Category Archives: Полезные статьи

WHAT CAN I DO AFTER EMBRYO TRANSFER?

Summer is approaching and many of us are starting to make vacation plans. However, what about the women who are about to undergo an embryo transfer? In this article, we will look at this question and provide some ideas to help you make an informed decision.

Embryo transfer is the final step in an IVF treatment where, with the help of a thin catheter, the gynecologist deposits the embryos into the uterine cavity.

After embryo transfer, you can return to your normal lifestyle. You don’t have to lie down all day (if you don’t want to), but it’s extremely important to take enough time to rest. Avoid intensive workouts, stressful situations, as well as overheating (going to the beach or sauna, taking a bath, etc.).

CAN I STILL TRAVEL?

In general, most medical professionals recommend avoiding long trips immediately after an embryo transfer. The first 24 hours after the procedure are crucial for the implantation of the embryo, which is why it is important to minimize stress.

However, short trips or moderately strenuous activities that do not involve excessive physical exertion are generally considered safe.

It is recommended that you listen to your body and take the necessary precautions by avoiding heavy lifting, intense exercise or anything that may put unnecessary strain on your body.

During your vacation, don’t forget to eat well and drink enough fluids in the summer heat. Avoid swimming in pools due to the risk of infection.

Of course, before you book your trip, it’s a good idea to discuss your plans with your reproductive health specialist. They can give you the best advice on whether traveling would be safe for your specific case.

Ембриотрансфер при ин витро

Thrombophilia is a condition in which the blood has an increased tendency to form blood clots. Pregnancy is a state in which the woman’s blood becomes more prone to clotting, and this tendency is further enhanced in women with thrombophilia. This can lead to serious complications during pregnancy and childbirth.

TYPES OF THROMBOPHILIA

Inherited thrombophilias include factor V Leiden mutation, prothrombin G20210A mutation (also referred to as factor II mutation), protein C deficiency, protein S deficiency, antithrombin deficiency and methylenetetrahydrofolate reductase mutations. Acquired thrombophilia is associated with antiphospholipid syndrome and unfortunately is one of the most severe forms of thrombophilia.

TESTING FOR THROMBOPHILIA

Congenital thrombophilias are detected by genetic testing for mutations. Antiphospholipid syndrome is diagnosed when there are positive tests for lupus anticoagulant, anticardiolipin antibodies and anti-β2-glycoprotein antibodies.

WHAT ARE THE RISKS ASSOCIATED WITH THROMBOPHILIA?

Thrombophilia can increase the risk of conditions such as pre-eclampsia, miscarriage, stillbirth, and placental abruption. Women with thrombophilia are also at higher risk of developing deep vein thrombosis (DVT) during pregnancy.

Apart from pregnancy complications, thrombophilia is connected to an increased risk of heart attack, stroke and pulmonary embolism.

RISK PREVENTION

To manage the risks associated with thrombophilia during pregnancy, women may need to take anticoagulant medications, which help to prevent blood clots from forming. They may also require regular ultrasounds to monitor the health of the fetus and placenta. Even if you suspect you may suffer from thrombophilia, don’t take any medications unless they have been prescribed by a physician!

It is important for women with thrombophilia to discuss their pregnancy plans with their healthcare provider and receive appropriate counseling and treatment to reduce the risk of complications.

ПОВТАРЯЩА СЕ НЕУСПЕШНА ИМПЛАНТАЦИЯ И ИН ВИТРО: КАКВО ТРЯБВА ДА ЗНАЕМ?

Stem cell have the unique ability to transform into any cell in the human body.

It is believed that the beginning of the study of stem cell was in the 1960s after the research of Canadian scientists Ernest McCulloch and James Till. The umbilical cord contains two types of stem cells: hematopoietic, found in the blood of the umbilical cord, and mesenchymal, found in the tissue of the umbilical cord.

WHAT CAN STEM CELLS BE USED FOR?

As medicine advances, new uses for stem cells are constantly being discovered. They are approved for the treatment of nearly 100 severe conditions, including blood disorders, different types of cancer, metabolic disorders, autoimmune diseases, etc. Studies are underway on the use of stem cells to repair the heart after a heart attack. Stem cells are also used to repair severely damaged soft tissues.

IS STEM CELL HARVESTING DANGEROUS FOR THE DONOR?

Stem cells are harvested from the baby’s umbilical cord after birth. The process is painless and safe for both mother and baby. Usually both cord blood and tissue are harvested. The procedure can be performed either by the delivery team or by a person from the tissue bank of your choice.

FOR HOW LONG ARE STEM CELLS STORED?

Stem cells are stored for a period of 20 years. After that, the contract can be renewed by your child who will already be an adult.

HOW MUCH DOES STEM CELL HARVESTING COST?

The entire procedure of performing the necessary laboratory tests, the harvesting itself, processing and storage of the stem cells for 20 years costs about BGN 5,000. Most tissue banks offer various installment payment options.

There is an option to donate stem cells to the National Public Umbilical Cord Stem Cell Donor Bank, which is free of charge. The difference with private tissue banks is that in a public tissue bank the preserved biological material is made available to the people who need it, whether they are donors or just people needing a transplant.

ESSENTIAL TESTS AND TIPS FOR A PEACEFUL PREGNANCY

In women with Hashimoto the immune system attacks the thyroid gland, which secretes the hormones Triiodothyronine (T3) and Thyroxine (T4). Due to structural and functional damage, over time the thyroid gland starts to secrete smaller amounts of T3 and T4. The medical term for this condition is “hypothyroidism” (“hypo” – sub, low). The main function of both hormones is to regulate basal metabolic rate, heart rate and body temperature. When T3 and T4 levels are low, the metabolic and heart rates drop and body temperature decreases. This leads to a number of other symptoms, most notably constipation, fatigue and weight gain.

GETTING PREGNANT WITH HASHIMOTO

As we have discussed in previous articles, being overweight by itself makes conceiving more challenging because of the hormonal imbalance it causes. The increased amount of fatty tissue converts male sex hormones (androgens) into female sex hormones (estrogens). Often this is accompanied by insulin resistance (cells do not react to insulin), which in turn leads to elevated levels of insulin and androgens (male sex hormones). All of these factors have a negative effect on ovulation. It can become irregular or stop completely, which makes getting pregnant more difficult.

Even if they are not overweight, women with Hashimoto have a hormonal imbalance associated with decreased levels of T3 and T4. This can in itself lead to ovulation disorders and difficulty getting pregnant.

Even after getting pregnant, hormone levels in women with Hashimoto have to be monitored much more closely, because pregnancy has higher demands on the thyroid gland. If those are not met complications and even miscarriage can ensue. However, close monitoring of the pregnancy and good management of the autoimmune condition greatly improve chances of an uncomplicated pregnancy carried to term.

All this may sound alarming but remember that modern medicine offers very good management of Hashimoto’s thyroiditis. The most important thing is early diagnosis! In February 2018, the famous American supermodel Gigi Hadid announced on social media that she was diagnosed with the autoimmune disease. However, that did not stop her from becoming the 5^th highest paid model in 2017, with $ 9.5 million annual income.

Some couples, in order to conceive, need donor eggs. To confirm that, your fertility specialist will first order a panel of tests. An alternative to donor eggs would cryopreservation a.k.a. egg freezing earlier in your life.

WHO MIGHT NEED DONOR EGGS?

The main category of patients who might benefit from donor eggs are the so-called “low responders”. Those are women, who do not respond well to ovarian hyperstimulation due to their age or premature ovarian failure, or women who have not frozen their own eggs.

WHO CAN BE AN EGG DONOR?

In Bulgaria, according to Ordinance 28 on Assisted Reproduction, egg donation «can be from anonymous donors or from related donors (sister, cousin)» In both cases, the donor must meet strictly defined criteria: age, to have at least 1 live-born child, and to have negative test results for HIV, hepatitis B and C, and syphilis.

WHEN IS IT APPROPRIATE TO FREEZE MY OWN EGGS?

There are a few situations where your doctor might recommend egg freezing. For example, if you’ve been diagnosed with premature ovarian failure or you have family history for premature menopause. Also, cancer patients can greatly benefit from egg freezing, as life-saving chemo- or radiotherapy can impact ovarian reserve and fertility.

CAN I FREEZE MY EGGS WITHOUT MEDICAL INDICATIONS?

There is also the so-called egg freezing for social reasons, which is becoming increasingly popular. It is suitable for women who would like to postpone motherhood for later in life due to career development, studying, lack of a suitable partner, etc. We know that as you get older, not only does the quantity but also the quality of eggs decreases, which affects fertility, as well as the success rate of assisted reproduction. When you choose cryopreservation, the eggs remain at the age at which they were frozen, which gives women great freedom to choose the best moment to become mothers.

EGG QUALITY- HOW CAN I HAVE THAT ASSESSED? (newlifeclinic.bg)

Egg freezing — Ин витро клиника, акушерство и гинекология България (newlifeclinic.bg)

Asked questions about New Life’s donor egg program (newlifeclinic.bg)

Surrogacy is a reproductive method where one woman carries a pregnancy for another and, after the birth of the child, hands it over to its biological parents.

It represents a suitable alternative for couples where assisted reproductive techniques have not led to the desired pregnancy, or pregnancy could be life-threatening or in the case of a homosexual couple.

INDICATIONS FOR SURROGACY

From a medical perspective, conditions in which surrogacy would be appropriate include:

1. Absence of a uterus or severe defects of the reproductive system
2. Multiple failed IVF attempts
3. Severe form of antiphospholipid syndrome, lupus or thrombophilia
4. Advanced stage of chronic kidney disease
5. Need for life-saving treatment, which is contraindicated during pregnancy — for example chemotherapy.

TYPES:

Depending on the genetic relationship between the surrogate mother and the child, there are 2 types of surrogacy:

1. Traditional — in this case, the oocyte that will be fertilized belongs to the surrogate mother and, accordingly, the child will carry her genes.
2. Gestational – gametes from future parents or donor eggs/sperm are used. In the second option, the child will be genetically related to only one of the future parents.

In addition, it also can be:

1. Altruistic – the surrogate does not receive payment for the service. Only medical costs are covered.
2. Commercial — the surrogate receives a commission outside of medical costs.

SURROGACY AROUND THE WORLD

Surrogacy laws vary widely from country to country. Additionally, the conditions for hiring a surrogate are also not the same around the world.

In most European countries such as France, Austria, Germany, Italy, etc. surrogacy is prohibited by law. In some countries, such as Belgium, The United Kingdom and the Netherlands, it is allowed, but only when it is done altruistically, i.e. without additional payment.

Ukraine, Russia and Georgia are among the countries with the most liberal surrogacy laws. Even commercial surrogacy is allowed there and there are numerous agencies that offer it. This is also the reason for the so-called «reproductive tourism» to these countries.

SURROGATE MOTHERHOOD IN BULGARIA

At the moment, surrogacy in Bulgaria is not allowed and is not applied as a possible alternative for couples with reproductive problems. The woman who gave birth to the child is considered its mother. In 2010, an attempt was made for a draft law aimed to legitimize surrogacy in our country. According to that, only altruistic surrogacy would be allowed, and only for married couples. For now, however, this option remains impossible in Bulgaria, and couples wishing to become parents in this way have to travel abroad.

КАКВО ПРИЧИНЯВА ИНФЕРТИЛИТЕТ ПРИ ЖЕНИТЕ?

ПОВТАРЯЩА СЕ НЕУСПЕШНА ИМПЛАНТАЦИЯ И ИН ВИТРО: КАКВО ТРЯБВА ДА ЗНАЕМ?

IMPLANTATION FAILURE — WHAT ARE THE GENERAL REASONS?

The success rate of in vitro fertilization is determined by various factors. This means that several cycles often have to be carried out until the desired pregnancy is achieved. It is no secret that the process is often long and associated with many emotions.

Although there is no official definition of recurrent implantation failure (RIF), it is generally accepted that it is when pregnancy has not occurred after at least 3 transfers of healthy embryos.

The reasons for this serious problem can be both on the part of the woman and on the part of the embryo. In this article, we will present some of the most common factors contributing to RIF.

MOTHER’S AGE

  Studies show that IVF is most successful in women up to the age of 35. With increasing age, cases of aneuploidy (abnormal number of chromosomes) in the resulting embryos increase, leading to a higher number of failed implantations. Interestingly, such a difference in in vitro success was observed to a much lesser extent when donor eggs were used, supporting the idea that maternal age affects egg quality.

UTERINE ANATOMY ABNORMALITIES

Various conditions such as fibroids, hydrosalpinx or congenital abnormalities of the uterus can prevent implantation. They are usually diagnosed before the in vitro cycle has started. At the discretion of your obstetrician-gynecologist, you may be offered surgical treatment.

IMMUNOLOGICAL PROBLEMS

When RIF cannot be explained by another reason, the next step is looking for an immune system abnormality. Among the most common immunological causes of implantation failure are:

1. Elevated levels of some antibodies — antiphospholipid, anticardiolipin, anti-β2 glycoprotein-I antibodies, as well as lupus anticoagulant, typically seen in women with antiphospholipid syndrome, are associated with recurrent implantation failure.
2. Some features of the woman’s immune system — imbalance between Th1 and Th2 cells, as well as abnormally increased activity of uterine NK cells.

A RECEPTIVE ENDOMETRIUM

The endometrium (uterine lining) undergoes significant changes in its morphology during the menstrual cycle, without which pregnancy could not occur. Under the influence of estrogens and progesterone, the thickness of the endometrium increases to about 8mm. In addition, there is a period called the «implantation window», around 19-21 days, when the uterus is receptive to the embryo and implantation can occur. In a certain percentage of women, this period of uterine receptivity is shifted from the normal time, resulting in infertility.

Recurrent IVF implantation failure is a complex problem. The various reasons that can lead to it determine the availability of different methods of treatment.

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In the following lines, we will pay attention to the main tests that pregnant women will have to undergo in the next 9 months.

For expectant new mothers, pregnancy and childbirth can be full of uncertainty and worry. Between being overwhelmed with new information and adjusting to the changes your body is going through, pregnancy can be quite a challenge. Yes, fears and anxieties are normal, but it’s important not to let these feelings completely overwhelm you.

We prepare in many ways for the arrival of the little baby, from designing the perfect nursery to the right diets and exercises. But, it is important not to forget to tune our consciousness to the truly amazing experience that comes with the appearance of new life in the world.

Any pregnancy is established with a urine or blood pregnancy test (testing the levels of ß-hCG- pregnancy hormone). It is recommended that the first examination with an obstetrician-gynecologist be done about 10 days after the delay of the menstrual cycle.

The main tests during pregnancy in the different periods are the following:

Regular examination of PCC, urine and blood sugar

Examination of the pregnant woman’s blood group and Rh (Rhesus factor).

Early biochemical screening — 11-13 weeks – early fetal morphology

Sexually transmitted infections

Microbiological examination of vaginal discharge and smear test

Late fetal morphology

You will likely have many thoughts and questions during your pregnancy. Coping with symptoms and making lifestyle and daily routine changes can be overwhelming at times.

Here are some tips to help you relax during this time:

Take time for yourself — every day

Do something that you like and that is just for you.

Talk to your loved ones, friends, and family — about everything that bothers you.

Be active every day (if this is not prohibited for medical reasons)

Exercise releases endorphins that will improve your mood. You don’t have to do strength training or go to the gym. Just try to incorporate different activities into your daily routine, be it a walk outside.

Be realistic about how much you can do (whether at work, at home, or in your social life)

 Balance your diet

Do not hesitate to ask your gynecologist about anything that interests you.

If you are concerned, talk to your supervising OB/GYN or midwife.

Source: Аптеки Запад – Онлайн аптека с грижа за Вас! | APTEKIZAPAD.BG

FACTORS FOR A HIGH RISK PREGNANCY

There are many risk factors that could lead to pregnancy complications. Many of them can be managed, which means that every mother-to-be should be aware of them so that she can take the necessary measures.

CHRONIC DISEASES AND PREGNANCY

The control of chronic diseases is important not only for our quality of life, but also for the normal course of pregnancy. Many chronic diseases exacerbate during pregnancy, which necessitates more frequent check-ups, taking medications, tests and increased stress for the expectant mother.

Hypertension. Uncontrolled high blood pressure (over 140/90mmHg) increases the risk of developing preeclampsia and low birth weight of the fetus. Therefore, it is mandatory to measure your blood pressure during your regular pregnancy check-ups, as well as at home.

Diabetes. If you are planning a pregnancy, you should consult with your endocrinologist regarding a possible change in your diabetes therapy. Poorly controlled diabetes in the first weeks of pregnancy can lead to birth defects, and later fetal macrosomia (a larger than normal baby) and hypoglycemia (low blood sugar) at birth.

Thyroid disease. Both increased and decreased thyroid function have been linked to heart problems and fetal neurodevelopmental disorders.

Being overweight. Excess weight is associated with an increased risk of developing gestational diabetes and giving birth to a large fetus, which could necessitate a cesarean delivery. High-grade obesity before getting pregnant is associated with fetal heart defects. It is important to optimize your weight if you are planning a pregnancy or if you are already pregnant — not to gain more than the recommended weight.

HIV/AIDS and other infections. HIV can be transmitted to the fetus during pregnancy, childbirth or breastfeeding. These days, there are medications for both mother and baby that greatly reduce the risk of transmission. If you want to get pregnant, it is highly recommended to get tested for HIV, as well as other transmissible infections (gonorrhea, chlamydia, syphilis, hepatitis B and C).

HARMFUL LIFESTYLE FACTORS

Alcohol. According to research, there is no safe amount of alcohol you can consume during pregnancy. Children of women who drank alcohol during pregnancy may suffer from FASDs (Fetal alcoholic spectrum disorders), which could manifest as disorders of the nervous system, behavior and intellectual development.

Smoking. Smoking, including passive smoking, during pregnancy is associated with an increased risk of miscarriage, stillbirth, and sudden infant death syndrome. If you’re trying for a baby, it’s best to quit smoking before you get pregnant.

Drug use. Like alcohol and cigarettes, drugs (including marijuana) can negatively affect fetal development and increase the risk of sudden death or stillbirth.

Sedentary lifestyle. If you have no contraindications — moderate workouts and walks are extremely beneficial for pregnant women. Exercise prevents obesity during pregnancy and may help with easier labor.

If you have concerns about your health and how it may affect a current or future pregnancy, talk to your OB/GYN. They will give you valuable advice on how to reduce the risks of possible complications.

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«Wish! 2023» Campaign donates two in vitro procedures at New Life clinic.

For another year, New Life Clinic and its partners donate two in-vitro procedures with included stimulation and tests to couples with reproductive problems.

The «Wish» campaign has been a tradition for the medical center for years and regularly starts in the most magical month of the year — December, and its end is announced on Midwives ‘Day in the new year — 21.01.

Again in 2023, the campaign will make the dream of two Bulgarian families come true by donating two in vitro procedures.

For more information follow the link: https://newlifeclinic.bg/%d0%bf%d0%be%d0%b6%d0%b5%d0%bb%d0%b0%d0%b9-%d1%81%d0%b8/