Generally the following:

-          Normal fertilization

-          The rate at which they develop

-          Where they are from a development point of view on either day3 or 5 ( Cell number or morphology depending whether day 3 or 5)

-          The percentage of fragmentation within the embryo

-     The thickness of the Zonb Pellucida (“shell”)

- Week 32 answers kindly provided by Dr. Stephan Volschenk -

DHEA is still very controversial. A few years ago a few very small powered studies were published on the matter. None were prospective though and it had kind of “fallen by the wayside” Recently new interest has been shown in the matter, especially in the U.S. Large randomized studies are however needed on the matter in order to determine whether it does make a difference or not. It might have no benefit at all for all we know. The side effect profile, if taken with supervision, is very low and therefore some institutions are of the feeling that one has nothing to loose in taking it now or at least until we have more evidence as to its effect.

- Week 32 answers kindly provided by Dr. Stephan Volschenk -

Ovulation generally occurs 35-44 hours post the “trigger” The luteal phase is 14 days long. However, in a small percentage of patients the egg can be released either before 35 hours or after the projected 44 hours post “trigger”. Therefore it is clear that it does not automatically leads to a 14 day luteal phase, but as a whole it generally does. (give or take a day either side)

- Week 32 answers kindly provided by Dr. Stephan Volschenk -

This depends entirely on how long after the embryo transfer this is done. A reassuring level 14 days post ET is usually in the vicinity of  about 100.

- Week 32 answers kindly provided by Dr. Stephan Volschenk -

The issue with having had a trachelectomy from a fertility point of view is that the endocervical canal is destroyed/removed. This region is of extreme importance when it comes to natural conception. The mucus being produced in this area not only nurtures the ejaculated sperm, but also serves as a sperm reservoir, releasing sperm up into the genital tract at regular intervals. None of the “sperm friendly” preparations on the market can ever take over this function. Therefore, seeing that you are 35 years old as it is, I would encourage you to proceed directly to assisted reproduction and not waste any more time.

- Week 32 answers kindly provided by Dr. Stephan Volschenk -

Daar is geen verskil in die tyd wanneer aspirasie moet plaasvind tussen pasiente wat geneig is tot OHSS en die wat nie is nie. Die “trigger” vind as ‘n reel plaas wanneer die leidende 3 follikels tussen 17-18mm in deursnee is en die aspirasie volg 35 uur later.

Een moontlikheid rede vir hoe die eierselle gelyk het soos u beskryf het is eenvoudig dat die eiersel kwaliteit swak was in die betrokke siklus.

- Week 32 answers kindly provided by Dr. Stephan Volschenk -

Testing for Auto Immune diseases are very difficult at the best of times. The reason is that one is not certain as to what you are testing for as the spectrums of these disorders are very wide. You therefore have to have a certain condition in mind in order to request a test that will make any sense. Screening is very unreliable for the same reason. The best we can do for now, and this is purely a shot in the dark so to speak, is to do an ANF and ACA test.

- Week 32 answers kindly provided by Dr. Stephan Volschenk -

CGH ( cytogenetic comparative hybridization) is in its infancy worldwide and has only recently come to the fore. It is still very expensive due to the research phase that it is going through and has a while to go still before becoming commercially available. Due to the technical difficulties it will not be available everywhere in the world, but rather at larger dedicated centres with a dedicated genetics facility. The research is mainly being conducted in the U.K. and the U.S. and presently, and for a while still, will not be available locally.

- Week 32 answers kindly provided by Dr. Stephan Volschenk -

The risks for ectopic pregnancy after reconstructive surgery is around 4% – 10%. Maternal age, number of children desired, coexisting infertility factors, risk for ectopic pregnancy and treatment costs are the key variables to consider when advising couples on the relative advantages and disadvantages of tubal reconstruction and IVF. IVF is the treatment of choice for older, reproductively aged woman with significant tubal diease. IVF is the preferred treatment option for women with both proximal and distal tubal disease. The extent of tubal disease and pelvic pathology are important factors in determining the prognosis for success after surgical repair.

- Week 32 answers kindly provided by Dr. Stephan Volschenk -

There are a few important issues:

-          How old are you?

-          What is your hormone status like?

-          What is the condition of your pelvis and uterine cavity?

-          Are your fallopian tubes open?

 If all of the above are in order and you are 26 years of age, the chance of conceiving per attempt with good quality sperm is around 18% – 20%. This is cumulative over a 3-4 month time period. The older you are the less the chance per attempt.

- Week 32 answers kindly provided by Dr. Stephan Volschenk -