Frequently asked questions and answers to them

During the first visit, the doctor performs a vaginal ultrasound examination. Therefore, it is best to attend the first visit between the 10th and 25th day of the cycle, when monthly bleeding is not present. If menstruation is present at the time of the visit, the diagnosis may be limited to a transabdominal ultrasound. If bleeding is light or there are strong medical indications, ultrasound may be performed vaginally

The attending physician reserves more time for the first visit. During it, he/she will ask about the date of the last menstrual period, the regularity and length of the cycles, the course of treatment to date, among other things. Usually, he or she will also review the results of the tests already carried out and carry out a gynaecological and ultrasound examination of the patient. Sometimes the choice of treatment method is also decided on the basis of these at the first visit.
In some cases, the doctor may order laboratory tests for patients, which are necessary to start the treatment process:

• patient - determination of hormone levels (including AMH, TSH, FSH, Prolactin, FT3, FT4, E2, Testosterone), blood group, morphology, clotting time, electrolyte levels and cytology.
• to the patient - semen examination
• both of you - virological tests, i.e. determination of anti-HIV, anti-HCV, HBS antigen and WR reaction levels and karyotype testing.

All laboratory (blood) tests can be carried out at the Invimed clinic. You do not need to make an appointment for blood tests, just come to the clinic during the clinic's opening hours. For information on the hours when the tests can be performed, please call: 500 900 888, at the clinic reception or by sending your question to: invimed@invimed.pl.

Due to the need to confirm the identity of patients who use the clinic's services, please do not forget to bring an identity document (e.g. identity card, passport, permanent resident's card) with you to your appointment, treatment or examination. Lack of ID may result in the appointment not taking place due to the lack of patient identification. Patient identification is necessary to guarantee the safety of the procedures carried out.
For your first visit to the Invimed clinic, please bring completed and signed medical questionnaires, one for your partner and one for your partner. The medical questionnaires will be sent by the Invimed consultant to the email address indicated by the patient at the time of the first appointment.
Medical questionnaires can also be downloaded from the Documents to download page on our website. To download a medical questionnaire form:

• for the partner (click here).
• for a partner (click here)

It is important to bring with you your previous treatment history, i.e. hormone test results, semen test results, imaging results, descriptions of procedures and operations performed (including histopathology), or information sheets from hospital stays.

Invimed achieves an IVF success rate of approximately 54% - this is the average for all IVF cycles carried out between 2015 and 2017. We confirm clinical pregnancy after the first attempt in as many as 57% cases. These high rates reflect the number of childbirths among patients who have achieved 6 or more mature oocytes ready for fertilisation during the stimulation process.

For more information, see the article: Effectiveness of in vitro.

Since July 2014, IVF drugs have been on the list of reimbursable medicines. The average cost of the drugs ranges from PLN 2,000 to PLN 4,000.

Preparation for the LP procedure - the extraction of ova - begins with hormonal stimulation of the ovaries. The patient should take the preparations prescribed by the doctor according to his/her instructions. Hormonal stimulation ends with the administration of a hormonal drug (usually hCG hormone), which triggers oocyte maturation. It is administered approximately 36 hours before the planned ovarian puncture.

The day before surgery

The day before the procedure, the KOM (Care Coordinator) verifies the tests contained in the couple's medical records and calls the patients to inform them of the exact time of the planned procedure. If virological tests (especially important for embryologists) are missing for the procedure, the material for these will be collected on the day of the procedure by 10:00 a.m. Material for other tests can be collected after 10:00 a.m.

Research required for OPU:

in both partners - HBs antigen, anti-HCV antibodies, HIV antibodies, WR/VDRL reaction, anti-HBc antibodies, anti-CMV antibodies in IgG and IgM class, blood groups;
in a woman, additionally morphology, Na, K, APTT, toxoplasmosis and rubella antibodies in IgG and IgM classes and smears: cytology result, vaginal biocenosis, chlamydia trachomatis PCR.
It is important that test results, with the exception of blood group and cytology, are no more than six months old.

On the day of surgery

Preparation for the procedure is mainly about being fasting, which means not consuming any food or drink, including water, for at least eight hours before the scheduled time of the procedure. You can only swallow medication first thing in the morning, drinking a small amount of water. It is also important to take care of your personal hygiene.

The couple must attend the surgery with identification documents. If there is any history of anaesthesia concerns, please bring your medical records with you for the anaesthetist to see.

The patient may also carry something light to eat after the LP so as not to be fasting for long after the procedure and something to drink (in autumn and winter, a warm drink from a thermos would be best). We advise against any products that, if eaten on an empty stomach, can cause nausea (including raw fish and hard to digest fruit).

After the procedure, the patient is not allowed to drive for 24 hours, so it is advisable to think in advance about how to get to and from the clinic.

Embryo transfer is usually carried out 3 days after oocyte retrieval, but can also be carried out on day 2 or day 5. Day 1 from the day of cell retrieval is considered to be the day after the LP. The day of transfer depends on the number of cells retrieved, the quality of the developing embryos and the decision of the couple and the practitioner.

Contraindications to insemination are:

• inflammation of the reproductive organs
• myomas of the uterus (depending on the location)
• fallopian tube obstruction
• endometrial pathologies
• identification of the neoplastic process
• other severe systemic diseases
• presence of bacteria in semen and other semen pathologies

Insemination attempts can be repeated several times. The reduction in the number of treatments is due to the decrease in the chances of achieving a pregnancy, according to various reports, after 6 or 9 treatments. If the treatments are not effective, further medical consultations are carried out in order to choose another method of treatment.

Insemination efficacy ranges from 10 to 25% per cycle, depending on semen parameters, the woman's age and the number of mature follicles after stimulation.

The insemination procedure does not require any special preparation. One hour before the procedure, the patient should drink approximately 1 litre of fluids. We also remind you to take your identity document with you.

Semen testing should be carried out at the beginning of the infertility diagnosis, preferably before the first visit to the infertility clinic.

In addition to diagnosing the couple's infertility, semen testing may be performed for other medical indications. These include:

• conditions before and after reproductive tract surgery
• planned cancer therapy (indication for sperm freezing)
• conditions following treatment for cryptorchidism, testicular torsion etc. in childhood
• conditions after treatment with sex steroids (including use of anabolics) and glucocorticoids

A semen test is a test that can be carried out on men in the course of carrying out a diagnosis for infertility. It is a completely non-invasive test.

The semen test represents the actual condition for a period of six months and the test should be carried out again after this time.

The conditions under which the semen is donated, the temperature and the storage time during delivery to the laboratory all significantly affect the subsequent evaluation of the parameters. It is therefore recommended that semen (if possible) is donated in the clinic. If this is not possible, it should be remembered that the semen should be donated under hygienic conditions (after washing the penis with soap and water). All the ejaculate should go into a special sterile container. The tightly closed container should then be delivered to the laboratory at human body temperature in no more than 30 min. The sample should be protected from the sun.

Standards for semen parameters have undergone numerous modifications over the years. The first development of semen standards by the World Health Organisation (WHO) dates back to 1980. Further modifications were introduced in 1999 and then in 2010. A selection of the more important semen parameters according to the most recent standard in force is presented below:

WHO 2021 standards

ejaculate volume: ≥ 1,4 mL pH: 7,2
sperm count: ≥ 16 million/mL
sperm count in the ejaculate ≥ 39 million/mL
percentage of sperm with normal motility: ≥ 30% with progressive motility
morphology (structure): ≥ 4% sperm with normal shape
viability: > 54% spermatozoa

The correct preparation and execution of the test is crucial for a correct reading of the semen parameters and thus a correct assessment of the man's actual fertility. Before the test itself, 3 to 5 days of sexual abstinence should be observed. Studies show that below 3 days there is too low a concentration of sperm in the semen, while above 5 days there may be an increased percentage of dead sperm. The recommended abstinence period also has to do with the varying intensity of intercourse between men.

Yes. The patient chooses the clinic to which she wishes to transfer the embryos. The selected clinic submits the appropriate application to the Invimed clinic, which issues the biological material. The transfer takes place between clinics. The patient cannot collect it herself. The cost of transport is the responsibility of the patient.

The law states that six ova can be fertilised. The statistical average shows that of the six embryos created, only four develop properly and are suitable for transfer. Therefore, at InviMed, patients who are under 35 years of age are given one embryo. According to the law, it will be possible to fertilise more ova in women over 35. This group of patients at InviMed will be able to be given two embryos at a time.

All the ova obtained as a result of stimulation are collected. From these, mature, normal ova are selected that are capable of fertilisation. If there are more than six, the remaining cells can be frozen and used for the next IVF cycle. A maximum of six ova can be fertilised in one IVF cycle.

Yes.

They can be donated to another couple in need or kept for a period of 20 years. According to the law, after this time the embryos will go up for adoption. The cost of storing the embryos is paid by the patient.

There is no obligation to declare that a child has been born as a result of IVF. The obligation to make a declaration at the Registry Office only applies to couples who are not married and are embarking on an IVF procedure using donor or donor reproductive cells. If a man does not make a declaration at the Registry Office, the couple will not be able to start the IVF procedure.

The intention of the legislator in creating this provision was to safeguard the interests of the child. A man, by signing a declaration at the Registry Office that he will be the child's father, will assume full parental rights, including maintenance obligations.

If a couple (not married and using donor reproductive cells) has undergone an IVF procedure (before a November 2015, i.e. before the law came into force), as a result of which the patient has already become pregnant, there is no obligation to declare to the USC. If, on the other hand, she still has unused embryos that were created at the same time as an already used embryo then, before the planned next pregnancy (transfer), it will be necessary to make such a declaration.

No. The new provisions apply to people who start procedures after 1 November 2015.

More than 6 ova can be fertilised after two unsuccessful IVF cycles.

The cost of storing embryos is paid by patients.

There is no legal requirement to do so. It will depend on the goodwill of the clinics.

Yes, because it is not ethically questionable. Embryos cannot be destroyed, whereas both ova and sperm can be disposed of.

Yes, once these clinics have obtained the relevant permits from the Ministry of Health.

Yes. You can donate both your embryos and those from donation for adoption. This requires the consent of both partners.

Yes. You can donate both your own embryos and those from donation for adoption. In Poland, donation is anonymous.

Married couples do not have to write a declaration before insemination at the Registry Office. This would be necessary if the couple were in an informal relationship. In that case, the man would have to sign a declaration at the Registry Office that he will be the father of the child before the procedure. This would mean that he would assume full parental rights, including maintenance obligations. Also, the partner, within three months of the man's declaration, would have to make a declaration to the Civil Registry Office that the man would be the father of the child. At the clinic, the man would have to sign a document certifying that he had completed the required formalities at the Registry Office.

Yes, it is necessary to make declarations at the Registry Office.

The embryos will only go on the register if the couple donates them. If the couple does not use the embryos within 20 years, the embryos will go to donation at the end of that time and will then be on the register.

No. The register only applies to embryos that will go to donation.

IVF treatment is possible after other treatment methods have been exhausted, carried out for a period of not less than 12 months. Exceptions are situations where it is known that methods other than IVF have no chance of success.

This is not possible. In vitro fertilisation can only be used by couples who are in a formal or informal relationship. If the couple is not married, both partners must sign a consensual declaration when embarking on IVF. According to the law, the partner will be the father of the child.

No. It is not possible to name a woman who wants to donate her egg cell to us. This also applies to male sperm donation. All donors are anonymous.

No. It is not possible to indicate the woman to whom you want to donate your egg cell. This also applies to male sperm donation. All donors are anonymous.

Yes, donation is anonymous in Poland. However, children born from donation can obtain selected donor data once they reach the age of majority: the donor's date and place of birth and test results. This data will be stored in the Register of cell and embryo donors maintained by the Ministry of Health.

Yes. Consent must be withdrawn in writing. Withdrawal is possible until the start of the IVF procedure.

No more than ten children can be born from donated cells. The clinics monitor and report the number of births and, on this basis, allow donors to continue donating reproductive cells.

No.

If the embryos are not used within 20 years or if both partners die, they will be donated. Another couple will receive them.

Yes, if he or she has given his or her prior consent or so decided by the Guardianship Court.

Yes, after 20 years or after the death of both partners.

No. Embryos cannot be taken from the clinic bank in person. This can be done through the clinic by indicating another clinic to which they are to be transported.

Genetic testing of embryos can only be carried out for medical indications. This is decided by the doctor.

Fertility preservation, i.e. the collection and freezing of reproductive cells, is only possible for medical reasons. That is, when there is a risk of loss or impairment of fertility due to disease (e.g. oncology), injury or treatment.

No. Any patient, at any time during treatment, can make an appointment. No referral is needed to sign up for psychological workshops or to join a support group either.

A consultation is a conversation that is about your experiences and needs in your current situation, so no special preparation is needed. Before the talk, you can ask yourself: what do I want to achieve with this talk? - this can make it easier to formulate solutions.

The indication that a psychologist should be involved in the treatment process is a frequent and quite natural procedure. The situation of infertility treatment involves experiencing many different emotions, including difficult ones. These emotions affect the physiology and cause tension (stress), which can affect how patients feel during treatment and how they cope with the disease. Psychological consultations aim to reduce stress levels and are therefore a standard part of the treatment process. Each patient is offered one free psychological visit.

There is a stereotype that a conversation with a psychologist is related to the analysis of childhood experiences. In reality, the conversation is about the current situation, so in many cases it does not deal at all with events from the distant past. In addition, it is worth remembering that it is the patient who decides what content he or she wants to discuss in the interview and what content he or she does not want to discuss.

The psychological consultation at the Invimed clinic is completely voluntary and is intended for people who feel the need to talk to a psychologist. The fact that you have participated in psychotherapy or received psychological help in the past is not a contraindication for talking to an infertility psychologist, as this is often a completely different working model and relates to a specific treatment situation. Previous experience of psychotherapy can be helpful during the consultation, but does not necessarily have any influence on the conversation. It is always up to the patient to decide what they want to talk about and what topics they are prepared to discuss during the consultation.

Psychological workshops organised from time to time are an open form of discussion where you can exchange views, experiences and insights with other people experiencing a similar situation, but you are not obliged to share your own experience if you do not want to and do not feel ready to do so. Workshops are a different form of work than a support group or individual meetings with a psychologist. They aim to draw attention to certain phenomena and are often linked to elements of education on a specific topic, sometimes complemented by various exercises.

Seeing a psychologist is not a last resort. Many people choose to seek psychological consultation only at the time of a severe crisis, when they are already in such an emotional state that they are unable to cope on their own. However, it is advisable to seek psychological support a little earlier, even when you feel you are coping with a personal situation. A psychological consultation at an early stage of treatment helps to sort out emotions, thoughts, fears and the various doubts that may naturally arise. This is not a guarantee that the crisis will never occur, but it allows you to look at the situation from different angles and gives you a chance to confidently hedge against any difficult emotions that may arise in the future.

Infertility treatment can be a long-term process. It is a time of expectation, hope, but also disappointment, a kind of test for the relationship. That is why it is worth consulting a psychologist before starting the treatment process, in order to find out what the psychological aspects of infertility treatment are, what difficulties and problems we may encounter during the treatment process. Equipped with such knowledge, you will be able to go through the sometimes difficult and lengthy treatment process more easily.

During the first meeting, the psychologist will collect a short interview from you about the treatment process you are in, what stage you are at and what is still to come. He will ask you whether you are experiencing any psychological and emotional difficulties during your treatment. He will answer any questions you may have and briefly outline any problems or difficulties you may encounter during the course of your treatment.

The diagnosis and treatment of infertility involves the experience of negative emotions in both partners, however, the way these emotions are experienced and shown is different in men than in women. Women tend to have a need to share their experiences, thoughts, talk, seek support from loved ones, and have a need to understand the situation. Men, on the other hand, are more likely to experience feelings of shame, hide from family and friends that they are infertile, and avoid talking about infertility. Set on acting and solving problems, they feel powerless in the face of the situation, depressed by the suffering of their female partners. Feelings of helplessness and powerlessness can cause men to close themselves off, unwilling to talk about their feelings, escaping into work, sport or other activities. This behaviour can make their female partners feel alone in the treatment process, convinced that they do not care about the child as much as they do. It is worth remembering that the differences in the response to infertility are natural and result from a different way of coping with the problems, and not from ill will, as this avoids or reduces the frequency of conflicts, feelings of loneliness and misunderstanding during treatment by both parties.