This is a known phenomenon and is wonderful. We however do not have a good scientific explanation for this.

- Week 22 answers kindly provided by Dr. Stephan Volschenk -

It depends again on where you are doing your ART. Some clinics, especially in Germany, only do day 2 ET’s for example. Some only do day 3 and others day 5 and somewhere in between all of the above, some do day 3 and day 5 transfers depending on the embryology.

- Week 22 answers kindly provided by Dr. Stephan Volschenk -

Cetrotide protocols are not new. It has been around for quite a few years now. About 65% of all cycles worldwide however, are still Lucrin cycles. This is probably due to the fact that Lucrin has been tried and tested for many years , having given good results for many years. The availability of Cetrotide has given us more options and the ability to change protocols where required.

There is no guarantee that the cetrotide will lead to a different outcome, but is worthwhile doing if indicated. It is unlikely that the reason for the immature eggs was the Lucrin – it could be that it was just a particular bad cohort of eggs or ovarian dysfunction

- Week 22 answers kindly provided by Dr. Stephan Volschenk -

ART is unfortunately not an exact science, and it is therefore difficult to predict whether the embryos will do better being back in the uterus on day 3 or stay in the dish ‘till day 5. Generally, if one has 3 or more good 8 cell embryos on day 3 , one can safely grow them to day 5 without the risk of not having nothing to transfer on day 5. If there are less than 3 good embryos on day 3, it does not really make a difference as to whether you transfer on day 3 .

- Week 22 answers kindly provided by Dr. Stephan Volschenk -

AMH is an indicator of egg quantity and indirectly, possible egg quality. A very high AMH is more likely than not an indication of underlying PCOS. A low AMH is an indicator of diminished ovarian reserve volume and can not be prevented as one can not stop one’s biological clock. It is important to remember that AMH is just one of a few tools in order to establish ovarian reserve volume and should be interpreted in conjunction with all the other tools available.

- Week 22 answers kindly provided by Dr. Stephan Volschenk -

There was a time when it was thought that metformin was not safe during pregnancy. However, subsequent studies have shown that it does not seem to pose any problem and is therefore used more and more in PCOS patients. Research have also shown that while on metformin during pregnancy, the incidence of developing glucose intolerance and abnormally large babies is significantly less. The dosage is the same as during that of TTC and is generally 1500mg per day in two to three divided dosages .

- Week 22 answers kindly provided by Dr. Stephan Volschenk -

The world is at present ,divided with regards to single or double embryo transfers and is much dependent on where you happen to find yourself in the world when doing ART. The only way however to try and ensure a singleton pregnancy is doing an elective SET.(There is a possibility of 0.8% of a single embryo leading to an identical twin pregnancy)A few factors have to be taken into consideration though, before embarking on an elective SET namely:
1)    Age
2)    Number previous attempts
3)    Reproductive history
4)    Embryo quality on the day of transfer
5)    Successful freezing program of the clinic

It is therefore clear from the above that the decision as to whether or not to do an elective SET is not an easy one as one would aim for the best outcome of being pregnant when presented with all the facts.

- Week 22 answers kindly provided by Dr. Stephan Volschenk -

Testing for autoimmune disorders in infertile couples will depend on whether there is an indication to test for it and will not be done on a routine basis. The main indications will be:
1)    Recurrent miscarriages
2)    Repeated failure to implantation following IVF/ICSI
3)    A history of autoimmune diseases such as rheumatoid arthritis, autoimmune thyroiditis, etc.

- Week 22 answers kindly provided by Dr. Stephan Volschenk -