FAQ from our webinar “ART: Meet with the Reproduction Specialist”

There are always a lot of questions to the Reproduction specialist about the process of Infertility treatment. ADONIS Fertility International has organized the special meeting with one of the main leading fertility specialists – Dr. Julia Kochet, Head of ADONIS ART Department.

She has more than 23 years of experience in the medical field and about 11 years in the sphere of Reproductology. 

Dr. Julia answered all the required questions with a broad informational and experienced background. 

What is the main role of a Reproductive specialist according to your personal opinion? 

Dr. Julia: “The main aim of each fertility doctor is to give the opportunity and to help families achieve the dream of the baby. It is the most important dream that anyone could have.”

As we know, you are constantly taking part in foreign medical conferences, what are the main leading trends in Fertility? 

Dr. Julia: “The main discussions all over the world revolve around the main topic – the safety of the patients during the COVID-19 pandemic. Even during the lockdown time, ADONIS clinics continue their work. The Reproductive operations are in an exclusive list, so there is no slow down in these spheres. But the COVID times add the new level of safety and confidence which we provide with the responsibility.”

So, if the theme of COVID-19 was taken up, tell us, please, how the Reproductology and the Infertility treatment have changed because of it?

Dr. Julia: “The key word right now is double Control. That’s how really the Reproductive sphere has changed because of COVID. We control each step of the Program and each participant and his health state – we are constantly testing for COVID, watching for symptoms or changes in a health conditions, we control wearing masks. If any participant of the Program has a positive COVID test, we pause the Program to ensure the safety and total health for the procreation – it is a worldwide practice – to restart it again after.”

What are the main practices about vaccination during Infertility treatment – Surrogacy, IVF and other reproductive technologies? 

Dr. Julia: “First of all, over 80% of ADONIS medical staff are already vaccinated, 20% of those who have no vaccinations, they have some contraindications to do it, but you can be sure that all of them are allowed to work with the patients only after the PCR testing for COVID. Because number one for us is to ensure the safety of the patients, and be sure that our staff can’t be the source of the virus. We are in close contact with patients – whether its embryo transfer or check-up, the main aim is safety. The first moment the vaccine became available in Ukraine – our doctors were the very first ones that have received vaccination.”

Let’s look from the patient’s side. What are the main actions for the patient (of any Infertility Program) during COVID-19 pandemic, especially when there was no vaccination yet?

Dr. Julia: “Nevertheless, that some Programs (Surrogacy, for example) were paused during the first lockdown because of COVID-19, we had continued to operate and to provide the treatment for patients. The immediate actions in those times was thorough testing – before the start of the stimulation or puncture, сonstantly. We are focused on the custom approach only.

If the positive test for COVID was identified on the stage of the Program which is really essential and can’t be paused – the patient was isolated with the medical staff in special gear, the whole processes are constantly controlled to ensure the best health and treatment.”

Okay, and what about vaccination for the patients? What is the practice during Infertility Treatment?

Dr. Julia: “If you are getting ready to experience the Assisted Reproductive Technologies, you should pass all the examinations to exclude contraindication (not only from the reproductive prospective) for the vaccine and after this we recommend getting vaccinated. But, please, pay attention, that you can start the Infertility Program only in 1 month after vaccination. 

Moreover, even after the vaccination is done, we continue the practice with PCR testing for patients, because we care about people around – because the vaccination is not the prevention that you can’t be the disease carrier.”

This is great. Is there a special practice for Donors during the pandemic period? 

Dr. Julia: “If we are speaking about the Donor’s examination, it is even more strict than just the patient’s treatment. In addition to all precautions that were mentioned above – PCR testing, vaccinations, waiting period before restart after it – if the Donor receives the positive COVID-19 test, we will move forward with puncture, but all the genetic material will be not used in the Infertility Program. 

As for the Surrogate Mothers, if the positive COVID-19 test is revealed – the embryo transfer will not be conducted (the families will be informed without doubts). Because the impact of COVID-19 for reproductive health is not studied and the safety of patients is of vital importance.”

It’s really important! But let’s rerun the simulation when at the middle of the Surrogate program, one of the sides (the Intended parents or the Surrogate itself) wanted the Surrogate mother to get the vaccination. What is your advice in such a situation?

Dr. Julia: “Actually, we do not recommend doing vaccination during the stimulation. One of the main reasons is the influence of different medications which are used to prepare the body of the Surrogate for stimulation. The organism can have an unpredictable reaction when such lawyers of influence will be – the vaccination and the medical supplies (hormonal and others).”

What is about vaccination during pregnancy?

Dr. Julia: “Okay, there are no 100% accuracy and approved studies in the area of influence of the vaccine during the pregnancy period. No one really has a significant amount of data to ensure the impact, that’s why we recommend making the decision case by case, but generally I do not recommend doing the vaccination during the pregnancy. It’s a really serious discussion which needs to be considered from different eagles.”

Some specific questions to ask you. 

What are the requirements to use the IVF treatment egg retrieval transfer?

Dr. Julia: “Without knowing each specific case it is really hard to identify, but generally the requirements include: 

  • if the patient trying to unsuccessfully conceive during a year
  • if you the patient is diagnosed with tube abstractions or uterine problems
  • if the couple has challenges with male fertility as well
  • if the patient over 35 years old
  • if the patient had operations with ovaries and try to conceive during half a year unsuccessfully”

And how Assisted Reproductive Technologies are successful in Surrogacy? Because we are already controlling so many factors.

Dr. Julia: “In case of Surrogacy, one of the biggest factors is the total health of the Surrogate. Naturally the success during Surrogacy is much higher than during other Programs. Our Surrogates go through really strict examination and evaluation. I do not know any other institution which has such a strict level of diagnosis before approval. We constantly have complaints from the candidates because of it!

The combination of control, check-ups and strict attention to the medical process give us the best results from Surrogacy,  patients which undertake the IVF treatment for agrit rival transfer have no such a perfect state in most cases.”

Let’s move to the PGD testing. In what cases are the PGD testing recommended?

Dr. Julia: “There is no common recommendation for all patients to undertake the PGD testing, each case is considered individually. But, in general, – for patients with several failed IVF attempts, for age-related patients (36-38 years old women and 45-46 years old men) we advise to have such testing to exclude the possibility of having an unhealthy embryo.”

And why in some cases the embryo of lower quality would implant better than higher quality embryo? 

Dr. Julia: “We are talking about morphology, not genetics. If the embryo, even of lower quality, is perfectly landed into the window of implantation – the success is defined. When the higher quality embryo can have a different situation.”

In other words, if the couple has embryos of not the highest quality, it’s not the reason to give up?

Dr. Julia: “Absolutely, with professional ADONIS help we can reach the highest results.”

And the last question, highly hypothetical. What can science yet not do in Assisted Reproductive Technology? And what you wished it could do?

Dr. Julia: “One of the things I really want is to have the exact information about the perfect time for the window implantation. Science is only working towards this aspect. It’s only a matter of time.”

And tell some wishes for the parents who are only thinking about Assisted Reproductive Technology or in a difficult situation.

Dr. Julia: “You have to believe, you need to keep on going. Everything is being done from the side of ADONIS to reach success.”

Full recording of the webinar you can always watch on our YouTube chanel:

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