Female Hormones
Q1: What can be done for low progesterone levels?
A: Progesterone can be supplemented via various methods including oral medication, injections, or vaginal inserts.
Q2: What is considered a low AMH level?
A: Anti-Müllerian Hormone (AMH) is a key indicator of ovarian reserve. An AMH level below 0.7 ng/ml suggests a greater likelihood of poor response to IVF.
Q3: If my AMH is low and my doctor recommends IVF, should I check other hormone levels?
A: This depends on individual circumstances. Your doctor may suggest testing for other hormones such as LH, PRL, FSH, and E2 through blood tests.
Menstrual Cycle / Ovulation
Q4: If my menstrual cycle is short (24-26 days), does my ovulation occur 14 days before my next period?
A: This is generally a correct assumption, but ovulation can vary each cycle. Ovulation tests and ultrasound monitoring can provide more accurate estimations.
Q5: If I see a significant temperature shift and positive ovulation test, does that confirm normal ovulation and clear fallopian tubes?
A: While these indicators suggest ovulation, they do not guarantee normalcy. Blocked fallopian tubes are not directly linked to ovulation.
Q6: How can I confirm if an egg has been released?
A: In addition to ovulation tests, ultrasound monitoring of follicle growth can help ascertain whether ovulation has occurred.
Q7: Does the ovulation trigger injection affect menstrual cycles?
A: No, it does not.
Q8: My menstrual cycle is 26-28 days, but my ovulation tests show ovulation around days 15-17. Is this a concern, or are the tests unreliable?
A: While your cycle length may be consistent, ovulation days can vary. We recommend monitoring follicle growth with ultrasound for more accurate predictions.
Q9: Based on my temperature chart, is ovulation indicated on low temperature days or high temperature days?
A: Ovulation is indicated by a significant change in temperature.
Q10: Should we try to conceive before or after ovulation for a higher success rate?
A: Engaging in intercourse before, during, and after ovulation maximises your chances of conception.
Ovaries
Q11: Does the size of ovaries affect fertility?
A: While ovarian size can play a role, the most accurate assessment of ovarian function is through AMH blood tests and ultrasound evaluations of follicle count.
Q12: Is there a cure for Polycystic Ovary Syndrome (PCOS)?
A: Currently, there is no complete cure. It’s recommended to consult a specialist for tailored treatment options, which may include monitoring follicles or fertility medications.
Uterus
Q13: Can medication to stimulate ovulation increase the chance of fibroid recurrence?
A: There is a possibility, depending on the dosage and duration of the medication.
Q14: If the endometrium is thin, can IVF reduce miscarriage rates?
A: IVF allows for monitoring endometrial thickness before embryo transfer, which can enhance implantation rates, but it does not inherently lower miscarriage risks.
Q15: How long should I rest after fibroid removal surgery before resuming sexual activity? I have no issues with my fallopian tubes, yet I experience monthly cramps. Why is that?
A: Rest for 4-6 weeks and monitor for any signs of inflammation or lower abdominal pain post-intercourse. Cramps can result from various factors, such as endometriosis, not solely from fallopian tube issues.
Q16: What should I be aware of if I have a retroverted uterus?
A: Similar to fibroid removal, a rest period of 4-6 weeks is advisable. Monitor for any signs of inflammation or discomfort after sexual activity. Cramps may not solely relate to tubal issues but could indicate other conditions.
Fallopian Tubes
Q17: If a woman is 35 years old, with one normal and one partially blocked fallopian tube, will this affect conception?
A: Yes, the extent of the blockage can impact fertility.
Q18: What causes fallopian tube blockage, and what are the solutions?
A: Blockages can result from conditions like endometriosis, pelvic inflammatory disease, previous surgeries, or hydrosalpinx. Treatment options depend on the cause and condition of the tubes.
Sperm Quality
Q19: If the male partner has abnormal sperm morphology, is IVF necessary?
A: Not necessarily. It depends on the extent of the abnormalities, along with sperm density and motility.
Q20: How can a man improve sperm quality, including normal morphology?
A: Improving sperm morphology can be challenging. Focus on a balanced diet rich in various fruits and vegetables, adequate vitamins, regular exercise, and proper rest. Supplements designed for men may also help.Q21:
Screenings
Q21: After a hysterosalpingogram (HSG), is it necessary to abstain from sexual activity?
A: You may resume sexual activity, but avoid intercourse from the first day of your menstrual cycle until the HSG procedure to prevent pregnancy, as it involves X-ray imaging.
Treatments and Procedures
Q22: Does taking ovulation medication for six cycles affect the IVF medication plan?
A: No, it does not. It is advisable to discuss your IVF plan with your primary doctor.
Q23: Is an HSG mandatory before IVF?
A: Not necessarily; it depends on individual circumstances.
Q24: Can we select the gender of our baby through IVF?
A: The Human Reproductive Technology Ordinance (Cap. 561) prohibits gender selection for social or other non-medical reasons, except in cases with clear medical justification.
Q25: If the male partner has sperm abnormalities, should we choose IUI or IVF?
A: Both IUI and IVF can be considered, depending on the severity of the sperm abnormalities, quantity, density, and motility.
Q26: Can we try ovulation induction medications before attempting IUI?
Yes, especially if the menstrual cycle is longer than usual.
Q27: What are the chances of conception during a natural cycle (without ovulation induction)?
A: Using ovulation induction medications can increase the number of eggs, but success rates depend on the woman's age, health status, and the quality of the male partner's sperm.
Q28: Is an HSG required before IUI? Will not having an HSG affect the outcome?
A: It’s not mandatory; however, if both fallopian tubes are blocked, IUI won’t assist in achieving pregnancy.
Q29: Is an ovulation trigger injection mandatory for IUI? Can we opt for oral medication instead, and how long does it take?
A: IUI can be performed in either a natural or stimulated cycle. The choice between oral medications or injections depends on individual circumstances, with stimulation typically lasting 8-12 days.
Q30: What is the risk of ectopic pregnancy with IVF?
A: The risk is similar to that of natural conception. Recent studies indicate that frozen embryo transfers may reduce the risk of ectopic pregnancy by at least 1%.
Q31: Are there side effects from the ovulation trigger injection? How often can it be administered?
A: Generally, there are no significant side effects, though some patients may experience sensitivity. The injection is typically administered once per cycle, based on the patient’s needs.
Q32: Does IUI offer any special benefits for women with a retroverted uterus? Does it affect success rates?
A: There are no specific advantages; success rates are primarily influenced by the woman’s age, health, and the quality of the male partner's sperm.
Q33: Are there side effects associated with IUI and IVF?
A: Some patients may experience ovarian hyperstimulation syndrome (OHSS) during IUI and IVF due to stimulation medications. Risks associated with egg retrieval in IVF include infection, bleeding, and injury to nearby tissues, though these are minimal. Multiple embryos can also lead to a higher risk of multiple pregnancies.
Q34: After undergoing an HSG, if one fallopian tube is patent, is IUI an option?
A: Yes, it’s advisable to proceed with IUI on the side with the patent fallopian tube to enhance the chances of conception.
Q35: Is it necessary to collect sperm on the same day as egg retrieval for IVF? What if the male partner cannot comply?
A: It’s not mandatory to synchronise; sperm samples can be preserved beforehand. If the male partner has viable sperm but feels pressured, it’s recommended to collect samples naturally in advance.
Q36: What is the average number of IVF attempts needed for a successful pregnancy? Does age factor into this?
A: IVF success rates are influenced by the woman’s age, overall health, and the quality of the male partner's sperm.
Q37: For repeated IVF failures, aside from PGD/PGS, what other options are available?
A: Solutions depend on the reasons for IVF failure and should be addressed individually.
Others
Q38: If using a lubricant due to vaginal dryness, will it affect sperm motility?
It’s advisable to use lubricants that do not contain spermicide.
Q39: Is it acceptable to use manual stimulation before ejaculation into the vagina?
A: Yes, but if pregnancy does not occur within six months, consulting a specialist for further assistance is advisable.
Q40: What is the success rate at Ren An Reproductive Medicine Centre?
A: Clinical pregnancy rates reflect our success rates, indicating the presence of one or more gestational sacs via ultrasound. Success is influenced by female age, health, and male sperm quality.
Please click to view our Success Rate.Q41: Are there reference costs for treatment available?
Q42:
A: Women over 35, those with previous pregnancy complications, or couples with known genetic issues should consider pre-implantation genetic diagnosis (PGD/PGS). Non-invasive prenatal testing, chorionic villus sampling, amniocentesis, and structural ultrasound can provide insights into fetal health. The natural chance of congenital anomalies is about 3-4%, while IVF carries a 4-5% chance, but the likelihood of delivering a healthy baby remains above 90%.
Please note that the information provided is for reference purposes only and does not constitute professional medical advice or treatment recommendations.
For further inquiries or to schedule a fertility assessment, please do not hesitate to contact our centre. We are here to support you every step of the way.
