Female work-up: We perform the entire infertility work-up on site, which involves an initial consultation, hormonal measurements, ultrasound studies, hysterosalpingography (if needed), hysteroscopy (if necessary), and genetic testing (when indicated).
Male work-up: The entire male work-up is performed on site as well. The initial step is a semen analysis. If needed we proceed with hormonal, genetic and bacteriologic evaluation. The physical exam and more invasive tests (e.g.: biopsy) are performed by our own andrologist who is a specialist in male infertility.
Genetic testing: We offer genetic testing to couples with recurrent pregnancy loss, repeated implantation failure, or when the obstetric or family history is suggestive of genetic abnormality. Under such circumstances we obtain a karyotype (number and structure of the chromosomes) from both partners.
Immunologic testing: Immunologic testing is offered to couples with recurrent pregnancy loss. We look for abnormalities of the thyroid gland, certain hematologic problems and the presence of anti-phospholipid antibodies.
Uterine cavity evaluation: We evaluate the uterine cavity prior to the first IVF cycle or if any surgical intervention involving the uterus has happened since the last assessment. In addition, we examine the cavity if the obstetric history or ultrasound findings are suggestive of an abnormality. We primarily use ultrasound for the evaluation, but if needed, we also perform hysteroscopy. During the ultrasound study a small amount of sterile physiologic saline solution is infused into the cavity to better outline any pathology (saline sonohysterogram).
Intrauterine insemination (IUI): IUI is offered as the first line of treatment to couples with unexplained, immunologic, mild male factor infertility as well as to those with early stages of endometriosis. For couples with the above-mentioned problems when the woman is over 40 years of age we recommend standard IVF treatment.
In vitro fertilization (IVF): We offer IVF to couples with tubal factor infertility, male factor infertility, severe endometriosis or when other treatments have failed. We also recommend IVF as the first line treatment to women over the age of 40 years.
Intracytoplasmic sperm injection (ICSI): ICSI is offered to couples with severe male factor infertility, with poor fertilization in prior cycles, and entering treatment following failed insemination cycles. We also use surgically obtained sperm for ICSI (TESE: testicular sperm extraction).
Assisted hatching (AHA): AHA is a laboratory procedure performed on the embryo. With a gentle laser we create a small opening in the layer surrounding the embryo thereby facilitating hatching and implantation. We offer AHA to women over 35 years, to those with 2 or more previous IVF failures, when the layer surrounding the embryo is too thick and in frozen embryo transfer cycle.
Blastocyst culture: Most of our transfers have traditionally been on day 3, but we increasingly use day 5-6 (blastocyst stage) embryo transfer to improve outcome. We use several stimulation protocols to best meet your needs.
Donor sperm and egg (oocyte) use is possible in indicated cases.
Prior to starting a treatment you will need to visit us for an initial consultation. We ask that you have all relevant medical documents with you and that the visit be scheduled for the first half of your cycle. For the initial consultation you should try to come with your partner, but you may come alone as well. During this consultation we take a history, perform an ultrasound, discuss the tests that need to be done, review treatment options and provide you with the necessary documentation (treatment plan, prescriptions, consent forms, etc.).
The tests (see Tests Required) can be performed by your local gynecologist. You may fax or email us the results for review.
In order to minimize the number of days spent in Budapest, we usually start the IVF cycle with a brief course of oral contraceptive pretreatment. While you are on the pill an ultrasound is performed to assess the ovaries (can be performed by your local physician), and 3-4 days after the last pill stimulation with injections is started. We first need to see you on day 6 of stimulation. An average stimulation lasts 10-11 days. Egg retrieval is scheduled 2 days after the last day of stimulation. The embryo transfer is performed 2-5 days after the retrieval. Soon after the transfer you may travel again. This requires a minimum of 10-12 days of stay in Budapest.
We ask all our patients to have updated results (within 6 months) of the following tests prior to initiating infertility treatment:
- FSH, LH, estradiol, PRL, TSH hormone levels day 3 of menstrual cycle
- Pap smear (from within 1 year accepted)
- Cervical culture for Chlamydia
- Rubella screen
- HIV, hepatitis B and C screen (both partners)
- Complete blood count, liver function, electrolytes, ECG
- Semen analysis
- (If indicated we also ask for genetic testing, male hormonal evaluation, immunologic testing.)
- (Uterine cavity evaluation: we usually perform this ourselves during the initial visit [saline sonohysterogram, a quick, simple, painless ultrasound evaluation]. We also accept hysteroscopy results performed by others.)