Dr Antoine Abu Musa, Chief Medical Officer, NOW-fertility, in conversation with Cassie Destino, Founder, IVF Support UAE
Introduction
‘Difficult’ IVF cases tend to fall into 2 main categories:
- Repeated implantation failures.
- Issues related to advanced maternal age (over 40 years of age).
A third group is cases where there is a low AMH, irrespective of age, but these tend to be less difficult to deal with, albeit there may be a limited number of eggs available which will ultimately affect the chances of a successful pregnancy.
In other examples, it may be the duration of the failure to conceive that could indicate a more complex case, particularly when no cause has yet been identified.
Advanced maternal age
Over the age of 40, the eggs that women produce will be lower in both quantity and quality. However, it is not necessarily the case that there will automatically be a poor prognosis from IVF based on age alone. Medical history, lifestyle, BMI and ovarian reserve are all factors affecting the chances of a successful outcome.
Women over 40 may still have an acceptable ovarian reserve, although there will be a higher chance of producing embryos that are abnormal, and in these cases NOW-fertility recommends proceeding to IVF as quickly as possible to give the best possible chance of a successful outcome before the ovarian reserve decreases further.
How BMI affects an IVF cycle
A raised BMI can affect the response to stimulation medications and pregnancy rates are known to be lower in women who are overweight or obese. We recommend therefore that these patients try to lose some weight before starting IVF treatment, although we recognise how difficult this is and how much time it can take, further jeopardising the chances of success. There are also risks to losing too much weight too quickly or resorting to extreme measures such as surgery, therefore we suggest a gradual loss of around 5 – 7% over the 2 -3 months before starting IVF is the most sensible plan.
Repeated pregnancy loss and implantation failure
At NOW-fertility we see many patients who have had repeated failures at other clinics and are understandably devastated. We support these patients at two levels.
The first is psychologically and emotionally, with our team of nurses, care coordinators, counsellors and physicians available round the clock.
Secondly, when it comes to clinical care, we have a network of partner clinics worldwide and so are able to direct patients to the most appropriate clinic for their individual needs.
Immunity issues
The immune system plays an important role in implantation and successfully carrying a pregnancy. Sometimes patients produce good quality embryos, which successfully develop into blastocysts, but no pregnancy occurs due to a suspected immunity issue. Treatment with immunomodulators is something to consider where appropriate, but this is still a matter of some debate and the evidence shown by studies so far is acceptable but not definitive.
How can NOW-fertility help?
NOW-fertility has an experienced and expert multilingual team. Each patient has a dedicated care coordinator, nurse and consultant who are always available to support you through the whole process. Consultations are done online for maximum convenience, monitoring is arranged for you close to home and medications can be delivered to you by our online pharmacy. Our partner clinics are located thoroughout Europe, the Middle East and North Africa and your care team will recommend the best clinic for you based on your individual needs and the treatment you require. You only need to travel to your chosen clinic once you are ready for the egg collection and embryo transfer (if applicable) stage of your treatment.
Contact us to find out how we can help you: https://now-fertility.com/contact/
Published by NOW-fertility’s Communication Department.
Communication Manager: Annette Eckersley
E: annetteeckersley@now-fertility.com
This information was correct at the time of publishing and may not reflect our current practices, prices or regulations
