CEF Thailand: Things to know before starting IVF cycle

　　Before undergoing IVF treatment, there will always be some problems inevitably. Patients need to think about many things before egg retrieval. We invite CEF doctor to answer patients’ questions.

　　Although my ovarian function is poor, I still have one or two follicles grow in the ovaries. Why the doctor couldn’t retrieve any eggs?

　　CEF doctors said that follicles and eggs are not the same concept. For women with low ovarian function, the follicles may sometimes be empty follicles. No granulosa cells or eggs are found during the puncture and suction of the follicle. The main reason is that damage occurs in the early stages of the oocyte. But the follicle continues to grow due to stimulation by hormones. The cause of Empty Follicle Syndrome may also be related to the use of stimulation medications. Another reason is that the abnormal endocrine of the follicular fluid in the empty follicles leads to the lack of biologically active HCG in the follicles. So the cumulus complex cannot be separated from the follicular wall, and it has nothing to do with the ovary itself, indicating that some patients need longer or larger doses of HCG in order to release the cumulus complex from the wall of follicle.

　　During pre-cycle screening, the doctor saw adhesion tissues in my uterine cavity. What should I do?

　　Intrauterine adhesion refers to the partial loss or fibrosis of the endometrium due to damage, which leads to adhesion between the front and back walls of the uterine cavity. It does not affect the egg retrieval procedure but needs to be addressed before embryo transfer. Mild intrauterine adhesion isn’t a big problem and can be treated with drugs when undergoing IVF cycle. Moderate and severe intrauterine adhesion needs surgery, after which medications will be used to regulate the endometrium. Firstly, retrieve eggs to create embryos. After the embryos are successfully cultured, they can be frozen first and then transferred after body recovers. The cause of intrauterine adhesion might be previous uterine cavity surgery, such as curettage after abortion, fetal arrest or induction of labor, uterine fibroids removal or uterine correction surgery, or intrauterine infection such as post-uterine infection, or infection during the puerperium.

　　What is the requirement for uterine size and endometrium thickness in IVF treatment?

　　Regarding the size of the uterus, it varies from person to person. Under normal circumstances, the width of the uterus is 4-5 cm, the length is 7-8 cm, and the thickness is 2-3 cm. This is the normal size of the uterus. As for thickness of the endometrium, it is generally between 9-12mm before and after ovulation. CEF doctor believes that the ideal endometrial thickness is 8-10mm. Within this range, the receptivity of the uterus is the best. If it is higher than 14 mm or lower than 6 mm, it will be difficult for embryos to attach.

　　What are the ways to improve eggs and semen quality?

　　CEF Thai doctors recommend men to do the following things to improve sperm motility: maintain healthy lifestyle; do not use sauna and hot springs; quit smoking and alcohol; eat less spicy food; exercise properly; do not do long-distance cycling; take protein, zinc and selenium supplements.

　　Women can also improve the quality of their eggs through diet change such as eating some beans and fish. Women are born with all the eggs they have for their lifetime. They should avoid things that may harm their eggs such as tobacco and alcohol, etc. Proper exercise is also good for egg quality. It is also important to not put too much pressure on yourself

　　Will IVF treatment affect ovarian function?

　　It takes a period of time for ovaries to fully recover after egg retrieval procedure. Generally speaking, IVF treatment should not affect ovarian reserve function. In women’s natural menstrual cycle, multiple follicles will grow at the same time in the early stage of follicular development. Without stimulation medications, only one follicle keeping growing and becomes dominant and the other follicles will become atretic. The use of ovulation stimulation medications allows those follicles to continue to grow and develop, so retrieving eggs from those follicles will not affect ovarian reserve function.