Commonly Asked Questions When Seeking Fertility Help

For those trying to conceive, finding the right fertility help is extremely important and can be very overwhelming. Where do you start? What happens when you take your first steps?

To find out what you guys wanted to know, we turned to our lovely Fertility Help Hub IG followers, to ask what you would ask when first starting IVF treatment or visiting a fertility specialist at a clinic.

Trusted fertility clinic, FertilityPort (based in Prague), have answered your commonly asked questions, to guide you on your way. If you’re seeking fertility help, read on.

Words by FertilityPort Prague

www.fertilityport.com | @fertilityportprague

1. What’s the (IVF) success rate for people with unexplained infertility?

This depends on the age of the woman. In general, the chance of IVF success with unexplained infertility is as follows (also based on the information collected in National Registers):

• Up to 30 years > 45% chance

• 31-35 years > approx. 30-35% chance

• 36-40 years > approx. 10-15% chance

• Over 42 years > below 5% chance

When using an egg donor (with semen sample evaluated as ‘Normozoospermia’), it is a 55-65% IVF success rate. For embryo donation or egg donation combined with sperm donation, it is up to a 65% chance. However, donated gametes usually do not have primary unexplained sterility.

IVF success rates presented by every fertility clinic, should be based on true data. According to the recommendation of SÚKL (State institute for Drug control), false information could be considered incomplete compliance with the Act on Human Tissues and Cells, and the Act on Non-Specific Health Services.

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?2. What day do you start stimulation in your cycle?

Stimulation starts from Day 2 of period bleeding.

3. How long does the IVF process take from start to finish?

IVF stimulation starts from Day 2 of the cycle (in other words, Day 2 of period bleeding). The application of subcutaneous drugs is about 10 days (on average), and egg collection is most often (by more than 80% of patients) Day 13-15 of the cycle. Then the embryo transfer most likely happens 5 days after the egg collection.

The embryo transfer could also occasionally take place after 3 days (following egg collection). HCG blood tests are required two weeks from the day of embryo transfer, and the ultrasound confirming the pregnancy happens within the next 14 days, which is four weeks after the embryo transfer.

Related Article – IVF with Egg Donation: Why People Turn to Egg Donors

4. How often should you expect to hear from someone from the team during the cycle?

Communication between our patients and our IVF coordinator is on a daily basis, outlining the next treatment steps and how things are progressing.

5. What should I prepare for? Fertility tests explained

Regarding treatment with your own gametes (egg / sperm):

For a female partner – age, vaginal ultrasound (especially Antral follicle count, but ideally also a complete overview of the anatomy of the uterus (womb), ovaries and surroundings). As well as AMH, TSH and Prolactin from the blood sample.

For a male partner – a semen analysis is required.

In all cases, results should not be older than three to six months at the start of the stimulation phase.

As egg collection is under general anaesthesia, we require blood tests and ECG from the beginning of stimulation. The blood test consists of a quick test, blood count, APTT, QUICK, Na, K, Cl, ALT, AST, urea, creatinine, APTT. We also ask for a conclusion from this examination, and whether the patient is fit to undergo the general anaesthesia (even if it is just a short one).

Regarding treatment with egg donation:

For a female partner – age, vaginal ultrasound (especially Antral follicle count, but ideally also complete overview of the anatomy of the uterus, ovaries and surroundings), as well as TSH and Prolactin from blood sample. For a male partner – a semen analysis is required. In all cases, results should not be older than three-six months as stimulation starts.

Regarding treatment with embryo donation:

For a female partner – age, vaginal ultrasound (especially Antral follicle count, but ideally also complete overview of the anatomy of the uterus, ovaries and surroundings), as well as TSH and Prolactin from blood sample. In all cases, results should not be older than three to six months by the time of beginning of the stimulation.

Related Article – How Fertility Port Prague is Treating Patients During Covid-19

6. What tips for coping with IVF Injections?

Patients usually cope with IVF injections very well, otherwise they ask their partner to help with the administration. You can turn to Fertility Help Hub’s app to chat with others going through fertility treatment at the same time, who will pass on tips.

7. What are the side effects of fertility treatment medication?

Below is a list of possible side effects, but the human body is unpredictable, so there might be some others. However, the incidence of serious side effects is reported to be below 1% of all stimulations, as well as complications from stimulations requiring hospitalization or surgical treatment.

The most commonly reported reactions are:

• Headache

• Ovarian cysts

• Syringe injection reactions (e.g., pain, erythema, hematoma, swelling and/or irritation at the injection site).

Mild and moderate Ovarian Hyperstimulation Syndrome (OHSS) is also often reported and should be considered as a stimulation-related risk. Serious cases of OHSS are less common. Very rarely, thromboembolic events may occur. The following definitions apply to the frequency of adverse reactions:

• Very common (= 1/10)

• Common (= 1/100 to <1/10)

• Uncommon (= 1 / 1,000 to <1/100)

• Rare (= 1 / 10,000 to <1 / 1,000), very rare (<1 / 10,000).

Very Common: Headache, vascular disorders, ovarian cysts, reactions at the injection point (e.g., pain, redness, bruising, swelling and/or irritation at the site of application).

Common: Abdominal pain, abdominal distension, abdominal discomfort, nausea, vomiting, diarrhoea, reproductive system and breast disorders, mild to moderate OHSS (including associated symptomatology), acne, weight gain.

Uncommon: Serious OHSS (including associated symptomatology).

Rare: Complications of serious OHSS, general disorders and reactions at the site of application.

Very Rare: Immune system disorders, mild to moderate allergic reactions including anaphylactic reactions and shock nervous system disorders, thromboembolism (both OHSS-related and non-OHSS-related) respiratory, thoracic and mediastinal disorders, exacerbation or worsening of asthma gastrointestinal disorders.

Related Article – IVF: 5 Tips to Avoid Common Mistakes During IVF Treatment

8. Do I have a decision as to how many embryos are transferred?

We strictly recommend the transfer of only one embryo (for all types of therapies). If there is no absolute contraindication (especially anatomical defects, like repeated surgeries on the uterus or for example internal disease or other), the transfer of 2 embryos is possible after signing a negative consent form related to double embryo transfer (this is where they sign that despite the recommendation of the doctor, the couple decided for themselves). But two embryos are the limit, so we don’t do a transfer of more than 2.

9. Is bed rest recommended after embryo transfer?

Yes, we do recommend bed rest for approx. 20-30 mins.

10. How quickly can you do another round of IVF if the first fails?

It depends how the last IVF cycle ended:

• Negative HCG Test – patients can start their next stimulation, with bleeding immediately after the negative test.

• Biochemical Pregnancy – patients can start their next stimulation, with bleeding immediately after the negative test.

• Spontaneous Complete Miscarriage (without RCUI) – patients can usually start their next IVF stimulation with subsequent bleeding after the miscarriage.

• Spontaneous Miscarriage with RCUI – patients can usually start their next IVF stimulation within approximately their 2nd – 3rd bleed following the miscarriage.

This is of course unless the healing is not complicated, with infections etc.

If you’d like to find out more about fertility treatment in the Czech Republic and how FertilityPort Prague can help you, click here to find out more.

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