Johanna (@raven_ways): "We are finally living our dream, that we fought for so many years!”
Johanna and Michael, a couple from Sweden, arrived at the OLGA Clinic in 2023 carrying the weight of a long and exhausting fertility history. At 40 and 42 years old, they had already undergone 10 unsuccessful IVF attempts – two in Malmö, Sweden, and eight in Munich, Germany. Their previous treatments, which included natural IVFs and IVFs in standard antagonist protocols, had yielded almost no results, with only one biochemical pregnancy to show for years of effort.
Johanna’s medical profile presented several challenges: advanced maternal age (40), low AMH (0.5 mcg/l), a history of cervical conizations and stenosis, an intramural fibroid, and rheumatoid arthritis in remission. When they first contacted OLGA Clinic, they felt truly hopeless.
Despite all the challenges we were able to reach the baby in just one IVF attempt at OLGA Clinic using their own eggs and sperm.
Here is the overview of their previous attempts in Sweden and Germany:
Step 1: Thorough analysis of previous medical history, IVF attempts and current general health situation
Dr. Anna Gusareva spent hours of work analyzing all the medical files, discussing with the patients their situation and creating individualized medical strategy for them.
Step 2: Building a Foundation of Egg and Sperm Quality at OLGA Clinic
The second step was to move away from the "one-size-fits-all" stimulation approach. To boost egg and sperm competence and address potential deficiencies, we started both partners on a rigorous supplement regimen.
The goal was to increase the energy supply for eggs and sperm, FSH/LH responsiveness of the ovaries, decrease the oxidative stress and elimunate vitamin and iron deficiences.
Step 3: A Sophisticated Stimulation Strategy at OLGA Clinic
Dr. Pavel Semenov was a treating doctor, responsible for the stimulation process. After an initial stimulation in February 2024 was cancelled due to insufficient follicle development, the OLGA team adjusted the strategy. Dr. Pavel chose a tailored GnRH Agonist protocol with Pergoveris 300 IU, preceded by Oral Contraceptive Pill (OCP) pretreatment.
The logic was precise: the OCP synchronized the follicles so they would grow at the same pace, and the agonist protocol provided a "stronger prevention of a parasitic LH-peak". This allowed the follicles to grow slower, smoother and longer and gave the eggs more time to collect energy and cytoplasmatic competency before the final trigger of Ovitrelle on day 14 took place.
36 hours later egg retrieval was performed and 3 eggs were collected, all of them mature (MII).
Step 4: Embryological Precision and PGT-A at OLGA Clinic
Dr. Anna Gusareva was responsible for the embryological step. Because fertilization failure happened with IVF before, she utilized ICSI for fertilization. This time, the results were excellent: out of 3 mature eggs collected, all 3 fertilized normally. Two reached the blastocyst stage (graded 4AB and 3AB). Through PGT-A testing, one 4AB blastocyst was confirmed to be chromosomally normal (euploid), providing the couple with a vital breakthrough.
Step 5: Mastering the Maternal Environment for successful embryo transfer at OLGA Clinic
While the embryo was found to be euploid, we kept it in the freezer and focused on Johanna’s uterus and the whole body to ensure maximal chances of implantation and ongoing pregnancy.
- Hysteroscopy: Dr. Andreas Baseos performed a hysteroscopy in May 2024, removing a small polyp and adhesions, cervical dilatation and correcting a mild bicornuate uterine shape. He also noted that because of Johanna’s anatomy of acutely retroverted uterus, a history of cervical stenosis and an "amputated" cervix, the embryo transfer should be done under general anesthesia.
- Treating Endometritis: A biopsy revealed pronounced chronic endometritis (confirmed by CD8 and CD20 cell counts). This was treated with a targeted course of antibiotics and probiotics.
- ERA Test: An Endometrial Receptivity Analysis (ERA) determined Johanna’s personal "window of implantation" was exactly 129 hours after the start of progesterone.
The Result: A New Life
Dr. Pavel followed Johanna through the steps of stimulation and egg retrieval, maternal check-up, preparation for the transfer and performed the embryo transfer.
In October 2024, the single euploid 4AB blastocyst was transferred. To ensure total precision and avoid pain due to her cervical anatomy, the transfer was performed under general anesthesia.
The meticulous preparation paid off. In June 2025, Johanna and Michael finally became parents to a healthy baby boy, weighing 4150 grams and measuring 51 cm. This victory was the result of their extraordinary courage and a multidisciplinary effort by the OLGA team.
Acknowledgements
To Dr. Anna Gusareva for analyzing all the data from Johanna and Michael and believing in their success using own eggs and own sperm
Dr. Pavel Semenov for creating competent eggs
Dr. Anna Gusareva for embryological step
Dr. Andreas Baseos for thorough hysteroscopy
Dr. Pavel Semenov for diagnostics and treatment of maternal reasons and individualized preparation to embryo transfer, which made it possible for the body to keep the pregnancy
Olya Malysheva and Dr. Olga Romanova for following through the whole pregnancy
Alexandra Belyak and Darya Ivanova for communication, logistics, coordination and support on distance
To Johanna and Michael without whose courage, will, action, mutual love and support this baby would not have been possible
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