PGD | Gender Selection in Cyprus
PGD is the only procedure in the world where gender selection success rates are more than 99% accurate. Preimplantation Genetic Diagnosis (PGD) is not only a test used for selecting gender, it also checks the genetic health of an embryo to prevent hereditary diseases being passed onto the baby. The embryos are checked in our laboratory.
We recommend PGD for the following reasons:
- For patients who want to know the gender of their baby, even before implantation
- For patients who have had more than one miscarriage
- For patients that risk passing on chromosomal abnormalities or monogenic disorders, such as sickle cell disease
- For patients whose IVF treatment has failed several times
- For patients suffering abnormalities in the spermatozoa
- For patients with age-related issues
Stages of PGD Treatment at Miracle IVF Centre
Stage 1 – First Contact with Experienced Patient Coordinator
We will receive your message through our contact us form, or via direct email, letting us know you are interested in our services. When we have received your contact details and your preferred method of communication, a patient coordinator will reply to give you a comprehensive overview of what to expect. We will discuss what tests are needed to start the process and get a history of any previous treatments. During these conversations we will strive to understand your personal situation and give you the time to ask about us as a team, our hospital, the treatments we provide and let us know of any personal issues you may have. Last but not least, we understand that undertaking an IVF cycle abroad can be daunting and we will spend as much time as you need to feel comfortable and happy with your choice to use Miracle IVF Cyprus. You can rest assured that your coordinator will be with you every step of the way and will meet with you every time you come to the hospital.
Stage 2 – Tests Before We Can Start
Before we are able to plan your treatment cycle, there are a number of tests you need to undergo (see below). These tests determine your fertility and your ovarian reserve. These tests are important as we plan your medication protocol based on the results. You may well have had these tests previously, but we need the results to be dated between 1 and 6 months before you plan to fly to Cyprus. All blood tests need to be completed on day 2, 3 or 4 of your menstrual period.
The tests that are needed:
- FSH (follicle stimulating hormone)
- LH (luteinising hormone)
- AMH (anti-mullerian hormone)
- TSH (thyroid stimulating hormone)
- E2 (estradiol)
You will also need to have a trans-vaginal ultrasound scan so an antral follicle count can be performed. It is possible to ask your own doctor or the local gynaecology department to perform these tests. If there is a personal reason to not involve them in your treatment, or they refuse, please ask your coordinator to inform you about other clinics near you who can carry out these tests for you. When you receive the results, please send them via email to your coordinator. Your results will be reviewed by Dr. Firdevs, and she will confirm when you are ready to proceed with IVF treatment using your own eggs.
It is also possible for us to carry out these tests and the ultrasound here in Cyprus at Miracle Hospital. If you would prefer this, you would need to fly out on day 1 of your menstrual period and spend approximately 20 days here to complete your chosen treatment.
Stage 3 – Compulsory Prescribed Medicines
At this stage, you will be sure of which treatment you will be doing and we will be planning for your arrival. As soon as the required tests (above) are completed and you have an idea of which month you are coming to start your IVF treatment with us, we will advise you to start on a monthly contraceptive pill. This will regulate your monthly menstrual period. You do not have to take this advice. However, we recommend it so you will know exactly when your menstruation will start. You will have less to worry about and will be free to plan your trip and book your flight ticket. It will also allow you to plan the time you need to take off from work and allow you to inform your employer well in advance. Miracle IVF Centre will send you a prescription of the medication that you need to take before you’re ready to start your IVF treatment. Using this prescription you can get your medication from your own pharmacy. Please ask your patient coordinator for information about our suppliers if you find the costs locally are too high, as we collaborate with a lot of UK distributors. We can get it cheaper for you and deliver it directly to you. There are some countries, including Ireland and the Netherlands that offer their citizens subsidised medication abroad and we can help you to get the medication for free or certainly for lower costs.
In addition to the prescription you will receive a unique, individually prepared protocol from our specialist IVF Doctor, Dr. F, for your specific treatment. This will provide you with instructions on how to take the medications, and when. The protocol is in an easy to read calendar format. Please do not forget to get in touch with your coordinator if you need help or assistance regarding the prescription.
Medications to Use Before Coming to Cyprus:
You will start daily injections from day 2 until day 11 of your menstrual period. The medication contains Gonadotropins, made up of hormones, LH (luteinising hormone) and, FSH (follicle-stimulating hormone). This will stimulate your ovaries to produce follicles. The second medication is called “Cetrotide”, and you will use this injection from day 6 to day 11 of your treatment cycle, at which point your follicles will be around 12-14 mm in size. Cetrotide is started after follicle stimulation to prevent untimely ovulation by blocking the hormone (Gonadotropin-releasing hormone-GnRH) that causes eggs to be released from the ovaries.
Medications to use Whilst in Cyprus:
Dr. F. will perform a trans-vaginal scan upon your arrival in Cyprus to check your follicle growth and uterine lining. If your ovaries need a little more stimulation, she will prescribe further medication. If not, she will prescribe the hCG trigger shot ready for egg collection.
Stage 4 – Arriving in Cyprus
If you decide to come to Cyprus for the whole treatment period, you will arrive on day one of your menstrual period. Otherwise you should arrive on day 10 of your cycle, which means 9 days after your menstrual period has started. Your Miracle IVF Centre coordinator will contact you to set up an appointment for the following day and you will be informed at what time your pick-up is planned from your holiday address. Alternatively, you can make your own way to the hospital. During your first visit at the clinic, before having a trans-vaginal ultrasound scan, you will meet all of our team members including Dr. Firdevs.
The outcome of the scan will tell us what happens next. Ideally, your follicles should be around 18 mm-20 mm. Dr. F will measure your follicles and inform you if there is a need for further stimulation or whether you are ready for the hCG trigger injection that completes the maturing process. If there is a need to stimulate the follicles further, we will wait one more day before administering the hCG injection; if the follicles are big enough you will take the trigger injection around midnight that night.
Stage 5 – Oocyte Retrieval (Egg Collection)
You will be shown to a patient bedroom upon arrival. This is made to feel like a hotel room and will provide all the comforts you need whilst at the hospital. All the bedrooms are equipped with up to date electric hospital beds, a fridge, a sofa or chair, and a well-furnished bathroom with a European toilet. The egg retrieval will be scheduled when the follicles have reached an appropriate size, approximately 36 hours after the hCG-injection.
Egg Collection is done under light sedation so that you will be comfortable. The procedure will take 15 minutes. Please note that you’re not allowed to eat or drink on egg collection day because of the sedation you will be given. The egg collection will take place using an ultrasound guided follicle puncture and your eggs will be immediately transferred to our laboratory. As the doctor starts the egg collection process, your partner will be asked to provide a sperm sample. To obtain the highest quality of sperm, we recommend you do not have sexual intercourse for at least 2 days prior to egg collection. We do recommend he ejaculates on the day you have your first scan in Cyprus. To maximise fertilisation rates we use the most advanced technology and are working in accordance with the latest research in the IVF field. To increase the number of eggs that will fertilise we offer all of our patients ICSI, for free.
Stage 6 – Embryo Culture in our Lab
The embryologist will verify if fertilisation has occurred. This means that we will monitor (after 24 hours) the pronuclear stage; a pronuclear is the nucleus of an egg cell/a sperm cell that must combine during the process of fertilisation. Each one contains half the number of chromosomes of the male and female. During the next few days, the embryos remain incubated to develop. As recommended by our Embryologist it is necessary to leave the embryos undisturbed and not remove them from the incubators to keep the environment consistent. If you prefer, we do offer 24/7 monitoring during the development process, allowing for daily updates, via EmbryoScope.
Stage 7 – PGD Genetic Analysis
According to our laboratory rates, 90% of the pronuclear embryos will develop and will be comprised of 8 cells on the third day. Embryo biopsies are done on day 3 and examined in the lab for genetic diagnosis. The analysis takes 2 days. The results are shared with the couple on the day of embryo transfer before the procedure takes place.
Stage 8 – Embryo Transfer
You will make the final decision on how many of the embryos you would like to be transferred. Our recommendation is to transfer three embryos as this will give the best chance of a pregnancy from one IVF cycle.
During the embryo transfer you will wear sterilised theatre wear. There is no need for sedation during this procedure and you are allowed to eat and drink. It is necessary to have a comfortably full bladder, so you will need to drink water beforehand. Using a vaginal speculum, the doctor will expose your cervix and sterilise the vagina and the cervix. With the help of specialist equipment, your embryos will be transferred into the uterus under ultrasound guidance. After the transfer, you will need to lie down flat for at least 2 hours and the nurses will return you to your private bedroom on a trolley. It is recommended to rest as much as you can in your hotel. If you prefer, it is possible to fly the same evening, but we recommend you wait until the next day to go back home.