Your IVF Process: One Step at a Time

In life it is rare to get everything at once. First, we strive to get an education, then to achieve success in our professional field, then to create a family and give birth to our children. Each step takes time and energy. And these steps are so difficult to combine, for example, to achieve success at work while starting a family. And we, of course, want to do everything in the best possible way.

Equally, a successful and efficient IVF process requires a step-by-step and focused approach. For example, it may be not possible to create both competent embryos and receptive endometriumEndometrium — the lining covering the uterine cavity at the same time — each link in the reproductive chain may have its own individual rhythm, which we should hear, understand and accept, and only in this dialogue move towards the goal — pregnancy and live birth.

IVF is a big task and a big project both in terms of high expectations and huge emotional, physical and financial investments.

So that a big task does not look impossible, and a big project ungraspable, we divide it into separate stages (“eat an elephant one bite at a time”). It allows us to focus on achieving the goals of each stage, and from these small goals get the main goal – an on-going pregnancy and live birth.

Below we describe our IVF process step by step. It will help you manage your expectations.

IVF process step by step. One challenge — one solution.


Each step of your IVF journey will have its own focus and goal:

Steps in your IVF process and goalsFocusLogistics
Month 1: IVF Cycle

The Goal: Viable Embryo at BlastocystBlastocyst — the stage that a human embryo normally reaches on day 5-6 of development. This is the stage on which the embryo implantation begins. stage;
normal for 23 chromosomeChromosome — is a unit of genetic information in a cell which contains DNA and proteins. Abnormal number of chromosomes in cells of embryos, makes an embryo’s development stop. An abnormal number of chromosomes in embryos, is responsible for 70-80% of pregnancy losses in the first 12 weeks pairs
  • Creating competent eggs by individualized stimulation
  • Collecting and fertilizing eggs
  • Growing blastocysts
  • Blastocyst biopsy and PGT-APGT-A (PGS – historical name) — Preimplantation Genetic Testing for Aneuploidies. This genetic testing of embryos, finds embryos normal for 23 pairs of chromosomes, from those available. By excluding abnormal embryos from use, live birth rates are increased per embryo transferred and time to ongoing pregnancy is shortened. PGT-A is applicable in women of 35 years of age and older and on individual indications - selecting embryos with a normal number of chromosomes from the available embryos
  • Gentle freezing of blastocysts by vitrification to stop time for them and free us to move our focus to the next step – the optimal preparation of endometrium ready for implantationImplantation — the process of recognition and connection between receptors on the surface of the embryos and the surface of the endometrium followed by invasion of the embryo into the endometrium</span
Your ovarian stimulation takes place in your local country according to our Treatment Plan. You come to St. Petersburg for 10 days — for laboratory tests, last ultrasound examinations and egg retrieval. Egg retrieval is planned dayX+- 2 days. You can leave 24 h after.
Arrival and departure schedule depends on your OLGA Doctor’s working schedule: arrival Thursday – departure Saturday next week or arrival Friday – departure Sunday next week.
Month 2: Cool Down Cycle

The Goal: Cooling down ovaries after stimulation
Pill intake to help ovaries shrink after stimulation and stop producing residual levels of ProgesteroneProgesterone — the main pregnancy hormone. Progesterone production by the ovary begins at ovulation. Progesterone influences the endometrium and times its readiness for implantation — implantation window 
Month 3: HysteroscopyHysteroscopy — endoscopic check of uterus. “Hyster” = “Uterus” and “Scopy” = “Looking” in Greek. Hysteroscopy is done via the natural pathway. Hysteroscopy enables surgical treatment of problems inside the uterus which may be responsible for IVF failures Cycle

The Goal: Diagnostics and possible microsurgical treatment of potential macroscopic findings in the uterine cavity; taking endometrial samples for cell/microbe/DNA/RNA tests; defining implantation windowImplantation window is a time frame under 72 hours when special receptors are present on the surface of endometrium, which can recognize receptors on the surface of embryos to start the implantation process

Receptor — is a protein structure on the surface of one cell, which recognizes a specific molecule or another receptor on the surface of another cell (like a key and lock). With the help of receptors cells, they can communicate with each other. An example of such dialogue: implantation dialogue between embryonic cells and endometrial cells during the implantation process.
  • EstradiolEstradiol — the main female hormone responsible for growing the lining in the uterus. Estradiol is produced by the growing follicle in the ovary and Progesterone treatment helps to restore endometrial receptivity.
  • Hysteroscopy helps to find and micro-surgically treat macroscopic conditions which may negatively influence chances of implantation: polyps, micro polyps, adhesions etc.
  • ERA testERA test — is an abbreviation for “Endometrial Receptivity Array”. The aim of an ERA test is to confirm on which day, after the beginning of progesterone supplementation, the endometrium is receptive to the embryos, and hence implantation will be most probable checks implantation window based on certain protein expression levels in endometrium.
  • Histological and immunohistochemical testing of endometrium tissue helps to identify potential abnormalities at microscopic cell levels.
  • PCR testing of endometrium for bacteria and viruses.
  • Scratching done during Hysteroscopy may improve blood flow and increase the chance of implantation.
  • Hysteroscopy may not be necessary for all patients. If hysteroscopy is not indicated, the Month 3 can be used for Embryo Transfer. Hormonal preparation for the embryo transfer and hysteroscopy is similar.
Your preparation for the Hysteroscopy and ERA test takes place in your local country according to our Treatment Plan. You come to St. Petersburg for 5 days — for laboratory tests, last ultrasound examinations, hysteroscopy, consultation, recommendations, prescription, buying medication which may not be available in your local country.
Arrival and departure schedule depends on your OLGA Doctor’s and Surgeon’s working schedule: arrival Sunday – departure Thursday or arrival Monday – departure Friday.
Month 4: After Hysteroscopy Treatment Cycle

The Goal: Optimizing endometrium with the help of medication
  • Within 2 weeks after Hysteroscopy, we receive results of histological, immunohistochemical and PCR testing of endometrium tissue. Based on these results individual medication may be added to your treatment plan: antibacterial and antiviral medication, growth factors and immune-modulating medication. The aim of this treatment is to optimize endometrium and increase chances of implantation in the following cycle.
  • 3 weeks after Hysteroscopy the result of the ERA test arrives, which provides information about how many hours after the start of Progesterone supplementation we should do embryo transfer in the following cycle.
  • At the end of this cycle a down-regulation injection is applied to switch off ovarian hormone production for one month. This is necessary for being able to reproduce the implantation window in the following cycle.
 
Month 5: Embryo Transfer Cycle

The Goal: To achieve successful implantation and on-going pregnancy
Here all the three pieces of the puzzle should come together: transfer of a chromosomally normal blastocyst into your optimally prepared endometrium in the right timingYour preparation for your Embryo Transfer takes place in your local country according to our Treatment Plan. You come to St. Petersburg for 5 days – for laboratory tests, last ultrasound examination, consultations with doctors and nurses, actual Embryo Transfer, recommendations, prescription, buying medication which may not be available in your local country.
Arrival and departure schedule depends on your OLGA Doctor’s working schedule: arrival Sunday – departure Thursday, arrival Monday – departure Friday, arrival Tuesday – departure Saturday; arrival Wednesday – departure Sunday.
Potential months 6,7,8.. More embryo transfers if necessary and possible

The Goal: Potential next Embryo Transfer to achieve successful implantation and on-going pregnancy
In OLGA Clinic you have:
51.6% chance of live birth after 1 ET
75.4% chance of live birth after 2 ETs
85.6% chance of live birth after 3 ETs
88.9% chance of live birth after 4 ETs

If after the first embryo transfer no pregnancy was achieved:

a) In case there are chromosomally normal embryo(s) available after the last IVF cycle, the next embryo transfer can be done in the very next cycle. Important is that the patient does not stop hormonal medication before having spoken to the doctor. We usually book this call in advance for the doctor and the patient to speak as soon as the HCG test result is received.
b) If there are no chromosomally normal embryos available, stimulation of ovaries can be started right away or after a short course of pill, based on medical/social/emotional situation.

 
Your treatment after positive pregnancy test until Live Birth

The Goal: A Baby
  • Continued hormonal support, low molecular Heparin and other medication will be given to avoid the risk of miscarriage and reduce the risk of a premature birth
  • You will be educated about miscarriage prevention
  • We will continue dialogue with you via e-mail, phone, skype with our doctors and nurses until you give birth!
 

Month 1
Your IVF Cycle

The Goal: to have a viable embryo at the blastocyst stage, normal for 23 chromosome pairs

We are often asked, if PGT-A improves egg and embryo quality?

No, PGT-A is only a method of embryo testing. It helps to eliminate good looking, but abnormal blastocysts from usage. It does not make your embryos better — it identifies those embryos with a normal number of chromosomes from those that are available.

To be able to test good looking embryos at blastocyst stage, we first need to create them. This may be challenging, especially in patients, who have not had any blastocysts in previous attempts. We learn from the past and know how to use this knowledge for the future success.

How to achieve viable blastocysts, even if past attempts have resulted in no blastocysts at all?

Step 1. Your Individualized stimulation

The Goal: competent eggs with sufficient levels of energy

Two women of the same age and the same AMH levels may benefit from different stimulation schemes. We gain knowledge and a good feeling based on your medical history, test results and information about your previous IVF attempts. When you thoroughly inform us of the data from your past IVF attempts, you create the basis for us to create a successful treatment plan for you.

During two weeks from the beginning of the cycle till ovulationovulation — when the egg Is released from the ovary (or egg retrieval) eggs need to multiply their energy resources hundreds of times. It is clear enough that energy is needed to create a viable embryo. A sperm does bring half of a genome, but only the egg possesses the power stations for the development of the embryo. They are called mitochondria, if a cell was a city, mitochondria would be this city’s power plants.

Individualized and balanced treatment plan helps eggs to collect enough energy for fertilization and embryonic development.

We also recommend diet, lifestyle adjustments, vitamins and supplements aimed at increasing egg energy levels.

Step 2. A Gentle, quick, and painless egg retrieval

The Goal: one follicleFollicle — a mature follicle is a 2 cm bubble containing a 0,1mm egg. Follicles are located in the ovary — one mature egg

We take great care in making the egg retrieval gentle, quick, and painless, this ensures that the egg retrieval day will be a good day for all our patients.

During egg retrieval, we focus on every single follicle and every single egg. If our patient would like to proceed towards egg retrieval having even just one single follicle, we will go for it and do our very best.

Step 3. First class process in our EmbryoLab

The Goal: Blastocysts, Normal for 23 Chromosome Pairs
  • Elegant and soft IVF and ICSI procedures
  • Careful and reliable blastocyst growing
  • PGT-A (genetic testing of embryos to find the normal ones from those available)

Little embryos are like children or flowers: they need to be talked to in a nice way and handled with love and care. Our embryologists feel like they look after flowers or work in a kindergarten, rather than growing embryos :)

Dr. Svetlana Shlykova, Dr. Anna Gusareva and Dr. Maia Shestakova have hearts full of love and hands full of skill. The Embryos in their lab gain all this special attention, love, and care.

Dr. Svetlana Shlykova, Dr. Anna Gusareva and Dr. Maia Shestakova

The Embryos in their lab gain all this special attention, love, and care

 

Step 4. Gentle freezing of your blastocysts by vitrification (FREEZE ALL)

The Goal: to stop time for the embryos and use this time for optimizing your maternal side before embryo transfer
  • Why don’t we transfer fresh embryos? — Because endometrial receptivity in stimulated cycles is lower than in natural cycles, or cycles on HRT.
  • Why do we freeze all embryos? — We freeze all the embryos to stop time for them for a while so that we gain 1-2 months to focus on your endometrium and other maternal factors.
  • Why not try with a fresh embryo right away and then try with a frozen embryo later, if fresh transfer hasn’t worked? — Because many patients will have just the one usable embryo and we must create VIP conditions for its transfer to achieve a maximum result.
  • Why are we not afraid “to risk the embryo by freezing it”? — Because we have above 95% survival rates after freezing/thawing via vitrification.

In many spheres of our life we cannot get two goals at once and chasing two rabbits at once will just lead to catching noneIn many spheres of our life we cannot get two goals at once and chasing two rabbits at once will just lead to catching none.

In many patients getting eggs and embryos is like one rabbit and preparing an optimal endometrium and implantation window like the other, and we can catch both only when we chase them one by one, in a separate setting and timing.

Logistics

Your ovarian stimulation takes place in your local country according to our Treatment Plan. You come to St. Petersburg for 10 days — for laboratory tests, last ultrasound examinations and egg retrieval. Egg retrieval is planned dayX +- 2 days. You can leave 24 h after. Arrival and departure schedule depends on your OLGA Doctor’s working schedule: arrival Thursday — departure Saturday next week or arrival Friday — departure Sunday next week.

Month 2
Cool Down Cycle

The Goal: to give ovaries time for cooling down after stimulation

Several weeks after stimulation, even after menstruation, ovaries may still be hormonally active, producing Estrogen, and especially Progesterone. Normally Progesterone is being produced only after ovulation and declines to zero by the time of menstruation. Production of Progesterone during and after menstruation makes endometrium not receptive in the current cycle. Therefore, usually the cycle after a stimulated cycle is used for giving ovaries rest. Ovaries need to cool down and shrink before beginning of the cycle in which the embryo transfer or ERA test (defining the implantation window) is planned. Pill intake from the start of menstruation, which comes within 2 weeks after egg retrieval, helps ovaries shrink after stimulation and stop producing residual levels of Progesterone. Usually after 3 weeks of pill a woman is ready to start the embryo transfer cycle or hysteroscopy/ERA test cycle.

Month 3
Hysteroscopy Cycle

The Goal: Diagnostics and possible microsurgical treatment of potential macroscopic findings in uterine cavity; taking endometrial samples for cell/microbe/DNA/RNA tests; defining implantation window

Hysteroscopy helps to find and micro-surgically treat macroscopic conditions which may negatively influence chances of implantation: polyps, micro polyps, adhesions etc.

Hysteroscopy may not be necessary for all patients. If hysteroscopy is not indicated, this cycle can be used for Embryo Transfer. Hormonal preparation for the embryo transfer and hysteroscopy is similar since the goal of Hysteroscopy in our clinic is to evaluate the place of implantation under the same conditions as for the actual embryo transfer.

Treatment in a Hysteroscopy cycle imitates an Embryo Transfer cуcle and consists of natural or synthetic Estradiol and Progesterone hormones; to imitate the phases of the normal menstrual cycle. If an ERA test is planned, a down-regulation injection is usually done several days before the beginning of the Hysteroscopy cycle to gain full control over hormonal levels and obtain reproducibility of the hormonal setting in the Embryo Transfer сycle.

We call this treatment a training cycle because this helps us evaluate your endometrial response to certain hormonal dosages in advance and choose the right hormonal dosage specifically for you in your Embryo Transfer cycle. Also, hormonal therapy with Estradiol and Progesterone helps to restore endometrial receptivity, even in those patients who have had impaired endometrial receptivity previously.

After we have had an opportunity of viewing your endometrium at different stages before and during stimulation and at the egg retrieval, we will come back to you with information as to whether we see any sonographic signs of polyps, adhesions, or other structures in endometrium, which may reduce the chances of implantation. If we see those potential reasons for a future failure, we will recommend a Hysteroscopy.

A Hysteroscopy is an endoscopic investigation of the uterine cavity — looking at the uterus from inside!

‘Hysteroscopy’ comes from the Greek meaning: “Hyster” = “Uterus” and “Scopy” = “Looking”.

Hysteroscopy provides us with the opportunity to look inside your uterus via a natural pathway, with the help of a tiny video camera. In our clinic, we do full surgical hysteroscopy under general anesthesia, which means we have the opportunity to infuse liquid in the uterus to straighten all the little corners of uterine cavity so as to see all the hidden details which may not be seen by quick office-based hysteroscopy. During a hysteroscopy we can treat possible abnormal findings (polyps, adhesions) microsurgically and hence increase the chances for a successful implantation.

Scratching, which is a nice peeling for the uterus — can be done to improve blood flow and facilitate implantation

Picture 1. Scratching, which is a nice “peeling for the endometrium” — lining of the uterus.

During a hysteroscopy, a scratching – like a peeling - might be performed to make the uterine cavity fresher, smoother, with better blood flow and more attractive for the embryo to implant.

During hysteroscopy several tissue tests are taken:

  • Histological and immunohistochemical testing of the endometrium tissue helps to identify potential abnormalities at microscopic cell levels.
  • PCR testing of the endometrium for bacteria and viruses.
  • ERA test checks implantation window based on certain protein RNA expression levels in the endometrium.
    ERA is an abbreviation for “Endometrial Receptivity Array”. The aim of the ERA test is to confirm on which day and time, after the start of Progesterone supplementation, the endometrium is most receptive to the embryo. In the majority of women, the implantation window  takes place around day 6 of Progesterone supplementation and lasts around 60 hours. However, in 20-30% of women the implantation window may start earlier or later or last less hours.  We believe it to be important to investigate the implantation window in patients who come to us after multiple unsuccessful attempts.
 

Hysteroscopy findings can explain why it may be so hard for embryos to attach and grow

Picture 2.  A metaphor for some of the causes of failure — findings in the uterus that make implantation difficult.

During a hysteroscopy, the reasons why it was hard for the embryos to implant in the past can be found: polyps, adhesions, inflammation and many others. Eliminating or correcting these intrauterine reasons of failure increases the likelihood of a future successful implantation and carrying pregnancy to term.

 

Luxurious environment for your VIP embryo after hysteroscopy and treatment

Picture 3. A VIP site for a VIP embryo to implant

Picture 3 is a metaphor for a well-prepared uterine cavity ready for embryo recognition and acceptance. After a hysteroscopy, removal of polyps or scar tissue, scratching, hormonal, immune and blood thinning therapy, it will be easier for the embryo to implant. It often happens that out of several blastocysts obtained within an IVF cycle, only one has a normal number of chromosomes. This is our VIP embryo, and our task is to create all the necessary conditions for its successful implantation.

Logistics

Your preparation for the Hysteroscopy and ERA test takes place in your local country according to our Treatment Plan. You come to St. Petersburg for 5 days — for laboratory tests, last ultrasound examination, hysteroscopy, consultation, recommendations, prescription, buying medication which may not be available in your local country. Arrival and departure schedule depends on your OLGA Doctor’s and Surgeon’s working schedule: arrival Sunday — departure Thursday or arrival Monday — departure Friday.

Month 4
After Hysteroscopy Treatment Cycle

The Goal: Optimizing endometrium with the help of medication

Within 2 weeks after Hysteroscopy, we receive results of histological, immunohistochemical and PCR testing of endometrium tissue.

Depending on the findings and micro-surgical treatment during hysteroscopy, specific treatment may be recommended: growth factors after having removed scar tissue and for thin atrophic endometrium, antibiotics, and antiviral medicines for chronic inflammation, immune therapy for signs of  autoimmune aggression. The aim of this treatment is to optimize endometrium and increase chances of implantation in the future.

In some cases, such as with endometriosis, we may recommend longer treatments after hysteroscopy to suppress the endometriosis and its negative influence on implantation.

All the medication which needs to be taken after hysteroscopy and up until the embryo transfer, can be bought in our neighboring pharmacy, if necessary.

3 weeks after Hysteroscopy the result of the ERA test arrives, which provides information about how many hours after the start of Progesterone supplementation we should do the embryo transfer in the following cycle. Then we adjust the Treatment Plan accordingly.

At the end of this Month 4 (After Hysteroscopy Treatment Cycle) a down-regulation injection is usually administered to switch off ovarian hormone production for one month. The aim of this downregulation injection is to avoid premature ovulation. Premature ovulation may make the timing of your implantation window different from the one found optimal for your embryo transfer. This downregulation injection is also necessary for being able to accurately reproduce the implantation window in the Embryo Transfer Cycle.

The duration of downregulation treatment, without estrogen coverage in the hormonal scheme aimed at the embryo transfer, does not exceed 7 days, so the undesired symptoms are highly unlikely to appear in such a short period of time.

Month 5
Embryo Transfer Cycle

The Goal: To achieve successful implantation and on-going pregnancy

Here all the three pieces of the puzzle should come together: transfer of a chromosomally normal blastocyst into your optimally prepared endometrium in the right timing.

Medication to grow a receptive endometrium

After you have stopped Estradiol and Progesterone in your After Hysteroscopy Treatment Cycle or, if there was no hysteroscopy, then at the end of your Cool Down Cycle, menstruation begins, and this is the start of your Embryo Transfer Cycle.

As we know from the IVF Success chapter, the endometrium grows due to the Estrogens, which are prescribed in the Embryo Transfer Cycle in the form of tablets, patches and/or gels. We monitor the growth of the endometrium with the help of the ultrasound to assess the thickness and decide if additional doses of Estrogen are required.

The doses of Estrogens during the preparation for the embryo transfer are much lower than the levels of Estrogen during pregnancy, which are produced by the placenta.

For the patients who have previously faced the problem of thin endometrium, growth factors can be used to stimulate the growth of the endometrium, low molecular weight heparins - to improve blood flow. For the patients with the signs of immune system aggression — prednisolone, intralipids, and/or IVIG therapy may be used to make the woman's immune system friendly towards the embryo. After a thorough review of the previous attempts and your investigation in the clinic, the necessary medications are added to the Treatment Plan on an individual basis.

Progesterone

Progesterone intake usually starts six days before the embryo transfer date. If the ERA test showed that the implantation window is earlier or later, we adjust the start of the Progesterone accordingly.

We recommend taking two forms of Progesterone at once: vaginal suppositories / vaginal cream + injections. Why both? — This combination is the best way to reduce the incidence of bleeding, early pregnancy loss and increase the chances for an on-going pregnancy.

The Embryo Transfer itself

Our standard practice is a Single Elective Embryo transfer.

Out of 100 transfers of a single embryo with a normal number of chromosomes in our clinic, 49 end in a live birth. It means that each transfer of an embryo with a normal number of chromosomes in our clinic has a 49% chance of resulting in an on-going pregnancy and live birth (Diagram 1).

Diagram 1. Clinical pregnancy rate and live birth/on-going pregnancy rate per one embryo transfer with own eggs, depending on whether or not PGT-A was used to check the chromosomal status of the embryo (data from the embryo transfers performed in 2020 and 2021).

 

What is the chance of reaching an on-going pregnancy and live birth after the 2nd, 3rd and 4th embryo transfers in O.L.G.A. Clinic? (Diagram 2)

In O.L.G.A. Clinic you have:

  • 51.6% chance of live birth after 1 ET
  • 75.4% chance of live birth after 2 ETs
  • 85.6% chance of live birth after 3 ETs
  • 88.9% chance of live birth after 4 ETs

Diagram 2. Cumulative live birth rateLive birth rate — are calculated per embryo transfer. Live birth rates show percentage of embryo transfers which resulted in live birth in all groups of patients who received embryo transfers within 1131 consecutive embryo transfers at the O.L.G.A. Clinic in the years 2019 — 2021)

As a result, if we persevere and consistently move towards the goal, the chance of having a baby after 4 embryo transfers in the O.L.G.A. Clinic is 88.9%.

When working with donor eggs, it will be quite easy to have 4 embryo transfers, because the donor has many eggs. Also, when we use donor eggs, blastocysts develop more frequently and most of them carry normal number of chromosomes.

When working with patients’ own eggs, especially in women after multiple IVF failures (to whom this entire page is devoted), the first challenging task is to obtain this golden VIP embryo — a morphologically usable blastocyst with a normal number of chromosomes. The second complex task is to create such VIP conditions in the uterus for this VIP embryo, so that the embryo couldn’t but agree to the offer made 😊 and implant with all the possible chances.


The transfer of two embryos will not increase pregnancy rates considerably but will significantly increase the life/health risks for the mother and the children if a twin pregnancy occurs. That is why we stick to the concept of preserving our high success rates, not through increasing the number of transferred embryos, but through clinical strategy and laboratory excellence.

Your Embryo transfer day is a very important day. All the recommendations about medication and further process are done by our doctors and nurses the day before so that on your embryo transfer day you are feeling confident and comfortable that all the steps following the embryo transfer are secured. We prepare for your embryo transfer to be a soft, gentle procedure and a happy experience for you.

Logistics

Your preparation for your Embryo Transfer takes place in your local country according to our Treatment Plan. You come to St. Petersburg for 5 days — for laboratory tests, last ultrasound examination, consultations with doctors and nurses, actual Embryo Transfer, recommendations, prescription, buying medication which may not be available in your local country. Arrival and departure schedule depends on your OLGA Doctor’s working schedule: arrival Sunday — departure Thursday, arrival Monday — departure Friday, arrival Tuesday — departure Saturday; arrival Wednesday — departure Sunday.

Have questions?

Get a Free Consultation!

Potential months 6, 7 or 8
More embryo transfers if necessary and possible

The Goal: Potential next Embryo Transfer to achieve successful implantation and on-going pregnancy

If after the first embryo transfer no pregnancy was achieved:

  1. In case there are chromosomally normal embryo(s) available after the last IVF cycle, the next embryo transfer can be done in the very next cycle. Important is that the patient does not stop hormonal medication before having spoken to the doctor. We usually book this call in advance for the doctor and the patient to speak as soon as the HCG test result is received.
  2. If there are no chromosomally normal embryos available, stimulation of ovaries can be started right away or after a short course of pill, based on medical/social/emotional situation.
  3. In some cases there may be a transition to using donor eggs based on medical situation, recommendation of the Clinic and patient’s decision.

Your treatment after positive pregnancy test until Live Birth

The Goal: A Baby

Once your embryo has been transferred into your uterus you will continue to take Estradiol and Progesterone for 10 days before taking a pregnancy test (this will be a blood test). Should the test result be positive, you will carry out an ultrasound scan 3 weeks later to confirm your pregnancy.

You will continue with your hormonal medication until 12-13 weeks of pregnancy when the placenta becomes mature and produces enough hormones to support the pregnancy itself. From this stage of pregnancy, you will not usually need more specific support than you would need in a naturally conceived pregnancy and the prognosis of carrying it to the full term is very good. After most of your hormonal support is discontinued, you will only take Progesterone, in a low dose, up to week 32 to keep your cervix long, strong and closed and to reduce the risk of a late miscarriage, or an early birth. In some cases, we recommend continuing with low dosages of Aspirin and low molecular Heparin to improve function of the placenta and reduce risk of late complications in the pregnancy such as preeclampsia.

We will also continue our dialogue with you, up to positive pregnancy test, ultrasound examination and onto live birth, advising and supporting you throughout this journey.

This is because we know that the pregnancy alone is not the desired result. The result is a baby in your arms.

Please contact us to arrange your online individual consultation with one of our doctors, this will allow them to talk personally with you about your medical history and then advise you on your ideal treatment plan for having a baby.

Get a Free Consultation!

Some possible scenarios

Best luck Scenario (the shortest – takes 3 months)

Best luck Scenario (the shortest – takes 3 months)


Scenario 2
(takes 6 months)

Scenario 2 (takes 6 months)


Scenario 3
(takes 7 months)

Scenario 3 (takes 7 months)


Scenario 4
(takes 8 months)

Scenario 4 (takes 8 months)


Scenario 5
(takes 9 months)

Scenario 5 (takes 9 months)


There may be more scenarios that are less common: more IVF cycles and just one embryo transfer till pregnancy is achieved or just one IVF cycle and several embryo transfers until on-going pregnancy and baby. There may be even two hysteroscopies sometimes. But most importantly you should know that if we are moving logically step by step and do not lose time, it usually does not take longer than 9 months to achieve an on-going pregnancy.

We hope that our long-term experience of successful work with patients with the most difficult medical cases together with your perseverance and wish to reach the goal will help us achieve the birth of your healthy, strong and happy baby.

If you would like to discuss your situation and chances with us, please call or email us. We have time for you, and we will be happy to discuss any initial questions with you and agree on a time for an individual consultation with our doctor.

Get a Free Consultation!

Contact us now! Get a free consultation!

  • Hidden
  • Hidden
  • Hidden
  • Hidden
  • We ask you provide your full Date of Birth for more exact medical advice
  • This field is for validation purposes and should be left unchanged.
Dr. Olga's Patients' Gathering in Stockholm

Dr. Olga's Patients' Gathering in Stockholm

August 2017



Dr. Olga Zaytseff with “golden egg" Hjalmar @pyretnilsson born a year ago at just one IVF attempt with own eggs + PGS at our clinic. His der Mom @aingeborg came to us at the age of 40 after 5 IVF attempts and several miscarriages before coming to us


Dr. Olga's Patients' Gathering in Oslo

Dr. Olga's Patients' Gathering in Oslo

September 2017


Success Stories

After 7 unsuccessful embryo transfers in a local clinic, in April Andreas and Hanna have got their sweet baby boy after their second embryo transfer in O.L.G.A. Clinic. "Dear Dr. Nina, You were our doctor during IVF at O.L.G.A. clinic and I just wanted to let you know that our baby boy is here now!! You made the impossible possible!!! And we are forever grateful to the bottom of our hearts!!!" - Hanna and Andreas

Read more

After we have been involuntarily childless for 7 years, done 2 IVF treatments in Sweden with 2 embryo transfers and 1 miscarriage... I got pregnant on the first try! Isak is here now and 5 embryos are left in the freezer at @olgafertilityclinic

Read more

We are so happy to share with you the story of our dear patients Liza and Niklas who have got their long-awaited daughter Mira at the age of 43 with the help of IVF with their own eggs and PGT-A in O.L.G.A. Clinic.

Read more

"Do not wait to take the next step till it feels right. It most likely never will, because the process of going through fertility treatment is weird. START – just do what has to be done", Lene Gammelgaard

Read more

Watch video about our Team!



Media & Press

ALLAS.se, Sweden. 6 August 2019. Text & Malin Aunsbjerg

Read more

BILLED-BLADET, Feb 2021. Text: Helle Skram De Fries SE OG HØR, Feb 2021. Text: Nikolaj Bonde, Niko@Sh.Dk

Read more

Anna-Maria Stawreberg, photo: Anna Rut Fridholm. Tara magazine, December 2019, Sweden

Read more