Klinike na zapadu

Nadezhda clinic, Sofija, Bugarska

Dear ...,

Thank you for your enquiry.

My name is Iva Stoykova and I'm responsible for international patients of Nadezhda clinic. Dr Stamenov, Head of the clinic, who takes care of patients from abroad, is on holiday by 4 September but as soon as he comes back, he'll be glad to review your case - it usually takes around no more than a week. The clinic has specific medical questionnaires (for female and male partner). I will fill in the questionnaires for you as you have already provided most of the information, but will probbaly get back toy you with a few additional questions. It's very good that you have removed the hydrosalpinx as its presence dramatically reduces the succes of an IVF treatment.

Regarding your questions, here are some answers:

1.Please describe what would be the procedure for IVF treatment in your clinic – from consultations to the embryo transfer? You come for an initial consultation. If further tests are needed, you can do these at Nadezhda clinic or in Belgrade clinic and then e-mail the results. The IVF treatment usually starts on day 2-3 of your menstrual period. You have ovarian stimulation for about a week including monitoring of the development of your eggs - ultrasound scans and blood tests, ovulation fixed by Pregnyl or Ovitrelle, follicle puncture, egg fertilization (IVF or ICSI) with the sperm of your partner (fresh or frozen depending on his availability), embryo cultivation and everyday information about the development of your embryos, then embryo transfer and then it's recommended that you stay in bed for 2-3 days in order to help embryo implantation. So in total you need to stay in Sofia for around 15 days. You can read everything in detail at http://www.medspa.bg/en/view-treatment-and-rehabilitation/1/1-infertility-ivf.html
2.What method of IVF do you recommend for us? Usually ICSI is used as well as assisted hatching in order to ensure better chances for embryo implantation.
3.What is the complete price for the IVF treatment (including all necessary steps and all recommended procedures for our case, from the start to the end of embryo transfer), without medicines? We are also interested in embryo freezing. The package price for an IVF treatment in the clinic is 2600 euros - check what the price includes at http://www.medspa.bg/docs/Non-donor_IVF_eng.pdf or have a look at the clinic's website http://invitro-bg.com/en-eu/we/prices/ The stimulation medications are paid separately as each woman requires different doses. Medications cost around 700 - 1000 euors. Embryo cryopreservation for 1 year costs 205 euros.
4.What protocol and medicines do you recommend for me? You need to discuss this with Dr Stamenov at the initial consultation.
5.What is the maximum number of embryos transferred per one cycle? The number of embryos to be transferred is recommended individually depending mainly on the embryos’ quality, patient’s age, treatment and obstetric history. However, Ordinance 28 regulates the maximum number of embryos allowed for transfer and these limits depend on patient’s age and number of previous unsuccessful embryo transfers, as well as on the stage of embryo development. In your case it will be up to 3 embryos in case of embryo transfer on day 2 or 3 and up to 2 embryos in case they are at blastocyst stage (transfer at day 5). The doctor will discuss the best option for you prior to the embryo transfer.
6.Do you practice the permanent embryo monitoring with embryoscope? I will ask the embryologists at the clinic tomorrow.
7.What is the estimate date to begin the procedure, based on the attached information and your schedule and availability? Maybe November 2012? Expected beginning of my menstrual cycle is about 15th November. November is fine.
8.What is the success rate for “our case group” in your Clinic? Each couple is an individual case, but you can check clinic's statistics at http://invitro-bg.com/en-eu/we/success/
9.Do you practice that one doctor leads patient from the beginning to the end of the treatment? As I've mentioned above, Dr Stamenov takes care of patients from abroad - from the beginning to the end of treatment, including follow-up care.
10.Do you recommend us to use some vitamins or herbal products prior to IVF treatment? Folic acid is most important to you. As far as I know Dr Stamenov does not recomment vitamins for the woman as usually they increase appetite and the woman may put on undesired weight:) but you may discuss this topic at the initial consulation too.
11.Do you recommend any specific activities or anything which can improve our chances for success? Moderate sport activities are recommended in order to be fit and have good blood circulation. Better avoid swimming pools. Relaxing massage, including aromatherapy is fine.
Dear and ,

please feel free to ask any other questions you may have. I suppose a decisive factor for your choice will be the cost, so, please let me know if the package price above is OK for you and if you'd like to go ahead with Nadezhda clinic. In that case I'll also ask you to scan and e-mail if available any original documents that you have, such as semen analysis, ultrasound scans, etc.

Kind regards,

Iva

Iva Stoykova
MEDSPA Case Manager
www.medspa.bg
+359 885 272738

Dr. Stamenov iz klinike Nadežda se meni jako dopao. "Špijunirala" sam ga po internetu, čitala njihove forume. Žene ga obožavaju, u Bugarskoj je zvezda i kod njega na konsultacije čekaju 1 - 1,5 godinu.
Problem je što se do njih dolazi posredstvom ove agencije, koja traži 500 evra depozit, što je za nas bilo neprihvatljivo. Posle su ponudili 250...