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Ask the Doctor – Patient Questions

In this section you will find frequently asked questions on subjects regarding the fields of in vitro fertilisation (IVF), maternal-foetal medicine, genetics and molecular biology. Here also you can submit your questions to our team of established associates, who will respond quickly, responsibly, and reliably to your queries. In the form below, simply type in your question and click on “Submit”.

How much does 4 + 2 do?

Dear Maria, thank you for your question, which I feel more than happy to answear. All donors in our centre are submited in genetic screening regarding chromosomal anomalies (karyotype) and also cystic fibrosis (ΔF 508 mutation). Furthermore following the letter of the law we screen about sickle cell disease, thallasaimia and also HIV, HCV,HBsAg, syphilis, ABO/Rhesus. The recipient couple are entitled to know this information before they commence any trial on our donation programme. Please feel free to contact us for any further information you might need.

According to the law in Greece the maximum age of a woman that could undergo an egg donation procedure is appointed at 50 years of age.

Dear friend, this is a very interesting question. Unfortunately, the answer is not very encouraging. At the moment we can not interfere with spermatogenesis in terms of cell mechanisms completion, therefore we can not force evolution of spermatocytes or spermatids to mature spermatozoa. On the other hand, there have been some attemps in the past to use spermatids to fertilize the ovum. Those attemps were rather unsuccecful due to low fertilization and even lower pregnancy rates. Those teckniques are not in use any more. The most probable and effective solution in order to achieve a pregnancy would be sperm donation. The use of antioxidants (vitamins, selenium, folic acid etc), cessation of smoking and alcohol consumption and proper nutrition for at least 3 months might enhance spermatogenesis. Thank you for your question and I hope I was helpfull. Always at your disposal for any other quieries you might have.

Dear friend, thank you for your questions. Chromosomal anomalies in the male and female are diagnosed through Karyotyping (blood test) which is quite easy. If the male has a chromosomal anomaly, the anomaly passes into the sperm with the exception of mosaicism (where only a proportion of sperm would have the anomaly). Therefore the anomaly would be inhereted in the embryos either it is an egg donation or a natural cycle. Karyotyping of sperm (FISH) would indentify the proportion of sperm carrying the anomaly (mosaicism or not). In case of non-mosaicism the entire sperm count carries the anomaly and should not be used but instead turn to sperm donation. In case of mosaicism a preimplantation diagnosis of embryos is needed in order to identify those with a chromosomal anomaly that should be excluded from embryo transfer. Failure in the first attempt in egg donation cycles should not disappoind you as pregnancy rates are 50-60% for each cycle and there is always the probability of failure. Success in the second attemp seems to be around 50-60% as well for each cycle. Thank you once more for your question and wwe are always at your disposal for any further queiries you might have.

Dear Madam/Sir, Thank you for your question. Firstly, let me point our that our donation programme and therefore experience is extensive with more than 1000 donation cycles per year for the last 15years, with excellent results (pregnancy rate 68%). According to Greek law, egg donation programme can be implemented to couples when woman's age does not exceed 50years old. As far as for the egg-donors, they should be <35years. In our centre egg-donors age is less than 32years old with proven more than average fertility (previous pregnancy, high antimullerian hormone, low FSH, high antral follicle count). Further more we run blood test to all donors in order to determine blood type/rhesus, exclude chromosomal anomalies (karyotype, cystic fibrosis), haemoglonopathies (electrophoresis), and also diseases like (Hepatites B, Hepatites C, HIV I+II, Herpes, Syphiles). Please feel free to contact us for any further information you might need. We would be more than happy to provide our help.

Dear Maria, thank you for your question which I am more than pleased to answear. Let me point out that we have an extensive and well organized donation programme with more than 1000 cycles/year covering almost every European country. The first step is to gather and send us labatory results regarding hormonal tests, semen parameters, hysterosalpigography etc. After checking the test results and discussing your own wishes and needs we request a two month period in order to retrieve the donor who would fullfill the requested criteria. During this time you will always be communicating with the same one member of our stuff who would be appointed to you and being responsible and always at your disposal, for all the matters regarding your trial (medication, cycle synchronization of donor, arrival in Greece etc). If you wish, transportation and accomondation can also be arranged by members of our clinic to your best interest. For any questions or quieries please do not hesitate to further contact us. Kind regards

Dear mis Intzilaki, We would like to apologize for the delay in answering your question which was due to technical problems with our website. Firstly, let us say you are a courageous woman and worth of admirration for the things you have achieved with the health problem you are dealing with. Secondly it seems that you are in menopause, you are not ovulating, and since you are not having a living together partner the appropriate solution would be embryo donation. Even if we apply hormone therapy and you are able to ovulate the oocytes according to your age would be of poor quality. In order to answer to your questions we had a meeting with our legal department to inform us about the letter of the Greek law. The truth is that the law isn't exactly clear to whether women with your health issue can undergo an IVF treatment. Moreover we dont have any previous knowlege of a similar case in bibliography and no expertise in handling similar situations. We are trully sorry but the advisory board of Iakentro came to a decission that our center is not capable of fullfiling the desire of you achieving a pregnancy. Maybe it would be suitable for you to have a second opinion in a different counrty where fertility clinics can address your question in a different manner. We hope the best of luck.

Dear madam, Our donation programme is fully coorditated with the greek law for assisted reproduction technics which states that there is no concept of transaction (buing and selling) between donors and receipients. The law clearly states that there is only a copensation given to the donor for her time and working hours spent, the cost of medication and transportation. As far as it concerns your question our country lacks women of chinese origin, therefore we are trully sorry but we cannot provide any assistance. We are at your disposal for any other question you might have. Thank you.

Dear Ivan, thank you for your question and I appologise for the delayed answer due to personal reasons. Unfortunately, the donation program is not covered in Greece regarding public insurance funding and E112 form. If this is what you are looking for we wont be able to accomodate you. But let me emphasize that IAKENTRO sustains a well established donation program for a decade now with more than 1500 donation cycles/year with excellent results and one of the highest success rates in terms of pregnancy rares and live birth rates around Europe. We will be more than happy to be of any assistance if you decide to. Best Regards.

Dear madam, thank you in advance for your time to contact our fertility centre. We are more than happy to respond to all your questions. We will be pleased to examine your medical file and provide consultation as soon as it is brought to our attention. We dont have waiting lists and we can start right away provided that we have consider and choose the correct treatment ptotocol. Please enclose all details regarding your previous attempts and also the rest of your medical history (medication, age, medical condition). It is better if you use the email address that I provide you now which is more private '' infofr@iakentro.gr" instead the one you have been using. The medical issue that you mention does not pose a problem as long as it is controled within normal limits. Once more we will be happy to respond possitively to your medical issue.

Dear Miss Rikke, I am more than happy to respont to your question. Let me first outline than our centre has a longterm well established donation program with more than 1500 cycles/year and one of the higher pregnancy rates in Europe. The answer to your question is positive. We can provide the kind of servise you request with great joy. It believe it would be more helpfull if we discussed further the details and plan the procedure through a telephone contact or via the personal mail of Iakentro if you agree. Thank you for your question and we will be at your disposal whenever you choose. Kind Regards.

Dear Ioanna, let me first underline that our donation program is well established for many years and our results are among the best in Europe. The whole procedure begins by a direct telephone communication where we explain certain aspects of our program. Afterwards we will ask you to provide as by mail results of some laboratory figures essential for choosing the right donor and also provide with other preferences you might have. From that moment we need approximately a two month interval in order to find and choose the proper donor. The beginning of your treatment commence at the same day with the donors. From that day, transfer of the embryos and implantation occurs in approximately 15 days. Thank you for your question and we are at your disposal. Looking forward for a direct communication. Kind Regards.

Dear friend, I apologize for delaying answering your question which was due to a personal medical problem. The results for the year 2012 are at the same level to those of 2011, which can be found in our site. An update of our site regarding those results is in progress. Thank you for your consideration and we are at your disposal.

Dear friend, I am more than pleased to answer your question. It is true that when the age of woman exceed the time limit of 42 yrs the rates of natural conception, succesful pregnancy and birth of a healthy baby is around 5%. That is because, from that age on, not only the capacity of the ovaries to produce oocytes diminishes but also the quality of those oocytes is poor due to increased number of chromosomal anomalies. Regardless of menstruation (indication that you are not menopausal) ovarian reserve can be measured by hormonal assays like antimullerian hormone (AMH) and FSH. So, to answer your question, YES, you can be treated in our fertility centre in various ways. We can implement fertility treatments in terms of IVF within a natural cycle (no medication) or within a modified natural cycle (small amount of medication). Otherwise, the most efficient way to achieve pregnancy is oocyte donation. In this way we easily overcome the barrier of advanced age since women who donate oocytes are younger than 32 yrs old. The procedure is by law completely anomymous and the women who become donors are thoroughly checked for HIV, HCV, Hbsg, syphiles, haemoglonopathies, kariotype anomalies, cystic fibrosis and others. So, I may say that if accepting donated oocytes is not a vital issue for you, then medicaly this is the most efficient and proper way to achieve a pregnancy and give birth to a healthy child. Otherwise we can still try with your own eggs as we hve mentioned above. This alternative is time consuming and does not ensure us results, due to some difficulties. That is, even though you are menstruating, it is not certain that you have a monthly ovulation and that we can retrieve an oocyte. Even more, even if we retrieve an oocyte the quality may be impaired and the fertilisation or the implantation of the embryo may fail. I dont mean to discourage you but you are entitled to the real facts and fertility rates in order to make a proper decision. We are always at your disposal for any further questions you might have.

Dear friend, thank you for your question which I am more than pleased to answer. Let me give you an overview of our results and some comments: IAKENTRO, FERTILITY CENTRE Frozen embryo Clinical pregnancy rates 2011 < 35 yrs (62,1%), 35 - 37 yrs (47,4%), 38 - 40 yrs (41,4%), > 40 yrs (32,1%) Clinical pregnancy rates are the same between frozen and fresh embryos. There are some publications indicating that there might be an advantage transferring frozen to fresh embryos in a new cycle. There is only same concern regarding survival of the blastocyst during the procedure of freezing and thawing, that is because 5-10% of the total blastocysts (5th day embryos) undertaking this procedure will not survive. Those embryos though that will survive hold the same or even better chances of giving a clinical pregnancy and a live birth. You can find more information if you guide through our site into the section of results. Let me just add that IAKENTRO performs over 2000 IVF/ICSI cycles per year and sustains a well established donation progarm. We are at your disposal for any further information.

Dear Evie, thank you for your quiery which I am more than happy to answer. According to the details you have given me, you are eligible for IUI in our centre regarding your age and special features. On the other hand I have to underline some facts and bring to your attention further choices you can make. You are 44 years and this is interpreted in a 2-3% of getting pregnant on your own even with IUI. This is because , even if you have a regular ovulation (which we dont know, as menstruation is not a reliable marker), the quality of the egg produced every month is highly possible to hold an impaired function. Therefore there is great chance of difficult fertilisation, leading to low pregnancy rates or evenmore to early pregnancy lost if a pregnancy at last occurs. We have a way to overcome these drawbacks, using egg donation treatment which I recon is the most appropriate method for your needs. In constrast, if you insist on using your own eggs then ICSI on repeated natural cycles can increase your chances for achieving a viable pregnancy. During this procedure, using mild (modified natural cycle), or no stimulation at all (natural cycle), we follow up follicle growth with ultrasound examinations. Then just before ovulation occurs, we aspire the egg, which then we attempt to fertilize in laboratory with intracytoplasmic sperm injection (ICSI). If a blastocyst occurs, then we either proceed to embryo transfer or else to cryopreservation and attempt another cycle, in order througth this repeated procedure to assemply 2-3 blastocysts and then proceed to embryo transfer. This method increases our chances for pregnancy but it is time consuming, without secure results and it does not reduce the risk of early pregnancy lost due to possible impaired egg-embryo function. On the other hand, egg donation is not time consuming and can provide us with 50% pregnancy rates leading to increased life birth rates. So, if using a donated egg is not a most determining factor for your decision, then I believe that egg donation is the most appropriate choice to make. Once more, thank you for your question. We are at your disposal for any further details.

Dear Antonia Cristina, First I want to apologize for the delayed response to your e-mail. That is because I was travelling abroad for business matters. Regarding your question I would like to say that colleagues in Copenhagen Fertility Centre advised you well. Seeking for egg donation is the proper choice at the point we are if we want good and direct results since you have already tried conventional ICSI with no results. It is true that in women age >42years the egg-DNA quality and egg quantity decreases compared with younger women. That means that you may experience ovulation and menstruation (thought some times you do not), but a pregnancy is unlikely to occur, or if it occurs, most often it is driven to early miscarriage (biochemical pregnancy), due to age, of egg/sperm, induced genetic impairment. Therefore egg-donation seems to be the proper solution. Our donation program is quite extended and well established, with more than 2000cycles/year. The whole procedure is by law strictly confidential and anonymous. All donors are of age <30 years with proven fertility and are being examined for haemoglonopathies, chromosomal defects (karyotype), blood/ rhesus type and infectious diseases (hepatides, HIV, RPR). We always try to match couples and donors in critical characteristics like blood/rhesus type, eyes, skin colour and special preferences. So, regarding your question the chances of getting pregnant are pretty good exceeding 50%/cycle. Other factors, like endometrial receptivity, smoking, alcohol consumption, autoimmune disease or thrombophilia can depress fertility and pregnancy rates, but all these are parameters that we successfully deal with. Sperm freezing can be done in Coppenhagen, but there must be some kind of communication between fertility centres directly as sperm is consider to be a biological specimen and there are specific rules in Europe, regarding transportation of biological specimens. We hope the best of luck to your trial, we expect to shortly hearing from you and thank you for your queries.

Dear Maria, thank you for your question, which I feel more than happy to answear. All donors in our centre are submited in genetic screening regarding chromosomal anomalies (karyotype) and also cystic fibrosis (?F 508 mutation). Furthermore following the letter of the law we screen about sickle cell disease, thallasaimia and also HIV, HCV,HBsAg, syphilis, ABO/Rhesus. The recipient couple are entitled to know this information before they commence any trial on our donation programme. Please feel free to contact us for any further information you might need.

Dear Sir, thank you for your interesting question. First let me apologise for the delay in answearing your quiery, as I was travelling abroad. It seems there are two aspects regarding your question, the legal and the medical one. We procede to this kind of treatment as a last choice, mostly in cases of multiple early miscarriages and biochemical pregnancies, where we cannot determine any obvious (male or female) cause. This cross-over procedure is consider a diagnistic tool in order to compare homologous and heterologous embryos created in different matches (egg donation or sperm donation, or both), that might give us an idea of the causative factor leading to miscarriages. In addition, our legal system does not allow during the same cycle the transfer of gamets to the uterus deriving from diferrent origins (holologous-IVF and eterologous-donation). Therefore it is a diagnostic procedure that can be used only under specific medical advise, but the embryos that would be created could not be transfered all together and mixed up in the same woman in one cycle. Usualy egg-donation embryos are cryopreserved and be usued in a subsequent cycle in the unfortunate event of another miscarriage. Furthermore, it is not medical advisable for the couple to undergo an IVF stimulation and at the end to use egg-donation as the endometrium most of the times in not properly prepared and the pregnancy rates are lower. What is advisable is either an IVF treatment or a gamete donation treatment for better results. Especially for women older than 42yrs, egg donation is probably the most succesfull and therefore most appropriate choice. I hope to have answered your question in detail. Please feel free to email us again, if further specification is needed. Kind Regards.