Ovulation Induction (OI)

Ovulation induction is a fertility treatment for women who do not ovulate, usually presenting with rare bleeds (every 45-60 days) or even absent periods. The most common causes of failure to ovulate are Polycystic Ovarian Syndrome (PCOS), significant weight fluctuations and hyperprolactinemia cause by stress. Two types of medication are used to induce ovulation: tablets (clomiphene, letrozole) or daily injections of Follicle Stimulating Hormone (FSH. The cycle is tracked with blood tests and ultrasounds, to confirm the best time to conceive.

Intrauterine Insemination

Intrauterine Insemination (IUI) is one of the simplest, less invasive treatment options that aim to increase the number of sperms that reach the follicle when ovulates, which therefore increases the chance of fertilisation.

IUI is a recommended treatment for you if you:

• Have been diagnosed with unexplained infertility
• Have been diagnosed with mild male factor infertility
• Have irregular or absent ovulation
• Have a hostile cervical condition  
• Cannot have regular or penetrative sexual intercourse
• Need to use donor sperm

IUI can occur either during the natural cycle or after using ovulation-sinducing medication

The procedure is usually easy and pain free.

In Vitro Fertilization (IVF) is one of the primary treatments offered for couples experiencing infertility. It is a process that removes egg/eggs from a woman’s ovaries and fertilises them with sperm in a laboratory. The fertilised eggs (embryos) are then returned to the woman’s womb to implant and continue as a normal pregnancy.

Some common reasons why IVF may be required include:

• blocked or damaged fallopian tubes
• male infertility relating to sperm quality or quantity
• endometriosis
• ovulation disorders including premature ovarian failure
• polycystic ovarian syndrome (PCOS)
• increased difficulty of conceiving naturally as women age
• unexplained infertility
• recurring miscarriage
• potential genetic issues where embryo screening may help.

Taken into account different IVF protocols we will together decide which is best for you. The process itself is more or less the same, lasting approximately two to two and a half weeks.

• Every month one egg grows on your ovaries. In IVF we stimulate your ovaries to help your body produce more eggs, if its ovarian reserve is adequate . This usually involve a series of injections which are easy to manage
• We remove those eggs the day of egg retrieval. Egg retrieval is performed under sedation by one of our consultant gynaecologists.
• Within the same day, your partner will provide us a sample of his sperm
• Our embryologists prepare the sperm for insemination and then perform ICSI/IMSI which involves injecting the sperm directly into the egg

• If the embryo/s fertilise, we culture them in the lab up till day 3 or 6 and either we will freeze them for a future cycle (Freeze all method) or we proceed with embryo transfer

• Surplus embryos are frozen upon request and can be used for another cycle
• Then you’ll have a 2-week wait while we see if you’re pregnant (b-hcg blood test)

There are a number of reasons why someone may choose for egg, sperm or embryo donation treatment.

Your fertility specialist may advise donation fertility treatment if:

• Your ovaries or your testes do not produce enough eggs or sperm
• Your eggs or your sperm are not of high enough quality to have a realistic chance of pregnancy
• there is a high risk of an inherited disease being passed to your children (i.e cystic fibrosis)
• you are a single woman

The process followed depends on the individualised fertility treatment our team planned according to your needs and wishes.

Please note:

• According to the Greek Legislation, all egg and sperm donors are anonymous.

 Τhere are no waiting lists for donation treatments

In cases of azoospermia (no sperm in the semen), when it is caused by a production problem within the testicle itself, Micro – Tese is the most advanced procedure of sperm extraction. A cut to the scrotum allows access to the testicles. These are then opened and multiple small biopsies are taken under microscopic visualization, targeting areas of the testes more likely to contain sperm using a microscope. Once we have the sperm, we can continue the rest of the IVF cycle. The whole process is being performed under an anaesthetic, with same day return to usual activities. The procedure itself can be done either prior to egg retrieval or simultaneously.

Until recently embryos were chosen according to their appearance under the microscope after three or five days of development in the incubator. Nowadays, Preimplantation Genetic Testing enables would-be parents to avoid the risk of inheriting a known genetic condition to their children and increase the chances for a healthy pregnancy.

• Preimplantation Genetic Testing for Aneuploidy (PGT-A) is the process of screening an embryo for chromosomal alterations (called aneuploidy) before it is transferred back in to the uterus. All chromosomes can be assessed and only embryos identified at low risk of chromosome abnormalities are selected for embryo transfer.

All women in their late thirties and early forties should consider this option, especially if they have already had unsuccessful IVF treatment or miscarriage.

• PGT for single gene defects (PGT-M): PGT-M is a useful tool for couples with a family history of single gene diseases such as cystic fibrosis, thalassemia, fragile X syndrome, Huntington’s Disease, etc. Through analysis of the embryos, it is possible to select those that are free from the disorder.

Uncertainty about future fertility can be intimidating. Egg freezing is option for everyone who

• Is worried about her future fertility
• Is at risk due to a medical issue such as cancer
• Will undertake surgery to the ovaries, so their ovarian reserve maybe jeopardised
• Is not in a position to have a child but would like the chance in the future

The process starts similar to IVF: we stimulate the ovaries so several eggs can be collected, followed by a regular egg collection procedure. Once the eggs are collected, we use the latest cryopreservation techniques known as vitrification to freeze and store eggs for future use. If and when you decide to attempt a pregnancy using your frozen eggs, they will be thawed and fertilised in the laboratory, with the resulting embryo/s placed into the uterus. 

Egg freezing gives every woman suitable for treatment the choice to start a family later in life, whenever she decides to be a mother, maintaining roughly the fertility she has at the time of freezing.