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If you have questions about infertility, please do not hesitate to contact. We always do our best to reply quickly to all your questions. Several of our clients have similar questions and hence we have prepared some answers to the frequently asked questions.

What is infertility and when should I contact the doctor?

Infertility is usually defined as inability to become pregnant despite regular unprotected intercourse. If the couple has not been able to conceive within at least one year, it is recommended to visit the fertility specialist.

What are the reasons for infertility?

Reasons for infertility may be very different. From female side, for example, ovulation disturbances, closed Fallopian tubes, endometriosis, uterus problems, early menopause are most common. From male side, for example, genetic or anatomic reasons, genital tract infections can cause lower amount and slower movement of sperm cells. In some cases, the reasons for infertility remain unexplained. It is believed that also thee lifestyle of a person as well as the environmental factors can affect persons fertility.

What do IUI, IVF, ICSI, FET mean?

In vitro fertilization (IVF) methods have been developed to help the infertile couples. The simplest is IUI (intra uterine insemination), in case of which, considering the egg cell ovulation time, the sperm is placed inside a woman’s uterus using a special catheter. When the IUI procedures do not give positive results, the classical IVF procedure is used, where eggs and sperm cells are put together in lab conditions. In case of more serious infertility of a man, ICSI (intracytoplasmic sperm injection) is performed during which one sperm cell is injected directly into the egg by using the micromanipulator. After the IVF/ICSI procedure, the embryos are grown in lab conditions for 2-6 days and 1-2 embryos are selected (rarely 3 embryos) for transferring to the uterus. If good quality embryos remain from the procedure, these can be frozen and used in the future in FET (frozen embryo transfer) procedure.

Is the sperm sample necessary?

Since couple’s infertility can be caused both from male and female side, it is always necessary to analyze the sperm. Sperm sample gives a quick overview about the quality of sperm and helps the doctor to decide which kind of infertility treatment method should be used for a specific couple.

Is there an age limit for going to IVF procedure?

According to the laws valid in the Republic of Estonia, Nova Vita Clinic treats infertility of the women between the age of 18 and 50. Estonian Health Insurance Fund supports the IVF procedures up to the age of 40. There is no upper age limit for men.

What is the percentage of success of IVF procedure?

The result of the IVF treatment depends on the reasons for infertility and is generally in negative correlation with woman’s age. Usually 30-40% of women become pregnant after the first IVF procedure. Some couples may need to pass several IVF treatment cycles. Generally, the cumulative success rate is 80–85%, meaning that most of couples benefit from modern fertility treatment methods.

If the first IVF procedure does not give any results, how fast it is possible to plan the next procedure?

The recommended that between two IVF procedures there is 2 to 3 months. Sometimes it is individual when couple is ready for next IVF cycle and it also depends on psychological components.

Does smoking and use of alcohol influence effectiveness of fertility treatment?

Smoking and lot of alcohol certainly reduce your opportunities to become pregnant. Several studies have proved that smoking has negative impact on quality of egg cells and reduces the sperm fertilization capability. If you are planning to become pregnant, you should quit smoking at once and reduce consumption of alcohol.

Does the obesity affect fertility?

Excess body weight (body mass index over 30) inhibits the fertility of women as well as men. It is more difficult for people wo are overweight to get pregnant naturally as well as by IVF, also there are more abortions among overweight women. Overweight men have lower sperm number and reduced sperm motility compared to men with normal weight. For women, also being underweight inhibits fertility (body mass index below 19).

How to calculate the menstrual cycle?

Length of the menstrual cycle is calculated from the first day of bleeding until the beginning of the next menstruation. In average, the menstrual cycle lasts 28 days but it may vary individually (especially for women with ovulation disturbances).

How exactly should the time of hormone injections be followed?

Hormone injections necessary for stimulation of ovaries should be made daily at the same time, as far as possible. Little variation is allowed but not more than -/+ 1 hour. Drug that ensures final maturation of the egg cells (Ovitrelle vou Diferilin) must be administered at an exact prescribed time (36 hours before the retrieval of eggs procedure).

Can I eat and drink before retrieval of egg cells?

Since, egg collection is done under intravenous anesthesia, you can not eat or drink 6 hours before the planned procedure. We suggest to take some snacks with you that you can eat after the procedure of retrieval of egg cells. You can have a lunch at downstairs of Tammsaare Business center after the procedure.

What should be avoided after retrieval of egg cells?

Please follow the recommendations of your attending physician who has prepared your treatment plan. Avoid sexual contact after retrieval of egg cells (until pregnancy test). It is also not recommended to engage in active sports and lift weights. Avoid going to the bath immediately after inserting medicine to the vagina.

Can I eat and drink before embryo transfer?

Embryo transfer does not use anesthesia and you can eat as usual on the day of procedure. Urinary bladder could be full when coming to the procedure (avoid going to toilet about 1 hour before the procedure).

How do the drugs used in fertility treatment influence the health of the woman?

Generally the drugs used in fertility treatment do not have any side effects. The most serious possible side effect of the infertility drugs is the hyperstimulation syndrome (serious form 0.6-1%) which means that the ovaries of a woman react to the selected treatment dose too acutely and too many egg cells mature in the ovaries. When you start the infertility treatment, it is very important to follow the recommendations of the attending physician very precisely and go to the ultrasound examination on agreed times during which the physician can assess how the drugs impact a specific woman.

Is it possible to use the donor cells, if needed, and how long is the queue for using these?

You can use sperm as well as egg donor in Nova Vita Clinic. We have our own sperm bank and it is also possible to organize ordering of the donor cells from the sperm bank in Denmark. It may take some months to find a suitable egg donor.

Can I freeze my eggs and use them in the future, if needed?

Woman’s fertility starts to decline after the age of 30 and some women have the menopause already before the age of 40. To prevent problems related to infertility, a woman in 30ies could let check her fertility and when the woman wishes to postpone becoming pregnant, freezing of eggs may be considered. It is possible to freeze eggs in the Nova Vita Clinic.

Dr. Elle Talving

Naistentautien ja lisääntymislääketieteen erikoislääkäri
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Dr. Peeter Karits

Naistentautien ja lisääntymislääketieteen erikoislääkäri
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