IVF IN NORTH CYPRUSSTEP BY STEP IVF PROCESS IN NORTH CYPRUS

Starting IVF treatment can be an exciting but nerve wracking experience. Usually, IVF treatment is pursued once other treatments have failed, following months of trying to get pregnant unsuccessfully. If you’re feeling overwhelmed try not worry, most people do, however we aim to make your treatment at Ada IVF in North Cyprus as relaxing and stress free as possible. Please see next slides for detailed steps regarding our IVF treatment plan.

Step 1 – Getting Started

First thing to do is get full information on our IVF with ICSI treatment from our Patient Coordinator either by calling or sending an email via our CONTACT US page. You will be advised in detail the cost of treatment, tests required, the IVF process etc. Please take this opportunity to ask any questions at all at this stage as it is very important you understand the treatment process fully from beginning to end (plus everything round about and in between).

Step 2 – TestsBefore commencing your IVF treatment there are tests that need to be carried out in order for Dr Verda to assess your fertility levels and prescribe the correct dose of medication you will need to take before coming to Cyprus.

These are:

Hormone blood tests: FSH (Follicle Stimulating Hormone), AMH (Anti-Müllerian Hormone), TSH (Thyroid Stimulating Hormone), E2 (Estradiol) and Prolactin

Trans-vaginal ultrasound scan: Antral Follicle Count

Once you have the results you just need to email them to Lyndsay and she will then let you know Dr Verda’s advice. All being well Dr Verdawill confirm it is possible to go ahead with IVF treatment. We also ask you to complete and return a medical information form by email.

It is also a good idea for your partner to have a semen analysis carried out before the treatment to make sure there are no problems.

If you wish you can come to Cyprus and have the tests carried out here followed by the treatment. If this is preferred then you would need to arrive in Cyprus on the first day of your menstrual cycle and stay for approx. 20 days.

Once all the details have been discussed and treatment has been agreed we do ask for a deposit in order to schedule your treatment (this is non-refundable). It is possible to use a combined contraceptive pill in order to regulate your cycle and able you to plan ahead for your desired treatment date

Step 3 – MedicationAs mentioned above you will need to take medication before arriving at the Clinic and the tests will determine the correct dose. We will send you a prescription and a medication protocol clearly showing what medication to take and when to take it and advise options for obtaining the medication. The stimulation medication is in the form of subcutaneous injections, the purpose of which is to stimulate the follicles that contain the eggs and to prevent premature ovulation.

You will need further medication during your treatment in Cyprus which will be detailed on your protocol. Dr Verda will advise of any changes to this once she has seen you and we can organisethe medication to be delivered to your hotel.

Step 4 – In CyprusInitial scan

With day one of your menstrual cycle marking day one of the treatment process, medication follows and on day 10 you are due to fly to Cyprus. Lyndsay will be in touch that evening to advise your pick up time for the following days appointment. Lyndsay is based at the hospital and so will be there to meet you for all of your appointments.

You will have a trans-vaginal ultrasound scan to check the development of your follicles. (DrVerda may prescribe additional stimulation medication at this stage if necessary). If your eggs are ready then a nurse will administer a Pregnyl (hCG) injection that evening at your hotel. The Pregnyl injection stimulates the final maturation of eggs in the ovaries. The eggs will be then collected 34 to 36 hours after the Pregnyl injection is administered.

Step 4 – In CyprusEgg & Sperm Collection

You will again be advised your pick up time for the day of egg collection. Upon arrival at the hospital a nurse will show you to your room and provide you with the garments necessary to wear for the procedure. You will be taken to the operating room when ready where you will be sedated and sleep throughout the whole procedure. Since you will be sedated you must not eat or drink after midnight the previous evening but don’t worry we will remind you of this when you are inCyprus.

Your eggs will be collected under transvaginal ultrasound guidance. A needle is inserted through the vaginal wall into the ovaries using ultrasound to locate each follicle. The follicular fluid is drawn up to obtain the eggs. Generally, the egg retrieval takes 20-30 minutes. You may experience some cramping and a little bleeding after the procedure however this is perfectly normal. You are able to take a mild painkiller if necessary.

While you are having your eggs collected we will be preparing the sperm sample from your partner (or donor). Abstinence from ejaculation for two to three days prior to providing the semen specimen is recommended.

Step 4 – In CyprusFertilisation

The most motile sperms are selected for fertilisation. To ensure fertilisation the ICSI procedure is carried out. This technique involves the insemination of each egg by the micro-injection of a sperm into it.

When you feel ready you will be taken back to your hotel however we will advise how many eggs were collected while you are at the hospital, the sperm quality and any other information regarding the procedures carried out that day.

After 24 hours we will be able to call and update you regarding the fertilization and advise how many embryos you have.

Step 4 – In CyprusEmbryo Transfer

The embryos are transferred on either day three or day five of development. Our embryologist is highly skilled in identifying healthy embryos and in some cases will recommend extending embryo development to day five, known as blastocyst stage. Blastocyst transfer is common in IVF cycles as it can increase the chances for success while decreasing the likelihood of multiples. DrVerda will work closely with our Embryologist to determine if a day three or day five transfer is ideal for you.

On transfer day Dr Verda will discuss with you the quality and quantity of your embryos. You can then decide how many you wish to have transferred. Again you will be shown to a room by the nurse and provided with the necessary garments.

Step 4 – In CyprusEmbryo Transfer

Embryos are transferred to the uterus through a soft embryo transfer catheter. This procedure is much like a pap smear and does not require any anaesthesia and is usually painless. The embryos are placed in a small amount of fluid inside the catheter, which is passed through the cervix at the time of a speculum examination and ultrasound guıdance. The embryos are placed in a manner so they reach the top part of the uterus. The catheter is removed and checked to ensure that all the embryos have been transferred.

You are required to have a full bladder for the transfer procedure and so we advise to begin drinking water on the way to the hospital. After the embryo transfer is complete, your bed will be wheeled from the procedure room into your private room, all while you remain lying flat on your back. Since you must remain as flat as possible, a bed pan will be brought to you by the nurse approx. 15 minutes after your transfer procedure if needed.

If you wish, good quality embryos that are not transferred can be frozen in liquid nitrogen, carefully labeled then stored in the embryo bank. These can be used in subsequent cycles if pregnancy is not achieved at the first attempt or if you decide to have more children at a later date.

Step 5 – The ResultThe most accurate test for pregnancy is the beta hCG blood test 12 days after your embryo transfer (day 1 being the day after transfer took place). hCG is human chorionic gonadotropin, better known as “the pregnancy hormone”. The body begins to produce hCG when an embryo begins to implant in the uterus. Understandably you will feel the desire to test early however please wait until day 12. The ovulation trigger injection the nurse administered prior to egg collection (Pergnyl injection) contains hCG and if you test too soon you may pick up traces of this and NOT the hCG produced by pregnancy. The Pregnyl injection can remain in your system for 8-10 days so testing too soon may give a false positive. The beta hCG test will report the level of hCG hormone that is present.

We understand in some cases it can be difficult to have a blood test carried out. A home pregnancy test will indicate whether or not there is any detectable hCG in your urine, not the level present. Please wait to carry out a home pregnancy test 14 days after embryo transfer. Please note hCG is present in urine in the highest concentration first thing in the morning.

Step 5 – The ResultIf you have a positive result then you must continue the medication as advised by Dr Verda, it is very important. You can also advise your doctor / gynaecologist as you will need support and subsequent tests and scans. You should repeat the beta test in 2 to 3 days. The goal is to have the level of hCGdouble every 3 days. If it does another beta test should be carried out in another 2-3 days time. If all three betas indicate a healthy pregnancy, then a vaginal ultrasound will be scheduled between 6 to 8 weeks of the pregnancy. At that time, your doctor will be looking for a heartbeat and a gestational sac to confirm the pregnancy.

If the result is negative and you have had a blood test on day 12 then all medication should cease straight away.

If the result is negative and you have carried out a urine test on day 14 then we recommend that you continue taking the medication as advised by Dr Verda for another 2 days and test again. If the result is still negative then all medication should cease right away.

If you get a negative result on your pregnancy test it is devastating to say the least. Dr Verda will answer any questions you have about the procedure and discuss further options for you if you wish.

IVF quick view steps:Contact Coordinator at Ada IVF for full treatment information

Have required tests done at your local fertility clinic / GP

Pay deposit to schedule treatment

Prescription and medication protocol is sent to you

Buy medication

Time in Cyprus: 8 day minimum including travel days.

IVF with ICSI treatment process (though may be subject to change)◦ Day 1 – First day of menstruation

◦ Day 2 – Stimulation injections begin

◦ Day 10 – Fly to Cyprus

◦ Day 11 – Scan and Pregnyl (hCG) injection

◦ Day 13 – Egg and sperm collection

◦ Day 16 – 3 day embryo transfer OR

◦ Day 18 – 5 day embryo transfer