Frequently Asked Questions

At Adella, we start with your medical and reproductive history, not a standard treatment protocol.

Our doctors, embryologists, and other specialists assess your results as part of a complete picture. The goal is to ensure that every recommendation has a clear medical rationale and a well-defined role in your treatment plan.

You will understand what to expect, why each step is recommended, and what the realistic outcomes and limitations are.

Since 2025, Adella Fertility has been part of Embryos Group, a growing network of reproductive medicine clinics.

For patients, this means access not only to the expertise of a single team, but also to a coordinated network with shared medical standards, aligned laboratory processes, and expertise shared across clinics.

Clinical outcomes are monitored, analysed, and used to continuously improve medical and laboratory decision-making throughout the group.

Adella Fertility Clinic has an embryology laboratory, an operating theatre, consultation rooms, its own clinical and andrology laboratories, and a cryobank.

Examinations are performed using General Electric ultrasound equipment, supporting accurate diagnosis and treatment monitoring.

The embryology laboratory is equipped with systems for internal monitoring and control of laboratory conditions. As part of Embryos Group, it operates in accordance with harmonised standards and group-wide quality control procedures.

The published figures provide context for the experience gained: over 10,000 couples treated across the group and more than 8 years of clinical practice in Bulgaria.

The reported figures include a 45% pregnancy rate following frozen embryo transfer with PGT-A, a 55% pregnancy rate for procedures using donor eggs, a 96% embryo survival rate, and an 80% fertilisation rate.

These percentages do not represent an individual prognosis or guarantee of success. They should be interpreted in the context of the patient population, the type of procedure, and the method used to calculate each indicator.

Yes. Adella Fertility Clinic is among the medical facilities that have a contract with the Centre for Assisted Reproduction (CAR) for 2026. This allows approved procedures to be carried out at the clinic in accordance with the conditions specified in the authorisation issued by CAR.

The medical documentation required for the application is prepared by the chosen medical facility. Our team will review your medical history, assess whether you meet the eligibility criteria, and guide you through the necessary documents and next steps.

Women who are under the age of 43 on the date of application, hold Bulgarian citizenship or permanent residency status in Bulgaria, and meet the medical criteria for funding may apply.

Medical indications include certain types of fallopian tube damage or absence, severe endometriosis, male factor infertility, unexplained infertility, a confirmed monogenic disorder or balanced chromosomal rearrangement in either partner, as well as certain cases of cancer in women.

Eligibility is determined following a review of the complete medical documentation, rather than based on a single test result.
 

The application process begins with submitting an application form in the approved format. This must be accompanied by medical documents confirming the relevant indication for funding, as well as a medical summary outlining the applicant’s medical condition and confirming the absence of contraindications. The specific tests and documents required depend on the underlying cause of infertility.

The following documents are also generally required:

• A copy of the applicant’s identity card, marked “True Copy of the Original”;
• A declaration confirming that the applicant and her partner are not related by blood;
• Informed consent forms signed by both the applicant and her partner;
• Declarations confirming that neither the applicant nor her partner has been placed under legal guardianship;
• Medical documentation specific to the diagnosed condition.
• The medical documentation is prepared by the clinic contracted with the Centre for Assisted Reproduction (CAR), while the applicant completes the remaining forms using the current official templates.

Before submission, it is important to check that all documents are complete and accurate, as missing or incorrect information may delay the review process.

The total cost depends on the consultations and tests required, the type of procedure, medications, fertilisation method, and laboratory techniques involved.

Additional costs may arise from genetic testing, the use of donor eggs or sperm, vitrification, cryopreservation, or a subsequent frozen embryo transfer.

The cost is determined by each patient’s individual treatment plan, rather than a standard package applied to all patients.

Before treatment begins, you will receive information about the planned stages and their associated costs.

We will explain which services are included, which are charged separately, and under what medical circumstances the initial cost estimate may change.

If an additional laboratory technique or a change to the treatment plan becomes necessary during the cycle, the reasons and financial implications should be discussed with you in advance.

Funding options depend on the medical indications, the type of procedure, and the current eligibility criteria of the relevant national or local programmes.

Our team will explain which funding options may be available in your case, what documentation is required, and which stages of treatment or services are not covered.

Approval for funding does not automatically mean that all medications, laboratory techniques, genetic tests, or storage fees are included.

Sometimes, a treatment cycle may need to be modified, postponed, or cancelled for medical reasons. This may occur due to an insufficient or excessive response to ovarian stimulation, changes in the patient's health, or other safety-related considerations.

The financial implications depend on the consultations and examinations already carried out, medications used, and laboratory procedures completed.

Before treatment begins, you should receive clear information about how individual services are charged if such changes become necessary.

Your first consultation begins with a discussion of your reproductive and general medical history. We will talk about how long you have been trying to conceive, which tests and procedures you have undergone, and whether you have any diagnosed medical conditions or previous pregnancies.

We will review your existing test results and explain whether any further investigations are needed. The goal is not to provide a ready-made treatment protocol at your first appointment, but to establish a clear direction based on your individual circumstances.

Whenever possible, having both partners present helps us assess their reproductive health as a whole. Difficulties conceiving may be related to female, male, or combined factors.

If one partner is unable to attend, the consultation can still take place. We will clarify what additional information or tests may be needed at a later stage.

There is no need to arrange extensive testing on your own before your first appointment. You can bring any existing test results, medical reports, and records from previous treatments.

After reviewing these documents, we will determine which test results are still relevant and whether any additional investigations are needed. We do not prescribe the same set of tests for every patient, as each test should have a clear medical purpose and the potential to influence the treatment plan.

Your treatment plan is tailored to your age, ovarian reserve, the condition of your uterus and fallopian tubes, semen analysis results, and the outcomes of any previous treatments.

We do not assess individual test results, diagnoses, or unsuccessful treatment attempts in isolation. We will discuss the available treatment options, their expected benefits, and their limitations, so you can make an informed decision together about the next step.

Intrauterine insemination (IUI) may be suitable when ovulation is occurring, at least one fallopian tube is open, and semen parameters are sufficient to allow fertilisation to occur naturally.

In vitro fertilisation (IVF) may be recommended in cases of fallopian tube abnormalities, more severe male factor infertility, endometriosis, diminished ovarian reserve, genetic indications, or previous unsuccessful treatments.

There is no fixed number of IUI attempts that is appropriate for everyone. The decision is based on your individual medical circumstances and the time available in relation to your reproductive potential.

IVF treatment involves several interconnected stages: medical assessment, controlled ovarian stimulation, follicular monitoring, egg retrieval, fertilisation in the laboratory, and embryo development monitoring.

When conditions are suitable, an embryo may be transferred into the uterus. In other cases, suitable embryos are vitrified (frozen), and the embryo transfer is scheduled for a subsequent cycle.

Before treatment begins, you will receive information about the medications, examinations, procedures, and the expected timeline of the entire treatment cycle.

In conventional IVF, eggs are placed together with specially prepared sperm, allowing fertilisation to occur without the direct injection of an individual sperm cell.

With ICSI (intracytoplasmic sperm injection), an embryologist selects a single sperm and injects it directly into a mature egg. This method may be recommended in cases of severe male factor infertility, surgically retrieved sperm, or certain outcomes from previous treatments.

ICSI is not automatically the better option for every couple and does not guarantee fertilisation or embryo development. We select the most appropriate method based on individual medical and laboratory indications.

The outcome of IVF treatment is influenced by age, ovarian reserve, egg quality and maturity, semen parameters, the fertilisation method, and embryo development.

Other important factors include the condition of the uterine cavity and endometrium, any underlying medical conditions, and the outcomes of previous treatments.

Not every IVF cycle progresses to embryo transfer. If a cycle does not reach this stage, we analyse each step to understand what the results reveal and whether any adjustments to the next treatment plan are warranted.

After fertilisation, embryologists monitor the early development of the embryos. They assess whether fertilisation has occurred normally, the rate of cell division, morphological characteristics, and whether the embryos reach the appropriate developmental stage.

Not every egg is mature, not every mature egg is fertilised, and not every embryo continues to develop. This is part of the natural biological selection process and does not automatically indicate a problem in the laboratory.

Additional laboratory techniques are not routinely included in every IVF cycle.

PICSI may help select individual sperm before ICSI based on their ability to bind to hyaluronan. ZyMot uses a microfluidic system to isolate a fraction of progressively motile sperm.

Assisted oocyte activation may be considered following complete fertilisation failure or a very low fertilisation rate in a previous ICSI cycle. Before recommending any of these techniques, we will explain its purpose, limitations, and expected role in your treatment.

PGT-A (Preimplantation Genetic Testing for Aneuploidy) is a genetic test performed on cells biopsied from an embryo at the blastocyst stage. It assesses whether the analysed sample contains the expected number of chromosomes.

The test may provide additional information when selecting between multiple embryos, in cases of advanced maternal age, or in certain situations involving recurrent pregnancy loss or unsuccessful embryo transfers.

PGT-A does not analyse all genes, does not treat or correct abnormalities in the embryo, and does not guarantee implantation or pregnancy.

A euploid result means that the expected number of chromosomes has been identified in the analysed cells. An aneuploid result indicates the presence of a missing or extra chromosome.

A mosaic result indicates a mixed signal from cells with different chromosomal compositions. Interpreting this result requires an individual assessment and often a consultation with a medical geneticist.

In some cases, the result may be inconclusive due to the quantity or quality of the genetic material. If this happens, we will discuss the possible next steps with you.

Eggs can be frozen to preserve fertility for personal or medical reasons. Embryos are vitrified when they will not be transferred during the same treatment cycle or when suitable embryos remain after an embryo transfer.

Sperm can be cryopreserved before medical treatment that may affect fertility, prior to a surgical procedure, or when a sample needs to be collected and stored in advance for assisted reproduction.

Freezing does not guarantee a future pregnancy, but it provides the opportunity to use the preserved reproductive material at a later stage.

Eggs, sperm, and embryos are stored in a cryobank under strictly controlled conditions.

The specific storage period depends on the medical circumstances, informed consent, the storage agreement, and applicable regulations. Before the storage period expires, decisions regarding continued storage and the future use or disposition of the material must be clarified.

You will receive information about the storage conditions, required documentation, and fees associated with extending the storage period.

Donor eggs may be considered when the chances of obtaining a suitable embryo using a patient’s own eggs are extremely limited or when this is not possible.

Donor sperm may be considered as part of treatment when suitable sperm cannot be obtained from the male partner or when there is a significant risk of transmitting a hereditary condition.

Low AMH levels, a single semen analysis, or one unsuccessful treatment attempt are not sufficient on their own to recommend a donor programme. The decision is made following a comprehensive medical and reproductive assessment.

Donors undergo a medical assessment, infectious disease screening, and a review of their personal and family medical history in accordance with applicable regulations.

Depending on the donor programme, non-identifying characteristics such as height, body build, eye and hair colour, blood type, and ethnic background may be taken into consideration.

No medical or genetic screening can eliminate all potential future risks. We will explain what information is available and its limitations before you make a decision.

A fresh embryo transfer is performed during the same treatment cycle in which the eggs are retrieved, provided that embryo development, the condition of the endometrium, and the patient’s overall health allow it.

In a frozen embryo transfer, the embryo is vitrified (frozen) and transferred into the uterus during a subsequent natural or hormonally prepared cycle.

Neither approach is universally better. The choice depends on patient safety, embryo development, and the conditions required for successful implantation.

An embryo transfer usually takes just a few minutes and does not require anaesthesia. Prolonged bed rest is not necessary afterwards unless your doctor has provided specific recommendations based on your individual circumstances.

You can generally return to your normal daily routine, avoiding strenuous activities. You will receive clear instructions regarding your medication, physical activity, and when to contact the clinic.

The timing of the blood pregnancy test is determined by the type of embryo transfer and the day of embryo development at transfer. Testing too early may produce misleading results, so it is important to follow the recommended schedule.

If the pregnancy test is positive, the first ultrasound is often scheduled between the 6th and 8th week of pregnancy. The exact timing depends on the method of conception, β-hCG levels, symptoms, and medical history.

The method of conception is taken into account, but an IVF pregnancy is not automatically classified as high-risk.

Pregnancy monitoring includes obstetric consultations, ultrasound examinations, laboratory tests, and prenatal screening. The frequency of these assessments depends on the mother’s health, the number of fetuses, placental factors, and the progression of the pregnancy.

When IVF treatment has been carried out at Adella, the obstetric team can use the available information about the procedure, embryo transfer, and early pregnancy monitoring to support ongoing care.

You do not need to be experiencing a crisis to seek psychological support.

Counselling can be helpful before or during fertility treatment, after an unsuccessful attempt or pregnancy loss, or when considering a donor programme, taking a break, or discontinuing treatment.

It does not dictate how you should feel or make decisions for you. Instead, it provides a confidential space where you can explore your emotions, relationships, and personal boundaries.

Yes. Counselling sessions can be individual or attended together as a couple, depending on the topics you would like to discuss.

Partners do not always experience fertility treatment in the same way. One may want to talk about their feelings in detail, while the other may prefer to focus on practical steps.

Couples counselling is not about deciding who is right. It helps ensure that both perspectives are heard and understood.

There is no universal diet that can guarantee pregnancy or improve IVF success rates.

Nutrition and lifestyle counselling can help you establish balanced eating habits, use supplements safely, choose appropriate physical activities, and manage metabolic or endocrine conditions.

Recommendations are tailored to your health, daily routine, personal preferences, and treatment plan, without extreme restrictions or labelling foods as “good” or “bad”.

Nutrition can complement medical care, but it cannot cure polycystic ovary syndrome (PCOS), endometriosis, diabetes, insulin resistance, or thyroid disorders.

Supplements are not necessarily risk-free simply because they are available without a prescription. They may contain overlapping ingredients, provide inappropriate doses, or interact with prescribed medications.

We will review the supplements you are currently taking and discuss whether there is a medical reason to continue, adjust, or discontinue any of them.