A diagnosis of infertility can be devastating, one that you never expected to hear. However at Medfem Fertility Clinic we believe that knowledge is power, and so we have done our best to try and capture some our most frequently asked questions below. We hope that this information will be of assistance to you.

How do you know if you need treatment at an infertility clinic?
At Medfem Fertility Clinic we believe that you should not waste time in seeing a specialist if you are concerned about your fertility. Otherwise the guidelines are that you should see a specialist if you have failed to conceive after one year or trying if you are younger than 35, or after six months of trying if you are older than 35.

Does Medfem Fertility Clinic treat both men and women for infertility?
Yes. Our treatments encompass both male and female factor infertility. Even if only one partner is actively undergoing treatment, we have found it beneficial to both partners to be present whenever possible during discussions and procedures.

Do you treat single females?
Yes. Medfem Fertility Clinic has an excellent sperm donor program. Our sperm bank is populated by an ethnically diverse range of sperm obtained from healthy men. For further information visit our sperm donation page.

Do you treat lesbian couples?
Yes. Once again, Medfem Fertility Clinic has an excellent sperm donor program. We are a progressive and impartial innovative fertility clinic with a long history of working with non-traditional families (same-sex couples, and single men and women).

Does Medfem have counselling services?
Mandy Rodrigues is the resident psychologist at Medfem Fertility Clinic. For further details view the information under our Treatments and Services.

How much will it cost?
For up to date information on our pricing please visit treatment costs.

When do I pay?
All payments for treatments and procedures are to be made prior to the process being carried out.

What methods of payment do you accept?
We accept both credit card and cash.

Will I get pregnant on my first IVF cycle?
Many of our patients do fall pregnant on their first round of IVF. For those that do not we take the learning’s gleaned from the failed IVF to modify the treatment plan with the objective of falling pregnant as quickly as possible.

What treatments do you offer?
We offer a comprehensive range of fertility treatments to ensure the best possible chance of a successful pregnancy. For more information visit our website section on Treatments and Services.

What are your success rates?
Medfem Fertility Clinic prides itself on being one of the most successful fertility clinics in South Africa. Our success rates have continued to climb over the years, and we are an internationally acclaimed clinic. The experience and quality of our embryology team and the dedication and skills of our doctors, nurses and support staff all lead to our achievements. For both IVF and ICSI we exceed the national average in each of the age groups. To see our current success rates click here.

Do you have an egg donor program?
We work closely with a number of local egg donor agencies. For further information visit the Treatments & Services section of our website.

What are some of the factors that determine pregnancy success in an infertile couple?

• Female age, particularly
• Underlying cause of infertility, e.g. ovulation problems are more likely to respond to relatively simple, medical treatment
• Duration of infertility
• Prior pregnancy with the same partner

What are the effects of age on fertility?

• Decreased chance of conceiving (a decline in egg quantity and quality)
• Increased risk of miscarrying (due to increased chance of unbalanced separation of chromosomes during cell division)

What does the lab look at in the sperm analysis?

• Your doctor will review the results of the sperm test with you and your partner. The sperm analysis looks at concentration, motility, how well they are swimming in a forward direction, viability, morphology, presence of infection and the total number of sperm that are moving.

How does the success in terms of pregnancy compare between frozen embryos and fresh embryos?
The success of pregnancy from frozen embryos is as good as using fresh embryos. The quality of embryos being frozen influences how well they survive the thawing process and thus how well they result in pregnancy. In some cases it will be advised to freeze embryos to improve the chances of success where the endometrial lining quality might be in question for example.

How thick should the endometrium be to increase the chances of implantation?
To best optimise the chances of implantation, studies have shown that the endometrial thickness should be 6 mm or more. Best implantation rates in IVF have been shown to be with lining thickness of 10 mm or more but there are many studies to show that implantation can occur with endometrial thickness as low as 5 mm – just not as easily.

What will happen if my endometrium is too thin?
As a standard protocol we treat all our IVF patients with estrogen to help increase the local estrogen that the endometrium is responding to.

Are IVF cycles are ever cancelled?
Yes. Sometimes patients do not respond to the stimulation medications as expected. They produce too few eggs or eggs that are not growing together. These women may benefit from stopping the cycle and starting again with a different protocol and/or a higher dose of medications at the start.

How does Medfem Fertility Clinic assess egg and embryo quality?
Consistent with the best ART laboratories throughout the world our embryologists use a “morphological” classification when describing and grading eggs and embryos. This means that a set of visual features is used to describe the characteristics leading to a score and grading label. It is important to understand that the behaviour and subsequent outcome both in egg performance and embryo performance is not absolutely tied in to these descriptions. They act as a guide to monitoring and describing progress and in decision making.

How can I be sure that the IVF laboratory will not mix up any of my sperm, eggs or embryos with those from another patient?
An error of this type has never happened at Medfem Fertility Clinic. We take special precautions and extra care and follow strict protocols, and double check every step of each procedure. Petri dishes and test tubes containing sperm, eggs or embryos are labelled with duplicate identifying information for each patient and colour coded to prevent mix-ups. Each time a procedure is performed by an Embryologist, a second Embryologist has to witness the event before they are released to our specialists. If the sperm are being used to inseminate a partner’s eggs, a second Embryologist verifies that the correct eggs and sperm have been removed from the incubator before the Embryologist performing the procedure can actually proceed with the insemination of the eggs.

Surplus embryos being frozen after a transfer are catalogued with full name, ID, date of freezing and details of the embryos being frozen. Embryos are frozen inside special straws and in addition to careful labelling, colour-coding is also used as an added precaution. As with other procedures, a second member of the laboratory staff has to witness the procedure and verify patient and embryo details for any freezing or thawing event.

Can you tell the sex of my embryos?
It is possible to determine the sex of an embryo by performing a procedure called Preimplantation Genetic Screening (PGS). This involves drilling a small hole in the shell surrounding the embryo and removing one or more cells. The cell can then be screened in a genetic laboratory to determine if it contains two X chromosomes (female) or one X and one Y chromosome (male). However, PGS testing is not allowed in South Africa for gender selection alone, unless there is a history of gender based chromosomal problems in the family.

Can I take herbal supplements during infertility treatment?
As there is often minimal to no research conducted on herbal supplements we suggest you do not take any during infertility treatment.

Can we have sex during treatment?
Continuing with your sex life is important during treatment. There may be times when your physician recommends not having sex such as when it is approaching time for an insemination or production of sperm to be used in IVF. Women undergoing IVF treatment may find intercourse uncomfortable as the ovaries can get quite large during stimulation.

How often will I have an ultrasound?
Ultrasounds normally begin on day 3 of the cycle and then again on day 8 or 9 to monitor the development of follicles. After day 10 you may be advised to have an ultrasound every day or every other day depending on your response. The monitoring ultrasounds occur in the morning at Medfem Fertility Clinic.

Can I exercise during treatment?
Moderate exercise is beneficial to your health and to reduce stress. You may be advised to limit the types of exercise (e.g. high impact) during treatment by your doctor. It is not advisable to take up excessive exercise for the first time during treatment.

Is IVF egg retrieval painful?
At Medfem Fertility Clinic egg retrieval is conducted under anaesthetic so you should feel no pain.

Do I need to rest after an embryo transfer?
Lying down after an embryo transfer does not impact the chance of a pregnancy establishing itself. You will be recommended to take it easy for the remainder of the day after your embryo transfer but you do not need to take the day off work.

My partner may not be able to attend the clinic on the day of the egg retrieval. What can we do?
It is possible to arrange for freezing of a sample prior to the procedure. Speak to your doctor regarding this.

What can be done to improve sperm count and motility?
Independent of the infertility contributor factor, a healthy life style is very important to optimize the testicular function and the potential of male fertility. You can also:

• Avoid smoking, drugs or excess consummation of alcohol
• Avoid activities that increase the testis and scrotum temperature (hot tubs, saunas, sitting for prolonged periods, etc.)
• Talk with your doctor about the influence of some medications on the sperm function: antihypertensives (for high blood pressure), antihistaminines (for allergies), antihyperlipidemics (for high cholesterol) or antidepressants

At Medfem Fertility Clinic we recommend that our patients take Staminogro, a supplement specifically designed for the support of those trying to conceive.

How many embryos should be transferred?
At Medfem Fertility Clinic we recommend transferring a maximum of two embryos in order to reduce the risk of triplets or more. The more embryos that are transferred, the higher is the risk for multiple pregnancies, possible complications for the mother during the pregnancy, and increased risks for the child due to a probable premature delivery. We care for the health of our patients (and of future babies) and that is why we feel that it is our responsibility to keep you well informed on the consequences and possible outcomes of your procedure.

What will happen during my first appointment?
Your fertility specialist will do an ultrasound examination to evaluate your uterine and ovarian health. We recommend you do the tests in our Welcome Pack or if you had investigations done within the last 6 months you can bring them along to make your first appointment more meaningful.

Will I be able to start with the treatment immediately?
This will depend on where you are in your monthly menstrual cycle, the results of your blood tests and the outcome of the ultrasound scan done during your first appointment.

I have had extensive investigations done. Do I need to bring the results or will the tests be repeated?
We would appreciate if you could bring along a copy of your medical files – especially from previous fertility attempts. This will certainly aid in giving us insight and prevent unnecessary repeats of investigations.

Do I need to see the doctor during a specific time during my menstrual cycle for the first appointment?
You can see the doctor any time during your cycle – even if you still bleeding.

Is there anything I can start doing to prepare my body in the meantime?
Lifestyle certainly play an important role in the quality of eggs and sperm produced. We suggest the following approach: * Diet – Low Glycaemic Index plan * Supplements – Staminogro (multivitamin) + Comegavite (essential Fatty acid) * Stress – A Time Urgency + Stress Management course is run at Medfem by Mandy Rodrigues (clinical psychologist). See www.timeurgency.com

I am on birth control. When should I stop for the first appointment?
We recommend you stop one month before your first appointment.

Have you got a cut off age to do fertility treatments?
Blood tests are necessary to evaluate your ability to produce healthy eggs. Your physical age does not always correlate with your fertility; however the uterine ability to carry a baby to full term after the age of 50 is diminished.

Breastfeeding – how long should I stop before I can come for a treatment?
We recommend you stop for at least three months and then do a prolactin blood test to determine if you can start again.