Frequently Asked Questions About Fertility Solutions and Innovations

Less than 35 years

A woman is born with all the eggs she will ever produce when she is born, at puberty her ovarian reserve is about 1 million eggs, and by 25 an average woman’s ovarian reserve would be around 300,000. From the age 35, the ovarian decline is steeper and steeper until she has depleted her reserve wherein she will have entered menopause. For this reason, it is recommended  that women freeze their eggs before they turn 35. In fact, live birth success rates are higher for women who have frozen their eggs before age 35, compared to women who are using their own eggs frozen at ages 36+. 

If you are a male and your sperm count is low, or if your sperm are not very motile or if your sperm are misshapen, you should consider using donor sperm. Alternatively, if you are a carrier of a genetic condition that you would not like to pass down to offspring, a sperm donor should be considered as an option in order to conceive. If you are a woman who is medically infertile due to age or another condition, using an egg donor would be a good option if you are trying to conceive. If you have had multiple failed rounds of IVF due to unexplained infertility or otherwise, you should use donor eggs. 

The side effects of egg freezing medication are similar to PMS symptoms and occur as a result of the medication causing  fluctuations in hormones.  Women tend to experience headaches, mood swings, bloating, fluid retention and  breast tenderness. The good news is these symptoms only last a couple of day to a couple of weeks, which is a small sacrifice compared to the joy of having a child.

OHSS is Ovarian Hyperstimulation Syndrome, and it is a rare side effect of the stimulation medication given to women undergoing IVF. The medication used will sometimes cause the blood vessels surrounding the ovaries to leak fluid, resulting in swelling in the ovaries. The symptoms associated with OhSS are abdominal pain and swelling, nausea, vomiting and excessive thirst.  Most cases of OHSS are mild, however in some cases the reaction can be severe- it is important that the clinic you choose to get treatment is monitoring you closely on the medication phase. OF all the IVF cycles performed, 5% of women develop OHSS and less than 1% of women experience severe OHSS.  Some of the risk factors in women associated with OHSS  are women with PCOS< women with a higher number of follicles before starting treatment and women receiving higher than needed doses of medication.OHSS is temporary and in mild cases the symptoms tend to resolve on their own, in more severe cases, you may need to be admitted to the hospital, where they would monitor your treatment. In these cases you may be given IV fluids, and medication to lessen your symptoms. You may also be given Gonadotropin releasing hormone antagonists to suppress ovarian activity. 

Currently, Cyprus, the United Kingdom, and the United States allow same sex male and same sex female couples to use egg donors, sperm donors or surrogates.  Denmark, France, Greece, Portugal  and Spain allow same sex female couples to use donor eggs or sperm, however since the use of a surrogate is ether reserved for heterosexual couples in these countries, or not permissible at all, it is not possible for same sex male or female couples to use a surrogate in order to conceive. 

At present, the countries which allow single women to undergo IVF with donor sperm or donor eggs are  Spain, Portugal, Estonia, the United States, Greece, Cyprus, Latvia, Mexico, Russia and Barbados. 

Fresh embryo transfers are a procedure in which the eggs retrieved and fertilized are placed back in the woman’s body as soon as they are ready (3-6 days post fertilization). Frozen embryo transfers require the eggs to be retrieved , fertilized and frozen for later use. It was previously the case that fresh embryo transfers had better outcomes when compared to the frozen embryo transfers, due to the embryos being damaged when they were frozen. However, with the development of superior  cryopreservation technology, the success rates of fresh and frozen embryo transfers are generally the same, and the difference between the two choices is dependent on the preference of the intended parent(s). For example, fresh embryo transfers tend to be cheaper than frozen embryo transfers as there are less steps involved and less equipment being used. 

No. Blood type of the egg donor or sperm donor will not affect the outcomes of pregnancy or the health of the child, if it is a different blood type as the intended parents or the surrogate. The only reason why blood type would matter is if the intended parents do not want to reveal that their child is born through donation, as only certain blood types are possible based on the blood types of the parents. For example, in parents where both of them have a B blood type, they could only produce offspring with O or B blood types,  it would be impossible for them to be fully biologically related to a child with an A or AB blood type. 

There is no evidence that the use of topical retinols and retinoids can harm an individual's reproductive health, they have been shown to harm the development of a fetus. Retinoids can pass through the skin to the bloodstream and to the fetus. SOme of the birth defects associated with the use of retinoids include:  hydrocephalus , microcephaly, learning disabilities, abnormal ear and eye formation, cleft palate and other facial abnormalities.

Rogaine and finasteride are medications used to treat hair loss. Rogaine has been approved for use in men and women, whereas finasteride is mainly given to males. Rogaine has not been found to affect the reproductive health of men and women, however some studies have shown that finasteride use can affect men’s sperm count and testosterone levels. Additionally, this medicine can be passed through semen and may affect the developing fetus. 

Moderate to excessive  alcohol intake has been shown to harm both female and male reproductive health. Smoking has been also shown to reduce fertility and negatively impact hormone production, and it may impact the DNA in sperm. Sedentary lifestyle has been associated with reduced fertility in men because of the higher than average scrotal temperatures which negatively impacts semen quality. High sugar intake has been found to affect the quality of eggs in women, as insulin(the hormone produced in order to carry sugar to tissues in the body) and the hormones that mature eggs are chemically similar. When insulin levels are too high, our bodies mistake this hormone for the ones used to mature our eggs, and cause a negative feedback loop to stop the hormone needed from being produced. This lowers the number of eggs being matured  and also affects the ovulatory cycle. In males high blood sugar was found to lead to DNA damage in sperm, which reduces the chances of the sperm being able to fertilize the egg, thus negatively impacting fertility.

The cost of doing IVF with your own eggs or donor eggs in reputable clinics are most affordable in Spain, Cyprus, and the Czech Republic. The costs start from €3000-€7000 in these countries, which seems like a lot, but not when compared to countries like the UK and the US, where the cost to use your own eggs or donor eggs in IVF goes from €7000-€15,000. 

AMH is an acronym for anti mullerian hormone, and it is produced by the granulosa cells of your ovarian follicles. It is stipulated that your AMH levels are reflective of the abundance of your ovarian reserve, with lower AMH levels associated with a depleted ovarian reserve, however just looking at AMH levels alone is not enough to gauge whether or not one is fertile or not. For one, AMH is not indicative of the quality of the eggs being produced, and low AMH levels does not always mean one has a diminished ovarian reserve. For example, women who use hormonal contraceptives sometimes have lower AMH levels than is considered ‘good’ for their age bracket, because the hormones in the contraceptive are artificially suppressing AMH. When assessing a woman’s true fertility, several hormones are investigated including: FSH, LH, PRL. Pelvic scans are also performed in order to understand the number of follicles a woman has and to assess whether or not she has PCOS or endometriosis; conditions that negatively impact her ability to conceive.

Embryo transfers and egg retrievals are not painful for two different reasons; the egg retrieval occurs under sedation-as it involves a needle being placed into the vagina  and the embryo transfer requires the use of a catheter which does not hurt when inserted in the woman being treated. For the egg retrieval, women are usually put under twilight anesthetic while a fine hollow needle is inserted into the vagina. The needle will advance from the vaginal wall into the ovaries and aspirate fluid from the follicle. Post egg retrieval  procedure most women feel mild discomfort, spotting or period cramping. In the embryo transfer, a catheter is used to guide the embryo into the uterus, and due to the nature of the equipment no sedation or anesthetic is required. Post embryo transfer some women do experience mild or moderate cramping, however this discomfort is far less painful than the symptoms following egg retrieval. 

Since egg donation relies on stimulating and maturing as many eggs as possible, eggs that would otherwise have been discarded during a woman’s natural menstrual cycle, the procedure has no bearing on a woman’s plan to start or extend her family in the future. 

The option of transferring a single embryo or two or more embryos has been heavily debated in medicine, and it is best to listen to what your doctor recommends in your specific case rather than going off the experiences of other people. Of course, there are pros and cons to each single or multiple embryo transfer option. For the pros of the multiple embryo transfer: it has been found that there are increased pregnancy rates when two or more embryos are  transferred compared to one. The cons of multiple embryo transfers: are the risks associated with multiple pregnancy, for example: chances of twins dying before, during and after delivery is higher than singleton pregnancy due to the increased risk of premature delivery. There are higher risks of cerebral palsy in twin pregnancies compared to singleton pregnancy, and also higher risks of long term disability in the children.