How to prepare yourself for examination for IVF in Bangkok?
Female
There are 2 periods during menstrual cycle which are most appropriate time for fertility investigation.
- Day 2 of period : this is the right time measure hormones that correlate to ovarian function.
- Day 12-14 of menstrual cycle : transvaginal ultrasound and pelvic examination will yield information about condition of cervix, cervical mucous ,uterine lining ,uterus and ovaries.
Male
Semen analysis is the primary and essential part for male fertility investigation. You need to abstinence for 3-5 days before you come to Bangkok Infertility Center and give your semen sample. The computer assisted semen analyzer will provide semen analysis result in a very short period of time and whether other investigation is required will be discussed with infertility specialist.
What is body mass index and its significance?
Body mass index is an indicator to point out that each individual has normal weight distribution or not. The body mass index or BMI = body weight in kg. / (height in meter)2 Normal BMI = 18.5-25.0 kg. / m2 BMI over 25.0 kg. / m2 consider as overweight.
There is a very high prevalence of obese women in the infertile population and many studies have highlighted the link between obesity and infertility. A large proportion of infertility women have polycystic ovary syndrome (PCOS) which is also linked with increased risk of obesity and other metabolic anomalies.
The association between obesity and / or PCOS and hyperinsulinism, hyperandrogenism and abnormal secretion of other hormones, such as leptin, underlies many reproductive disorders observed in this population.
It has been demonstrated that weight loss can improve the fertility of obese women through the recovery of spontaneous, where as other will have improved response to ovarian stimulation infertility treatment. Therefore, it is proposed that following the initial assessment of infertility and body mass index or other measurement of obesity, various weight management interventions, including diet, exercise or pharmacotherapeutic approaches, should be considered for overweight and obese infertile women.
What is the benefit of embryo culture and transfer at blastocyst stage?
Once IVF program had completed its stimulation part, oocyte retrieval will be performed. Eggs and sperms will be put together and cause fertilization, fertilized egg will develop and become embryo.
- Day 1 embryo will be at pronuclei stage
- Day 2 embryo will be at 4 cell stage
- Day 3 embryo will be at 8 cell stage Day 4 embryo will be at morula stage
- Day 5 embryos will be at blastocyst stage
In order to raise embryo up to day 5, you need a skillful embryologist and sophisticated laboratory. Once the embryo reaches blastocyst stage and the quality is good, then the chance of pregnancy after smooth embryo transfer may be as high as 40%. But if you have very good day 3 or 4 embryos for transfer, the chance of pregnancy is also as high as 35-40%. So the benefit of blastocyst transfer is to reduce number of embryos replaced and still maintain high chance of pregnancy. The appropriate number of embryo replacement for any women less than 38 years old should be 2 and for anyone older should be 3 embryos at a time.
Is there any relationship between obesity, PCOS and infertility?
Yes, there is. Right now, It seems that there is more correlation between obesity, PCOS and infertility. First line management for this problem is weight management and below is the summary, explanation and recommendation for the problem.