Infertility FAQs
Infertility is defined as one year of actively trying to conceive without success. Generally an evaluation is encouraged in this scenario. Sometimes an evaluation is recommended much earlier, typically after six months of attempted conception, if the couple has an obvious potential fertility problem such as a history of tubal disease, menstrual irregularity, prior abnormal semen analysis, or maternal age > 35 years of age.
Here are many potential problems that can lead to infertility. The most common is advancing maternal age. Oocyte number and quality decline as a woman reaches her mid to late thirties, and declines far more rapidly by her early forties. Other female causes of infertility include tubal disease from prior infection or surgery, endometriosis, uterine abnormalities including fibroids, polyps, adhesions, or infection, and ovulatory problems. Male factors also can contribute significantly as well in up to 40-50% of cases. These abnormalities most often are noted in the semen analysis and include issues with sperm concentration, motility, and morphology.
When you begin your journey to parenthood at LIV, you will consult with a personal advisor — a committed member of our team — who will acquire an extensive medical history from you and your partner and address any questions or concerns that you may have. When you are ready to take the next step, your LIV advisor will help you plan your first visit to Puerto Vallarta. We understand that the IVF procedure can seem frightening, so here at LIV we have developed a program that allows you to feel comfortable and confident during each step of your journey.
This is a very broad question which often requires a very complicated and in-depth discussion, especially when individualizing treatment for a patient or couple. However, in general, the treatment options include observation, lifestyle management including nutritional adjustment and exercise, intra-uterine insemination, surgery (such as hysteroscopy), ovulation stimulation with oral or injectable medications, in vitro fertilization (IVF), intra-cytoplasmic sperm injection (ICSI), gender selection, and donor services.
In Vitro Fertilization (IVF) is a process created to overcome many abnormalities that can prevent pregnancy, including tubal disease, advancing maternal age and sperm abnormalities. In general, multiple oocytes (eggs) are stimulated to grow with injectable gonadotropins, and then obtained from the patient via trans-vaginal needle aspiration while the patient is under anesthesia. These eggs are then fertilized in the laboratory, either by mixing sperm with the eggs to allow “natural” fertilization, or by ICSI. The fertilized egg becomes an embryo. Embryos are generally grown for 3-5 days before the best-quality embryo(s), generally one or two, are replaced into the uterine cavity via a process called embryo transfer. If additional high-quality embryos remain, they can be cryopreservered (frozen) indefinitely.
The cost of the medication entirely depends on your own personal circumstances. Once the doctor has reviewed your test results and determined the dose you require then we will be able to estimate the cost. Similarly with the medication required during and after treatment, this will depend on what is prescribed once the doctor has carried out your initial scan and treatment in Mexico. However, check our packages with medication included.
Your doctor will organize a prescription for the medication you are required to take at home in preparation for the treatment in Mexico. You can buy this medication from your local pharmacy or we work with third-party international pharmacies that can deliver it directly to your home. Medication required during your treatment in Mexico will be prescribed and provided to you at the clinic.
Egg Collection FAQs
Ovulation induction may last for approximately 12 days.
When monitoring infertility specialists are observing ovarian response to the stimulation medication. We are monitoring the follicle development and the correct size for the retrieval.
The number of eggs collected depends on each individual patient’s fertility levels and ovarian reserve. The Ultrasound scan which our DR. will carry out on your first appointment will allow him to see how well your follicles have developed and be able to give you an indication then of how many eggs you are likely to produce. In addition, the number of embryos created depends on how many eggs produced and the quality of the sperm used.
Yes, you will be lightly sedated for the procedure and not feel any pain. You may have some spotting and cramping afterwards though and this is perfectly normal.
A mild pain killer can be taken if required. The doctor will give you instructions for your after-care medications.
IVF Cycle & Embryo Transfer FAQs
Embryos are typically transferred 5 days after fertilization, once they have reached the blastocyst stage. In some cases, transfers may occur on day 3, depending on infertility factors and embryo quality. Your doctor and the lab director will advise you on the best option for your situation
A blastocyst embryo is an embryo that has developed for about 5 to 6 days after fertilization, during which it reaches a more advanced stage of development. At this stage are more likely to implant successfully in the uterus. Embryos are typically transferred at this stage, as they have a better chance of developing into a healthy pregnancy compared to earlier-stage embryos
Before an embryo can attach to the wall of the womb, it has to break free or ‘hatch’ from its outer layer which is called the zona pellucida. Assisted hatching is when a hole is made or the outer layer is thinned helping the embryos to ‘hatch’ to increase the chances of pregnancy. We do carry out Assisted Hatching at LIV to increase the embryo implantation rate.
If you have a number of good quality embryos left that are not transferred, then there is the option to freeze them. These can be used in a cycle at a later date in case the first cycle is unsuccessful, or if you decide you wish to have more children in the future.
Some patients on a tight time scale do travel home the evening after their transfer however we advise to wait until at least the following day before flying home. Flying or any other mode of transportation has not been shown to have any adverse effects on embryo transfer.
As with any medication taken there can be some side effects however it is quite rare that patients notify us of any. The side effects will be noted on the medication information leaflet. If you do experience any side effects, please let us know. Every patient responds to the ovarian stimulation differently therefore a risk relating to the IVF procedure may be that it has to be cancelled due to poor ovarian response or ovarian hyper-stimulation. Also if the male partner does not produce any quality sperm in his sample or through a testicular biopsy procedure then the treatment may also need to be cancelled. Regardless, the doctor will explain and present the best alternative options to help achieve pregnancy.
The transfer process is very smooth and most patients do not experience any bleeding or spotting after their transfer however if you do it is nothing to worry about. A reason for some spotting could be because you have a narrow cervical opening. The blood is not coming from your uterus and your embryos are not affected in any way. The tiny drop of blood is not your embryo so you should keep calm and carry on with your everyday activity. In the extremely unlikely event that you experience heavy bleeding after the transfer then you should let us know immediately.
During embryo transfer, the doctor will clean your vaginal canal and the cervix with a sterile fluid. After the embryo transfer you might experience a wet feeling, which is just this fluid leaking out. There is no need to panic thinking it is your embryos, the fluid is not from your uterus while your embryos have been transferred and remain safe inside.
Embryos are graded based on their appearance and development at specific stages during in vitro fertilization (IVF). Grading occurs at various stages, with the most common being the cleavage stage (day 2 or 3) and the blastocyst stage (day 5 or 6).
At the cleavage stage, embryos are graded based on their cell division, symmetry, and degree of fragmentation (small pieces of cytoplasm breaking off). At the blastocyst stage, embryos are graded based on their developmental progression and structure.
Embryo grading helps determine which embryos have the best potential for implantation, though it does not guarantee success. Factors such as the woman’s age, the overall health of the embryo, and the specific conditions of the IVF cycle also play significant roles in pregnancy outcomes.
Low sperm count generally is not a problem because we use the ICSI procedure. The quality of the sperm is the most important thing. If you suspect that there could be underlying sperm problems then you should have it tested before commencing treatment.
Yes, you can use your own egg donor. However, the donor will need to undergo all the standard fertility blood tests and scans to ensure there are enough eggs for the treatment. The doctor will inform you if your known potential donor is a suitable candidate for donation
Better known as “the pregnancy hormone”, hCG is human chorionic gonadotropin. The body begins to produce hCG when an embryo begins to implant in the uterus. The beta hCG blood test should be carried out on day 12 after your embryo transfer. The beta hCG test will give you a quantitative report i.e. it will report the level of hCG hormone that is present which can give a good indication of how many embryos have implanted. If the first beta hCG test is positive you should repeat the test in 2 to 3 days. The goal is to have the level of hCG double 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 the 6 to 8 week mark of the pregnancy. At that time, your doctor will be looking for a heartbeat and a gestational sac to confirm the pregnancy.
While there are no guarantees when it comes to having twins after embryo transfer, as this is determined by nature, transferring up to two of the highest-quality embryos can increase the chances of having twins. The goal is that more than one embryo will successfully implant.
PGD stands for Pre-Implantation Genetic Diagnosis, also known as PGT. It involves removing cells from an embryo (embryo biopsy) at the blastocyst stage to determine if the embryo is genetically normal and if the chromosomes are balanced. PGD can also be used to test for specific genetic mutations, if planned in advance. There are various pros and cons to this procedure, so it is important to have an in-depth discussion with our fertility doctors and the laboratory director to determine if PGD is appropriate for you.
The recommendation regarding intercourse during fertility treatment depends on the type of treatment. For an insemination cycle (IUI), intercourse is generally allowed. However, for an IVF cycle, it is typically advised to avoid intercourse starting 4 days before egg retrieval. After the retrieval, it is recommended to wait until your next period (if not pregnant) or until at least 6 weeks of pregnancy (if pregnant). This helps avoid any complications and ensures the best possible environment for conception or early pregnancy. Always follow the specific instructions provided by your fertility specialist, as individual cases may vary.
