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What is semen analysis?

Semen analysis is the basic test that may be performed in men in the diagnostic process for infertility. It is completely non-invasive. Two types of semen analysis may be carried out: general and extended.

General analysis includes:

  • macroscopic assessment: volume, viscosity, pH, colour, smell,
  • microscopic assessment: sperm count, viability, integrity of the plasma membrane and motility of sperm.

Extended analysis additionally includes the assessment of sperm morphology.

Results of semen analysis are valid for a period of 6 months, after which the analysis should be repeated.

How to interpret the results of semen analysis?

Reference values for semen characteristics have been adjusted a number of times over the years. Reference values for semen analysis were first established by the World Health Organization in 1980. The reference values were adjusted in 1999 and then in 2010. Listed below are reference values for the selected main semen characteristics according to the current standard:

2010 WHO reference values 

  • volume of ejaculate: ≥ 1.5 mL pH: 7.0 – 8.0
  • sperm count: ≥ 15 million/mL
  • sperm count per ejaculate: ≥ 39 million/mL
  • percentage of sperm with normal motility: ≥ 32% with progressive motility
  • morphology: ≥ 4% of sperm with normal morphology
  • vitality: > 58% of sperm
  • leukocytes in semen: < 1 million/mL
  • agglutination test (MAR, IBT): < 50% of sperm

Can a semen sample for analysis be brought from home?

The conditions of the production of sperm as well as the temperature and period of storage during transport to the laboratory are all factors which significantly influence the assessment of sperm parameters. Therefore, semen should be collected at the InviMed clinic.  

How to prepare for semen analysis?

It is essential to prepare appropriately for the analysis and ensure that it is carried out properly in order to obtain valid results of the assessment of semen parameters and, thus, to correctly assess fertility. The analysis should be carried out after 3 to 5 days of sexual abstinence. Studies show that where the period of abstinence is shorter than 3 days, the concentration of sperm in semen is too low, and where the period exceeds 5 days, there may be an increased percentage of dead sperm. The recommended period of abstinence is also linked to different frequency of sexual activity of particular men.

How effective is the in vitro fertilisation treatment?

Many factors affect success rates which need to be born in mind when evaluating your chances. At InviMed, 50% of IVF treatments are successful for women up to 35 years old. Across all age groups our success rate is 43%.

Comparing various national success rates: in Poland the average success rate is 35.2%, in Spain 34.0%, in the UK 30.1%, Germany 28.0% and Italy 21.1%. The European average is 29.9%.

How should I prepare for the first appointment?

No special preparations are required. The purpose of the first visit is for the doctor to understand your case and your medical history. It is important, however, to take all medical test results as well as be ready to provide information about any previous medical treatments.

Examples of test results: hormonal tests, sperm tests and imaging examinations. Examples of medical information: descriptions of procedures and surgeries undergone (including histopathological examinations) and hospital discharge summary reports.

Should my male partner take part in the first appointment?

We encourage both partners to come to the first appointment. It enables us to conduct a complete medical interview and have a full medical record of both partners.

How much do medications cost to prepare for the in vitro fertilisation procedure?

The average cost of medications ranges from 2,000 to 4,000zl, which is from £380 to £760.

How should I prepare for the ovum pick-up procedure?

A few days before the procedure, a midwife will verify if all of your medical documentation is present and correct (tests for: morphology, viruses, electrolytes, blood group, APTT – blood coagulation). If any results are missing, the midwife will contact you by telephone and ask you to deliver any missing results on the day of the procedure.

Before the procedure, patients must also remove all nail vanish or other nail decorations. This is because a sensor will be placed on your finger and any obstruction can lead to incorrect sensor readings.

When is the embryo transfer performed?

The embryo transfer is usually conducted 3 days after ovum pick-up (puncture procedure), but it may be also conducted on the 2nd or 5th day. The exact transfer date depends on the number of oocytes taken and the quality of the developing embryos. The decision is made by both the patient or couple and the doctor in charge of the treatment.

Who can qualify to the treatment? Is it open to unmarried couples?

The procedure is open to couples, no matter whether married or unmarried. However, if a couple are not married, the man who participates with her female partner in the in vitro procedure using donor eggs, donor sperm or donated embryo will be obliged to sign a declaration at the Registry Office in Poland that he will be the child's father.

 At the clinic, at the visit following the embryo transfer procedure the man signs the consent form for fertility treatment in which he declares that he has completed the formalities required at the Registry Office. Care coordinators will help patients with all practicalities to ensure a smooth process.

What is the price in Euros or Swedish kronas?

The price of the programme is 18,000 Polish zloty (PLN) - approximately EUR 4300 or SEK 39,000 (01/10/2014). Please check online for the latest exchange rates.

Can I choose to have twins?

Please consult this issue with a doctor. However, we advise against this for health reasons. From the clinical point of view, it is a high-risk pregnancy which may be dangerous for both the mother's and children's health.

Our policy is to transfer a maximum of 2 embryos. When transferring 2 embryos, the likelihood of a twin pregnancy is about 18%. Transferring 3 embryos increases the likelihood to 30%, but it is highly irresponsible and a threat to mother and children. The occurrence of twins by natural conception is about 1% by comparison.

What happens to the remaining embryos?

The remaining embryos are frozen and stored at the clinic. There is no cost to store them for one year (included in the programme’s cost). If you would like to store them for an additional year, the price is 350 Polish zloty (PLN).

You can use these frozen embryos in further treatments for as long as they are stored.

How many times do I need to go to Poland?

We recommend two visits to an InviMed clinic.

First visit – an appointment to check if you qualify for treatment. The doctor will examine you and instruct you to undergo the required medical tests. If you qualify, the doctor will prescribe medicines which need to be taken at home to prepare you for the embryo transfer. We recommend that you come to this appointment with your male partner who will donate sperm.

Second visit - two days before the embryo transfer is the second appointment. Afterwards, you will stay for 4-5 days during which the transfer will be performed. If your male partner was unable to come to the first visit, he will need to come this time to donate sperm.

When can I begin preparation for the embryo transfer?

Preparation for the embryo transfer can begin after the egg cells are available. It can start on the earliest suitable day based on your menstrual cycle.

If you chose a donor from the catalogue, there is a 1-3 month waiting period. If you choose egg cells available from the donor egg bank, there is no waiting period.

When we confirm availability of the egg cells at the clinic, we will contact you to start the preparation.

Does the preparation need to begin on a specific day?

Yes, you have to start taking medicines on the first day of the menstrual cycle. Details of the treatment can be found in the instructions [here].

Please discuss these details with your local doctor. You can also consult your doctor at InviMed, who is always available to help.

How do recipients prepare for the embryo transfer?

Recipients must prepare their bodies hormonally. The procedure involves imitating the natural cycle using small dosages of estradiol and progesterone (hormonal medicines). Every treatment is personalized for the patient. Procedures may significantly differ for patients who menstruate and for patients whose period needs to be stimulated.
Find the detailed description of the preparation [here]. Please hand these instructions to the doctor who will prepare you.

How much in advance should I reserve the sperm donor?

The sperm donor needs to be reserved at least 1.5 weeks before the procedure.

Why do young women donate their egg cells?

There are various reasons. Donors want to help other women who dream of having a child. They may also decide to donate for financial reasons. Donors receive compensation for donating oocytes.

Can another couple also use egg cells from the same donor that we chose?

Yes, with limitations. Egg donors may only record a few pregnancies before they are removed from the donor catalogue. This is controlled by the donor egg bank. Until an egg donor exceeds the number of pregnancies which disqualifies her from being a donor, other couples are able to use her egg cells.

Is the transfer of at least one embryo guaranteed?

With frozen oocytes, there is never certainty about how many of them will be fit for fertilization. For this reason, there is a compensation system in place if it is not successful. Patients have the option to make another attempt at a significant discount after the first procedure.

How much does the egg donation programme cost? What is included?

The price for the standard egg donation programme is 18,000 Polish zloty (PLN). This includes:

  •     8 frozen mature egg cells (oocytes) from one donor
  •     thawing the egg cells and the whole embryological procedure
  •     embryo transfer
  •     vitrification (freezing) of any remaining embryos and storing them for 1 year
  •     transfer of the remaining frozen embryos within 1 year of the first transfer (if the initial attempt did
  •     option to use frozen egg cells or embryos in further treatments (to have another child)

Not included: 

  •  medicines to prepare for the transfer which are prescribed by the doctor
  •  health tests to join the programme (e.g. viruses, infectious diseases, cytology). These tests can be done by your doctor or at an InviMed clinic. Please see InviMed’s [price list].

What do I need to qualify for treatment?

Please discuss your treatment history, i.e. the procedures undertaken and the test results with the doctor during your appointment at an InviMed clinic. The doctor will be able to answer your questions. If you would like to make an appointment with a doctor, please contact us at kontakt@invimed.co.uk

Is it necessary to undergo all medical tests in the patient tests card?

Yes, it is necessary to undergo all the tests listed in the patient tests card. The doctor needs the results to decide if you qualify for the programme.

Tests for recipients include: blood group, Hbs antigen, Anti HCV, Anti HIV, WR, Toxoplasmosis, Rubella, Cytomegaly and Chlamydia. In addition, breast examination, vaginal swab and cytology screening results must be presented.

Your partner should undergo the following tests: Hbs antigen, Anti HCV, Anti HIV, WR, VDRL, Chlamydia, Cytomegaly and extended sperm examination.

If further tests are necessary, the doctor will inform you about it after the first appointment.

Do I have to make special preparations for the first appointment in Poland?

No. The doctor at InviMed will assess if there are any medical issues preventing you from joining the programme. Please take to your first appointment all valid tests results and treatment history of yours and your partner.

Do both partners need to come to the first appointment?

Yes, your male partner should come in order to be qualified to the treatment. Additionally, he needs to leave semen. 

How should my male partner prepare to give sperm?

Your male partner must abstain from all sexual activity for 3-5 days before giving sperm. He should also consume very limited or no alcohol in this period.

How long do we need to stay in Poland?

It is enough to spend one day in Poland for the first visit. We recommend 4-5 days for the second visit to Poland, which includes the embryo transfer.

4-5 days are needed for the second visit because: on the third day, the embryo transfer will take place. On the fourth day after some rest, the return to your country of residence can be planned.

Can patients who do not ovulate join the egg donation programme?

Yes, patients without an ovulation cycle can take advantage of the egg donation program.

Are there weight limitations for recipients in the egg donation programme?

Yes. Patents who are significantly overweight should consult a dietician and try to reduce weight.

How is the sperm donor selected?

You can select a sperm donor during an appointment with your doctor. If you live abroad, you will need to send your preferences by e-mail. The donor will be matched accordingly by our embryologists.

The sperm donor can be selected according to the following criteria:
• Blood group
• Rh factor
• Eye colour
• Hair colour
• Height
• Weight
• Education level

How many egg cells are donated?

The programme includes eight vitrified egg cells from one donor.

Can I provide my own egg donor?

Close family members (sister, cousin) can be donors. However, this is an issue which must be decided by a doctor.

Is embryo cultivation to the blastocyst stage included in the price of the procedure?

Yes, embryo cultivation to the blastocyst stage is included in the price of the procedure.

What medical tests need to be performed? Are they included in the price?

To join the egg donation programme, you need to present valid test results for various viruses and infectious diseases as well as from a breast examination and cytology screening. The list of the required tests can be found in the patient [tests card].

The costs of these tests are not included in the programme's price.

How long will I wait for the donor egg cells?

All eggs are available at our bank. It means there is no waiting time for egg cells and you can have an embryo transfer as soon as your doctor confirms your readiness.

How should I prepare for the insemination procedure?

The insemination procedure doesn't require any special medical preparation. However, patients should drink about 1 litre of water an hour before the procedure. Please also remember to take relevant ID.

Insemination is not recommended in a number of cases, including:
• reproductive organs infections
• uterine myomas (depending on location)
• tubal obstruction
• pathology of endometrium
• presence of cancer
• other serious systemic diseases
• presence of bacteria in sperm and other sperm pathologies

You are welcome to contact us if you are unsure if these are relevant for you.

Can the insemination treatment be repeated?

Insemination attempts may be repeated many times. Your chances of getting pregnant is the key factor. Some research recommends a limit of 6 or 9 procedures.

If multiple procedures prove ineffective, further medical consultation is advised to find a different treatment method.

How effective is the insemination procedure?

Insemination success rates range from 10 to 25% per cycle. The chances depend on various factors, including: sperm parameters, the woman's age and the number of mature follicles after hormonal stimulation.