The Story of Liza and Niklas and their little “Golden Egg”

Dr. Elena and Dr. Olga comment:

I. What was our approach that has helped Liza and Niklas?

Viable embryos, capable of development up to healthy live birth, have 23 chromosome pairs in their genome. On day 5 it is too early yet, and even if an embryo has reached a blastocyst stage and looks good under the microscope, these good looks do not correlate with normality for 23 chromosomes. Hence these good looks do not correlate with the probability of live birth either.

Natural selection in the first 12 weeks of embryonic development still continues, and those embryos with abnormal number of chromosomes, which have achieved implantation, will sadly result in a miscarriage.

Not all that glitters is gold.

Not all the good-looking blastocysts have a normal number of chromosomes.

In the age of 43 only one out of 8-9 blastocysts is expected to have a normal number of chromosomes.

Liza happened to be exactly within statistical expectations: 7 out of 8 blastocysts happened to have an abnormal number of chromosomes, and 1 out of 8 blastocysts – normal! Congratulations!

Before transferring this embryo into the uterus, it was important to create the best possible environment for this embryo to stay. We have done hysteroscopy and have found some scar tissue and inflammation in the uterus – the consequences after Liza’s miscarriages. We have removed scar tissue and treated inflammation, having done everything possible for the “golden embryo” to wish to implant and stay.

Our efforts were rewarded by successful embryo transfer and healthy live birth! Congratulations! 

II. What is PGT-A?

PGT-A is a method which checks embryos for normality for 23 chromosomes before a potential transfer. PGT-A helps to exclude abnormal embryos from usage.

By excluding abnormal embryos from usage PGT-A helps:

• To increase pregnancy rates per embryo transfer
• To reduce miscarriage rates per embryo transfer
• To increase live birth rates per embryo transfer
• To shorten the time to pregnancy (reduces the number of embryo transfers required to create a pregnancy)

PGT-A is a very helpful method for women above 35 to shorten time to pregnancy.

What proportion of embryos at blastocyst stage are expected to have a normal number of chromosomes?

For example:

• Every second blastocyst is expected to have a normal number of chromosomes in the age group 35-37;
• In the age of 43 only one out of 8-9 blastocysts is expected to have a normal number of chromosomes by the age of 43.

[S. Munne et al. Blastocysts needed to transfer at least one euploid embryo: data from 10,852 pre-implantation genetic screening (PGS) cycles. Fertility Sterility September 2015 Volume 104, Issue 3, Supplement, Pages e13–e14]

III.  We split a big project into three smaller projects.

When a project feels too big and too complex, it is usual to split it into several smaller projects.

So, we do one step at a time.

Every step has its’ goal:

Step 1. Come to pick up your eggs and get a competent embryo normal for 23 chromosomes – your VIP embryo!

Step 2. Come to do hysteroscopy and prepare your uterus – a luxurious place for your VIP embryo to love it and stay!

Step 3. Put your VIP embryo into an optimally prepared and precisely timed environment and support it with reliable hormonal therapy to help it until it is strong enough!

IV. Reducing the number of transfers till live birth saves our patients from multiple frustrations.

We believe that women do not exhaust their psychological energy and endurance when coming to St. Petersburg three times. Unlike transfer after transfer, one does not expect to get pregnant when coming to pick up eggs or to do a hysteroscopy.

Only one out of these three trips – the transfer -  is full of expectations but with good reasons:

• the chromosomally normal competent blastocyst is already created during your visit number 1 and it awaits you in St. Petersburg;
• you have already prepared your uterus for successful implantation in your visit number 2.

Now you are doing your personalized transfer of a competent chromosomally normal blastocyst in your optimally prepared uterus. And yes, you are full of expectations and hope and with a good reason: by following this technology in O.L.G.A. Clinic you have 50% chance of live birth per one embryo transferred!

We are incredibly grateful to all our amazing Team for making these success rates possible.

V. Liza and Niklas’s alternative scenarios. 

1. How would Liza and Niklas’s story have turned out, if embryos had not been genetically tested prior to transfer? - If no PGT-A had been done, seven frustrating embryo transfers of embryos which were predetermined to early pregnancy loss, could have taken several years (together with some miscarriages after)!
2. Would they have had that much patience to undergo these many transfers experiencing failure after failure? Would Liza have ever come to transfer the golden embryo at all?
3. What would have happened if Liza and Niklas had had only 7 blastocysts and all of them were abnormal?
   They could have decided for another stimulation and could have found a “golden embryo” in the following IVF cycle. Or they could have decided to turn to egg donation as another viable way of shortening time to pregnancy.

In our clinic we believe it very important to provide our clients with transparent information about their situation, honest advice and options to choose from. We believe it is very important to have options and guidance.

Interested?

• Join our InstaLive with Liza and Niklas at @dr.olga.zaytseff! 14 June at 19:00 CEST Dr. Elena, Dr. Irina and Dr. Olga explain Liza's and Nikla's successful process and answer your questions.
• Join one of our webinars to find out more
• Book yourself a free consultation with one of our fertility specialists