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!
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.