Fertility counselling is a specialized medical service that aims to outline the woman/couple from a reproductive point of view. It consists in the prescription/evaluation of examinations (female and male) in order to define the biological age of the woman and the couple’s reproductive capacity and in the execution of a transvaginal gynaecological ultrasound (preferably in the early post-menstrual phase) with the aim of assessing the uterine cavity and the appendages with particular attention to the antral follicle count (follicles diameter < 10 mm). Diagnostic and instrumental evaluations will be integrated with the clinical history of the woman/couple and the possible desire for pregnancy. This counselling is certainly also useful to all young women who, for medical or social reasons, would like to know more about their current and future reproductive potential.
Psychological counselling can be carried out at different stages of the IVF process and has the following objectives:
- stress reduction through the promotion of useful strategies to face the difficulties that can derive from infertility problems and that, in some cases, are also caused by medically assisted procreation treatments;
- maintenance or recovery of harmony and stability in the couple’s relationship;
- reduction of anxiety levels;
- increased psycho-physical well-being.
In addition, the couple may benefit of psychological support before undertaking IVF treatment with gamete donation.
Genetic counselling is an integral part of the IVF cycle, especially in the presence of risk factors that can have a major impact on the health of the newborn child. The consultation with the geneticist aims to assess and inform the couple about their reproductive risk and to discuss about screening techniques thath can be used to minimize this risk.
Several scientific studies show how much nutrition can influence the time needed to achieve pregnancy, both in a natural way and through assisted fertilization. The nutritional workup includes counselling with a nutritionist who support the woman during the assisted fertilization providing her with specific guidelines or plans for each phase (stimulation, pick-up, post-pick-up, embryo transfer and post-transfer) with the aim of:
- restore the intestinal microenvironment;
- support the immune system;
- support the microcirculation;
- reduce inflammatory states;
- provide antioxidant protection;
- manage the glycemic balance that plays a key role in ovarian function
- help prevent or minimize any disorders such as swelling, fatigue, water retention and headaches that may occur during hormonal stimulation;
- support endometrial growth.
An endocrinologist with andrological competence is available to the couple in order to:
- evaluate hormonal disorders potentially responsible for oligo-anovulation and identify and treat endocrinopathies and dysmetabolisms to prevent pathologies during gestation (e.g. thyroid disorders, hyperinsulinemia);
- diagnose and quantify the extent of the seminological alteration; determine whether there is any real possibility of improving the parameters and/or whether it is possible to recover spermatozoa in the case of azoospermia;
- evaluate the time window for treatment compatible with the couple’s situation (female age).
In the case of an infectious pathology relevant for the couple’s reproduction (HIV, HBV, HCV, syphilis, CMV, etc.) the couple can avail themselves of infectious counselling in order to evaluate strategies to prevent the risk of horizontal transmission to the healthy partner in serodiscordant couples. This counselling is also strongly indicated to implement all possible therapies to reduce viremia and protect and the risk of vertical transmission to the unborn child.