When is it right for me to undergo fertility test?
A woman at a fertile age has a 15–20 % chance to conceive during her menstrual cycle. Sixty percent of the couples trying to have a baby succeed during the first six months of their attempts. If you have not become pregnant within a year of regular sex life, you need to try to determine the cause. In case you are already aware of problems that may cause infertility, such as disorders in your menstrual cycle, endometriosis, advanced age or an illness that requires medication, it is worth to arrange for tests even earlier. Testitis during childhood or retained testicles, which have been operated on, may reduce man’s fertility.
Doctors first examine your ovarian function, the passage through the Fallopian tubes, and the structure of the uterus. The quality of your partner’s semen is also examined. Treatment of infertility is an area within the medical field that is developing quickly and requires special skill. For this reason, you should not hesitate to make an appointment with an infertility doctor.
How soon can we start receiving treatment?
Usually we are able to arrange your first visit to our clinic within just a few weeks. All necessary examinations can be performed during the period of one menstruation cycle and after that treatment can begin according to your wishes.
How long does one kind of treatment last?
Hormone stimulation in IVF treatments usually lasts 10–14 days. You have to make 3–5 appointments for one treatment cycle. Visits during which we monitor the response of the ovaries to the stimulation are usually quite short.
If necessary, you and your partner are eligible for sick-leave on the day of oocyte collection. The embryo transfer is a short, painless procedure and does not necessarily require sick-leave. A pregnancy test two weeks after the transfer reveals whether or not the treatment has been successful.
Can I come for treatment from out of town as well?
The AVA Clinic receives clients from other cities, neighboring countries, as well as from abroad. You can visit your local gynecologist for ultrasound scans and in this way monitor the success of your hormone treatments. Our infertility doctor will then give you further instructions either by phone or e-mail. In this way, after your first visit, you will only need to make an appointment at the AVA Clinic for the oocyte collection and the embryo transfer.
Do treatments affect other areas of my life?
You can live a completely normal life during your treatments. There are no limitations pertaining to nourishment, exercise or intercourse. However, daily hormone injections must be taken at the same time everyday strictly abiding by the instructions given. Some of the hormones used in the treatments cause symptoms of menopause, such as sudden mood changes, irritability or unusual sweating.
Your lower abdomen may swell and you may feel pain, especially during the final stage of the stimulation, if many ovarian follicles develop. You should avoid heavy physical activity on the days of oocyte collection and the embryo transfer. Your partner should avoid ejaculation a few days before giving a semen sample.
What are our chances for success?
There are so many factors influencing the success of treatments that determining the success of treatments is impossible without taking all these factors into consideration. Your age, how long you have been infertile and the cause, your life-style, the kind of treatment, your body’s reaction to stimulation (i.e. the quality of and how many oocytes you produce), the quality of the semen, the quality of the embryos and the number of embryos to be transferred all influence the probability of conception.
Our infertility doctor will evaluate your chances for succeeding using various forms of treatments, once (s)he has gained knowledge of all the necessary factors influencing success. The National Research and Development Centre for Welfare and Health have compiled statistics for all of the results of IVF treatments in Finland. According to the statistics for the year 2004, one in five embryo transfers in IVF and ICSI treatments led to a successful childbirth.
What risks are involved in treatments?
Couples have great hopes and expectations with regard to treatments and for this reason knowing the risks involved and preparing yourself for the fact that everything may not go as you had planned is important. Thanks to our personnel’s top expertise, we are able to minimize the risk factors and once started, treatments very seldom need to be cancelled or terminated.
Risks involved in hormone stimulation.
Fertility treatments involve the use of hormones, which aid in maturation of not just one oocyte, but several oocytes during one menstruation cycle. The hormone preparations used today are usually extremely tolerable but for some people, they may cause fatigue, headaches, and symptoms resembling menopause, such as mood changes and hot-flashes.
Also, the area around the point where injection was given may feel tender. During the final stage of treatment, you may feel pain and swelling in your abdomen, especially if a large number of follicles develop in your ovaries. As with all procedures, there is a small chance of infection and bleeding when collecting the oocytes.
The most serious side effect of the hormone medication is ovarian hyperstimulation syndrome where the ovarian follicles grow too large, fluid gathers into your abdomen and the balance of fluids in your body becomes disturbed. This may require hospitalization, which entails just rest and curing the fluid imbalance. Serious hyperstimulation can be life-threatening and sometimes we must terminate the hormone treatment.
Usually we are able to go as far as collecting the oocytes, but since pregnancy would worsen the side-effects of hyperstimulation, it is safer to refrain from doing the embryo transfer. The embryos are then frozen for later and safer transfer. We may also need to discontinue hormone treatments due to lack of response to it and if we determine through ultrasound technique that the ovarian follicles are not developing. Extensive research has not indicated that the hormones used in fertility treatments pose any risk of ovarian or breast cancer to women.
Risks involved in fertilization and development of the embryo.
Usually clients reach the embryo transfer stage after which pregnancy becomes possible. However, things do not always go as planned, and the process of treatment may have to be discontinued at an earlier stage. Sometimes, we are not even able to collect just one oocyte, although this happens very seldom. This may be the case even if the ultrasound showed indications of ovarian follicles. The reason for this may be premature ovulation or a malfunction in the ovaries. Sometimes, all of the collected oocytes are immature in which case fertilization is not possible.
Unsuccessful fertilization may also take place even though the semen sample is normal and the oocytes are mature. Insufficient amount of quality sperm may account for this or there may exist problems with the sperm attaching to the surface of the ovum. Nevertheless, most often fertilization succeeds through subsequent treatment using the ICSI method.
Sometimes the fertilized oocytes fail to cleave and develop into an embryo, or they cleave abnormally. The sperm, oocyte, or both, as well as the particular stimulation or culture conditions may be the reason for problems with fertilization and/or in cleaving into embryos. Most embryos, which fail to implant to the uterus or lead to an early miscarriage, are abnormal with regard to either their chromosomes or metabolism, although they may seem normal when viewed through a microscope.
Why is a twin pregnancy a risk?
Receiving twins may seem like a real stroke of luck for a couple who has waited a long time to have children. But having pondered the idea in more detail, the couple may realize that they would rather increase the number of members in their family one child at a time. Pregnancies with multiple fetuses can be a health risk, but they are also a risk financially.
For instance, the risk of giving birth prematurely or giving birth to a baby whose weight is excessively low is much greater compared to pregnancies with one fetus. Moreover, complications during pregnancy and miscarriages during later stages of the pregnancy are also greater. For this reason, at the AVA Clinic we have decided to transfer two embryos at the most into the uterus. We strongly recommend that our clients have just one embryo transferred, especially if you are having your first treatments and the embryos are of good quality.
