What treatments does AAFC offer?
AAFC offers a comprehensive range of diagnostic tests for finding out the root of your infertility problem. If the nature of your problem is easily treatable, then you are prescribed a therapy and your condition is monitored for improvement. If conceiving naturally is still not possible, then we offer you a range of Assisted Reproductive Techniques (ARTs) that may be applicable for your case, with the more popular one being In-Vitro Fertilization (IVF) with or without Intra-Cytoplasmic Sperm Injection(ICSI).
However, choosing the route of IVF with or without ICSI are the methods of choice for the majority of patients, as with these ARTs a number of infertility problems can be bypassed, offering you the chance to conceive and deliver a healthy baby without the waiting of treating a condition.
If you require further information on the treatments we offer and their potential applications, please navigate our webpage for the full range of our services. We offer personalized treatments for each of our patients, so if you require specific information relating to your individual circumstances, please do not hesitate to contact us for a personal consultation.
What are PGD and PGS? Are they recommended for my case?
PGD stands for Preimplantation Genetic Diagnosis and PGS stands for Preimplanation Genetic Screening. These procedures involve removing a single cell from a 3-day stage embryo following In-Vitro Fertilization (IVF) or 5-10 cells from a blastocyst-stage embryo for a molecular level genetic testing. These tests look at the integrity of the genetic material (DNA) of the newly-formed embryo, and specifically its organization in chromosomes. They look for any mutations (genetic mistakes) that relate to a pre-existing condition you may have, as well as the lack and addition of chromosomes.
You will need this test if you already have a child with a serious genetic condition, or if you know / suspect that you and your spouse, both or one of you, are carriers of a condition, and you would like to make sure that it will not be passed on your prospective baby. Additionally, PGD and PGS are recommended with advanced maternal age, male infertility factor and recurrent implantation or pregnancy loss.
Do you offer any additional after care services if I successfully become pregnant?
While we perform the most relevant and most appropriate Assisted Reproductive Technique (ART) for your case, we also offer a series of examinations that allow us to monitor the progress of your pregnancy (Pregnancy follow up). These include regular ultrasound scans (transvaginal, abdominal, 3D / 4D) and blood work
Do you provide any services to help me cope with the emotional aspects of my fertility treatment?
Yes, in AAFC, we offer a range of services for fertility treatment support that are available for all of our patients who undergo assisted reproduction. These range from psychological support with our counselor to acupuncture and yoga. Sessions with our psychologist remain completely confidential and they can be booked at any stage of your treatment, by contact them directly (phone: +97137024000 or email: firstname.lastname@example.org).
Why scans are done transvaginally?
Transvaginal scans are a very important diagnostic tool. Your doctor can obtain a great deal of information from the detail conveyed by the images produced during this examination. Ovarian health, egg numbers and physiology (appearance) of uterus and cervix can be visualized very easily and quickly. Transvaginal scans are also a great tool for diagnosing the presence of polyps and fibroids, for instance.
Additionally, a transvaginal scan can be performed any time of the menstrual cycle and during pregnancy without the patient having to go through the uncomfortable pressure of a full bladder, as it happens with a conventional abdominal ultrasound.
Will I be able to be seen by a female doctor?
Yes, in AAFC we have female IVF specialists and if you prefer to be seen by woman, please request it at the time of booking your appointment for your initial consultation.
Do you have an emergency number that I can use, if I experience any complications?
Yes, if you experience any discomfort, complication, unexpected pain or symptom as a result of a treatment you had in AAFC, please contact us on +971-56-5354990.
Are you open afterhours or weekends?
We do have afterhours service and if you need urgent attendance please contact us on +971-56-5354990. .
What is going to be the cost of my fertility treatment?
The cost of assisted reproduction by IVF depends on the various additional treatments that may be required or selected by you. Our programs and cycles are tailor-made to your needs, and therefore, before we know what your case may require is impossible to list prices. For instance, the price of an IVF cycle will be different if there is requirement for sperm or egg freezing. Equally, if you have a treatable condition and a hysteroscopy can solve it, then this will be at an additional cost.
Please contact us for more information.
Why should I choose AAFC for my fertility treatment?
You should choose AAFC for your fertility treatment, because we are committed in helping you to conceive and deliver a healthy baby. We understand that facing infertility is an emotional and stressful time, and we are prepared through our knowledge and expertise, our friendly and welcoming outlook, to support you with every step on the way. Our team of medical and nursing professionals has international experience and is able to offer a highly personalized service, tailored to your needs, maximizing your chances in achieving a successful outcome.
What can cause infertility?
There are many potential reasons contributing to infertility. From 40-50% of cases, it is a male-factor related problem. Another big contributor is advanced maternal age.
Male factor problems are easily detected with a comprehensive semen analysis / seminogramand they involve problems with sperm quality, quantity and ability to swim towards the egg.
Female factor infertility due to age is characterized by reduced number and quality of eggs. Additionally, gynecological conditions, such as polyps and fibroids, can also contribute to infertility.
How long does it take to get started with an IVF cycle?
This time varies with each individual case. We will be able to estimate it after receiving results from your baseline investigations. These will indicate whether you need a treatment before we start with an IVF cycle, or whether your infertility problem is a straightforward assisted reproduction case. In this situation, we will be able to start your IVF cycle within weeks from your initial consultation. Your doctor will discuss with you the timeframe of your treatment at your initial consultation.
How long does an IVF cycle take?
A standard course of fertility drugs for ovarian stimulation takes about 2 weeks. If it is necessary to have a longer IVF cycle, the drug course may last up to 4 weeks (almost a full menstrual cycle). After this period, we will be able to perform your egg collection. Fertilization will occur immediately after that and within 3 to 5 days post-fertilization, we can perform embryo transfer. You can take a pregnancy test, 10-14 days after that.
he above description covers for a standard IVF case. Please be aware that individual circumstances may affect this timeline.
Are there any side effects associated with the drugs used for an IVF cycle?
There are reported side effects for almost all the available fertility drugs. However, we assess every of our patients and offer as much as possible a personalized tailored-to-your-needs service. Everyone reacts differently to medication, and there may be a very rare occasion that we will have to stop the treatment.
Common but manageable reported reactions are bloating, headaches, and abdominal tenderness. Please keep well hydrated throughout your IVF cycle, eat well and healthily, and if you experience any persisting abnormal symptoms, such as pain or bleeding, please contact us immediately.
A condition known as Ovarian Hyper-Stimulation Sundrome (OHSS) can occur due to an over-reaction to fertility drugs. Commonly, it is a minor side effect, but in a very small number of cases, it can be severe. Here in AAFC, we can manage and avoid OHSS effectively by carefully monitoring our susceptible patients and finding alternative more suitable treatments.
What happens if I miss a dosage of my fertility drugs?
Typically, this will not affect the overall outcome of your fertility treatment, but it depends from the medication that you forgot to take and your individual circumstances. If your drugs' instructions do not include advice for that occurrence, please contact your doctor as soon as you realize the missed dosage and ask for specific instructions.
Does the ovarian stimulation of my IVF cycle affect the overall supply of my eggs? Will I experience an earlier menopause as a result?
No, IVF treatment will not affect your egg supply (ovarian reserve) and it will not cause you an early menopause.
During every menstrual cycle, ten or more sacs or follicles that hold your eggs start to ripen, but only one or two make it to full maturation. With the ovarian stimulation of an IVF cycle, all of these follicles are driven to maturation simultaneously and eggs are collected for fertilization. In a normal, unstimulated menstrual cycle, the eggs that remain immature are lost during your period. So, an IVF treatment does not recruit more eggs than normal, it just increases the efficiency of the natural cycle by using all available eggs.
What is the difference between IVF and ICSI?
With In-Vitro Fertilization (IVF), the processed sperms are placed in a dish with the eggs, and they are allowed to swim around the available eggs, penetrate them and fertilize them.
With Intra-Cytoplasmic Sperm Injection (ICSI), a single sperm is injected by anembryologist into each of the available eggs. ICSI is employed when the swimming ability of the sperms is compromised and / or when the overall quality and quantity of the starting semen sample is low. In these cases, only the sperms with the best appearance (morphology) are selected and used for injection into the eggs.
Is there a chance that none of my early embryos will survive?
This depends from the quality of the eggs and the sperms that come together for the formation of the early embryos. About 40% of the early embryos reach the blastocyst stage, and transferring at this stage will give you a greater chance for a pregnancy to occur. There is always a small possibility that none of the embryos will develop after three days, resulting in cancelling the next step of the embryo transfer, but this is a very rare occasion.
How will I know whether more than one embryo should be transferred in my womb?
If you have a good prognosis for conceiving following IVF, your doctor will recommend you for elective Single Embryo Transfer (eSET). With eSET, only one embryo is selected and transferred in the womb, the best one. This strategy has been reported to have equal success rates to the transfer of more than one embryo, when your chances of achieving a pregnancy with an IVF treatment are high.
Alternatively, your doctor will advise you on the best number of embryos (1, 2 or 3) that can be placed back in your womb. This may depend from your particular circumstances, fertility history and age. A multiple pregnancy carries a number of risks, and if you are likely to develop pregnancy complications, such as pre-eclampsia and gestational diabetes, transfer of more than one embryo will have to be avoided.
Does IVF increase my chances of having twins or triplets?
With IVF, if more than one embryo is transferred in your womb, the chances of having twins or triplets are 20-40% higher than in normal pregnancy. These rates reflect mainly fraternal twins or triplets (different eggs fertilized by different sperms), but also, at a lower percentage, identical twins or triplets that may be caused by the IVF hormonal treatments. Sometimes, even transfer of a single embryo can end up in a multiple pregnancy, because this one embryo (3-day or blastocyst stage) can still split in two at a subsequent division resulting in duplets.
Naturally, women older than 35 years of age produce more Follicle Stimulating Hormone (FSH) than younger women. Although higher levels of FSH are a sign of declining fertility, this hormone is also responsible for egg maturation, and if in excess, more than one mature egg can be released.
Can I choose to have either a son or a daughter?
Yes, this option is available in AFFC with our gender selection strategy. We will offer you an In-Vitro Fertilization (IVF) cycle and the gender of your embryos will be determined with Preimplantation Genetic Diagnosis (PGD). The embryo with the sex of your choice will be transferred back in your womb.
When will I know whether I am pregnant after IVF?
A pregnancy test can be performed 10-14 days following embryo transfer. Overall, a typical case of IVF can take 2 to 3 months from the day of the initial consultation to the day of the pregnancy test.
Is there a higher probability for me to experience an ectopic pregnancy after IVF?
An ectopic pregnancy occurs when the embryo implants outside of the womb, in one of the fallopian tubes, or more rarely in one of the ovaries. After an IVF treatment, the chances of having an ectopic pregnancy are higher (2.5%) compared to a normal pregnancy (1%). Although insertion of the embryo is performed extremely carefully through a monitor, the embryo may not implant itself in the uterine wall. Instead, it may migrate to the fallopian tubes and attach itself there.
What are my options if I repeatedly experience an unsuccessful IVF?
Sometimes, for reasons that we cannot define (unexplained infertility), conceiving through the means of an IVF cycle may not be straightforward. In order to improve your chances before we try again, we perform an implantation failure investigation, which may pinpoint issues that may arise after embryo transfer, such as a not-fully receptive womb, for instance.
In cases that a miscarriage occurs after a pregnancy is confirmed following an IVF treatment, although it is a tragic occurrence, sometimes it does not mean that is necessarily something wrong with you. Miscarriages happen in natural pregnancies and often subsequent pregnancies can proceed without any problems. However, if you experience more than 2 spontaneous consecutive miscarriages, we will try to find answers on why this is happening through a comprehensive recurrent miscarriage investigation.
What are the success rates for an IVF with or without ICSI?
Our dedicated team of doctors, embryologists, technologists and nurses here in AAFC aim to offer you the best chance of achieving pregnancy. We are a new fertility center and our target is to become successful through helping you achieve your goal, the conception and delivery of a healthy baby.
The assisted reproductive techniques that we apply, including In-Vitro Fertilisation (IVF) with / without Intra-Cytoplasmic Sperm Injection (ICSI) are very well-established and if you are interested in international statistics, please visit the websites of SART(http://www.sart.org/detail.aspx?id=1906), Canadian Registry (https://www.cfas.ca/index.php?option=com_content&view=article&id=1126&Itemid=692) and HFEA (http://www.hfea.gov.uk/fertility-clinics-success-rates.html).
Is there something that my spouse and I can do to improve our chances of IVF success?
Improving and balancing your diet can really benefit your effort in becoming pregnant with assisted reproduction. Here in AAFC, we do have an in-house nutritionist that can help you with a pre-conception diet.
Additionally, lifestyle choices such as quitting smoking, reducing alcohol production and increasing your exercise levels can really contribute in improving your IVF chances.
Can I exercise during my IVF treatment?
Yes, you can exercise during an IVF cycle, but you should avoid any kind of lengthy, vigorous high-impact exercise. Recommended workouts include walking, swimming and fertility yoga.
Can I travel by airplane if I am undergoing an IVF treatment?
There is no documented contraindication for either the mother or the early embryo (if embryo transfer has taken place) when travelling by plane and undergoing an IVF treatment. If you are in a long haul flight, just take the normal precautions of exercising your legs regularly to avoid the risk of deep vein thrombosis. If you are more likely to develop this condition (because it runs in your family and / or you have had it before), please check with your doctor, before you make any travel arrangements.
Is it a bad sign for my health and fertility that I have very heavy and painful periods?
Heavy periods can be a characteristic of having a condition, such as dysmenorrhea, uterine fibroids and Polycystic Ovary Syndrome (PCOS) among others. The first step in these cases is to determine the reason of the bleeding, by performing blood test and maybe hysteroscopy with an endometrial biopsy. Heavy bleeding does not necessarily mean that there is something wrong with you, but it may affect your lifestyle (disrupting menstrual pains). In addition, if it is found to affect your fertility (as with uterine fibroids or PCOS for instance), you might be offered a low-dose hormone treatment or other medication. Please speak to your doctor for further information and a test for diagnosing the problem.
How often do I need to have a Pap smear test?
The frequency of a Pap smear depends on your age and whether you had an abnormal finding previously (presence of Human Papilloma Virus (HPV), for instance). Generally, if your last Pap smear was normal and there was no HPV, you can have a Pap smear test every five years. But if there was anything wrong, your doctor will tell you when to repeat it.
Is it safe to receive a HPV vaccine?
Human Papilloma Virus (HPV) or genital warts are a condition that is sexually transmitted. If you are sexually active and at risk of contracting HPV, receiving the vaccine will be beneficial. However, you cannot have it while you are pregnant.
How often do I need to have a breast exam?
With increasing age, for women around the age of 40 or above, a breast exam or mammogram becomes a necessity and has to be repeated every year. Between 35 and 40, it is recommended to perform one mammogram at least.
For younger women, an easy way to find any possible abnormalities, such as the presence of a lump or a mass, is through a monthly self-breast exam. After the end of your period evaluate the appearance and the feel of your breasts. You can do this by looking for any discernable changes in front of a mirror and by carefully feeling your breasts, in a circular motion, looking for a lump or a non-consistent part of the tissue. Use light pressure and cover all areas of your two breasts. You may find it easier to perform a self-breast exam in the shower, where soapy water can make it easier.
What are the most appropriate pre-pregnancy vitamin pills or supplements?
Generally, these are: folic acid (400 micrograms), calcium (200-300 milligrams), vitamin D (400 IU), vitamin C (70 milligrams) and vitamin B12 (6 micrograms), niacin (20 milligrams), thiamine (3 milligrams) and riboflavin (2 milligrams). Please also ask your doctor, who may have a different recommendation based on your individual circumstances.
What fertility tests are required from men?
The basic semen analysis / seminogram is very important for evaluating sperm function. A good quality sperm, able to swim and penetrate the egg is essential for fertilization. A comprehensive semen analysis will assess sperm count, motility, velocity, morphology, semen total volume, liquefaction (ability of semen to turn into liquid form), color and pH.
What instructions are there prior to semen analysis?
Before the basic semen analysis / seminogram, abstain from sexual activity for 3 to 4 days, unless your doctor advices you differently.
What happens if I cannot produce a sample on the day of the treatment?
If you are concerned that you will not be able to produce a sample on the day of the treatment for any reason, please speak to your personal patients' assistant, who will be able to organize a sperm freezing for you.
Can I produce a sample at home?
This may be possible, depending on how far you live from AAFC. The sample must be collected in a sterile pot and remain at a temperature between 20-37o C. Please make sure that the sample will arrive at our hands within 1 hour of production.
I had a vasectomy, can I still become a father?
Yes, you can still become a father. We can retrieve sperm from your testicular tissue, by a method called Percutaneous Epididymal Testicular Aspiration (PESA). With PESA, a needle-syringe aspiration system is employed for the collection of testicular fluid directly from the epididymis (a coiled tube at the back of the testes). Mature sperms can be retrieved by this liquid and used for Intra-Cytoplasmic Sperm Injection (ICSI).