Ask an Expert – by the team at Embryolab

It is always comforting reading through Q&As, as not only can you get the answers to a question that might relate to you, but you can see that you aren’t alone in your struggle to conceive. We asked the brilliant team at Embryolab to answer some readers questions. 

I have endometriosis. Can that affect my fertility? Will I need to do IVF?

 Though difficult to quantify, endometriosis is a relatively common condition, affecting roughly between 10-15% of women. It can have a variety of symptoms or may be insidious without any obvious signs. As regards fertility, it is estimated that around 30-40% of women with endometriosis do indeed have difficulties in conceiving. Although it has yet to be proven exactly how endometriosis can lead to low fertility, it is believed numerous factors come into play in this mechanism. Of course, at a more severe stage of the disease, anatomical factors impact on natural conception, such as symphysis around the fallopian tubes or large endometriotic cysts in the ovaries. Without having much information in your specific case, I can’t exclude the possibility of your fertility being affected by endometriosis. Despite that, there are solutions that can help. Endometriosis laparoscopy surgery can improve the chances of pregnancy both natural and IVF. Also, with the modern assisted reproduction protocol we can further increase the success rate through individualized treatment. When you decide to have a child it would be a good idea to consult a specialist reproductive gynaecologist for guidance on your attempt. 

Dr Nicholas K Christoforidis MD, FRCOG, DFFP, Consultant Obstetrician & Gynaecologist, Embryolab Scientific & Clinical Director, Embryolab Academy Co-Founder

 Recently my husband was diagnosed as having non-obstructive azoospermia. Our urologist recommended a biopsy. If spermatozoa are found in this way, what are the chances of them being capable of fertilization? If no spermatozoa are found and we proceed with a donor can I avoid IVF and have insemination? I am 34 years old and my test results are normal.

 It would be a good idea for your husband to take a series of tests so as to find the cause of the non-obstructive azoospermia and to evaluate to what extent it is reversible. One solution to your problem is in fact for him to have a testicular biopsy. I would suggest that you do a more contemporary method of testicular biopsy called microdissection-TESE or micro-TESE. This is performed by a specialist urologist who with the help of a microscope and an experienced embryologist can perform a targeted biopsy. Therefore the chances of finding usable spermatozoa are increased and injury to the testes is appreciably limited during the operation. If this method yields spermatozoa capable of fertilization these are capable of fertilization at a rate higher than half of the cases using ICSI. If indeed you decide to go ahead thus and provided your test results are normal, you can begin your attempt with insemination.

Alexia Chatziparasidou M.Sc., Sr. Clinical Embryologist, Embryolab Lab Director, Embryolab Academy Director

I am 32 years old and for about a year now my husband and I have been trying for a second child. Our first child is 2 years old. What would you advise me to do? To keep trying on our own or to consult a specialist and proceed with IVF?

 Many couples struggle to have a second child and a first successful pregnancy. In such cases it is likely that a problem has arisen which hadn’t previously existed. In your case after a year without results, I would suggest that you seek help from a specialized assisted reproduction centre. This does not mean that you have to start IVF treatment immediately. First you must establish what the problem is that is preventing you from having a second pregnancy. It would therefore be recommended that both you and your husband undergo a series of specialized tests indicated by your doctor. It is quite likely that your problem can be solved without resorting to IVF. In most cases like yours, the prognosis is better since you’ve already got one child. If you do eventually need IVF, then your treatment will be targeted on your specific problem.

Artemis Karkanaki MD, MSc, PGCert, PhD, Gynaecologist in Assisted Reproduction    and clinical embryology at Embryolab

I am 41 and my husband 42. I’ve been trying to get pregnant for the last two months. Does it make sense for me to start an IVF course right away?

Many couples wonder when is the time to seek help for assisted reproduction. Regarding your case, of course natural conception isn’t ruled out. However, the most important prognostic indicator both for natural conception and with IVF is the woman’s age, since the likelihood of becoming pregnant after 40 decreases greatly. For that reason we suggest you soon do an initial evaluation at Embryolab. A simple series of tests for yourself and your spouse can trace your reproductive profile. Having those in mind, a gynaecologist specialised in reproductive medicine can design an action plan so you do not waste any time.

At Embryolab, we know that fertility requires an individualised approach. The important thing is that every couple facing fertility issues will undergo the appropriate examinations, on the basis of which we select personalised treatments and methods to deal with fertility problems. We apply personalised reproductive medicine and adapt the innovation in each case separately so as to achieve the greatest benefits.

Michalis Kyriakidis MD, MSc, Gynecologist in Assisted Reproduction at Embryolab

Massive thank you to the team at Embryolab for this Q&A for our Ask an Expert section – if you have a questions you would like to ask an expert then please email 

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