Q	TOPIC: IVF SEASONAL IMPACT Do the success rates of IVF differ during Summer & Winter, ie...is it better to do IVF in Summer or winter? User Comment: I know they're wierd questions, but one of the many half baked Dr's I went to before Vitalab (no names mentioned) told us that it was better to do IVF in the summer so it'll be interesting to know.
A	There has been a lot of debate around this issue, that at the end of the day is “hogwash” There is no statistical significant difference in the pregnancy rates between summer and winter. This was reported in the “human Reproduction” journal in 2005 and stated in no uncertain terms that there is absolutely no difference. See the attachment of the article abstract.
	TOPIC: IVF HOT WATER BOTTLE/ELECTRIC BLANKET
Q	User Comment: While doing IVF in winter, is it advisable to use a hot water bottle or electric blanket during treatment or could this affect the outcome? I know they're wierd questions, but one of the many half baked Dr's I went to before Vitalab (no names mentioned) told us that it was better to do IVF in the summer so it'll be interesting to know.
A	As you will gather from the answer and accompanying attachment to the 1st question, it is clear that there is no difference in the outcome and therefore all the mentioned measures are of no use .
	TOPIC: LOW SPERM COUNT PREGNANCY
Q	Why is the likelihood of spontaneous pregnancy with a sperm count less than 10mil so low or almost impossible? Doesn't it only take 1?
A	Indeed, it takes only one sperm to ultimately fertilise the egg. However, it takes a lot of sperm to reach the egg in the fallopian tube, needing lots of stamina to swim the distance to the egg way off in the fallopian tube. Upon reaching the egg, it takes a lot of sperm, all working together to get the one sperm to actually penetrate and fertilise the egg. Therefore, a count of less than 10 million/ml is unlikely to do the job as strength lie in numbers in this case.
	TOPIC: EMBRYO FRAGMENTATION
Q	What percentage of embryo fragmentation is acceptable for transfer?
A	Anything below 20% fragmentation.
	TOPIC: IVF NUMBER OF ATTEMPTS - SAFETY
Q	How many IVF attempts can be done by a couple before it becomes medically unsafe?
A	This question is open to debate and there is no randomised evidence as to a specific number of attempts. As with anything in life, anything in excess is not good. The question would be what can be defined as “excess”? Common sense and previous outcomes should therefore be the guide as to when enough is enough.
	TOPIC: STERILE CLASSIFICATION
Q	How low does a man's SA need to be before he is classified as being sterile?
A	A man can only be classified as sterile if he has had an orchidectomy (removal of testicles) or if he is totally azoospermic with no evidence of sperm production in the testicles.
	TOPIC: OVARY PAIN AFTER ENDO EXCISION
Q	I have felt great since my excision surgery for stage II endometriosis, with one major exception, I still have a great deal of discomfort, or in my opinion, pain, during ovulation. The pain extends from my ovary right down my leg. What could be the cause of this?
A	There are 2 possible reasons for the discomfort. The one is possible scar tissue between the ovary and pelvic side wall and the other is the so called “Mittelschmerz pain” which is bleeding that occurs into the pelvis during the process of releasing the egg from the follicle.
	TOPIC: PGD
Q	When is PGD testing suggested?
A	PGD means “Pre Implantation Diagnosis”. Contrary to popular belief, this is not simply screening for a few possible common chromosomal abnormalities (rather known as PGS), but rather trying to diagnose a specific inheritable disease such as Cystic Fibrosis for example. These are therefore mainly for specific single gene defects. The embryo is mostly biopsied on day 3 during the 8 cell stage whereby a small hole is made into the shell surrounding the embryo, a single or sometimes 2 cells are removed and then analysed for a specific genetic defect.
	TOPIC: PGD & CGH
Q	What is the difference between PGD testing and CGH testing?
A	As explained in the previous answer, I think what you are actually referring to is PGS (Pre Implantation Genetic Screening).This is where the embryo is biopsied, mostly on day 3, by removing a single cell for analysis. The drawback to this method of testing is the fact that only a few chromosomes can be tested for, usually the 7 – 9 chromosomes that statistically speaking, have the biggest chance of being abnormal. Therefore the embryo can only be given the green light for the few chromosomes that it was tested for and not the whole compliment of 46 chromosomes. CGH ( Comparative Genomic Hybridization) on the other hand is much more advanced from the point of view that one can do COMPLETE karyotyping at a single cell level, in other words all 46 chromosomes. This technique is relatively new technology and only available in a university research setting. It will however become commercially available in the not too distant future.
	TOPIC: PGD & CGH – EMBRYO SURVIVAL
Q	What are the stats in embyros not making it due to PGD/CGH testing?
A	There are no statistics on this issue and will be very difficult to research as there are many reasons, other than biopsy, that can lead to embryo demise. What we do know is that the implantation rate per biopsied embryo is definitely lower than that of an embryo that has not been biopsied. (17% for biopsied vs. 23% for not biopsied) and that in older women, it may decrease the pregnancy rate. In a nutshell, PGS/PGD is just another tool that can be applied during ART , but it is definitely not the “holy grail” that everybody thoughtit was going to be and like all things in life, does have its limitations. It does not improve the pregnancy rates and only shows a small decrease in the miscarriage rate.