I am going to have IVF. What should I ask the doctor? What should I ask the embryologist?

Their role is the thorough investigation, care and appropriate management of the infertile couple. The individualised approach helps to reach a faster diagnosis and, combined with the appropriate treatment, increases the chance of success.

The embryologist works together with the gynecologist specialising in assisted reproduction, and their contribution to the treatment of infertile couples is important, through the assessment of eggs, processing of sperm, fertilisation, cryopreservation of gametes and embryos, and embryo biopsy.

A couple who have been trying systematically to conceive for at least one year without success should consult a specialist.

Female factors (ovulation disorders, tubal factor, anatomical abnormalities, endometriosis, polycystic ovary syndrome, age), male factors (abnormal semen parameters, inability to produce sperm, erectile dysfunction), mixed factors (involving both partners) and unexplained infertility are the most common causes of infertility.

We choose the appropriate treatment depending on the cause of infertility. In unexplained infertility, simpler treatments such as ovulation monitoring and intrauterine insemination (IUI) often provide the solution. For more serious causes of infertility, IVF is particularly effective.

First, the ovaries are stimulated with medication to produce more eggs. Modern protocols require taking medication for only 8-10 days. This is followed by egg retrieval and fertilisation and, depending on the treatment plan, embryo transfer or cryopreservation of the embryos.

The modern protocols and medications used are completely safe once a detailed medical history has been taken and the appropriate treatment has been chosen.

Embryo culture in the laboratory usually lasts 3 to 5 days. Day 3 embryos are at the cleavage stage and ideally have 8 cells, while on day 5 of development the viable embryos form blastocysts, consisting of 60-100 cells. Blastocyst culture and the rate of blastocyst formation are an indicator of the quality of the embryology laboratory.

The selection of embryos for transfer is based on various criteria, with the aim of increasing the chances of a successful pregnancy. The main criteria include the quality of the embryos, assessed by their development. In recent years we usually choose to transfer one or more blastocysts, that is, embryos that have managed to develop up to the fifth day in the laboratory. Other selection criteria are the history of infertility and whether the embryos have undergone preimplantation genetic diagnosis (PGD).

Preimplantation genetic diagnosis (PGD) is a procedure that allows the analysis of embryos before embryo transfer in order to detect genetic abnormalities or hereditary diseases. Younger couples with multiple failed attempts or miscarriages, women over 40 and couples who are carriers of hereditary diseases such as thalassaemia or cystic fibrosis have the option of having their embryos tested with this method, with the aim of using only the healthy ones.

Women should ideally consider fertility preservation by the age of 35. This is because after this age both the quantity and the quality of eggs decline. If a woman is forced to delay motherhood for medical reasons, or decides to because of professional or personal circumstances, fertility preservation is an option. The treatment is safe, and cryopreservation does not affect egg quality at all.

Embryo transfer can be carried out either in the same stimulation cycle (fresh cycle) or in a frozen cycle.

The method used to cryopreserve eggs and embryos is called vitrification. It is particularly safe, successful and offers high survival rates. Embryologists assess eggs for their maturity and embryos for their quality, cryopreserve them in the laboratory and store them in liquid nitrogen containers at -196°C.

Embryologists and gynecologists work closely together in all phases of IVF, such as egg retrieval and embryo transfer. Based on the medical and embryological history, they make decisions about the treatment plan and advise couples with the aim of providing the best care and chance of success.

The couple should consult gynecologists with proven experience and specialisation in IVF. In addition, they should feel comfortable with the treating doctor so that they can discuss the issues that concern them and decide on the treatment plan that suits them.

The heart of an IVF centre is its embryology laboratory. Modern technology and certified embryologists play an essential role in the success of assisted reproduction techniques. At the FIVI IVF centre at Iatriko Diavalkaniko Thessalonikis, we have one of the most modern laboratories and a specialised team of embryologists with vast experience, which results in particularly high success rates. Our aim is to be by your side and to look after you at every step of your treatment.