is especially true when patients are hoping to recieve treatment with donor eggs. Also, when it comes to using egg donors, our award-winning clinic has very strict criteria, allowing us to achieve very high levels of success.
-Practice makes perfect! Our clinic was established by Dr. Savas Ozyigit, an IVF pioneer, in 1998. Our clinic has treated over 10,000 patients within the 17 years of its existence.
This is not a complete list of advantages a couple will benefit from when receiving IVF treatment at North Cyprus IVF Centre. There are numerous advantages that are treatment-specific, which can be listed under a specific treatment. For various treatment options at our clinic in Cyprus, please visit our "Treatments" page.
From time to time, we all hear about new advancements in IVF technologies. Some of these lose their popularity over time when they cannot contribute positively to the existing technologies in practice while other innovations remain with us and become an integral part of IVF treatments. Time-lapse imaging technology (also referred to as embryoscope due to its commercial name) is one such innovation in the field of IVF that is here to stay for a long time.
Time-lapse imaging system is a technological breakthrough which allows the embryologist to monitor embryos in the incubator with a 24/7 surveillance system. With this ability, embryos are watched and observed continuously, allowing the embryologist to see the whole pattern of embryo growth and development through a built-in camera system. This is not possible with standard incubators, and the only way to check the development of embryos is by physically opening the doors of the incubator to look at the embryos. This puts embryos in contact with the air outside the incubator and may possibly increase the risk of embryo fragmentation. An embryoscope allows the embryologist to observe all embryos in the incubator without any interruption.
At North Cyprus IVF Centre, we are proud to offer you this latest IVF technology with a small additional cost also giving you a DVD of your embryos' initial stages of development - what a perfect gift to give your child when (s)he grows up! Please visit our "Embryoscope" page for more information.
Gender selection, or sex selection refers to selecting the sex of your unborn baby prior to pregnancy. At North Cyprus IVF Centre, this option is offered to two groups of patients:
1- Couples who would like to select the sex of their child due to a known genetic predisposition to a sex-linked (X-linked) condition. X-linked diseases are single gene disorders that point to the presence of gene mutations or gene defects on the X chromosome. Since males only acquire one copy of the X chromosome from the mother, only one mutated allele is sufficient to cause a sex-linked disease on males. This suggests that males are more prone to the majority of X-linked diseases compared to females.
2- Couples who already have children and would like to balance their family by having another child of the opposite sex. This group of patients usually have no fertility issues and are able to have healthy children via natural conception methods. However, natural conception may not always produce “balanced” offspring, therefore, assisted reproductive technologies come into play.
Regardless of your reasoning, gender selection can be legally offered at North Cyprus IVF Centre to both groups of patients. There are two alternative methods in practice at North Cyprus IVF Centre regarding sex selection. Namely, these are Pre-Implantation Genetic Screening/Diagnosis (PGS/PGD) and MicroSort.
1- Pre-implantation Genetic Screening / Pre-Implantation Genetic Diagnosis
PGD (Pre-implantation Genetic Diagnosis) refers to embryo selection as a response to a known genetic disorder running in the family, therefore, it is applied purely for genetic disease prevention purposes. PGS (Pre-implantation Genetic Screening), on the other hand, refers to applying the exact same method of embryo selection in cases where there is no known genetic disorder in the male or the female partner. PGS is the correct term used when the technology is used to screen the embryos for identifying their sex (known as sex/gender selection)
The PGD/PGS technique is used as a part of an IVF treatment. The patient must undergo IVF treatment so that we can obtain her eggs (or donor eggs can also be used in cases where the female patient cannot use her own eggs). The eggs obtained are fertilized with the male partner’s semen sample and embryos are created. Once the embryos reach a certain stage of development, they are biopsied so that genetic screening can be performed and the sex of each embryo can be revealed accordingly.
North Cyprus IVF Centre is the only official clinic offering MicroSort in Europe, Middle East, Asia and Africa. MicroSort is a sperm sorting method which enables us to sort a sperm sample into X (female) and Y (male) bearing cells. That way, by having a sperm sample sorted into two batches, we know which sperm batch has the capability of producing a male child and which one can produce a female child.
However, the MicroSort technology is not as accurate as the PGS method described above. It is only 75% accurate for selecting Y-bearing cells and about 85% accurate for selecting X-bearing cells. In other words, if you opt for using the MicroSort technique only without the PGS technique, there is a likelihood that the sex of your child may not be accurately selected.
The MicroSort technology also has certain requirements. The semen sample of the male partner must contain a minimum of 70 million total motile sperm in the ejaculate so that the sort equipment can be used. For sperm samples that do not meet this criteria, the sort mechanism does not work properly and we cannot get desired results.
If the sperm sample is found sufficient for MicroSort, and if the patients are willing to accept a lower accuracy of sex selection, the MicroSort technique can be part of an artificial insemination (IUI) cycle, which allows for a non-invasive treatment.
More information on our alternative gender selection treatments can be found on the "Gender Selection" page of our website.
In this article, we talk about the procedures and processes involved in donor egg IVF treatment at North Cyprus IVF Centre.
Patients who are interested in undergoing IVF treatment using donor eggs are likely to belong in one of the following groups:
1- Women who have undergone IVF treatment with own eggs but failed to achieve or maintain a pregnancy (IVF failures or recurrent miscarriages).
2- Women who are menopausal or peri-menopausal who may or may not have undergone IVF treatment before.
3- Women whose ovaries have been removed or damaged during surgery.
4- Women with genetic problems
5- Women who have undergone chemotherapy or radiation therapy.
IVF treatment using donor eggs is significantly different from standard IVF treatments in terms of procedures and the medication use. As opposed to standard IVF treatments, during egg donor IVF treatment, an egg donor undergoes the medication stage instead of the patient (recipient). However, the recipient also uses certain medication in order to prepare her body for pregnancy. The steps involved in IVF with egg donation are as follows:
Step 1: Testing and Assessment
During this step, we ask that the couple seeking donor egg IVF treatment undergo a number of tests in order to make sure that the couple is fit for pregnancy. The testing stage will be different for each patient depending on their unique history of infertility. For instance, a patient who has undergone failed cycles or recurrent miscarriages with her own eggs will first need to be assessed with respect to ovarian function. If ovarian function indicates low reserves and low oocyte quality, then relatively simple tests such as an ultrasound scan and a few blood tests will suffice. However, if there is any reason to believe that factors other than the egg quality may have contributed to previous IVF failures or recurrent miscarriages, then additional testing will be required.
A patient who has never had treatment before, but requires donor eggs due to older biological age, then a general health screening as well as an ultrasound scan will be sufficient as the first round of testing. But again, if the patient suffered from infertility previously, then additional testing will be required.
If the patient has had failed cycles using donor eggs previously, then certain additional tests must be completed before proceeding with another treatment. Given that success with donor eggs at North Cyprus IVF clinic is very high, a failed cycle with donor eggs calls for a thorough investigation in order to make sure appropriate measures can be taken prior to another treatment in order to maximize your chances of success.
Step 2: Preliminary Work
Once your testing has been completed and our IVF experts have made an effective assessment of your unique treatment requirements, we will be at a position to recommend treatment and formulate your treatment program. With your treatment program, we are able to prescribe your medication along with a calendar of treatment which specifies what needs to be done on a daily basis.
This is also the point where you select your egg donor. For egg donor selection, we will be providing you with a donor/recipient form so that you can specify your donor requirements and we can narrow down our donor pool according to these specifications. At the end of this process, we will be able to send you a few donor profiles to choose from. However, due to donor anonymity, we are not able to show pictures of our donors. For more information on donor recruitment, please visit our "IVF with Egg Donation" page.
Since the majority of our patients come from abroad, we can design our treatments so that the preliminary work can be carried out locally with your local consultant so that you can use your medication locally, have your initial monitoring and come to Cyprus for a total of 6 days to finalize your treatment. If you do not have a local consultant, we may be able to recommend you one depending on your location. The medication protocol which will be used will be a mild one, aiming to prepare your endometrium for a successful embryo transfer.
Step 3: Arrival in Cyprus
Your treatment calendar will specify which days you will be required to be present at our clinic for finalization of your treatment. Once in Cyprus, we will be able to pick you up at the airport, deliver to your choice of accommodation and provide all ground transfers back and forth between our clinic and your hotel. For more information on accommodation options, please see our “Accommodation” page.
During your 6-day stay, you will be required to attend 3 appointments with us. One for your initial consultation, one for providing your partner’s semen sample (if partnered. If using a sperm donor, this appointment will not be necessary), and one for the embryo transfer. Frequent updates can be obtained from your patient coordinator in between procedures.
Step 4: Embryo Transfer
This is the final step of your treatment, and perhaps the most significant step. During your last appointment, you will be given information about the progress of your embryos and will be offered the choice of how many embryos you would like transferred into the uterus. Legally, we are able to transfer up to 3 embryos, but we can also transfer 1 or 2 embryos per your request.
Improvements in IVF technologies enable us to incorporate the use of additional techniques and procedures into our daily IVF practice. One such innovation in fertility treatments is Cytoplasmic IVF Treatment, sometimes referred to as the "Three parent Family". While the "Three parent family" has an interesting ring to it, it is more of a catchy phrase rather than being a fully correct statement.
Cytoplasmic IVF Treatment at North Cyprus IVF Centre has been offered since 2012. While it has been almost three years since we have brought this concept into practice, it is important to mention that this treatment is still in its infancy years and the number of cases performed are still far from creating accurate and statistically significant numbers. However, data so far suggests that cytoplasmic transfer is able to increase success rates by 4 to 5 percent compared to standard IVF/ICSI treatments.
What is Cytoplasmic IVF Treatment?
Cytoplasmic IVF Treatment is the treatment option suited for two types of patients:
- Patients with known mitochondria defects
- Patients in older age brackets with likely mitochondria defects due to oocyte aging.
As women age, so do their eggs. Just like any cell, the egg cells is consisted of a nucleus, which contains the genetic material as well as a cytoplasm, which surrounds the nucleus. Within the cytoplasm, there are many other organelles. One of the most important organelles in the the cell is mitochondrion (plural, mitochondria). Mitochondria are responsible for providing the cell with its energy, which facilitates cellular growth and development. As the oocyte (egg cell) ages, so do the mitochondria found within the egg cell. As the mitochondria age, they fail to provide sufficient amount of energy for growth and development, therefore, the egg cells start to lose their viability. This is precisely where cytoplasmic IVF treatment gets in the picture.
With cytoplasmic IVF treatment, a young, healthy and pregnancy proven egg donor is used, very much like an egg donation program. However, it is not the eggs, or the genetic material inside her eggs that we are interested in. Rather, we are interested in the cyoplasm of the donor's eggs. In cytoplasmic IVF treatment, we extract the cytoplasm of the donor's eggs and inject it into the eggs of the recipient. That way, we can provide a healthier cytoplasm (therefore mitochondria) for the growth and development of the recipient's eggs. In a way, we make the recipient's eggs' host environment more friendly for growth. This provides us with a higher chance of IVF success when the own eggs of a patient is used in more advanced age brackets.
However, it should be known that this treatment also has its limits. This is a treatment option which provides a healthier host for the growth and development of your own genetic material. This is not a method that can correct and genetic problems with your eggs that may come with age. If the main reason why you are not able to fall pregnant or experience miscarriages is due to genetic problems associated with oocyte aging, then cytoplasmic IVF treatment is not likely to generate desired results and in such cases, IVF with egg donation should be considered.
IVF with cytoplasmic transfer is mostly recommended for patients with known mitochondrial DNA defects, or patients in more advanced age brackets who still have some ovarian activity, but standard IVF treatments fail to succeed even though the patient has viable oocytes during treatment.
Please check out our "Cytoplasmic IVF Treatment" page for more information.
There are certain things that you can do to help increase the chances of embryo implantation after an embryo transfer. Also, there are things that might hurt your chances of success which you should avoid. In this section, we have gathered information on the things that you should do or you should avoid in order to maximize your chances of success:
Things to do BEFORE embryo transfer:
- You will need to have one final ultrasound scan before your embryo transfer so that your IVF specialist can measure the endometrial thickness and make sure everything is in order for the embryo transfer procedure. Embryo transfer will not require anesthetics; therefore, you may have your normal breakfast on this day.
- Make sure that you have some time to yourself to relax and get rid of any negative thoughts you may have. Stress is our enemy; therefore, anything that will help you relax will help with your embryo transfer.
- Prior to embryo transfer, you may be prescribed a week of antibiotic use. During antibiotic use, it is important that you avoid sun exposure since antibiotics are sun-sensitizing drugs.
- It is strongly recommended that you do not smoke, drink alcoholic beverages or use recreational drugs while preparing for your IVF cycle. These can adversely affect egg and sperm count.
Things to do AFTER embryo transfer:
- On the day of your embryo transfer you will need to have your progesterone level checked. If your progesterone level is low, you may need additional progesterone supplementation in the form of progesterone injections. We will be able to perform the test at our clinic and supplement you with the additional injection if necessary. Progesterone is a naturally occurring hormone which helps maintain the endometrial thickness and provide a favorable environment for embryo implantation. In natural pregnancies, progesterone is released by the corpus luteum after ovulation. In IVF cycles, this needs to be supplemented externally.
- After embryo transfer, you will rest for a few hours at our clinic then you can go back to your normal routine. Once the embryo(s) has/have been transferred, there will be no additional measures to take beyond what we already use.
- Even though we won’t know whether you are pregnant or not until you have your beta hCG pregnancy test 12 days after the embryo transfer, we will need to assume that you are pregnant and take certain precautions for some time until you are in the safer pregnancy period. These include:
* No caffeine for the duration of your pregnancy. If you cannot do without coffee, then we recommend using decaffeinated coffee. You should also be careful about tea consumption as tea also has caffeine. Herbal teas (excluding sage and fennel) can be used. If you have to have caffeine, limit your use of caffeinated drinks to 200 mg per day.
* No fizzy drinks, at least for the first 12 days until your confirmed pregnancy. You should also not be eating gassy foods as fizzy drinks and gassy foods can upset your stomach and we want to avoid stomach cramps and contractions as they may negatively affect embryo implantation.
* No intercourse for 12 days after your embryo transfer, until your confirmed pregnancy.
* Avoid public pools, saunas or any other places that may expose you to chemicals and bacteria until it has been established that you have a healthy progressing pregnancy.
* Avoid smoking, drugs and alcohol altogether after your embryo transfer. Once the embryos have been transferred, drugs, cigarettes and alcohol can have very detrimental effects on your baby’s development.
* No vigorous or high impact exercise until after clinical pregnancy confirmation. Walking and other light aerobic exercises are okay. Avoid heavy lifting greater than 10 pounds for the duration of your pregnancy.
* Minimize your medication use (other than what is prescribed to you by us). Should you require medication use for any condition after your embryo transfer, please consult with us or the doctor who will be following your pregnancy.
* Avoid eating mercury rich fish (tuna and swordfish), unpasteurized cheeses and raw meats .
* 4 mg of folic acid a day is the established dose which needs to be taken during pregnancy. Folic acid is essential for development of your baby. Folic acid deficiency during pregnancy is associated with neural tube defects; therefore, use of a prenatal vitamin complex is essential after your embryo transfer.
* Keep using your progesterone supplements (crinone gel 8%) until the 12th week of your pregnancy. 12th week is when the placenta takes over progesterone secretion, therefore, you will no longer need to externally supplement it. On the 11th week of your pregnancy, you can go down to 1 application per day and continue like that for one week and on the 12th week of your pregnancy, stop using the crinone gel altogether.
* Similarly, you will keep using your estradiol valerate supplements (progynova/estrofem) until the 12th week of your pregnancy which is when the placenta takes over secretion of estrogen. You can half your dose on week 11 and stop altogether on week 12.
* Flying is relatively safe after embryo transfer. Most of our patients fly back home the day after embryo transfer. However, if you have 48 hours to spare, then we recommend flying back home 48 hours after the embryo transfer. The first 24 hours should have more resting and less moving around, but you can enjoy Cyprus and do a bit of sightseeing the next day.
We wish you a successful embryo transfer!
In Vitro Fertilization (IVF) is a fertility treatment options for couples who cannot achieve and/or maintain a successful pregnancy, therefore, need medical assistance. There are various types of fertility treatments depending on whether the couple uses their own egg and sperm cells or require the use of an egg or a sperm donor. Patients in older age brackets have a few alternative options when it comes to a successful IVF treatment. North Cyprus IVF Center is one of the few clinics in the world offering flexible and customizable treatment options for patients based on their specific needs. Due to favorable laws in North Cyprus, our ISO certified and award-winning clinic can quickly adopt new technologies and new treatment methods as they become available while many other clinics may not be able to offer such treatments to their patients due to increase bureaucracy or very high costs of adopting these technologies. At North Cyprus IVF, we are happy to announce that we are one of the few clinics that can offer various options for patients in older age brackets, thus offering high IVF success.
IVF over 45 or even over 50 is possible. However, there are a few considerations that need to be made when offering treatment to women older than 45 years of age. It should be kept in mind that your overall health and well-being is our top priority and we would not be comfortable with offering any treatment that may put your own health at risk. Therefore, before proceeding with treatment, we ask that you have a standard health screening to make sure that you are fit for pregnancy. This screening would include a blood glucose and bloos pressure checks as well as other routine screenings such as complete blood count and liver/kidney function tests. Once we make sure that there are no problems to proceed, we will be able to design the most suitable treatment option for you.
It should be kept in mind that over 45 years of age, your ovarian reserves have highly depleted and the quality of any remaining reserves have been highly compromised. While it may still be possible to obtain and maintain a healthy pregnancy in such age brackets, it is very challenging and requires a careful treatment planning. In 45+ IVF patients, there are two groups of women; women who would like to be pregnant using their own eggs, and women who would like to use donor eggs for a successful pregnancy. Procedures will be different in both cases:
1- Women over 45 who would like to use their own eggs for pregnancy: In this group, the most important step is to make an assessment of the level of fertility. This assessment is made by hormone testing. In this age bracket, the standard FSH/LH testing may not produce accurate results, therefore, on top of the FSH/LH tests, we specifically ask for the Anti-Mullerian Hormne (AMH) test so that we can make an assessment of the ovarian reserves and proceed with treatment planning accordingly. Once we have made an assessment, we will be able to decide whether you have any oocytes in your reserves that can be recruited for ovulation. If there are, then we will be able to offer you a customized treatment program that will aim to maximize your chances of a successful outcome. For instance, if you have an acceptable level of ovarian reserves, but the quality may have been compromised due to oocyte aging, then Mini IVF or IVF with Cytoplasmic Transfer can be ideal treatment types for you. In highly depleted ovarian reserves with compromised oocyte quality, Mini IVF is not recommended but IVF with Cytoplasmic Transfer would still be an option.
2- Women over 45 who would like to use donor eggs for pregnancy: Treatment is much less complicated in this group of women. Since eggs from a young and healthy egg donor are used, pregnancy rates are much higher. Our egg donation program is an exceptional program with exceptionally high success rates due to a number of reasons, which are explained in a previous blog article by Dr. Savas Ozyigit himself. Women seeking IVF treatment with donor eggs would need to undergo the health screening mentioned above as well as a trans-vaginal ultrasound scan to make sure there are no visible problems that can interfere with a successful pregnancy. Hormone testing for ovarian assessment will not be necessary as ovulation induction will not be performed. Please see our donor egg IVF treatment section for more information on this treatment program.
Regardless of whether you are planning on using your own eggs or donor eggs for IVF treatment, a careful assessment and a careful planning are the key factors behind a successful IVF outcome. Feel free to contact our clinic for more information on treatments.
Donor egg IVF treatment (IVF with Egg Donation) is a treatment option for women who are not able to conceive using their own eggs (oocytes). At North Cyprus IVF Centre, overall success rates with donor egg IVF treatment has been announced as 78% while this number can go as high as 96% for age-specific groups. Dr. Savas Ozyigit, director and chief of surgery at North Cyprus IVF Centre explains the high success rates with egg donation as follows:
Uterine fibroids are known to have an impact in a woman's ability to conceive naturally or even with IVF treatments. In this section, we talk about uterine fibroids and their effects on fertility and the specific ways that they can contribute to female infertility. If a woman has fibroids that can potentially impair her fertility, then removal of the fibroid may be necessary in order to achieve pregnancy.
Uterine fibroids are muscular tumors that form in the wall of the womb. The universal medical term used for fibroids is "myoma". Most of these tumor growths are non-cancerous and most women will have fibroids in the uterus without even noticing them.
Fibroids can be a single growth or there can be numerous small tumors in the uterus. The size of a fibroid can be as small as a melon seed or as big as a small melon. The larger the fibroid, the more problems it is likely to cause in the uterus regarding a woman's ability to conceive. It is not only the size of the fibroid that can affect a woman's ability to achieve pregnancy, but also the localization.
Fibroids are classified in three major categories based on their precise locations:
1- Submucosal fibroids: These are the types of fibroids that grow in the uterine cavity
2- Intramural fibroids: These are the fibroids that grow within the wall of the uterus
3- Subserosal fibroids: These are the fibroids that grow on the outside of the uterus.
Fibroids that are in the uterine cavity are the main types of fibroids that have a direct association with infertility. These fibroids can indent the cavity or pressurize the endometrium, therefore, directly affecting embryo implantation. However, other fibroids can also negatively affect chances of conception due to their sizes.
How Do Fibroids Cause Infertility?
- Fibroids located above the cervix can change its position and therefore restrict passage of sperm cells that can travel through the cervix.
- Certain fibroids can block the fallopian tubes, thus restricting oocyte movement and fertilization.
- Some fibroids can restrict the blood flow into the uterine cavity, where the embryo would normally implant and generate a pregnancy.
- Fibroids can also possibly cause changes in the uterine muscle that prevents embryo movement.
How do I know if I have a fibroid?
Fibroids can sometimes have certain symptoms while sometimes they may go unnoticed for years. A proper diagnosis requires a consultation with your gynecologist so that proper diagnosis measures can be used. However, it will be important to know about some of the symptoms of fibroids:
- Heavy bleeding and/or painful menstrual periods
- Feelings of fullness in the pelvic region
- Pain during sex
- Frequent urination
- Lower back pain
- Infertility and/or pregnancy losses
While not all the fibroids will impair your ability to achieve and maintain a healthy pregnancy, it is always a good idea to see your gynecologist at certain time intervals for routine testing and scans so that problems in the uterus do not go unnoticed.
Repeated Miscarriages are one of the most frustrating experiences a couple can have when trying for a baby regardless of whether conception takes place naturally or via assisted reproduction. If miscarriages occur after a natural conception, patients often do not read too much into it and keep trying a few times before they consult their doctors. In IVF treatments, if there are recurrent miscarriages, then the IVF specialist will be able to notice this earlier on and usually after a single miscarriage following treatment, additional tests will be required to rule out certain possibilities. Recurrent miscarriages can be treated in most cases and patients can have a healthy pregnancy to a full term.
One of the first things that needs to be addressed is the time frame in which miscarriages are taking place. The cause and severity of the problem may differ depending on whether your miscarriages are occuring earlier on during your pregnancy (within the first trimester) or later on.
Management of the problem requires an effective testing and diagnosis as well as appropriate measures to make sure the risk of a miscarriage can be minimized based on what the problem might be. (Read More).
Dr. Savas Ozyigit
Egg donation in Cyprus, Gender selection in Cyprus and IVF treatments in North Cyprus in general: you will find information on new advances in IVF technology and latest IVF practices. All the blogs are personally written by Dr. Savas Ozyigit and his expert medical team.