Dr Michalis Kyriakidis from Embryolab Greece answers some of the FAQ’s from the Fertility Show

We met so many incredible men and women at the Fertility Show in London recently. Everyone had their own fertility struggles, but all had one thing in common – the overwhelming need to be a parent.

It was a highly emotive couple of days, but with our support having been through our own fertility struggles, combined with the advice from some incredible doctors, we were able to help and guide people towards the answers they needed.

For those of you who were unable to attend, we thought we would share with you the most frequently asked questions and turned to the fantastic Dr Michalis Kyriakidis from Embryolab Fertility Clinic for the answers. 

Q: I am making good embryos but they just won’t implant. Why?

A: If this is the case, then you are probably dealing with what is called “recurrent implantation failure”. Recurrent implantation failure (RIF) is a clinical entity, which refers to a situation when implantation has repeatedly failed to reach a stage recognizable by pelvic ultrasonography. While there is no universally accepted definition for RIF, we believe that it is a consequence of embryo (affected by eggs and/or sperm), uterine or immunological factors. If you are experiencing RIF then you should seek advice from a specialized fertility doctor. In Embryolab we have organized a detailed set of test that may explain the cause of the problem. Unfortunately, in some of these cases we cannot identify a cause with the current conventional diagnostic tests. These are referred as unexplained cases.

Q: I keep miscarrying, should I be asking for a specific test before I go for IVF?

A: Recurrent miscarriage is a condition in which a couple experiences two or more consecutive miscarriages. After three miscarriages, we recommend an in-depth physical exam and testing. It is relatively uncommon and approximately 1% of women will experience this condition. A specialized reproductive gynecologist will guide you through the tests you need to do. These involve more specialized screening and possibly diagnostic operations. Embryolab has established a screening process that involves blood tests and diagnostic hysteroscopy and/or laparoscopy. In 50% of cases, we are able to identify the underlying problem and target our treatment to the detected abnormality. As a result, around 60% of women with unexplained recurrent miscarriage will have a successful next pregnancy.

Q: I have had 4 rounds of IVF but no one has explained why it isn’t working. Which tests should I ask for?

A: IVF failure is a problem for a couple and their doctor when it happens on the first round but it can become an emotional tragedy when it keeps repeating. Recurrent IVF failure has multiple known causes but many are not routinely considered as part of the pre-treatment analysis. These include cytogenetic abnormalities, age, antiphospholipid syndrome, uterine anomalies, thrombophilias, hormonal or metabolic disorders, autoimmunity, sperm quality, and lifestyle issues. These sometime have no apparent connection to fertility. If you have experienced multiple IVF failures, then a more detailed screening is recommended with specialized tests. You should seek the advice of a specialized and experienced fertility doctor to guide you through the process. In Embryolab we believe that, by studying every case separately and individualizing the treatment, we accomplish better results. IVF is not an industrial line but a personal matter.

Q: How can I improve the quality of my eggs?

A: The quality of eggs depends mostly on three basic factors that include age, lifestyle issues and individual body physiology and construction. It is obvious that we cannot reverse the effect of time.  However, we can make different lifestyle choices that may improve the quality of eggs. It is already known that smoking, obesity, unhealthy diets and stress can have an impact on egg quality. To improve egg quality, a woman should first reflect on her everyday life. By quitting smoking, reducing body weight, following a healthy diet and correctly managing her stress levels, she has made the first step to better eggs.

Q: How can I improve the quality of my endometrium?

A: The quality of the endometrial lining plays a very important part on the outcome of IVF treatment. The quality of the endometrium is affected by genetic factors, underlying structural or functional abnormalities as well as lifestyle choices. While a specialized fertility doctor can identify the first two, it is only you that can change your lifestyle. Improve your diet by adding antioxidants, stop smoking and start exercising. In Embryolab, we believe in a holistic approach of IVF treatment, so we have psychological and nutritional support available for the couples that receive treatment.

Q: Are more and more people really turning to IVF abroad? I think it sounds like a nicer option! If I decide to go abroad, what do I need to do first? Do I need to fly out to the clinic for a consultation first?

A: Many couples around the world find difficulties with their local health systems when dealing with fertility problems. This becomes even more complicated for UK residents with the constant cuts in funding or the long waiting lists. As a result, IVF treatment abroad is a more convenient and cost-effective solution. You can find excellent quality, world-class facilities and better results abroad at a reduced cost. Your first step should be to contact the clinic that interests you. In Embryolab, we offer a free video consultation to discuss the problem and plan the next steps of the couple’s treatment. In addition, we organize private meetings in Central London to meet the couples and hear their concerns. Last June, we co-organized with IVF Babble a very successful event ‘Meet the Experts’’ in Central London to inform the public of fertility problems and offer solutions.

Q: Will I have to use donor eggs if I am in my late 40’s?

A: The field of reproductive medicine is constantly evolving and new knowledge is coming out every year. We already know that a woman’s fertility decreases with time, both in terms of egg numbers as well as egg quality. This drop becomes more apparent in a woman by the late thirties and even more dramatic in her forties. By the late 40’s, the majority of eggs will have some kind of genetic problem. While a woman can get pregnant up to her late forties, the likelihood of having a healthy pregnancy and a healthy child is very low. As a result, we usually recommend IVF treatment using egg donation. However, this is not always the case as every person is different. You should discuss with a specialized reproductive gynecologist before making your decision. In Embryolab, we believe that an individualized approach brings the best results.

Q: Should I put back one or two embryos? I am in my mid-thirties.

A: The debate between a single or a double embryo transfer is an ongoing battle with no winners so far. Both approaches carry advantages and disadvantages. The general rule is to transfer one embryo in younger women and more in older women. But every rule has exceptions because every person is different. In Embryolab, we believe that the number of embryos we transfer is a joint decision made by the couple and the doctor. However, before deciding, the couple should be informed of the pros and cons of each approach. A trustworthy and transparent clinic should provide all the relative information so that you make an informed decision.

To get in touch with Dr Michalis Kyriakidis or any of the fantastic team at Embryolab, click here

Dr Kyriakidis will be holding free consultations in London on 1, 2 and 3 December, if you would like more information or to book a consultation with Dr Kyriakidis, please click here


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