{"id":11212,"date":"2022-05-20T09:15:51","date_gmt":"2022-05-20T09:15:51","guid":{"rendered":"https:\/\/olgafertilityclinic.com\/?page_id=11212"},"modified":"2024-07-12T07:29:50","modified_gmt":"2024-07-12T07:29:50","slug":"ivf-process","status":"publish","type":"page","link":"https:\/\/olgafertilityclinic.com\/en\/ivf-process\/","title":{"rendered":"Your IVF Process: One Step at a Time"},"content":{"rendered":"<ul id=\"H3tocList\" class=\"toclist\">\u00a0<\/ul>\n<p>In&nbsp;life it is rare to get everything at&nbsp;once. First, we strive to get education, then to achieve success in&nbsp;our professional field, then to create a family and&nbsp;give birth to our children. Each step takes time and&nbsp;energy. And&nbsp;these steps are so&nbsp;difficult to combine, for&nbsp;example, to achieve success at&nbsp;work while&nbsp;starting a family. And&nbsp;we, of course, want to do everything in&nbsp;the best possible way.<\/p>\n<p>Equally, a successful and&nbsp;efficient IVF process requires a step-by-step and&nbsp;focused approach. For&nbsp;example, it may be not possible to create both competent embryos and&nbsp;receptive <span class=\"tooltip\">endometrium<span class=\"tooltip-text\"><strong>Endometrium<\/strong> \u2014 the lining covering the uterine cavity<\/span><\/span> at&nbsp;the same time \u2014 each link in&nbsp;the reproductive chain may have its own individual rhythm, which&nbsp;we should hear, understand and&nbsp;accept, and&nbsp;only in&nbsp;this dialogue move towards the goal \u2014 pregnancy and&nbsp;live birth.<\/p>\n<p>IVF is a big task and&nbsp;a big project both in&nbsp;terms of high expectations and&nbsp;huge emotional, physical and&nbsp;financial investments.<\/p>\n<p>So&nbsp;that&nbsp;a big task does not look impossible, and&nbsp;a big project ungraspable, we divide it into separate stages. It allows us to focus on&nbsp;achieving the goals of each stage, and&nbsp;from these small goals get the main goal \u2013 an on-going pregnancy and&nbsp;live birth.<\/p>\n<p>Below we describe our IVF process step by step. It will help you manage your expectations.<\/p>\n<h3>IVF process step by step. One challenge \u2014 one solution.<\/h3>\n<p><strong><br \/>\nEach step of your IVF journey will have its own focus and&nbsp;goal:<\/strong><\/p>\n<table style=\"width: 100%;\">\n<tbody>\n<tr>\n<td style=\"width: 29.3527%;\"><strong>Steps in\u00a0your IVF process and&nbsp;goals<\/strong><\/td>\n<td style=\"width: 45%;\"><strong>Focus<\/strong><\/td>\n<td style=\"width: 25.558%;\"><strong>Logistics<\/strong><\/td>\n<\/tr>\n<tr>\n<td style=\"width: 29.3527%;\"><a href=\"#CNR1\"><strong>Month 1: IVF Cycle <\/strong><\/a> <\/p>\n<p><strong>The Goal: Viable Embryo at\u00a0<span class=\"tooltip\">Blastocyst<span class=\"tooltip-text\"><strong>Blastocyst<\/strong> \u2014 the stage that\u00a0a human embryo normally reaches on\u00a0day 5-6 of development. This is the stage on\u00a0which the embryo implantation begins.<\/span><\/span> stage;<br \/>\nnormal for\u00a023 <span class=\"tooltip\">chromosome<span class=\"tooltip-text\"><strong>Chromosome<\/strong> \u2014 is a unit of genetic information in\u00a0a cell which\u00a0contains DNA and\u00a0proteins. Abnormal number of chromosomes in\u00a0cells of embryos, makes an embryo\u2019s development stop. An abnormal number of chromosomes in\u00a0embryos, is responsible for\u00a070-80% of pregnancy losses in\u00a0the first 12 weeks<\/span><\/span> pairs<\/strong><\/td>\n<td style=\"width: 45%;\">\n<ul>\n<li>Creating competent eggs by individualized stimulation<\/li>\n<li>Collecting and&nbsp;fertilizing eggs<\/li>\n<li>Growing blastocysts<\/li>\n<li>Blastocyst biopsy and&nbsp;<span class=\"tooltip\">PGT-A<span class=\"tooltip-text\"><strong>PGT-A (PGS \u2013 historical name)<\/strong> \u2014 Preimplantation Genetic Testing for\u00a0Aneuploidies. This genetic testing of embryos, finds embryos normal for\u00a023 pairs of chromosomes, from those available. By excluding abnormal embryos from use, live birth rates are increased per embryo transferred and\u00a0time to ongoing pregnancy is shortened. PGT-A is applicable in\u00a0women of 35 years of age and\u00a0older and\u00a0on individual indications<\/span><\/span> &#8211; selecting embryos with a normal set of chromosomes from the available embryos<\/li>\n<li>Gentle freezing of blastocysts by vitrification to stop time for\u00a0them and\u00a0free us to move our focus to the next step \u2013 the optimal preparation of endometrium ready for\u00a0<span class=\"tooltip\">implantation<span class=\"tooltip-text\"><strong>Implantation<\/strong> \u2014 the process of recognition and\u00a0connection between receptors on\u00a0the surface of the embryos and\u00a0the surface of the endometrium followed by invasion of the embryo into the endometrium<\/span><\/span><\/li>\n<\/ul>\n<\/td>\n<td style=\"width: 25.558%;\">\n<p>Your ovarian stimulation takes place in&nbsp;your local country according to our Treatment Plan. You come to O.L.G.A. Fertility St. Peterbsurg\/ Cyprus for&nbsp;10 days \u2014 for&nbsp;laboratory tests, last ultrasound examinations and&nbsp;egg retrieval. Egg retrieval is planned day X+- 2 days. You can leave 24 h after.<span class=\"Apple-converted-space\">\u00a0<\/span><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 29.3527%;\"><a href=\"#CNR2\"><strong>Month 2: Cool Down Cycle<\/strong><\/a><\/p>\n<p><strong>The Goal: Cooling down ovaries after&nbsp;stimulation<\/strong><\/td>\n<td style=\"width: 45%;\">Pill intake to help ovaries shrink after&nbsp;stimulation and&nbsp;stop producing residual levels of <span class=\"tooltip\">Progesterone<span class=\"tooltip-text\"><strong>Progesterone<\/strong>\u00a0\u2014 the main pregnancy hormone. Progesterone production by the ovary begins at\u00a0ovulation. Progesterone influences the endometrium and\u00a0times its readiness for\u00a0implantation \u2014 implantation window<\/span><\/span><\/td>\n<td style=\"width: 25.558%;\">\u00a0<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 29.3527%;\"><a href=\"#CNR3\"><strong>Month 3: <span class=\"tooltip\">Hysteroscopy<span class=\"tooltip-text\"><strong>Hysteroscopy<\/strong> \u2014 endoscopic check of uterus. \u201cHyster\u201d = \u201cUterus\u201d and\u00a0\u201cScopy\u201d = \u201cLooking\u201d in\u00a0Greek. Hysteroscopy is done via the natural pathway. Hysteroscopy enables surgical treatment of problems inside the uterus which\u00a0may be responsible for\u00a0IVF failures<\/span><\/span> Cycle<\/strong><\/a><\/p>\n<p><strong>The Goal: Diagnostics and\u00a0possible microsurgical treatment of potential macroscopic findings in\u00a0the uterine cavity; taking endometrial samples for\u00a0cell\/microbe\/DNA\/RNA tests; defining <span class=\"tooltip\">implantation window<span class=\"tooltip-text\"><strong>Implantation window<\/strong> is a time frame under 72 hours when\u00a0special receptors are present on\u00a0the surface of endometrium, which\u00a0can recognize receptors on\u00a0the surface of embryos to start the implantation process<\/p>\n<p><strong>Receptor<\/strong>\u00a0\u2014 is a protein structure on\u00a0the surface of one cell, which\u00a0recognizes a specific molecule or\u00a0another receptor on\u00a0the surface of another cell (like a key and\u00a0lock). With the help of receptors cells, they can communicate with each other. An example of such dialogue: implantation dialogue between embryonic cells and\u00a0endometrial cells during the implantation process.<\/span><\/span><\/strong><\/td>\n<td style=\"width: 45%;\">\n<ul>\n<li><span class=\"tooltip\">Estradiol<span class=\"tooltip-text\"><strong>Estradiol<\/strong>\u00a0\u2014 the main female hormone responsible for\u00a0growing the lining in\u00a0the uterus. Estradiol is produced by the growing follicle in\u00a0the ovary<\/span><\/span> and&nbsp;Progesterone treatment helps to restore endometrial receptivity.<\/li>\n<li>Hysteroscopy helps to find and&nbsp;micro-surgically treat macroscopic conditions which&nbsp;may negatively influence chances of implantation: polyps, micro polyps, adhesions etc.<\/li>\n<li><span class=\"tooltip\">ERA test<span class=\"tooltip-text\"><strong>ERA test<\/strong>\u00a0\u2014 is an abbreviation for\u00a0\u201cEndometrial Receptivity Array\u201d. The aim of an ERA test is to confirm on\u00a0which day, after\u00a0the beginning of progesterone supplementation, the endometrium is receptive to the embryos, and\u00a0hence implantation will be most probable<\/span><\/span> checks implantation window based on&nbsp;certain protein expression levels in&nbsp;endometrium.<\/li>\n<li>Histological and&nbsp;immunohistochemical testing of endometrium tissue helps to identify potential abnormalities at&nbsp;microscopic cell levels.<\/li>\n<li>PCR testing of endometrium for&nbsp;bacteria and&nbsp;viruses.<\/li>\n<li>Scratching done during Hysteroscopy may improve blood flow and&nbsp;increase the chance of implantation.<\/li>\n<li><em>Hysteroscopy may not be necessary for&nbsp;all patients. If&nbsp;hysteroscopy is not indicated, the Month 3 can be used for&nbsp;Embryo Transfer. Hormonal preparation for&nbsp;the embryo transfer and&nbsp;hysteroscopy is similar.<\/em><\/li>\n<\/ul>\n<\/td>\n<td style=\"width: 25.558%;\"><span style=\"color: #444444; font-family: 'Open Sans', sans-serif; font-size: 15.307681px;\">Your preparation for&nbsp;the Hysteroscopy and&nbsp;ERA test takes place in&nbsp;your local country according to our Treatment Plan. You come to O.L.G.A. Fertility St. Peterbsurg \/ Cyprus for&nbsp;5 days \u2014 for&nbsp;laboratory tests, last ultrasound examinations, hysteroscopy, consultation, recommendations and&nbsp;prescriptions.<\/span><\/td>\n<\/tr>\n<tr>\n<td style=\"width: 29.3527%;\"><a href=\"#CNR4\"><strong>Month 4: After&nbsp;Hysteroscopy Treatment Cycle<\/strong><\/a><\/p>\n<p><strong>The Goal: Optimizing endometrium with the help of medication<\/strong><\/td>\n<td style=\"width: 45%;\">\n<ul>\n<li>Within 2 weeks after&nbsp;Hysteroscopy, we receive results of histological, immunohistochemical and&nbsp;PCR testing of endometrium tissue. Based on&nbsp;these results individual medication may be added to your treatment plan: antibacterial and&nbsp;antiviral medication, growth factors and&nbsp;immune-modulating medication. The aim of this treatment is to optimize endometrium and&nbsp;increase chances of implantation in&nbsp;the following cycle.<\/li>\n<li>3 weeks after&nbsp;Hysteroscopy the result of the ERA test arrives, which&nbsp;provides information about how many hours after&nbsp;the start of Progesterone supplementation we should do embryo transfer in&nbsp;the following cycle.<\/li>\n<li>At&nbsp;the end of this cycle a down-regulation injection is applied to switch off ovarian hormone production for&nbsp;one month. This is necessary for&nbsp;being able to reproduce the implantation window in&nbsp;the following cycle.<\/li>\n<\/ul>\n<\/td>\n<td style=\"width: 25.558%;\">\u00a0<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 29.3527%;\"><a href=\"#CNR5\"><strong>Month 5: Embryo Transfer Cycle<\/strong><\/a><\/p>\n<p><strong>The Goal: To achieve successful implantation and&nbsp;on-going pregnancy<\/strong><\/td>\n<td style=\"width: 45%;\">Here all the three pieces of the puzzle should come together: transfer of a chromosomally normal blastocyst into your optimally prepared endometrium in&nbsp;the right timing<\/td>\n<td style=\"width: 25.558%;\"><span style=\"color: #444444; font-family: 'Open Sans', sans-serif; font-size: 15.307681px;\">Your preparation for&nbsp;your Embryo Transfer takes place in&nbsp;your local country according to our Treatment Plan. You come to O.L.G.A. Fertility St. Peterbsurg\/Cyprus for&nbsp;5 days \u2013 for&nbsp;laboratory tests, last ultrasound examination, consultations with doctors and&nbsp;nurses, your Embryo Transfer, recommendations and&nbsp;prescriptions.<\/span><\/td>\n<\/tr>\n<tr>\n<td style=\"width: 29.3527%;\"><a href=\"#CNR6\"><strong>Potential months 6,7,8. More embryo transfers if&nbsp;necessary and&nbsp;possible<\/strong><\/a><\/p>\n<p><strong>The Goal: Potential next Embryo Transfer to achieve successful implantation and&nbsp;on-going pregnancy<\/strong><\/td>\n<td style=\"width: 45%;\"><strong>In&nbsp;O.L.G.A. Fertility you have:<\/strong><br \/>\n51.6% chance of live birth after&nbsp;1\u00a0ET<br \/>\n75.4% chance of live birth after&nbsp;2\u00a0ETs<br \/>\n85.6% chance of live birth after&nbsp;3\u00a0ETs<br \/>\n88.9% chance of live birth after&nbsp;4\u00a0ETs<\/p>\n<p>If&nbsp;after the first embryo transfer no pregnancy was achieved:<\/p>\n<p>a) In\u00a0case there are chromosomally normal embryo(s) available after\u00a0the last IVF cycle, the next embryo transfer can be done in\u00a0the very next cycle. Important is that\u00a0the patient does not stop hormonal medication before\u00a0having spoken to the doctor. We usually book this call in\u00a0advance for\u00a0the doctor and\u00a0the patient to speak as\u00a0soon\u00a0as\u00a0the HCG test result is received.<br \/>\nb) If&nbsp;there are no chromosomally normal embryos available, stimulation of ovaries can be started right away or&nbsp;after a short course of pill, based on&nbsp;medical\/social\/emotional situation.<\/p>\n<\/td>\n<td style=\"width: 25.558%;\">\u00a0<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 29.3527%;\"><a href=\"#CNR7\"><strong>Your treatment after&nbsp;positive pregnancy test until&nbsp;Live Birth<\/strong><\/a><\/p>\n<p><strong>The Goal: A Baby<\/strong><\/td>\n<td style=\"width: 45%;\">\n<ul>\n<li>Continued hormonal support, low molecular Heparin and\u00a0other medication will be given to avoid the risk of miscarriage and\u00a0reduce the risk of a premature birth<\/li>\n<li>You will be educated about miscarriage prevention<\/li>\n<li>We will continue dialogue with you via e-mail, phone, Zoom with our doctors and&nbsp;nurses until&nbsp;you give birth!<\/li>\n<\/ul>\n<\/td>\n<td style=\"width: 25.558%;\">\u00a0<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h3><a id=\"CNR1\"><\/a>Month 1<br \/>\nYour IVF Cycle<\/h3>\n<h6>The Goal: to have a viable embryo at&nbsp;the blastocyst stage, normal for&nbsp;23 chromosome pairs<\/h6>\n<p>We are often asked, if\u00a0PGT-A\u00a0improves egg and\u00a0embryo quality?<\/p>\n<p>No, PGT-A is only a method of embryo testing. It helps to eliminate good looking, but&nbsp;abnormal blastocysts from usage. It does not make your embryos better \u2014 it identifies those embryos with a normal set of chromosomes from those that&nbsp;are available.<\/p>\n<p>To be able to test good looking embryos at&nbsp;blastocyst stage, we first need to create them. This may be challenging, especially in&nbsp;patients, who&nbsp;have not had any blastocysts in&nbsp;previous attempts. We learn from the past and&nbsp;know how to use this knowledge for&nbsp;the future success.<\/p>\n<p>How to achieve viable blastocysts, even\u00a0if\u00a0past attempts have resulted in\u00a0no blastocysts at\u00a0all?<\/p>\n<h4>Step 1. Your Individualized stimulation<\/h4>\n<h6>The Goal: competent eggs with sufficient levels of energy<\/h6>\n<p>Two women of the same age and&nbsp;the same AMH levels may benefit from different stimulation schemes. We gain knowledge and&nbsp;a good feeling based on&nbsp;your medical history, test results and&nbsp;information about your previous IVF attempts. When&nbsp;you thoroughly inform us of the data from your past IVF attempts, you create the basis for&nbsp;us to create a successful treatment plan for&nbsp;you.<\/p>\n<p>During two weeks from the beginning of the cycle till\u00a0<span class=\"tooltip\">ovulation<span class=\"tooltip-text\"><strong>ovulation<\/strong> \u2014 when\u00a0the egg Is released from the ovary<\/span><\/span> (or egg retrieval) eggs need to multiply their energy resources hundreds of times. It is clear enough that&nbsp;energy is needed to create a viable embryo. A sperm does bring half of a genome, but&nbsp;only the egg possesses the power stations for&nbsp;the development of the embryo. They are called mitochondria, if&nbsp;a cell was a city, mitochondria would be this city\u2019s power plants.<\/p>\n<p>Individualized and&nbsp;balanced treatment plan helps eggs to collect enough energy for&nbsp;fertilization and&nbsp;embryonic development.<\/p>\n<p>We also recommend diet, lifestyle adjustments, vitamins and\u00a0supplements aimed at\u00a0increasing egg energy levels.<\/p>\n<h4>Step 2. A Gentle, quick, and&nbsp;painless egg retrieval<\/h4>\n<h6>The Goal: one <span class=\"tooltip\">follicle<span class=\"tooltip-text\"><strong>Follicle<\/strong> \u2014 a mature follicle is a 2 cm bubble containing a 0,1mm egg. Follicles are located in\u00a0the ovary<\/span><\/span> \u2014 one mature egg<\/h6>\n<p>We take great care in&nbsp;making the egg retrieval gentle, quick, and&nbsp;painless, this ensures that&nbsp;the egg retrieval day will be a good day for&nbsp;all our patients.<\/p>\n<p>During egg retrieval, we focus on\u00a0every single follicle and\u00a0every single egg. If\u00a0our patient would like to proceed towards egg retrieval having even\u00a0just one single follicle, we will go for\u00a0it and\u00a0do our very best.<\/p>\n<h4>Step 3. First class process in&nbsp;our EmbryoLab<\/h4>\n<h6>The Goal: Blastocysts, Normal for&nbsp;23 Chromosome Pairs<\/h6>\n<ul>\n<li>Elegant and&nbsp;soft IVF and&nbsp;ICSI procedures<\/li>\n<li>Careful and&nbsp;reliable blastocyst growing<\/li>\n<li>PGT-A (genetic testing of embryos to find the normal ones from those available)<\/li>\n<\/ul>\n<p>Little embryos are like children or\u00a0flowers: they need to be talked to in\u00a0a nice way and\u00a0handled with love and\u00a0care. Our embryologists feel like they look after\u00a0flowers or\u00a0work in\u00a0a kindergarten, rather\u00a0than\u00a0growing embryos\u00a0:)<\/p>\n<p>Dr. Svetlana Shlykova, Dr. Anna Gusareva and&nbsp;Dr. Maia Shestakova have hearts full of love and&nbsp;hands full of skill. The embryos in&nbsp;their lab gain all this special attention, love, and&nbsp;care.<\/p>\n<div class=\"ts-row\">\n<div class=\"column half\">\n<p><img decoding=\"async\" class=\"w100p bmar alignnone wp-image-2209 size-full\" src=\"https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/emb-team.jpg\" alt=\"Dr. Svetlana Shlykova, Dr. Anna Gusareva and&nbsp;Dr. Maia Shestakova\" \/><\/p>\n<\/div>\n<div class=\"column half\">\n<p><img decoding=\"async\" class=\"w100p bmar alignnone wp-image-2210 size-full\" src=\"https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/emb-lab.jpg\" alt=\"The Embryos in&nbsp;their lab gain all this special attention, love, and&nbsp;care\" \/><\/p>\n<\/div>\n<div class=\"clear\">\u00a0<\/div>\n<\/div>\n<h4>Step 4. Gentle freezing of your blastocysts by vitrification (FREEZE ALL)<\/h4>\n<h6>The Goal: to stop time for&nbsp;the embryos and&nbsp;use this time for&nbsp;optimizing your maternal side before&nbsp;embryo transfer<\/h6>\n<ul>\n<li><strong>Why&nbsp;don\u2019t we transfer fresh embryos?<\/strong> \u2014 Because&nbsp;endometrial receptivity in&nbsp;stimulated cycles is lower than&nbsp;in&nbsp;natural cycles, or&nbsp;cycles on&nbsp;HRT.<\/li>\n<li><strong>Why&nbsp;do we freeze all embryos?<\/strong> \u2014 We freeze all the embryos to stop time for&nbsp;them for&nbsp;a while&nbsp;so&nbsp;that&nbsp;we gain 1-2 months to focus on&nbsp;your endometrium and&nbsp;other maternal factors.<\/li>\n<li><strong>Why&nbsp;not try with a fresh embryo right away and&nbsp;then try with a frozen embryo later, if&nbsp;fresh transfer hasn\u2019t worked?<\/strong> \u2014 Because&nbsp;many patients will have just the one usable embryo and&nbsp;we must create VIP conditions for&nbsp;its transfer to achieve a maximum result.<\/li>\n<li><strong>Why&nbsp;are we not afraid \u201cto risk the embryo by freezing it\u201d?<\/strong> \u2014 Because&nbsp;we have above 95% survival rates after&nbsp;freezing\/thawing via vitrification.<\/li>\n<\/ul>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"w40p noshadow alignright wp-image-2208 size-full\" src=\"https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/ivf-rabbits.jpg\" alt=\"In many spheres of our life we cannot get two goals at&nbsp;once and&nbsp;chasing two rabbits at&nbsp;once will just lead to catching none\" width=\"441\" height=\"264\" \/>In&nbsp;many spheres of our life we cannot get two goals at&nbsp;once and&nbsp;chasing two rabbits at&nbsp;once will just lead to catching none.<\/p>\n<p>In&nbsp;many patients getting eggs and&nbsp;embryos is like one rabbit and&nbsp;preparing an optimal endometrium and&nbsp;implantation window like the other, and&nbsp;we can catch both only when&nbsp;we chase them one by one, in&nbsp;a separate setting and&nbsp;timing.<\/p>\n<h4><strong><em>Logistics<\/em><\/strong><\/h4>\n<p>Your ovarian stimulation takes place in&nbsp;your local country according to our Treatment Plan. You come to O.L.G.A. Fertility St. Peterbsurg\/ Cyprus for&nbsp;10 days \u2014 for&nbsp;laboratory tests, last ultrasound examinations and&nbsp;egg retrieval. Egg retrieval is planned day X+- 2 days. You can leave 24 h after.<span class=\"Apple-converted-space\">\u00a0<\/span><\/p>\n<h3><a id=\"CNR2\"><\/a>Month 2<br \/>\nCool Down Cycle<\/h3>\n<h6>The Goal: to give ovaries time for&nbsp;cooling down after&nbsp;stimulation<\/h6>\n<p>Several weeks after&nbsp;stimulation, even&nbsp;after menstruation, ovaries may still be hormonally active, producing Estrogen, and&nbsp;especially Progesterone. Normally Progesterone is being produced only after&nbsp;ovulation and&nbsp;declines to zero by the time of menstruation. Production of Progesterone during and&nbsp;after menstruation makes endometrium not receptive in&nbsp;the current cycle. Therefore, usually the cycle after&nbsp;a stimulated cycle is used for&nbsp;giving ovaries rest. Ovaries need to cool down and&nbsp;shrink before&nbsp;beginning of the cycle in&nbsp;which the embryo transfer or&nbsp;ERA test (defining the implantation window) is planned. Pill intake from the start of menstruation, which&nbsp;comes within 2 weeks after&nbsp;egg retrieval, helps ovaries shrink after&nbsp;stimulation and&nbsp;stop producing residual levels of Progesterone. Usually after&nbsp;3 weeks of pill a woman is ready to start the embryo transfer cycle or&nbsp;hysteroscopy\/ERA test cycle.<\/p>\n<h3><a id=\"CNR3\"><\/a>Month 3<br \/>\nHysteroscopy Cycle<\/h3>\n<h6>The Goal: Diagnostics and&nbsp;possible microsurgical treatment of potential macroscopic findings in&nbsp;uterine cavity; taking endometrial samples for&nbsp;cell\/microbe\/DNA\/RNA tests; defining implantation window<\/h6>\n<p>Hysteroscopy helps to find and&nbsp;micro-surgically treat macroscopic conditions which&nbsp;may negatively influence chances of implantation: polyps, micro polyps, adhesions etc.<\/p>\n<p>Hysteroscopy may not be necessary for&nbsp;all patients. If&nbsp;hysteroscopy is not indicated, this cycle can be used for&nbsp;Embryo Transfer. Hormonal preparation for&nbsp;the embryo transfer and&nbsp;hysteroscopy is similar since&nbsp;the goal of Hysteroscopy in&nbsp;O.L.G.A. Fertility is to evaluate the place of implantation under the same conditions as&nbsp;for the actual embryo transfer.<\/p>\n<p>Treatment in&nbsp;a Hysteroscopy cycle imitates an Embryo Transfer c\u0443cle and&nbsp;consists of natural or&nbsp;synthetic Estradiol and&nbsp;Progesterone hormones; to imitate the phases of the normal menstrual cycle. If&nbsp;an ERA test is planned, a down-regulation injection is <span style=\"font-weight: 400;\">usually<\/span> done several days before&nbsp;the beginning of the Hysteroscopy cycle to gain full control over hormonal levels and&nbsp;obtain reproducibility of the hormonal setting in&nbsp;the Embryo Transfer \u0441ycle.<\/p>\n<p>We call this treatment a training cycle because&nbsp;this helps us evaluate your endometrial response to certain hormonal dosages in&nbsp;advance and&nbsp;choose the right hormonal dosage specifically for&nbsp;you in&nbsp;your Embryo Transfer cycle. Also, hormonal therapy with Estradiol and&nbsp;Progesterone helps to restore endometrial receptivity, even&nbsp;in&nbsp;those patients who&nbsp;have had impaired endometrial receptivity previously.<\/p>\n<p>After\u00a0we have had an opportunity of viewing your endometrium at\u00a0different stages before\u00a0and\u00a0during stimulation and\u00a0at the egg retrieval, we will come back to you with information as\u00a0to whether\u00a0we see any sonographic signs of polyps, adhesions, or\u00a0other structures in\u00a0endometrium, which\u00a0may reduce the chances of implantation. If\u00a0we see those potential reasons for&nbsp;a future failure, we will recommend a Hysteroscopy.<\/p>\n<p>A <strong>Hysteroscopy<\/strong> is an endoscopic investigation of the uterine cavity \u2014 looking at&nbsp;the uterus from inside!<\/p>\n<p>\u2018Hysteroscopy\u2019 comes from the Greek meaning: \u201cHyster\u201d = \u201cUterus\u201d and&nbsp;\u201cScopy\u201d = \u201cLooking\u201d.<\/p>\n<p>Hysteroscopy provides us with the opportunity to look inside your uterus via a natural pathway, with the help of a tiny video camera. In&nbsp;O.L.G.A. Fertility, we do full surgical hysteroscopy under general anesthesia, which&nbsp;means we have the opportunity to infuse liquid in&nbsp;the uterus to straighten all the little corners of uterine cavity so&nbsp;as&nbsp;to see all the hidden details which&nbsp;may not be seen by quick office-based hysteroscopy. During a hysteroscopy we can treat possible abnormal findings (polyps, adhesions) microsurgically and&nbsp;hence increase the chances for&nbsp;a successful implantation.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" width=\"606\" height=\"467\" class=\"w40p noshadow fl wp-image-2208 size-full\" src=\"https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/apple-1.png\" alt=\"Scratching, which&nbsp;is a nice peeling for&nbsp;the uterus \u2014 can be done to improve blood flow and&nbsp;facilitate implantation\" srcset=\"https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/apple-1.png 606w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/apple-1-300x231.png 300w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/apple-1-370x285.png 370w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/apple-1-260x200.png 260w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/apple-1-87x67.png 87w\" sizes=\"(max-width: 606px) 100vw, 606px\" \/><\/p>\n<p class=\"pic\">Picture 1. Scratching, which\u00a0is a nice \u201cpeeling for\u00a0the endometrium\u201d \u2014 lining of the uterus.<\/p>\n<p>During a hysteroscopy, a scratching \u2013 like a peeling &#8211; might be performed to make the uterine cavity fresher, smoother, with better blood flow and&nbsp;more attractive for&nbsp;the embryo to implant.<\/p>\n<p class=\"cf\"><strong>During hysteroscopy several tissue tests are taken:<\/strong><\/p>\n<ul>\n<li>Histological and&nbsp;immunohistochemical testing of the endometrium tissue helps to identify potential abnormalities at&nbsp;microscopic cell levels.<\/li>\n<li>PCR testing of the endometrium for&nbsp;bacteria and&nbsp;viruses.<\/li>\n<li>ERA test checks implantation window based on&nbsp;certain protein RNA expression levels in&nbsp;the endometrium.<br \/>\nERA is an abbreviation for&nbsp;\u201cEndometrial Receptivity Array\u201d. The aim of the ERA test is to confirm on&nbsp;which day and&nbsp;time, after&nbsp;the start of Progesterone supplementation, the endometrium is most receptive to the embryo. In&nbsp;the majority of women, the implantation window\u00a0 takes place around day 6 of Progesterone supplementation and&nbsp;lasts around 60 hours. However, in&nbsp;20-30% of women the implantation window may start earlier or&nbsp;later or&nbsp;last less hours.\u00a0 We believe it to be important to investigate the implantation window in&nbsp;patients who&nbsp;come to us after&nbsp;multiple unsuccessful attempts.<\/li>\n<\/ul>\n<div class=\"cf\">\u00a0<\/div>\n<p><img loading=\"lazy\" decoding=\"async\" width=\"754\" height=\"442\" class=\"w50p fl wp-image-2209 size-full\" src=\"https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/pic1.jpg\" alt=\"Hysteroscopy findings can explain why&nbsp;it may be so&nbsp;hard for&nbsp;embryos to attach and&nbsp;grow\" srcset=\"https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/pic1.jpg 754w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/pic1-300x176.jpg 300w\" sizes=\"(max-width: 754px) 100vw, 754px\" \/><\/p>\n<p class=\"pic\">Picture 2.\u00a0 A metaphor for&nbsp;some of the causes of failure \u2014 findings in&nbsp;the uterus that&nbsp;make implantation difficult.<\/p>\n<p>During a hysteroscopy, the reasons why&nbsp;it was hard for&nbsp;the embryos to implant in&nbsp;the past can be found: polyps, adhesions, inflammation and&nbsp;many others. Eliminating or&nbsp;correcting these intrauterine reasons of failure increases the likelihood of a future successful implantation and&nbsp;carrying pregnancy to term.<\/p>\n<div class=\"cf\">\u00a0<\/div>\n<p><img loading=\"lazy\" decoding=\"async\" width=\"754\" height=\"442\" class=\"w50p fl wp-image-2210 size-full\" src=\"https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/pic2.jpg\" alt=\"Luxurious environment for&nbsp;your VIP embryo after&nbsp;hysteroscopy and&nbsp;treatment\" srcset=\"https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/pic2.jpg 754w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/pic2-300x176.jpg 300w\" sizes=\"(max-width: 754px) 100vw, 754px\" \/><\/p>\n<p class=\"pic\">Picture 3. A VIP site for&nbsp;a VIP embryo to implant<\/p>\n<p>Picture 3 is a metaphor for&nbsp;a well-prepared uterine cavity ready for&nbsp;embryo recognition and&nbsp;acceptance. After&nbsp;a hysteroscopy, removal of polyps or&nbsp;scar tissue, scratching, hormonal, immune and&nbsp;blood thinning therapy, it will be easier for&nbsp;the embryo to implant. It often happens that&nbsp;out of several blastocysts obtained within an IVF cycle, only one has a normal set of chromosomes. This is our VIP embryo, and&nbsp;our task is to create all the necessary conditions for&nbsp;its successful implantation.<\/p>\n<h4><em>Logistics<\/em><\/h4>\n<p>Your preparation for&nbsp;the Hysteroscopy and&nbsp;ERA test takes place in&nbsp;your local country according to our Treatment Plan. You come to O.L.G.A. Fertility St.\u00a0Peterbsurg \/ Cyprus for&nbsp;5 days \u2014 for&nbsp;laboratory tests, last ultrasound examinations, hysteroscopy, consultation, recommendations and&nbsp;prescriptions.<\/p>\n<h3><a id=\"CNR4\"><\/a>Month 4<br \/> After&nbsp;Hysteroscopy Treatment Cycle<\/h3>\n<h6>The Goal: Optimizing endometrium with the help of medication<\/h6>\n<p>Within 2 weeks after\u00a0Hysteroscopy, we receive results of histological, immunohistochemical and\u00a0PCR testing of endometrium tissue.<\/p>\n<p>Depending on\u00a0the findings and\u00a0micro-surgical treatment during hysteroscopy, specific treatment may be recommended: growth factors after\u00a0having removed scar tissue and\u00a0for\u00a0thin atrophic endometrium, antibiotics, and\u00a0antiviral medicines for\u00a0chronic inflammation, immune therapy for&nbsp;signs of\u00a0 autoimmune aggression. The aim of this treatment is to optimize endometrium and\u00a0increase chances of implantation in\u00a0the future.<\/p>\n<p>In\u00a0some cases, such as\u00a0with endometriosis, we may recommend longer treatments after\u00a0hysteroscopy to suppress the endometriosis and\u00a0its negative influence on\u00a0implantation.<\/p>\n<p>All the medication which\u00a0needs to be taken after\u00a0hysteroscopy and\u00a0up until\u00a0the embryo transfer, can be bought in\u00a0our neighboring pharmacy, if\u00a0necessary.<\/p>\n<p>3 weeks after\u00a0Hysteroscopy the result of the ERA test arrives, which\u00a0provides information about how many hours after\u00a0the start of Progesterone supplementation we should do the embryo transfer in\u00a0the following cycle. Then we adjust the Treatment Plan accordingly.<\/p>\n<p>At&nbsp;the end of this Month 4 (After Hysteroscopy Treatment Cycle) a down-regulation injection is usually administered to switch off ovarian hormone production for&nbsp;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&nbsp;your embryo transfer. This downregulation injection is also necessary for&nbsp;being able to accurately reproduce the implantation window in&nbsp;the Embryo Transfer Cycle.<\/p>\n<p>The duration of downregulation treatment, without estrogen coverage in&nbsp;the hormonal scheme aimed at&nbsp;the embryo transfer, does not exceed 7 days, so&nbsp;the undesired symptoms are highly unlikely to appear in&nbsp;such a short period of time.<\/p>\n<h3><a id=\"CNR5\"><\/a>Month 5<br \/>\nEmbryo Transfer Cycle<\/h3>\n<h6>The Goal: To achieve successful implantation and&nbsp;on-going pregnancy<\/h6>\n<p>Here all the three pieces of the puzzle should come together: transfer of a chromosomally normal blastocyst into your optimally prepared endometrium in&nbsp;the right timing.<\/p>\n<h4>Medication to grow a receptive endometrium<\/h4>\n<p>After\u00a0you have stopped Estradiol and\u00a0Progesterone in\u00a0your <strong>After&nbsp;Hysteroscopy Treatment Cycle<\/strong> or, if&nbsp;there was no hysteroscopy, then at&nbsp;the end\u00a0of your <strong>Cool Down Cycle<\/strong>, menstruation begins, and\u00a0this is the start of your Embryo Transfer Cycle.<\/p>\n<p>As&nbsp;we know from the <a href=\"\/ivf\/\">IVF Success chapter<\/a>, the endometrium grows due to the Estrogens, which&nbsp;are prescribed in&nbsp;the <strong>Embryo Transfer Cycle<\/strong> in&nbsp;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&nbsp;decide if&nbsp;additional doses of Estrogen are required.<\/p>\n<p>The doses of Estrogens during the preparation for&nbsp;the embryo transfer are much lower than&nbsp;the levels of Estrogen during pregnancy, which&nbsp;are produced by the placenta.<\/p>\n<p>For&nbsp;the patients who&nbsp;have previously faced the problem of thin endometrium, growth factors can be used to stimulate the growth of the endometrium, low molecular weight heparins \u2014 to improve blood flow. For&nbsp;the patients with the signs of immune system aggression \u2014 prednisolone, intralipids, and\/or IVIG therapy may be used to make the woman&#8217;s immune system friendly towards the embryo. After&nbsp;a thorough review of the previous attempts and&nbsp;your investigation in&nbsp;O.L.G.A. Fertility, the necessary medications are added to the Treatment Plan on&nbsp;an individual basis.<\/p>\n<h4>Progesterone<\/h4>\n<p>Progesterone intake usually starts six days before&nbsp;the embryo transfer date. If&nbsp;the ERA test showed that&nbsp;the implantation window is earlier or&nbsp;later, we adjust the start of the Progesterone accordingly.<\/p>\n<p>We recommend taking two forms of Progesterone at&nbsp;once: vaginal suppositories \/ vaginal cream + injections. Why&nbsp;both? \u2014 This combination is the best way to reduce the incidence of bleeding, early pregnancy loss and&nbsp;increase the chances for&nbsp;an on-going pregnancy.<\/p>\n<h4>The Embryo Transfer itself<\/h4>\n<p>Our standard practice is a Single Elective Embryo transfer.<\/p>\n<p>Out of 100 transfers of a single embryo with a normal number of chromosomes in&nbsp;O.L.G.A. Fertility, 51 end in&nbsp;a live birth. It means that&nbsp;each transfer of an embryo with a normal set of chromosomes in&nbsp;O.L.G.A. has a 51% chance of resulting in&nbsp;an on-going pregnancy and&nbsp;live birth (Diagram 1).<\/p>\n<p class=\"pic\">Diagram 1. Clinical pregnancy rate and&nbsp;live birth\/on-going pregnancy rate per one embryo transfer with own eggs, depending on&nbsp;whether&nbsp;or not PGT-A was used to check the chromosomal status of the embryo (data from the embryo transfers performed in&nbsp;2020 and&nbsp;2021).<\/p>\n<p><img decoding=\"async\" class=\"w60p alignnone wp-image-11309 size-full\" src=\"https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart3.jpg\" alt=\"\" \/><\/p>\n<p>&nbsp;<\/p>\n<p>What is the chance of reaching an on-going pregnancy and&nbsp;live birth after&nbsp;the 2<sup>nd<\/sup>, 3<sup>rd<\/sup> and&nbsp;4<sup>th<\/sup> embryo transfers in&nbsp;O.L.G.A. Fertility? (Diagram 2)<\/p>\n<p><strong>In&nbsp;O.L.G.A. Fertility you have:<\/strong><\/p>\n<ul>\n<li>51.6% chance of live birth after&nbsp;1 ET<\/li>\n<li>75.4% chance of live birth after&nbsp;2 ETs<\/li>\n<li>85.6% chance of live birth after&nbsp;3 ETs<\/li>\n<li>88.9% chance of live birth after&nbsp;4 ETs<\/li>\n<\/ul>\n<p class=\"pic\">Diagram 2. Cumulative <span class=\"tooltip\">live birth rate<span class=\"tooltip-text\"><strong>Live birth rate<\/strong> \u2014 are calculated per embryo transfer. Live birth rates show percentage of embryo transfers which\u00a0resulted in\u00a0live birth<\/span><\/span> in&nbsp;all groups of patients who&nbsp;received embryo transfers within 1131 consecutive embryo transfers at&nbsp;O.L.G.A. Fertility in&nbsp;the years 2019 \u2014 2021)<\/p>\n<p><img decoding=\"async\" class=\"w80p size-full wp-image-11298\" src=\"https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/06\/diag5b.png\" alt=\"\" \/><\/p>\n<p>As&nbsp;a result, if&nbsp;we persevere and&nbsp;consistently move towards the goal, the chance of having a baby after&nbsp;4 embryo transfers in&nbsp;O.L.G.A. Fertility is 88.9%.<\/p>\n<p>When&nbsp;working with donor eggs, it will be quite easy to have 4 embryo transfers, because&nbsp;the donor has many eggs. Also, when&nbsp;we use donor eggs, blastocysts develop more frequently and&nbsp;most of them carry normal number of chromosomes.<\/p>\n<p>When&nbsp;working with patients\u2019 own eggs, especially in&nbsp;women after&nbsp;multiple IVF failures (to whom this entire page is devoted), the first challenging task is to obtain this golden VIP embryo \u2014 a morphologically usable blastocyst with a normal number of chromosomes. The second complex task is to create such VIP conditions in&nbsp;the uterus for&nbsp;this VIP embryo, so&nbsp;that&nbsp;the embryo couldn\u2019t but&nbsp;agree to the offer made \ud83d\ude0a and&nbsp;implant with all the possible chances.<\/p>\n<p>\nThe transfer of two embryos will not increase pregnancy rates considerably but&nbsp;will significantly increase the life\/health risks for&nbsp;the mother and&nbsp;the children if&nbsp;a twin pregnancy occurs. That&nbsp;is why&nbsp;we stick to the concept of preserving our high success rates, not through increasing the number of transferred embryos, but&nbsp;through clinical strategy and&nbsp;laboratory excellence.<\/p>\n<p>Your Embryo transfer day is a very important day. All the recommendations about medication and&nbsp;further process are done by our doctors and&nbsp;nurses the day before&nbsp;so&nbsp;that&nbsp;on your embryo transfer day you are feeling confident and&nbsp;comfortable that&nbsp;all the steps following the embryo transfer are secured. We prepare for&nbsp;your embryo transfer to be a soft, gentle procedure and&nbsp;a happy experience for&nbsp;you.<\/p>\n<h4><em>Logistics<\/em><\/h4>\n<p>Your preparation for&nbsp;your Embryo Transfer takes place in&nbsp;your local country according to our Treatment Plan. You come to O.L.G.A. Fertility St. Peterbsurg\/Cyprus for&nbsp;5 days \u2013 for&nbsp;laboratory tests, last ultrasound examination, consultations with doctors and&nbsp;nurses, actual Embryo Transfer, recommendations and&nbsp;prescriptions.<\/p>\n<p class=\"getcons\">Have questions?<\/p>\n<p class=\"getcons\"><a class=\"button contactus ui large\" href=\"#footerform\">Get a Free Consultation!<\/a><\/p>\n<h3><a id=\"CNR6\"><\/a>Potential months 6, 7 or&nbsp;8<br \/>\nMore embryo transfers if&nbsp;necessary and&nbsp;possible<\/h3>\n<h6>The Goal: Potential next Embryo Transfer to achieve successful implantation and&nbsp;on-going pregnancy<\/h6>\n<p>If\u00a0after the first embryo transfer no pregnancy was achieved:<\/p>\n<ol style=\"list-style-type: lower-alpha;\">\n<li>In&nbsp;case there are chromosomally normal embryo(s) available after&nbsp;the last IVF cycle, the next embryo transfer can be done in&nbsp;the very next cycle. Important is that&nbsp;the patient does not stop hormonal medication before&nbsp;having spoken to the doctor. We usually book this call in&nbsp;advance for&nbsp;the doctor and&nbsp;the patient to speak as&nbsp;soon&nbsp;as&nbsp;the HCG test result is received.<\/li>\n<li>If&nbsp;there are no chromosomally normal embryos available, stimulation of ovaries can be started right away or&nbsp;after a short course of pill, based on&nbsp;medical\/social\/emotional situation.<\/li>\n<li>In&nbsp;some cases there may be a transition to using donor eggs based on&nbsp;medical situation, recommendation of the Clinic and&nbsp;patient\u2019s decision.<\/li>\n<\/ol>\n<h3><a id=\"CNR7\"><\/a>Your treatment after&nbsp;positive pregnancy test until&nbsp;Live Birth<\/h3>\n<h6>The Goal: A Baby<\/h6>\n<p>Once\u00a0your embryo has been transferred into your uterus you will continue to take Estradiol and\u00a0Progesterone for\u00a010 days before\u00a0taking 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.<\/p>\n<p>You will continue with your hormonal medication until&nbsp;12-13 weeks of pregnancy when&nbsp;the placenta becomes mature and&nbsp;produces enough hormones to support the pregnancy itself. From this stage of pregnancy, you will not usually need more specific support than&nbsp;you would need in&nbsp;a naturally conceived pregnancy and&nbsp;the prognosis of carrying it to the full term is very good. After&nbsp;most of your hormonal support is discontinued, you will only take Progesterone, in&nbsp;a low dose, up to week 32 to keep your cervix long, strong and&nbsp;closed and&nbsp;to reduce the risk of a late miscarriage, or&nbsp;an early birth. In&nbsp;some cases, we recommend continuing with low dosages of Aspirin and&nbsp;low molecular Heparin to improve function of the placenta and&nbsp;reduce risk of late complications in&nbsp;the pregnancy such as&nbsp;preeclampsia.<\/p>\n<p>We will also continue our dialogue with you, up to positive pregnancy test, ultrasound examination and&nbsp;onto live birth, advising and&nbsp;supporting you throughout this journey.<\/p>\n<p>This is because\u00a0we know that\u00a0the pregnancy alone is not the desired result. The result is a baby in\u00a0your arms.<\/p>\n<p>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\u00a0then advise you on\u00a0your ideal treatment plan for\u00a0having a baby.<\/p>\n<p class=\"getcons\"><a class=\"button contactus ui large\" href=\"#footerform\">Get a Free Consultation!<\/a><\/p>\n<h3>Some possible scenarios<\/h3>\n<p><strong>Best luck Scenario<\/strong> (the shortest \u2013 takes 3 months)<\/p>\n<p><img decoding=\"async\" class=\"w70p alignnone wp-image-11278 size-full\" src=\"https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/s1c.jpg\" alt=\"Best luck Scenario (the shortest \u2013 takes 3 months)\" \/><\/p>\n<p><strong><br \/>\nScenario 2<\/strong> (takes 6 months)<\/p>\n<p><img decoding=\"async\" class=\"w70p alignnone wp-image-11272 size-full\" src=\"https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/s2c.jpg\" alt=\"Scenario 2 (takes 6 months)\" \/><\/p>\n<p><strong><br \/>\nScenario 3<\/strong> (takes 7 months)<\/p>\n<p><img decoding=\"async\" class=\"w70p alignnone wp-image-11260 size-full\" src=\"https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/s3c.jpg\" alt=\"Scenario 3 (takes 7 months)\" \/><\/p>\n<p><strong><br \/>\nScenario 4<\/strong> (takes 8 months)<\/p>\n<p><img decoding=\"async\" class=\"w70p alignnone wp-image-11266 size-full\" src=\"https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/s4c.jpg\" alt=\"Scenario 4 (takes 8 months)\" \/><\/p>\n<p><strong><br \/>\nScenario 5<\/strong> (takes 9 months)<\/p>\n<p><img decoding=\"async\" class=\"w70p alignnone wp-image-11254 size-full\" src=\"https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/s5c.jpg\" alt=\"Scenario 5 (takes 9 months)\" \/><\/p>\n<p>\nThere may be more scenarios that&nbsp;are less common: more IVF cycles and&nbsp;just one embryo transfer till&nbsp;pregnancy is achieved or&nbsp;just one IVF cycle and&nbsp;several embryo transfers until&nbsp;on-going pregnancy and&nbsp;baby. There may be even&nbsp;two hysteroscopies sometimes. But&nbsp;most importantly you should know that&nbsp;if&nbsp;we are moving logically step by step and&nbsp;do not lose time, it usually does not take longer than&nbsp;9 months to achieve an on-going pregnancy.<\/p>\n<p>We hope that&nbsp;our long-term experience of successful work with patients with the most difficult medical cases together with your perseverance and&nbsp;wish to reach the goal will help us achieve the birth of your healthy, strong and&nbsp;happy baby.<\/p>\n<p>If&nbsp;you would like to discuss your situation and&nbsp;chances with us, please call or&nbsp;email us. We have time for&nbsp;you, and&nbsp;we will be happy to discuss any initial questions with you and&nbsp;agree on&nbsp;a time for&nbsp;an individual consultation with our doctor.<\/p>\n<p class=\"getcons\"><a class=\"button contactus ui large\" href=\"#footerform\">Get a Free Consultation!<\/a><\/p>\n<h3>Q&amp;A<\/h3>\n<div>            <div class=\"qae-faqs-container qae-faqs-list-container\">\n\t\t\t\t\t\t\t<ul class=\"qe-faqs-filters-container\">\n\t\t\t\t<li class=\"active\"><a class=\"qe-faqs-filter all-faqs\" href=\"#\" data-filter=\"*\">All<\/a><\/li>\n\t\t\t\t<li><a class=\"qe-faqs-filter\" href=\"#ivf-process\" data-filter=\".ivf-process\">IVF Process<\/a><\/li>\t\t\t<\/ul>\n\t\t\t<ol class=\"qe-faqs-index-list\"><div id=\"qe-faqs-index\" class=\"qe-faqs-index\">\n\t\t\t\t\t<li class=\"ivf-process\">\n\t\t\t\t\t\t<a href=\"#qaef-12881\">You recommend not more than two days of abstinence between the last ejaculation and sperm collection. What is the reason behind this?<\/a>\n\t\t\t\t\t<\/li>\n\n\t\t\t\t\n\t\t\t\t\t<li class=\"ivf-process\">\n\t\t\t\t\t\t<a href=\"#qaef-12882\">In the case of using frozen sperm samples for fertilization is there a possibility to perform regular IVF?<\/a>\n\t\t\t\t\t<\/li>\n\n\t\t\t\t\n\t\t\t\t\t<li class=\"ivf-process\">\n\t\t\t\t\t\t<a href=\"#qaef-12883\">Even though our clinic told us that the bad fertilization was mainly due to bad sperm (ICSI performed with a bad result &#8211; half of the eggs were fertilized abnormally with 3PN), it feels like my partner\u2019s health was dismissed. We feel like it\u2019s half of the equation for viable embryos, and that we need to go deeper into this subject.<\/a>\n\t\t\t\t\t<\/li>\n\n\t\t\t\t\n\t\t\t\t\t<li class=\"ivf-process\">\n\t\t\t\t\t\t<a href=\"#qaef-12884\">Is higher sperm motility always better? I.e. does MOT 50 has a higher success rate than MOT 20? Any difference depending on woman\u2019s age? What do you use at your clinic?<\/a>\n\t\t\t\t\t<\/li>\n\n\t\t\t\t\n\t\t\t\t\t<li class=\"ivf-process\">\n\t\t\t\t\t\t<a href=\"#qaef-12885\">My question is about heat and sperm quality. How long before egg retrieval a man shouldn\u2019t visit a sauna? For example, Is it OK for a man to go to a spa 1-2 months before? Or should he stay off heat for at least 74 days before leaving his sperm sample for treatment?<\/a>\n\t\t\t\t\t<\/li>\n\n\t\t\t\t\n\t\t\t\t\t<li class=\"ivf-process\">\n\t\t\t\t\t\t<a href=\"#qaef-12886\">It is clear that the quality of the egg plays a key role for success. So how can you help in improving the quality of the egg? How are your stimulation protocols different from other IVF clinics?<\/a>\n\t\t\t\t\t<\/li>\n\n\t\t\t\t\n\t\t\t\t\t<li class=\"ivf-process\">\n\t\t\t\t\t\t<a href=\"#qaef-12887\">How many simulations are \u201ctoo much\u201d (medically unsafe) and is it time to stop\/change strategy?<\/a>\n\t\t\t\t\t<\/li>\n\n\t\t\t\t\n\t\t\t\t\t<li class=\"ivf-process\">\n\t\t\t\t\t\t<a href=\"#qaef-12888\">l have gained a significant amount of weight during my treatments (10 kg in 1 year) My question is if losing weight would increase my chances for a successful treatment in the future?<\/a>\n\t\t\t\t\t<\/li>\n\n\t\t\t\t\n\t\t\t\t\t<li class=\"ivf-process\">\n\t\t\t\t\t\t<a href=\"#qaef-12889\">Regarding Melatonin you recommended me to take, in Sweden we have to have a recipe to get it. And on the flyer that comes with it, it says that it&#8217;s not recommended to use it if one wants to get pregnant. Is it true? Do you have any brands that you can recommend?<\/a>\n\t\t\t\t\t<\/li>\n\n\t\t\t\t\n\t\t\t\t\t<li class=\"ivf-process\">\n\t\t\t\t\t\t<a href=\"#qaef-12890\">Is there a slow stimulation cycle and a normal one and how do you choose which one the woman should go through for extracting eggs? What are the criteria for choosing either? Does one of them have less chance of abnormal chromosomes in the eggs extracted and why if so?<\/a>\n\t\t\t\t\t<\/li>\n\n\t\t\t\t\n\t\t\t\t\t<li class=\"ivf-process\">\n\t\t\t\t\t\t<a href=\"#qaef-12891\">When pulling out the follicles, do you pull them all out? Both the ones which are small and the ones which are mature? Does it ever happen that a follicle is hidden and left behind?<\/a>\n\t\t\t\t\t<\/li>\n\n\t\t\t\t\n\t\t\t\t\t<li class=\"ivf-process\">\n\t\t\t\t\t\t<a href=\"#qaef-12892\">If only one or two eggs are collected in each IVF attempt, do you recommend culture to a blastocyst? I also have another question. Does your clinic offer in vitro maturation of eggs? 2 of my ivf cycles failed because the eggs were not mature when the clinic retrieved them.<\/a>\n\t\t\t\t\t<\/li>\n\n\t\t\t\t\n\t\t\t\t\t<li class=\"ivf-process\">\n\t\t\t\t\t\t<a href=\"#qaef-12893\">Hello, are the incubators you use time-lapse incubators? Do you\/do you not recommend using them? Also, is the embryo culture media changed at Day 3, or is the same media used for both cleavage and blastocyst culture? Do you use EmbryoGen + BlastGen (culture media that has the addition of cytokine GM-CSF)? Do you find this helps (or not?)<\/a>\n\t\t\t\t\t<\/li>\n\n\t\t\t\t\n\t\t\t\t\t<li class=\"ivf-process\">\n\t\t\t\t\t\t<a href=\"#qaef-12894\">What is the \u00absurvival rate\u00bb for frozen embryos when thawed? Do you need to thaw more than one embryo to be sure when you prepare for an embryo transfer?<\/a>\n\t\t\t\t\t<\/li>\n\n\t\t\t\t<\/div><\/ol>\t\t<div id=\"qaef-12881\" class=\"qe-faq-list ivf-process\">\n\t\t\t<div class=\"qe-list-title\">\n\t\t\t\t<h4>\n\t\t\t\t\t<i class=\"fa fa-question-circle\"><\/i> You recommend not more than two days of abstinence between the last ejaculation and sperm collection. What is the reason behind this?\t\t\t\t<\/h4>\n\t\t\t<\/div>\n\t\t\t<div class=\"qe-list-content\">\n\t\t\t\t<p>The ejaculation can be even&nbsp;night before&nbsp;sperm collection, the &#8216;fresher&#8217; the sample is the better. We are not after&nbsp;high concentration but&nbsp;after better motility and&nbsp;competence of the sperm which&nbsp;usually comes with less days of abstinence.<\/p>\n<p><em>Dr. Anna Gusareva<\/em><\/p>\n<br \/><a class=\"qe-faq-top\" href=\"#qe-faqs-index\"><i class=\"fa fa-angle-up\"><\/i> Back to Index<\/a>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div id=\"qaef-12882\" class=\"qe-faq-list ivf-process\">\n\t\t\t<div class=\"qe-list-title\">\n\t\t\t\t<h4>\n\t\t\t\t\t<i class=\"fa fa-question-circle\"><\/i> In the case of using frozen sperm samples for fertilization is there a possibility to perform regular IVF?\t\t\t\t<\/h4>\n\t\t\t<\/div>\n\t\t\t<div class=\"qe-list-content\">\n\t\t\t\t<p>With frozen samples we use ICSI almost always, except for&nbsp;donor sperm. The reason for&nbsp;that is because&nbsp;after freezing-thawing the motility usually drops twice so&nbsp;only samples which&nbsp;were &#8220;donor-like&#8221; at&nbsp;the time of freezing can reach the high parameters, suitable for&nbsp;IVF, after&nbsp;thawing and&nbsp;preparation.\u00a0<\/p>\n<p><em>Dr. Anna Gusareva<\/em><\/p>\n<br \/><a class=\"qe-faq-top\" href=\"#qe-faqs-index\"><i class=\"fa fa-angle-up\"><\/i> Back to Index<\/a>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div id=\"qaef-12883\" class=\"qe-faq-list ivf-process\">\n\t\t\t<div class=\"qe-list-title\">\n\t\t\t\t<h4>\n\t\t\t\t\t<i class=\"fa fa-question-circle\"><\/i> Even though our clinic told us that the bad fertilization was mainly due to bad sperm (ICSI performed with a bad result &#8211; half of the eggs were fertilized abnormally with 3PN), it feels like my partner\u2019s health was dismissed. We feel like it\u2019s half of the equation for viable embryos, and that we need to go deeper into this subject.\t\t\t\t<\/h4>\n\t\t\t<\/div>\n\t\t\t<div class=\"qe-list-content\">\n\t\t\t\t<p>I understand your concern that&nbsp;usually less attention is paid to the male factor. I will explain why&nbsp;I think that&nbsp;the egg factor is the most important in&nbsp;your case as&nbsp;well as&nbsp;in many others. Poor fertilization results of your eggs after&nbsp;ICSI showed an interesting pattern in&nbsp;the pronuclear development \u2014 half of the eggs fertilized abnormally (3PN) which&nbsp;is a really rare case when&nbsp;ICSI is performed. During ICSI it is guaranteed that&nbsp;only one spermatozoid will be placed inside each egg, so&nbsp;presence of 3 pronuclei on&nbsp;the next day after&nbsp;ICSI indicates that&nbsp;two of these are from the egg, which&nbsp;means that&nbsp;egg was unable to complete meiosis properly \u2014 extrude the second polar body. It points toward egg problems with competence and&nbsp;cytoplasmic maturity.<\/p>\n<p>To overcome that&nbsp;situation we propose to do more individualized stimulation aiming for&nbsp;more synchronous\u00a0 growth of the follicles and&nbsp;prolonging it to get more mature and&nbsp;competent eggs. We believe that&nbsp;following basic lifestyle recommendations (refrain from smoking and&nbsp;alcohol intake, healthy diet and&nbsp;physical activity) together with intake of the supplements (we will give you the individual list) will help to increase parameters of your sperm and&nbsp;bust its energetic potential.<\/p>\n<p><em>Dr. Anna Gusareva<\/em><\/p>\n<br \/><a class=\"qe-faq-top\" href=\"#qe-faqs-index\"><i class=\"fa fa-angle-up\"><\/i> Back to Index<\/a>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div id=\"qaef-12884\" class=\"qe-faq-list ivf-process\">\n\t\t\t<div class=\"qe-list-title\">\n\t\t\t\t<h4>\n\t\t\t\t\t<i class=\"fa fa-question-circle\"><\/i> Is higher sperm motility always better? I.e. does MOT 50 has a higher success rate than MOT 20? Any difference depending on woman\u2019s age? What do you use at your clinic?\t\t\t\t<\/h4>\n\t\t\t<\/div>\n\t\t\t<div class=\"qe-list-content\">\n\t\t\t\t<p>No, if&nbsp;sperm motility is better it doesn&#8217;t mean that&nbsp;the outcome of IVF will be better. Only in&nbsp;severe cases of asthenozoospermia with complete loss of sperm motility it could have an adverse effect on&nbsp;the fertilization rate. In&nbsp;all other cases, the origin and&nbsp;the quality of sperm doesn&#8217;t matter in&nbsp;terms of the IVF result. Women&#8217;s age, on&nbsp;the contrary, has a major effect on&nbsp;pregnancy + live birth rates and&nbsp;sperm motility doesn&#8217;t add any difference.<\/p>\n<p><em>Dr. Anna Gusareva<\/em><\/p>\n<br \/><a class=\"qe-faq-top\" href=\"#qe-faqs-index\"><i class=\"fa fa-angle-up\"><\/i> Back to Index<\/a>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div id=\"qaef-12885\" class=\"qe-faq-list ivf-process\">\n\t\t\t<div class=\"qe-list-title\">\n\t\t\t\t<h4>\n\t\t\t\t\t<i class=\"fa fa-question-circle\"><\/i> My question is about heat and sperm quality. How long before egg retrieval a man shouldn\u2019t visit a sauna? For example, Is it OK for a man to go to a spa 1-2 months before? Or should he stay off heat for at least 74 days before leaving his sperm sample for treatment?\t\t\t\t<\/h4>\n\t\t\t<\/div>\n\t\t\t<div class=\"qe-list-content\">\n\t\t\t\t<p>Yes, heat negatively affects sperm quality, especially the motility of sperm. So&nbsp;men should refrain from long lasting hot tubs and&nbsp;saunas during 2,5 months prior to sperm collection.<\/p>\n<p><em>Dr. Anna Gusareva<\/em><\/p>\n<br \/><a class=\"qe-faq-top\" href=\"#qe-faqs-index\"><i class=\"fa fa-angle-up\"><\/i> Back to Index<\/a>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div id=\"qaef-12886\" class=\"qe-faq-list ivf-process\">\n\t\t\t<div class=\"qe-list-title\">\n\t\t\t\t<h4>\n\t\t\t\t\t<i class=\"fa fa-question-circle\"><\/i> It is clear that the quality of the egg plays a key role for success. So how can you help in improving the quality of the egg? How are your stimulation protocols different from other IVF clinics?\t\t\t\t<\/h4>\n\t\t\t<\/div>\n\t\t\t<div class=\"qe-list-content\">\n\t\t\t\t<p>There are many stimulation protocols existent precisely because&nbsp;each woman is unique. So&nbsp;we are not inventing new ones but&nbsp;select the best one for&nbsp;your individual situation. The knowledge about your previous attempts and&nbsp;protocols\/dosages\/duration\/follicular measurement\/outcomes help us a lot. The more detailed information we have &#8211; the more tailored will be the approach to stimulation and&nbsp;overall strategy. It is immensely important for\u00a0 the competence of the eggs how they were \u2018cooked\u2019 \u2014 prepared for&nbsp;future fertilisation and&nbsp;development by the right stimulation and&nbsp;precise list of supplements you take for&nbsp;2 months before&nbsp;the egg retrieval.<\/p>\n<p><em>Dr. Anna Gusareva<\/em><\/p>\n<br \/><a class=\"qe-faq-top\" href=\"#qe-faqs-index\"><i class=\"fa fa-angle-up\"><\/i> Back to Index<\/a>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div id=\"qaef-12887\" class=\"qe-faq-list ivf-process\">\n\t\t\t<div class=\"qe-list-title\">\n\t\t\t\t<h4>\n\t\t\t\t\t<i class=\"fa fa-question-circle\"><\/i> How many simulations are \u201ctoo much\u201d (medically unsafe) and is it time to stop\/change strategy?\t\t\t\t<\/h4>\n\t\t\t<\/div>\n\t\t\t<div class=\"qe-list-content\">\n\t\t\t\t<p><span style=\"font-weight: 400\">It all depends on&nbsp;a woman&#8217;s current general health and&nbsp;medical history. Also we calculate the probability of having a chromosomally normal embryo depending on&nbsp;the age, ovarian reserve and&nbsp;outcomes of previous attempts and&nbsp;discuss it with each patient. In&nbsp;each individual situation we assess the risks and&nbsp;benefits and&nbsp;decide if&nbsp;it is safe and&nbsp;useful or&nbsp;not to try again or&nbsp;should we use the alternative approach.<\/span><\/p>\n<p><em><span style=\"font-weight: 400\">Dr. Anna Gusareva<\/span><\/em><\/p>\n<br \/><a class=\"qe-faq-top\" href=\"#qe-faqs-index\"><i class=\"fa fa-angle-up\"><\/i> Back to Index<\/a>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div id=\"qaef-12888\" class=\"qe-faq-list ivf-process\">\n\t\t\t<div class=\"qe-list-title\">\n\t\t\t\t<h4>\n\t\t\t\t\t<i class=\"fa fa-question-circle\"><\/i> l have gained a significant amount of weight during my treatments (10 kg in 1 year) My question is if losing weight would increase my chances for a successful treatment in the future?\t\t\t\t<\/h4>\n\t\t\t<\/div>\n\t\t\t<div class=\"qe-list-content\">\n\t\t\t\t<p><span style=\"font-weight: 400\">The optimal BMI before&nbsp;the start of fertility treatment is below 30 kg\/cm3. The risks of the high BMI include: lower pregnancy rate, increased miscarriage rate, pregnancy complications, as&nbsp;well as&nbsp;significant health risks for&nbsp;the baby. Switching to a healthier diet and&nbsp;adding some exercising to lower your BMI would increase your chances for&nbsp;success.<\/span><\/p>\n<p><em><span style=\"font-weight: 400\">Dr. Anna Gusareva<\/span><\/em><\/p>\n<br \/><a class=\"qe-faq-top\" href=\"#qe-faqs-index\"><i class=\"fa fa-angle-up\"><\/i> Back to Index<\/a>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div id=\"qaef-12889\" class=\"qe-faq-list ivf-process\">\n\t\t\t<div class=\"qe-list-title\">\n\t\t\t\t<h4>\n\t\t\t\t\t<i class=\"fa fa-question-circle\"><\/i> Regarding Melatonin you recommended me to take, in Sweden we have to have a recipe to get it. And on the flyer that comes with it, it says that it&#8217;s not recommended to use it if one wants to get pregnant. Is it true? Do you have any brands that you can recommend?\t\t\t\t<\/h4>\n\t\t\t<\/div>\n\t\t\t<div class=\"qe-list-content\">\n\t\t\t\t<p><span style=\"font-weight: 400\">Regarding the dosage of Melatonin we recommend is completely safe for&nbsp;the period of preparation for&nbsp;IVF or&nbsp;ET. After&nbsp;embryo transfer you will stop using it. It helps sleep well which&nbsp;is very important for&nbsp;hormone production and&nbsp;general wellbeing. You can use any brand. To learn more about the supplements we recommend and&nbsp;their role in&nbsp;the fertility process please watch our pre recorded webinar by Dr. Alena Egorova, you can request access to it <\/span><a href=\"https:\/\/olgafertilityclinic.com\/en\/events\/get-access-to-webinars\/?wid=11\"><span style=\"font-weight: 400\">here<\/span><\/a><\/p>\n<p><em><span style=\"font-weight: 400\">Dr. Anna Gusareva<\/span><\/em><\/p>\n<br \/><a class=\"qe-faq-top\" href=\"#qe-faqs-index\"><i class=\"fa fa-angle-up\"><\/i> Back to Index<\/a>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div id=\"qaef-12890\" class=\"qe-faq-list ivf-process\">\n\t\t\t<div class=\"qe-list-title\">\n\t\t\t\t<h4>\n\t\t\t\t\t<i class=\"fa fa-question-circle\"><\/i> Is there a slow stimulation cycle and a normal one and how do you choose which one the woman should go through for extracting eggs? What are the criteria for choosing either? Does one of them have less chance of abnormal chromosomes in the eggs extracted and why if so?\t\t\t\t<\/h4>\n\t\t\t<\/div>\n\t\t\t<div class=\"qe-list-content\">\n\t\t\t\t<p><span style=\"font-weight: 400\">Our doctors are choosing stimulation protocol individually, taking into consideration all previous attempts, current ovarian reserve, age and&nbsp;much more. During egg maturation its energy levels have to multiply hundred times. Older eggs have deficiency of energy resources and&nbsp;need even&nbsp;more time for&nbsp;maturation. Hence too short stimulations may be just not enough for&nbsp;the cytoplasm of the egg cell to mature.<\/span><\/p>\n<p><em><span style=\"font-weight: 400\">Dr. Anna Gusareva<\/span><\/em><\/p>\n<br \/><a class=\"qe-faq-top\" href=\"#qe-faqs-index\"><i class=\"fa fa-angle-up\"><\/i> Back to Index<\/a>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div id=\"qaef-12891\" class=\"qe-faq-list ivf-process\">\n\t\t\t<div class=\"qe-list-title\">\n\t\t\t\t<h4>\n\t\t\t\t\t<i class=\"fa fa-question-circle\"><\/i> When pulling out the follicles, do you pull them all out? Both the ones which are small and the ones which are mature? Does it ever happen that a follicle is hidden and left behind?\t\t\t\t<\/h4>\n\t\t\t<\/div>\n\t\t\t<div class=\"qe-list-content\">\n\t\t\t\t<p><span style=\"font-weight: 400\">During egg retrieval the doctor aspirates fluid from all follicles with the visual cavity, regardless of size. It happens that&nbsp;some of the eggs we get from such follicles are immature but&nbsp;in some cases mature eggs could come from small follicles and&nbsp;vice versa. On&nbsp;ultrasound all follicles with cavity are usually seen quite clearly, so&nbsp;doctor wouldn&#8217;t miss them. But&nbsp;in some rare cases the anatomy of ovaries could be quite unusual and&nbsp;follicles could be hard to get by transvaginal access.<\/span><span style=\"font-weight: 400\"><br \/>\n<\/span><\/p>\n<p><em><span style=\"font-weight: 400\">Dr. Anna Gusareva<\/span><\/em><\/p>\n<br \/><a class=\"qe-faq-top\" href=\"#qe-faqs-index\"><i class=\"fa fa-angle-up\"><\/i> Back to Index<\/a>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div id=\"qaef-12892\" class=\"qe-faq-list ivf-process\">\n\t\t\t<div class=\"qe-list-title\">\n\t\t\t\t<h4>\n\t\t\t\t\t<i class=\"fa fa-question-circle\"><\/i> If only one or two eggs are collected in each IVF attempt, do you recommend culture to a blastocyst? I also have another question. Does your clinic offer in vitro maturation of eggs? 2 of my ivf cycles failed because the eggs were not mature when the clinic retrieved them.\t\t\t\t<\/h4>\n\t\t\t<\/div>\n\t\t\t<div class=\"qe-list-content\">\n\t\t\t\t<p>Yes, we always culture embryos to the blastocyst stage, disregarding the quantity of the eggs. We are confident in&nbsp;our culture conditions and&nbsp;believe it is better to transfer a viable embryo. So, if&nbsp;the embryo doesn\u2019t look viable we recommend not to transfer it and&nbsp;save a patient from this hard 2 week wait. We do not practice IVM because&nbsp;it is still an experimental technique and&nbsp;has a lot of limitations. But&nbsp;we have many patients with previously immature eggs only, who&nbsp;got mature eggs with the help of our doctors\u2019 individualized stimulation. Do not give up your eggs before&nbsp;you try our individual stimulation.<\/p>\n<p><em><span style=\"font-weight: 400\">D<\/span><span style=\"font-weight: 400\">r. Anna Gusareva<\/span><\/em><\/p>\n<br \/><a class=\"qe-faq-top\" href=\"#qe-faqs-index\"><i class=\"fa fa-angle-up\"><\/i> Back to Index<\/a>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div id=\"qaef-12893\" class=\"qe-faq-list ivf-process\">\n\t\t\t<div class=\"qe-list-title\">\n\t\t\t\t<h4>\n\t\t\t\t\t<i class=\"fa fa-question-circle\"><\/i> Hello, are the incubators you use time-lapse incubators? Do you\/do you not recommend using them? Also, is the embryo culture media changed at Day 3, or is the same media used for both cleavage and blastocyst culture? Do you use EmbryoGen + BlastGen (culture media that has the addition of cytokine GM-CSF)? Do you find this helps (or not?)\t\t\t\t<\/h4>\n\t\t\t<\/div>\n\t\t\t<div class=\"qe-list-content\">\n\t\t\t\t<p><span style=\"font-weight: 400\">Great questions! I see you are a pro! We do not have time-lapse incubators in&nbsp;the lab. There is no hard evidence that&nbsp;culturing embryos in&nbsp;these incubators will make a significant difference in&nbsp;terms of success rates. They provide good conditions for&nbsp;embryos because&nbsp;their culture is not interrupted by openings but&nbsp;the usefulness of time-lapse itself is debated by the scientific community. We use the same principle of uninterrupted culture in&nbsp;the same drop of media from Day 1 till&nbsp;Day 6, taking embryos out of the incubator only 3 times for&nbsp;a very brief period (on days 3,5 and&nbsp;6). <\/span><\/p>\n<p><span style=\"font-weight: 400\">We are using benchtop multi gas incubators which&nbsp;restore the initial conditions for&nbsp;the embryos very quickly, so&nbsp;these observations don&#8217;t harm them at&nbsp;all and&nbsp;the information we get is enough. So&nbsp;basically, time-lapse incubators for&nbsp;now are more of marketing than&nbsp;of real usefulness. Embryo-Gen and&nbsp;Blast-Gen can be useful for&nbsp;a very specific group of patients and&nbsp;we are considering trying it but&nbsp;have no own experience on&nbsp;them. There is no hard evidence they will help the unselected patient\u2019s population, unfortunately.<\/span><span style=\"font-weight: 400\"><br \/>\n<\/span><\/p>\n<p><em><span style=\"font-weight: 400\">Dr. Anna Gusareva<\/span><\/em><\/p>\n<br \/><a class=\"qe-faq-top\" href=\"#qe-faqs-index\"><i class=\"fa fa-angle-up\"><\/i> Back to Index<\/a>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div id=\"qaef-12894\" class=\"qe-faq-list ivf-process\">\n\t\t\t<div class=\"qe-list-title\">\n\t\t\t\t<h4>\n\t\t\t\t\t<i class=\"fa fa-question-circle\"><\/i> What is the \u00absurvival rate\u00bb for frozen embryos when thawed? Do you need to thaw more than one embryo to be sure when you prepare for an embryo transfer?\t\t\t\t<\/h4>\n\t\t\t<\/div>\n\t\t\t<div class=\"qe-list-content\">\n\t\t\t\t<p><span style=\"font-weight: 400\">Survival rate for&nbsp;the vitrified blastocysts in&nbsp;our clinic is around 95%. So&nbsp;most of the time we thaw only one blastocyst with the best score available at&nbsp;least 2 hours before&nbsp;transfer. In&nbsp;rare cases, if&nbsp;the embryo doesn&#8217;t look well after&nbsp;thawing, we have enough time to thaw one more.<\/span><\/p>\n<p><em><span style=\"font-weight: 400\">Dr. Anna Gusareva<\/span><\/em><\/p>\n<br \/><a class=\"qe-faq-top\" href=\"#qe-faqs-index\"><i class=\"fa fa-angle-up\"><\/i> Back to Index<\/a>\t\t\t<\/div>\n\t\t<\/div>\n\t\t            <\/div>\n\t\t<\/div>\n","protected":false},"excerpt":{"rendered":"<p>\u00a0 In&nbsp;life it is rare to get everything at&nbsp;once. First, we strive to get education, then to achieve success in&nbsp;our professional field, then to create a family and&nbsp;give birth to our children. Each step takes time and&nbsp;energy. And&nbsp;these steps are so&nbsp;difficult to combine, for&nbsp;example, to achieve success at&nbsp;work while&nbsp;starting a family. And&nbsp;we, of course, want<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":33,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"tags":[],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v18.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Your IVF Process: One Step at a Time - O.L.G.A. Fertility<\/title>\n<meta name=\"description\" content=\"Explore the comprehensive IVF process at O.L.G.A. Fertility Clinic, from initial consultation to embryo transfer. 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