IVF's small print
It’s definitely worth reading!
Ovulation induction and egg collection
- The female partner will take medication for ovulation induction. The egg collection is performed under mild anesthesia.
- During ovulation induction there is a small chance of ovarian hyper-stimulation syndrome (OHSS), especially in women with PCOS (polycystic ovaries syndrome, PCOS). This might occur due to an unexpected over-reaction to the medication despite the doctor’s efforts to prevent it. That is why your doctor needs to monitor your cycle closely by ultrasound and blood tests (hormone levels). In extremely rare cases, a woman with OHSS needs to be admitted in the hospital.
- The egg collection is a safe routine procedure. However, it is invasive, so some rare complications cannot be overlooked (trauma, pelvic infection).
- Another very rare complication of ovarian induction is thrombosis, because the medication might cause blood clotting.
- There can be no guarantee that a woman’s ovaries will respond to the medication. In some cases, ovulation cannot be induced (there are no eggs) so this treatment cycle cannot be completed (egg collection is cancelled).
- In some rare cases, no eggs are collected.
- A woman’s eggs are fertilized with the sperm using either classic IVF or ICSI depending on various parameters. Your doctor and the embryologists will inform you beforehand and on the day of egg collection.
- There is a chance that the eggs will not be fertilized or that the embryos will not develop normally. This might mean that no embryotransfer can take place.
- Not all eggs collected are suitable for ICSI. The embryologists prepare the eggs for ICSI and decide whether they are suitable or not.
- The embryos that remain in culture until day 5 after the egg collection are called blastocysts. Blastocyst culture might be suitable for you or not – the doctor and the embryologists will let you know.
- Not all embryos can develop into blastocysts.
- The number of embryos to be transferred is determined by the law (read below).
- About 55% of all natural cycle treatments (or when only 1 egg is collected) will proceed to embryotransfer.
- Cryopreservation is recommended only when the embryos are suitable. The embryologists make such decisions according to international guidelines and protocols.
- There can be no guarantee that embryos to freeze will be available.
- There can be no guarantee that frozen embryos will thaw normally or that they will be suitable for embryotransfer.
- Both partners need to sign an informed consent form before freezing their embryos.
- Frozen embryos may remain in cryopreservation for 5 years, according to the law. Cryopreservation can be extended for 5 more years (so 10 years in total) if the couple asks so in writing.
- Frozen embryos may be transferred only if both partners consent in doing so (they both need to sign a consent form).
- Frozen embryos may be destroyed only if both partners consent in doing so (they both need to sign a consent form).
- All couples should seek information about cryopreservation cost and yearly costs.
Pregnancy – Multiple pregnancy
- There can be no guarantee that the fertility treatment will be successful, even if it gets completed normally (embryotransfer).
- There can be no guarantee that a pregnancy will develop normally (birth of a living child).
- There is a small chance of ectopic pregnancy following an embryotransfer.
- There is a chance of miscarriage or birth of children with birth defects, same as in the general population.
Most couples seek information about the risk of multiple pregnancy following a fertility treatment. Multiple pregnancy is a known complication of IVF when 2 or more embryos are transferred. IVF success rates rise with the number of embryos transferred, but so does the risk of multiple pregnancy. The ideal outcome of IVF is one (1) healthy baby. Twin pregnancies due to IVF are still quite common (about 20-25%, while 1 in 80 in normal pregnancies). Most of the twin pregnancies have a good outcome, however the risk of complications, premature birth and low weight babies is increased. Also, almost all twins are born via CS (cesarean section). Many twins are born prematurely (before their 37th week of pregnancy) and with low weight (800-1.000 gr lower than normal). Several health problems are more common in premature babies.
How many embryos to be transferred?
The Greek law (last update: 2014) is absolutely clear about the number of embryos allowed for embryotransfer according to the female partner’s age and medical history.
- Women younger than 35: one (1) or two (2) embryos (using their own eggs).
- Women 35-40 years old: up to two (2) for the 1st and 2nd round of IVF, three (3) for the next cycle(s) (using their own eggs).
- Women 40 years old: up to three (3) embryos (using their own eggs).
- Women older than 40: up to four (4) embryos (using their own eggs).
As a woman grows older, her chances of getting pregnant get smaller, so the law allows for more embryos to be transferred.
In Gennima IVF, the percentage of good quality embryos is high thanks to the embryology lab. Practically, this means that each embryo has a higher chance of achieving a pregnancy. So, we can transfer fewer embros without the risk of lowering the chance of a successful IVF treatment. Single embryo transfer (SET) though inevitably offers a lower chance of success. In any case, each couple gets informed by the doctor and the embryologists about the number of embryos for transfer.
- Your treatment might get interrupted should unexpected technical problems occur in the lab, despite the fact that we take all necessary precautions. All the staff of Gennima IVF try their best every day to make sure that the embryos are cultured in the absolutely most suitable conditions. However, we cannot be held responsible in case of technical fault, fire or damages to the building.
- All patients are requested to provide updated contact information. Please let us know your new mobile phone number or your new address etc
- All patients have the right to stop their treatment at any time. Such a decision cannot the quality of medical care they currently receive or will receive in the future.
- The Accounting Dpt will inform all patients about the cost of their treatment in detail. The full amount is payable even of the treatment is not successful. Please the Accounting Dpt about the cost of your treatment and the ways you can pay.
- It is important that you have studied all information offered to you about your treatment. The doctors and nurses at Gennima IVF are there for you to provide all the information you need and to answer all your questions. You will be asked to sign a written consent depending on your treatment.