...It took them 7 trips to St. Petersburg within 1 year and 4 months to get their long awaited son Theodore💙 with the help of IVF-PGT-A and very specific treatment...

Michaela came to us after a long fertility journey, with all the thinkable and unthinkable embryonic and maternal reasons of recurrent implantation failures and pregnancy losses. Together with Dr. Elena, Dr. Nina, Dr. Svetlana and all the team we put our minds together to help this lovely couple become parents. It did not work at once, took us time to identify, understand and treat, and finally a healthy live birth was achieved with the help of IVF, PGT-A and treatment for immune and other maternal reasons of losses. The process was dramatic in all the ways, as I remember us sitting with Michaela and Victor in our library in O.L.G.A. Clinic in St. Petersburg in February 2022 on the very first day of the war, trying to decide whether to do a transfer the next day or not, knowing that not all the medical conditions for successful transfer were fulfilled, but also not knowing whether they would ever have a chance to come back… That transfer did not work, but they were able to come back…

Michaela @melanrothstein:

“In 2020 an old friend of mine, who had also tried to conceive for many years, got her first child with the help from O.L.G.A. clinic. She told me about the clinic’s seminars and my partner and I attended one in Stockholm. After many unsuccessful IVF pregnancies in Sweden we were ready to try something new and shortly after the seminar we felt we had enough information to make the decision of going to O.L.G.A. clinic. Some of the decision factors for us were that we were given the possibility of PGT-A testing of our embryos and many more tests on our reproductive health.

It has been a long and exhausting journey but in March 2023 we finally got our little rainbow❤️ with the help of IVF-PGT-A. During our trips we met many others with similar background stories since most patients who come to O.L.G.A. already have gone through a tough fertility experience. This made us feel less lonely and several of the patients are now my friends (you know who you are).

For us, some of the biggest differences with previous treatments and the ones in St. Petersburg were how the doctors worked WITH us. I many times felt we were all a team in this and that my partner and I were truly listened to. We were a bit of a difficult case (please watch the record of our Instagram live with Michaela to learn more) and no stone was left unturned. In the end we learned that I had several diagnoses to take into consideration and they were all treated successfully.

Would we have succeeded in another clinic, in another country? Maybe. But I’m pretty sure that this was the fastest and best way for us to become parents after all previous failed attempts and miscarriages. I don’t wish this difficult journey upon anyone else but I will always keep the memories from St. Petersburg close to my heart. I am humble and eternally grateful that we got the chance to become parents.”

Dr. Olga explains:

Michaela and her partner came to us just before her 39^th birthday, after 3 IVF cycles with 3 fresh and 2 frozen embryo transfers and 5 early pregnancy losses within 1 year. Michaela suffered strong pains in her lower abdomen, and endometriosis was suspected but never confirmed by reliable diagnostic methods.

Together with Dr. Alenka, Dr. Nina, Dr. Elena and Dr. Svetlana, we put our minds together, but it still did not work at once, it took us time to identify, understand and treat...It took Michaela 7 trips to St. Petersburg within 1 year and 4 months to get her son.

Because of 5 early pregnancy losses, Michaela and her partner chose a Combined Package with 100% Money Back Guarantee of Live Birth meaning that if no successful pregnancy was achieved within 2 IVF cycles with own eggs, the couple moves on to two more cycles with donor eggs.

Dr. Alenka has analyzed her history, prepared Michaela’s first Treatment Plan and planned the first visit to St. Petersburg for Michaela and her partner.

Trip-1. The first trip was in April 2021, when Dr. Nina got 5 eggs and 2 blastocysts were achieved, PGT-A tested and one was found to be chromosomally normal. Was it exceptional luck or was chromosomal angle not the main reason for the recurrent miscarriage?

Trip-2. In July 2021 a hysteroscopy was done with histological and immunohistochemical testing of endometrium, the ERA test showed that implantation window was likely to be 10 hours earlier than usual (118h after begin of progesterone supplementation instead of 128h). Since Michaela had a history of recurrentpregnancy loss Dr. Nina made some autoimmune tests and found the antibodies to membranes and nuclei of Michaella’s cells in her body– the immune system was attacking its own body. Hence, in preparation for the embryo transfer Cortisone, Aspirin and Intralipid were included to put the immune system at ease.

Trip-3. In October 2021 a transfer of the only chromosomally normal embryo was done, after Aspirin, Cortisol and Intralipid treatment and at 118h after beginning of progesterone supplementation. Sadly, no pregnancy was achieved.

Trip-4. In December 2021 Michaela came back for another egg retrieval and now Dr. Nina got 4 eggs and 3 blastocysts, PGT-A was done, and two out of three blastocysts were found to have the normal number of chromosomes! Embryo transfer after autoimmune treatment with Aspirin, Intralipid and Cortisol was planned for February 2022

In December 2021 Dr. Nina took a break from working in the O.L.G.A. Clinic and I took over Michaela’s treatment process. Michaela came back to St. Petersburg in February 2022

Trip-5. Two days before the embryo transfer in February 2022 by ultrasound in St. Petersburg, a pattern of Michaella’s endometrium has drawn my attention: it contained multiple 2-3 mm cysts, as it was Herpes, but on the endometrium. I could not leave this pattern unnoticed and brought this up to discussion with our leading expert Dr. Elena Lapina and we went through all Michaela’s files once again.

Dr. Elena has noticed a discrepancy between the result of the ERA test and the histology test. Histological testing after 128h of progesterone supplementation was saying there was insufficient luteal transformation → means endometrium is less mature than it should be after 6 days of progesterone intake. Shortage of progesterone receptors in endometrium or their incompetence could be an explanation for that. So called "progesterone resistance" (meaning endometrial tissue does not react to progesterone whatever levels of it are in the body) is not uncommon in patients with endometriosis or inflammation in endometrium. At the same time the ERA test is less receptive and recommends the embryo transfer 10 hours earlier than usual (after 118h of progesterone intake rather than after 128h). Dr. Elena said: This discrepancy is a very seldom pattern, and speaks about some active pathologic process going on in the endometrium.

The next day I called Michaela and asked her to come to have a talk. This was the first day of the war. Impossible to express how I felt. I focused on my patient. I said that the conditions for a successful embryo transfer were not fulfilled. I remember us sitting with the couple in our library in O.L.G.A. Clinic in St. Petersburg in February 2022, trying to decide whether to do a transfer of a precious chromosomally normal embryo, knowing that not all the maternal conditions for successful transfer were fulfilled, but also not knowing whether they would ever have a chance to come back… That transfer did not work, but they were able to come back…

Based on the medical parameters only, I would not have given a choice in such a case, I would have cancelled the embryo transfer. But this was the first day of the war and what was going to happen we could not have known.

On the same trip, because I saw ”Herpes-like-picture” in the endometrium, we took tests for viruses of Herpes group and an active EBV (Epstein Barr Virus) infection was identified.

Trip-6. In April 2022 Dr. Svetlana took over the treatment. Dr. Elena did another hysteroscopy and multiple tests to fine tune the treatment were done. Dr. Svetlana arranged a consultation with an infectious disease specialist who recommended anti-replication therapy to Michaela before the next embryo transfer. Michaela also remembered that in 1999 she had a heavy infectious mononucleosis (this is caused by an acute EBV infection) and in 2000 viral meningitis, so this infection persisted for 20 years. It persisted so long that it had changed the immune system and started attacking cells of the body — that is what was seen at the beginning of diagnostic search in O.L.G.A. Clinic, but happened to be just a tip of the iceberg.

Rectovaginal deep infiltrating endometriosis was suspected before Michaela came to us, but never confirmed by diagnostic methods to be able to use treatment against it, so Dr. Svetlana recommended an MRA of pelvis with contrast to confirm deep endometriosis. Deep endometriosis was confirmed in March 2023. The treatment against endometriosis was prescribed.

Trip-7. In July 2022 Michaela came to St. Petersburg for her third embryo transfer. In preparation for this transfer she took antiviral treatment against the Epstein Barr infection and endometriosis treatment. It was physically very hard for Michaela but she made it. On the day before the embryo transfer Dr. Svetlana took the tests to check the status of the EBV infection and was happy to see the virus was fully suppressed.

Dr. Svetlana made this embryo transfer and it was successful.

Little Theodor was born in March 2023.