Our Process

If you are interested in our services, you are probably wondering how things will proceed. To help you with such queries, we have broken down the course of action into consecutive steps:

We look forward to hearing from you via:

Our Clinical Coordinator will receive your enquiry, and if necessary, after discussing your case with the doctor, we will be glad to answer all your questions and give you full details about how we can assist you.

Please do not hesitate to inquire about anything you wish, we want you to be fully aware and confident while choosing our center.

Already at this initial stage, it is best to provide us with as much information as possible regarding yourself and your partner, including:

  • age, menstruation
  • indication for a requested type of treatment
  • relevant diagnosis and results of recent testing/examination
  • previous attempts (if any)
  • relevant medical history

This way, we will be able to advice you most appropriately. One of our strengths is a personalized approach to each patient care path.

The next step on your IVF journey will be to book your first appointment with our doctor in order to review the infertility problem and plan the most suitable treatment.  At Pedieos IVF Center, patients’ worries and opinions are taken into consideration and each case is treated as individual.

During your consultation with our doctor, the following examinations may be performed on site (if indicated):

  • for female partner:
    • Trans-vaginal ultrasound scan:
      • Antral follicle count (AFC)
      • Condition of uterus and ovaries, presence of fibroids, cysts etc.
    • Blood test:
      • Hormonal profile
    • for male partner
      • Sperm analysis:
        • count, motility and morphology by Computer – Assisted Sperm Analysis (CASA)

If further diagnostics will be necessary, such as fallopian tube patency test (hysterosalpingography – HSG) or genetic testing for infertility, you will be referred to our collaborating specialists to complete them.

Having your results, our doctor will confirm the type of treatment you should proceed with. As with most medical procedures, you and your partner will have to give your consent to treatment. The consent forms are necessary to protect you and your future child. Take time to reflect on any issues you may have before signing anything.

When you decide to start a treatment at our fertility clinic, the doctor will prepare a unique protocol which is customized for every patient and provides specific instructions, inter alia, regarding what medication to take and when to take them. The treatment is customized individually for every patient.

Nevertheless, don’t forget, you can phone or email your nurse coordinator at any time if you have questions or simply need some reassurance.

You can use our prescriptions to get medication from your local pharmacy anywhere in Cyprus.

There is a variety of medicines that can be used during an IVF treatment as well as when a pregnancy is achieved after IVF treatment.

First, the main purpose is to create sufficient number of follicles. In order to achieve this purpose, women are stimulated with injected medications. It is not pleasant to have injections daily, people often are scared of needles but it is actually not difficult to be done. Women or sometimes the partners are taught how to inject the medicines. Usually for the purpose of the stimulation LH and FSH are given. These two hormones directly stimulate the ovaries to produce ova. Also sometimes it is necessary to inject a specific category of medicines called antagonists. The purpose of the antagonists is to stop the premature LH rise which could lead to premature luteinisation.

The main medicines that are used are:

  1. For LH suppression
    • GnRH-agonist (Suprefact, Arvekap)
    • GnRH-antagonist (Orcalutran and Cetrotide)
  2. FSH product (follicle stimulating hormone) to stimulate development of multiple eggs: Bravelle 75 mg,  Fostimon 150 mg, Fostimon 75 mg, Gonal-F, Puregon, Elonva.
  3. FSH and LH: Merional 75, Merional 150, Menopur 75
  4. hCG (human Chorionic Gonadotropin) to cause final maturation of the eggs: choriomon 5000, averkap 0.1, pregnyl 5000

Please note that sometimes it is necessary to use a combination of the above medicines.

After the ovum pick up is completed, the therapy protocol changes. Women take progesterone in the form of vaginal gel and suppositories, or injectable or even sometimes orally. Progesterone is given to support a possible pregnancy. Additionally, they are given Estrogens but they usually come either as patches (sticker) or pills. Again, Estrogens are also needed in the case of pregnancy. It is also highly recommended for women to take antithrombotics, when indicated, after the ovum pick-up as high levels of Estrogen can cause thrombosis.

  1. Progesterone:
  • Suppositories or vaginal gel: Cyclogest 400mg , Utrogestan 100mg or 200mg,  Vasclor 8%, Crinone 8%
  • Injections: Prolutex 25mg
  • Oral pills: Duphaston, Utrogestan 100mg or 200mg
  1. Estrogens
  • Evorel-50 patches
  • Cyclacur (white pills only) or Progynova

Nursing teaching and support

Throughout the entire process, you will have great help from our nursing staff. They will teach you how to perform the injections on your own. If you still find it hard to do them by yourself, the nurse may teach your partner or a friend to do them for you. If that option also fails, you may wish to come to our center daily so that the nurses can perform the injections for you.

Undergoing an IVF treatment can cause stress and anxiety to women and their partners; especially, if the couple has already undergone repeated fertility treatments. Our nurses are available for discussion whenever you may need them. At Pedieos IVF Center, we always try to find a way to explain everything in great detail. Our nurses stand by your side during your treatment and are here to provide you with psychological support.

An In-Vitro Fertilization can be done in a stimulated or natural cycle.

In stimulated cycles, hormones called gonadotropins (FSH and LH) are administered in the form of subcutaneous injections in the lower abdominal area and their purpose is to stimulate your ovaries to produce ova.

During the treatment you will be administered one gonadotropin injection daily for 7-10 days starting from the beginning of your cycle. During that process, you will need to attend the clinic for monitoring of egg production and hormonal levels. On these appointments, an intrauterine ultrasound scan and blood sampling are performed.

In case of natural cycle, you will need to attend our center on day 7 of your cycle; you will not make any injections beforehand.

According to the combined results of the scan and blood test, the doctor will manage the next steps of your treatment appropriately.

You may be prescribed a gonadotropin releasing hormone antagonist (Orgalutran or Cetrotide) that suppresses pituitary and ovarian hormone production, thus prevents premature ovulation. This is important as your eggs must not be released too early before the pick-up day. It is administered in the same way as the previous medication, in the form of one subcutaneous injection.

The doctor will measure the follicles to check if they have developed in accordance with the plan, and decide whether you need any additional stimulation to finalize the maturing process or whether you are ready for the hCG injection that triggers ovulation (Arvekap, Suprefact, Choriomon or Pregnyl). Ideally, the majority of the follicles should be at least 16-17mm at this point. If the scan shows that your follicles are smaller than desired, you will simply have an additional day of stimulation. He will also monitor the development of the endometrium and check the thickness of inner uterine lining.

In case you will transfer frozen embryos from previous cycle or use donated ova, ovarian stimulation is not needed. There might be a need to introduce down regulation and/or estrogen hormone elevation by estradiol tablets (Cyclacur) in order to prepare the endometrial lining for transfer.

Unless you are using donated ova, approximately 36 hours after the ovulation injection, the ovum pick-up procedure takes place. Since the last injection (hCG) is administered late at night (e.g. 22:00), the egg collection happens early in the morning (e.g. 8:00).

You are not allowed to eat or drink anything (including water) from midnight the previous evening. Upon your arrival at Pedieos IVF Centre, a member of our team will show you to a private bedroom where you can prepare for the procedure.

When everything is ready, a nurse will take you from your bedroom into the operating theatre and you will be made comfortable on the gynecological bed. The anesthesiologist will put you under a general anesthesia; hence you will be completely asleep throughout the entire procedure, which takes about 10 minutes. Our doctor will collect your eggs via ultrasound guided follicle puncture and the laboratory will begin the fertilization process.

Typically, the male partner will need to provide a semen sample, on the same day as the egg collection (10:00 am the latest). In order to obtain the best quality possible, 2-5 days of sexual abstinence prior to providing the sperm sample is recommended. Should the sample be collected outside of our center, it must be kept close to the body in order to maintain body temperature, and it must be delivered within one hour of production.

If you are using donor sperm or previously frozen sample of your partner’s sperm, it will be thawed and prepared.

Depending on the concentration, motility and morphology of spermatozoa, classical IVF or ICSI is employed. After insemination, eggs are incubated for a period of 24 hours, after which fertilization rate and a number of pronuclear stage (PN) embryos are determined. At this stage, an egg is successfully fertilized and two pronuclei are seen in the cell, representing chromosomes from the mother and the father. Over the next day, the embryos will be left to develop. Meanwhile, it is best to have as little contact with the embryos as possible, because when the embryos are removed from the incubator, crucial conditions, such as humidity, concentration of gases and temperature change can affect their development. On the third day post egg collection, one of our embryologists will call to inform you about the progress of fertilization, quality of day 3 embryos (comprised of 6-8 cells) as well as advantages and eligibility criteria of culturing embryos till day 5 for a blastocyst transfer. The embryonic genome is activated after the 6-8 cell stage, therefore, if the conditions allow, extended culture will highlight embryonic arrest and help identify healthy embryos for transfer, though not all embryos that develop until day 5 will be chromosomally normal. If a guarantee of healthy embryos is needed then we must perform pre-implantation genetic diagnosis (PGD).

We will weigh up the pros and cons of each option and decide together whether we will proceed with a transfer of day 3 embryos or day 5 blastocysts.

Upon conclusion, you will be informed about the day and time of the transfer. We ask that you be at the clinic 30-60 minutes earlier in order to prepare for the process. Again, you will be shown to a room and provided with appropriate garments that you need to wear during the embryo transfer. There is no sedation given for this procedure so you can eat and drink normally throughout the day. Please note that we need your bladder to be full as this will provide a better view of your uterus during the process. In order to achieve this, you should empty your bladder 1-2 hours before your appointment and then drink a small bottle of water before the procedure. Please do not wear any perfumes on the day of the transfer. On arrival, we will give you an update on how many developing embryos you have and what quality they are. We will then discuss how many embryos will be transferred. Normally, we transfer 1 or 2, only in special cases 3 embryos (only women older than 39 years old are allowed to transfer 3 embryos).

Afterwards, you will be transported back to your private bedroom on a bed and you will need to remain in bed for 30-60 minutes after the transfer. On the evening of your embryo transfer you should relax and have as much rest as possible. From the following day onwards, you can continue your normal routine, although you must adhere to the “Dos and Don’ts” information that you will be given on the day of embryo transfer.

In case there are any supernumerary embryos, cryopreservation may be done. There is an extra charge for the vitrification, which includes one year of free storage. From then on, there is a small fee to pay monthly or yearly for keeping frozen embryos at our cryobank. The same applies to sperm samples.

In case the results of the preparation are not satisfactory (e.g. the progesterone level is high or lining of the uterus is not thick enough), transfer is not performed and the embryos are kept frozen to be transferred during another cycle.

As it is still too early to get an accurate result with a urine test, we perform a βhCG blood test 11 days after your embryo transfer, then again 2 days later, and we repeat it once more 7 days after.

  • If the βhCG blood test is positive and rising:

It is important to continue the medication exactly as prescribed for the first trimester. Your hormones are already artificially raised and so you must maintain that level until the placenta is strong enough to support the baby on its own.

At week 6 of gestation, you can have an ultrasound scan to confirm how many embryos have implanted and to check for the fetal heartbeat.

  • If the βhCG blood test is negative or dropping:

All medication should be stopped. You will experience bleeding approximately two to three days after stopping medication, once the hormones leave your system.

Nursing teaching and support

Throughout the entire process, you will have great help from our nursing staff. They will teach you how to perform the injections on your own. If you still find it hard to do them by yourself, the nurse may teach your partner or a friend to do them for you. If that option also fails, you may wish to come to our center daily so that the nurses can perform the injections for you.

Undergoing an IVF treatment can cause stress and anxiety to women and their partners; especially, if the couple has already undergone repeated fertility treatments. Our nurses are available for discussion whenever you may need them. At Pedieos IVF Center, we always try to find a way to explain everything in great detail. Our nurses stand by your side during your treatment and are here to provide you with psychological support.