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Изследвания преди ин витро



Prior to every IVF cycle with own oocytes and sperm, there are certain tests which are mandatory for both partners. If you want to find out what you are tested for before IVF and what happens if one of the tests is positive, this article is for you.

The first type of tests that you have to go through are blood tests for HIV, Hepatitis B (HBV), Hepatitis C (HCV) and syphilis. Due to the fact that these are the most common serious transmissible (contagious) diseases, the European Union Tissues and Cells Directives as well as Bulgarian Law require every IVF patient to be tested for them. If one of the above mentioned tests is positive that does not necessarily mean that the IVF cycle will be canceled. According to Bulgarian legislation the cycle can continue if “the establishment has equipment and a validated procedure for processing and differential storage” of the contaminated biological material.

If a woman, negative for HBV, has a positive partner, his sperm can be used for fertilization, only after the “recipient woman has been vaccinated”.  If a woman, negative for HCV, has a positive partner, his sperm can be used for fertilization, only after the “recipient woman has given written informed consent”. If the male partner is positive for syphilis, his sperm can be used only after he ”has been cured”.

According to Bulgarian law in women positive for HBV or HCV, the IVF cycle can continue again provided that “the establishment has equipment and a validated procedure for processing and differential storage”. However, in women positive for HIV or syphilis, the cycle has to be canceled and the procured oocytes or zygotes disposed of.

Blood tests for HIV, HBV, HCV and syphilis have to be done NO EARLIER than 3 months before the procedure (ovarian follicular puncture).

As well as the blood tests both the female and male partner have to submit to microbiology testing of vaginal secretions and ejaculate, respectively. This test shows whether those secretions contain any microorganisms (e.g. bacteria and fungi) and what types. Depending on the type of microorganism(s) found antibiotic treatment before the procedure may be necessary. Microbiology testing of both partners has to be done NO EARLIER than 30 days before the procedure.

In the presence of certain risk factors (e.g. trips to countries with high incidence of malaria and others) additional blood tests may be required. For men chlamydia testing of a urine sample is also mandatory.

It is important to know that these tests are not done in order to find the cause of infertility. They are required by law in order to minimize the risk of contamination for the patients and the clinic staff during the IVF cycle.



Thalassemias are a group of hereditary blood disorders, characterized by the presence of abnormal forms of hemoglobin and reduced life of erythrocytes. Different forms of thalassemia vary in severity, and thus in their symptoms. The name of these diseases comes from the Greek word for sea “thalassa” because they are most common in the Mediterranean.

Hemoglobin is responsible for transporting oxygen and carbon dioxide by the erythrocytes. It is a protein made of 4 chains – 2 alpha and 2 beta. When you have thalassemia, the formation of these chains is affected to a varying degree.


Thalassemia is caused by a mutation in the genes responsible for the production of hemoglobin’s chains. One could have only one or several mutations which are passed from the parent onto their children. Depending on which genes are affected, there is alpha and beta thalassemia. There are also subtypes whose symptoms vary in severity.


Usually they include fatigue, weakness, dark colored urine. The faces of the patients are often pale or yellowish due to the increased destruction of erythrocytes, and their abdomen may be swollen. Some forms of thalassemia occur immediately after birth, others around the 2nd year or later. In some people the symptoms are absent and they are only carriers of the mutation.


Thalassemias are hereditary diseases, and there is no way to cure them completely. Your condition or that of your child can be maintained through nutritional supplements rich in iron or blood transfusions in the more severe cases. It is extremely important to monitor the level of iron in the blood because its overdose can be harmful.


For women with thalassemia during pregnancy, anemia may get worse. Therefore, it is required to inform your obstetrician-gynecologist about your condition. It is also advisable to consult with a haematologist who will monitor your blood.

One of the greatest concerns of future parents is whether their child has a genetic disorder. The most severe form of thalassemia (Beta thalassemia major, Cooley’s anemia) can be diagnosed by prenatal genetic diagnosis and amniocentesis.


тест за виталност



A sperm vitality test shows what percentage of the spermatozoa in the sample are vital (alive). Patients are usually referred for this test after a low percentage of sperm motility is detected on semen analysis. The results of the sperm vitality test give important information to the treating urologist about diagnosing and treating the possible cause of infertility.

The sperm vitality test is also an important tool when a couple with male factor infertility is about to undergo an IVF procedure. The oocytes of these couples are fertilized by IntraCytoplasmic Sperm Injection (ICSI). During ICSI the embryologist selects a single spermatozoa and injects it in one oocyte. As a rule the spermatozoa selected are always with the best available motility and morphology. In cases of very low or no motility, sperm vitality test is used to select viable spermatozoa, since only they can fertilize oocytes.

There are different types of vitality tests. The 2 most commonly used are the Hypo-osmotic Swelling (HOS) test and the Eosin Nigrosin test.

The advantage of the HOS test is that spermatozoa are still alive and can be used for ICSI following the test. During the test spermatozoa are put in hypo-osmotic solution (i.e. in solution with lower concentration of solutes compared to the inside of the spermatozoa). Due to osmosis, water starts coming into the spermatozoa and if their membrane is functional (i.e. if they are alive), their tails start swelling and curling. This process is completely reversible and those spermatozoa can be used for ICSI after they are washed.

The Eosin Nigrosin test also distinguishes between viable and non-viable spermatozoa on the basis of their membrane integrity. Viable sperm do not let the red dye eosin penetrate their membrane and thus remain white, while non-viable sperm turn red. Nigrosin is a dark dye which improves contrast and makes it easier to distinguish viable and non-viable spermatozoa. The Eosin Nigrosin is often preferred for diagnostic purposes, as it is faster than the HOS test. However, sperm cannot be used for ICSI afterwards.

According to the World Health Organization (WHO) the reference value for sperm vitality is 58%. If less than 58% of your spermatozoa/those of your partner are non-viable, it is strongly recommended to consult with a urologist, specializing in fertility issues.

Oligozoospermia – OligoASTHENOzoospermia и OligoTERATOzoospermia


WHAT does THE SEMEN ANALYSIS TERM “Oligozoospermia” mean?

Dear friends,

We are certain that most of you know what semen analysis is and many have probably even had one themselves.  However, when you got the result of your semen analysis, did you understand them? If the answer is NO, then this article is for you.

The term “Oligozoospermia” is composed of the prefix “Oligo-” (from Greek – few), the word “zoo” (existing) and “spermia” (seed, semen). “Oligo-” refers to the number of spermatozoa in the ejaculate. The connecting word “zoo” in this case refers to the spermatozoa themselves, not the semen. “Spermia” is the only part that is always present in the conclusion of a semen analysis.

Thus, the term “Oligozoospermia” means that there is a reduced number of sperm in the whole ejaculate or a reduced concentration (number of sperm / ml of semen). The reduced number / concentration of sperm is determined by comparison with the reference values. New Life Clinic uses reference values ​​for concentration, motility and morphology that are in accordance with the 1999 World Health Organization Manual for the Processing of Human Sperm.
The reason is that the Center for Assisted Reproduction medical indications for financing of male factor infertility couples are also in line with this manual.

WHAT do “OligoASTHENOzoospermia” and “OligoTERATOzoospermia” mean? The reduced number / concentration of sperm is only one of the possible deviations. In addition, sperm motility could also be impaired. Motility deviations are marked by adding the prefix “astheno-“.Similarly, deviations from the reference interval for the third major parameter – morphology is marked by adding the prefix “terato-“. “Terato” comes from the ancient Greek word for “monster”. Morphology is, generally speaking, the shape of the spermatozoon. Therefore, having а large number of “abnormal / monstrous” sperm is termed Teratozoospermia.
It is very important to understand that the result of a semen analysis is not a diagnosis. Sperm parameters vary between different samples of the same patient, sometimes considerably. They are affected by a variety of factors, including the number of days of abstinence, and are subject to improvement.



The 33rd annual meeting of the European Society of Human Reproduction and Embryology (ESHRE) took place from 1st until 4th of July this year in Barcelona. We are proud that New Life fertility center had a representative at the most prestigious European Conference in the field of Assisted Reproduction. The most current topics in the field were discussed at the scientific forum. Those included newest methods for improving embryo implantation, innovations in embryo selection for transfer and freezing and others.

The founding of ESHRE was initiated by the father of in-vitro fertilization – the English biologist Professor Sir Robert Edwards. The main aim of the European Society of Human Reproduction and Embryology is to facilitate research and subsequent dissemination of research findings in the field to the general public, scientists, clinicians and patient associations. It also collaborates with politicians and policy makers throughout Europe. The society also promotes improvements in clinical practice through organizing teaching and training activities, developing and maintaining data registries and providing guidance to improve safety and quality assurance in clinical and laboratory procedures.