{"id":9,"date":"2020-03-09T22:05:05","date_gmt":"2020-03-09T22:05:05","guid":{"rendered":"https:\/\/olgafertilityclinic.com\/?page_id=9"},"modified":"2024-03-25T12:11:42","modified_gmt":"2024-03-25T12:11:42","slug":"ivf","status":"publish","type":"page","link":"https:\/\/olgafertilityclinic.com\/en\/ivf\/","title":{"rendered":"How to defeat IVF failures?"},"content":{"rendered":"<ul id=\"tocList\" class=\"toclist\">\u00a0<\/ul>\n<p>To find a solution to how to increase IVF success, we need to know and\u00a0understand the reasons of IVF failure.<\/p>\n<p>Our patients often have more than&nbsp;one reason why&nbsp;their pregnancies haven\u2019t happened yet&nbsp;or haven\u2019t progressed to the full term. Otherwise, first IVF attempts at&nbsp;their local clinics would have already led to a result, and&nbsp;we would never have met.<\/p>\n<p>To be able to solve or\u00a0correct each reason of\u00a0previous IVF failures we stick to the principle \u201cone challenge \u2014 one solution\u201d.<\/p>\n<p>When&nbsp;you have a big project, you tend to split it in&nbsp;several smaller projects with smaller goals, which&nbsp;lead to one big goal. The smaller goals here are: eggs, <span class=\"tooltip\">blastocysts<span class=\"tooltip-text\"><strong>Blastocyst<\/strong>\u00a0\u2014 the stage that\u00a0a human embryo normally reaches on\u00a0day 5-6 of development. This is the stage on\u00a0which the embryo implantation process begins.<\/span><\/span>, chromosomally normal blastocysts, prepared uterus, ready <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.<\/span><\/span>, and&nbsp;finally \u2014 a chromosomally normal blastocyst for&nbsp;a ready <span class=\"tooltip\">endometrium<span class=\"tooltip-text\"><strong>Endometrium<\/strong>\u00a0\u2014 the lining covering the uterine cavity<\/span><\/span> in\u00a0the right timing.<\/p>\n<p><strong>One big goal here is a baby.<\/strong><\/p>\n<p>The reasons for\u00a0IVF failure and\u00a0pregnancy loss can be divided into two groups: <b>embryonic and&nbsp;maternal.<\/b><\/p>\n<p><b>Embryonic reasons <\/b>for&nbsp;IVF failure and&nbsp;pregnancy loss mean that&nbsp;something is some reason inside the embryo. Due to these internal reasons the embryo is not viable and&nbsp;cannot develop, even&nbsp;in&nbsp;the best maternal conditions.<\/p>\n<p><b>Maternal reasons <\/b>for&nbsp;IVF failure and&nbsp;pregnancy loss include reasons within the female organism and&nbsp;can be explained by hormonal, immune or&nbsp;uterine factors.<\/p>\n<h2 class=\"sf notclear\">I. Overcoming embryonic reasons for&nbsp;pregnancy loss and&nbsp;IVF failure<\/h2>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"w40p fl noshadow wp-image-2193 rightmar\" src=\"\/wp-content\/uploads\/2020\/03\/Picture_A.png\" alt=\"Picture 1. Who&nbsp;is responsible for&nbsp;the outcome of IVF: a woman or&nbsp;an embryo?\" width=\"617\" height=\"617\" srcset=\"https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/Picture_A.png 617w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/Picture_A-300x300.png 300w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/Picture_A-150x150.png 150w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/Picture_A-370x370.png 370w\" sizes=\"(max-width: 617px) 100vw, 617px\" \/><\/p>\n<p class=\"pic\">Picture 1. Who&nbsp;is responsible for&nbsp;the outcome of IVF: a woman or&nbsp;an embryo?<\/p>\n<p>Embryonic reasons for\u00a0pregnancy loss and\u00a0IVF\u00a0failure are the most powerful and\u00a0at least 75% responsible for\u00a0the outcome of the fertility treatment and\u00a0pregnancy.<\/p>\n<h3 class=\"notclear cf\" style=\"margin-top: 0; padding-top: 0;\">I.1. Genetic situation in&nbsp;human embryos<\/h3>\n<p>\u2014 Human embryos of parents after&nbsp;the age of 35 often have an abnormal set of chromosomes [Fragouli et al., 2012] and, strange as&nbsp;it may sound, it is normal;<\/p>\n<p>\u2014 An abnormal set of chromosomes in&nbsp;the embryo almost always leads to a pregnancy loss at&nbsp;the pre-implantation stage (implantation failure) or&nbsp;at the post-implantation stage (miscarriage) [Scott at&nbsp;al., 2012];<\/p>\n<p>\u2014 An abnormal set of chromosomes is almost always of maternal origin, so\u00a0the embryo gets it from the egg;<\/p>\n<p>\u2014 The older the eggs are the more likely it is that\u00a0the embryo will have chromosome abnormalities, and\u00a0again, it is normal;<\/p>\n<p>\u2014 The influence of chromosomal errors on&nbsp;the morphology of the embryo (how the embryos look under the microscope) on&nbsp;5-6 day of development is insignificant. It means that&nbsp;the embryo may look normal but&nbsp;have the abnormal<span class=\"Apple-converted-space\">\u00a0 <\/span>set of chromosomes [Alfarawati et al., 2011].<\/p>\n<h4>What proportion of embryos at&nbsp;blastocyst stage is expected to have a normal set of chromosomes?<\/h4>\n<p class=\"pic\">\nDiagram 1. Proportion of blastocysts with a normal set of chromosomes in&nbsp;women of different age groups according to S. Munne et al.<img loading=\"lazy\" decoding=\"async\" width=\"1500\" height=\"431\" class=\"w70p alignnone wp-image-11201 size-full\" src=\"https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart2.jpg\" alt=\"\" srcset=\"https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart2.jpg 1500w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart2-300x86.jpg 300w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart2-150x43.jpg 150w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart2-768x221.jpg 768w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart2-270x78.jpg 270w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart2-900x259.jpg 900w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart2-1200x345.jpg 1200w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart2-1170x336.jpg 1170w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart2-870x250.jpg 870w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart2-370x106.jpg 370w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart2-554x159.jpg 554w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart2-306x88.jpg 306w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart2-260x75.jpg 260w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart2-87x25.jpg 87w\" sizes=\"(max-width: 1500px) 100vw, 1500px\" \/><\/p>\n<p class=\"pic-sm\">[S. Munne et al. Blastocysts needed to transfer at&nbsp;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\u2013e14]<\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>Every second blastocyst is expected to have a normal set of chromosomes in\u00a0the age group 35-37;<\/li>\n<li>Only one in\u00a08 blastocysts is expected to have a normal set of chromosomes by the age of 43.<\/li>\n<\/ul>\n<p class=\"pic\">\n<p>Diagram <b>2. Proportions of chromosomally normal blastocysts depending on&nbsp;the age of woman. O.L.G.A. Fertility data from 2019 to 2022<\/b>.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"w70p alignnone wp-image-11181 size-full\" src=\"https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart1.jpg\" alt=\"In the data we collected in&nbsp;O.L.G.A. Clinic from 2019 to 2022 these proportions of chromosomally normal blastocysts depending on&nbsp;the age of woman are nearly the same\" width=\"1500\" height=\"908\" srcset=\"https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart1.jpg 1500w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart1-300x182.jpg 300w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart1-150x91.jpg 150w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart1-768x465.jpg 768w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart1-270x163.jpg 270w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart1-851x515.jpg 851w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart1-1200x726.jpg 1200w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart1-839x508.jpg 839w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart1-870x527.jpg 870w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart1-370x224.jpg 370w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart1-554x335.jpg 554w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart1-306x185.jpg 306w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart1-322x195.jpg 322w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart1-260x157.jpg 260w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart1-87x53.jpg 87w\" sizes=\"(max-width: 1500px) 100vw, 1500px\" \/><\/p>\n<p>In&nbsp;the data we collected in&nbsp;O.L.G.A. Fertility from 2019 to 2022 these proportions of chromosomally normal blastocysts depending on&nbsp;the age of woman are in&nbsp;line with an earlier study by S. Munne et al.<\/p>\n<h3>I.2. PGT-A \u2014 genetic testing of human embryos<\/h3>\n<div>\n<p>Is there any way to identify which\u00a0of the blastocysts with normal morphology (\u2018good-looking\u2019) have a normal set of chromosomes and\u00a0which have not?<\/p>\n<\/div>\n<div>\u2014 Yes! This way exists and&nbsp;is called PGT-A.<\/div>\n<h4>\nWhat is PGT-A?<\/h4>\n<p>PGT-A \u2014 Preimplantation Genetic Testing for&nbsp;Aneuploidies (a<span class=\"tooltip\">neuploidy<span class=\"tooltip-text\"><strong>Aneuploidy<\/strong> \u2014 an abnormal number of chromosomes. An abnormal number of chromosomes in&nbsp;cells of embryos, makes an embryo\u2019s development stop. It is responsible for&nbsp;70-80% of pregnancy losses in&nbsp;the first 12 weeks of pregnancy.<\/span><\/span> \u2014 an abnormal set of chromosomes). This genetic testing of embryos locates the normal embryos, from those available. By excluding abnormal embryos from future use the <span class=\"tooltip\">live birth rates<span class=\"tooltip-text\"><strong>Live birth rates<\/strong> \u2014 are calculated per embryo transfer. Live birth rates show percentage of embryo transfers which\u00a0resulted in\u00a0live birth<\/span><\/span>\u00a0are increased per embryo transfer. It happens because&nbsp;the testing identifies embryos (with the abnormal set of chromosomes) that&nbsp;would lead to implantation failures and&nbsp;pregnancy losses, and&nbsp;they are not transferred into the uterine cavity.<\/p>\n<h4>What is the purpose of PGT-A?<\/h4>\n<p>PGT-A does not make embryos better. PGT-A selects embryos with a normal set of chromosomes from those available to use them for\u00a0the embryo transfer.<\/p>\n<h4>How is PGT-A carried out?<\/h4>\n<p>PGT-A tests the set of chromosomes in&nbsp;the\u00a0DNA taken from embryonic placenta. Embryos with an abnormal chromosomal set will not lead to a healthy live birth, hence they are excluded from use. Embryos with a normal set of chromosomes are used for\u00a0the embryo transfer.<\/p>\n<h4>What are the goals of PGT-A?<\/h4>\n<ul>\n<li>To reduce miscarriage rates<\/li>\n<li>To increase live birth rates per one embryo transfer<\/li>\n<li>To\u00a0shorten the time to a baby (reduce a number of embryo transfers before&nbsp;a baby is born)<\/li>\n<\/ul>\n<h4>What are the numbers?<\/h4>\n<p class=\"pic\"><strong>Diagram 3. STAR1 Trial Compared with SART(National Summary report USA 2014 &#8211; 2017) Pregnancy outcomes<\/strong><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"w80p noroundbor noshadow alignnone wp-image-2195 size-full\" src=\"https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/STAR_Chart.png\" alt=\"Diagram 3. STAR1 Trial Compared with SART(National Summary report USA 2014 - 2017) Pregnancy outcomes\" width=\"1200\" height=\"429\" srcset=\"https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/STAR_Chart.png 1200w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/STAR_Chart-300x107.png 300w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/STAR_Chart-1024x366.png 1024w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/STAR_Chart-768x275.png 768w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/STAR_Chart-1536x550.png 1536w\" sizes=\"(max-width: 1200px) 100vw, 1200px\" \/><\/p>\n<p class=\"pic-sm\"><strong>STAR<\/strong> \u2014 ongoing pregnancy rate per transfer, note that&nbsp;all these ongoing pregnancies resulted in&nbsp;a live birth<br \/>\n<strong>SART<\/strong> \u2014 live birth rate per one embryo transfer<\/p>\n<div>\n<p>The live birth rate per one embryo transfer of one embryo after&nbsp;PGT-A in&nbsp;our clinic is 51%. This means that&nbsp;in&nbsp;our clinic 51% of the transfers of a single embryo with a normal chromosome set lead to the birth of a child (Diagram 4).<\/p>\n<p class=\"pic\">\nDiagram 4. 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 from 2020 to 2022).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"w60p alignnone wp-image-11309 size-full\" src=\"https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2022\/05\/chart3.jpg\" alt=\"\" width=\"1200\" height=\"743\" \/><\/p>\n<h4><b><br \/> Who&nbsp;can benefit from using PGT-A to increase IVF success?<\/b><\/h4>\n<\/div>\n<p>Women aged 35 and\u00a0older have a significant increase in\u00a0live birth rates per each embryo transferred after\u00a0PGT-A, in\u00a0comparison to control (no PGT-A). Also, in\u00a0many cases (repeated pregnancy losses and\u00a0implantation failures) PGT-A increases IVF success for\u00a0women under 35 years old.<\/p>\n<h4>What is the process for&nbsp;biopsy and&nbsp;PGT-A?<\/h4>\n<p><strong>Picture 2. Process of biopsy<\/strong><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" width=\"719\" height=\"518\" class=\"w40p vmar alignleft rightmar wp-image-2188\" src=\"\/wp-content\/uploads\/2020\/03\/PGTA-em-p.jpg\" alt=\"A small piece of the embryonic external layer (future placenta) is taken by a pipette\" srcset=\"https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/PGTA-em-p.jpg 719w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/PGTA-em-p-300x216.jpg 300w\" sizes=\"(max-width: 719px) 100vw, 719px\" \/><\/p>\n<ol>\n<li>With a help of a pipette the embryologist takes a small piece of the embryonic external layer (future placenta);<\/li>\n<li>Immediately after&nbsp;the biopsy, the embryologist performs individual cryopreservation of each blastocyst;<\/li>\n<li>In&nbsp;the genetic laboratory, DNA is obtained from the cells of the embryonic placenta and&nbsp;is tested for&nbsp;23 pairs of chromosomes, then the answer is given on&nbsp;which embryos have a normal chromosome count and&nbsp;which do not;<\/li>\n<li>Embryos with an abnormal number of chromosomes are excluded from future use;<\/li>\n<li>Embryos with a normal number of chromosomes can be used for&nbsp;the embryo transfer.<\/li>\n<\/ol>\n<h3>I.3. Q&amp;A about PGT-A<\/h3>\n<div>            <div class=\"qae-faqs-container qae-faqs-toggle-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=\"#pgt-a\" data-filter=\".pgt-a\">PGT-A<\/a><\/li>\t\t\t<\/ul>\n\t\t\t\t\t<div id=\"qaef-12832\" class=\"qe-faq-toggle pgt-a\">\n\t\t\t<div class=\"qe-toggle-title\">\n\t\t\t\t<h4>\n\t\t\t\t\t<i class=\"fa fa-minus-circle\"><\/i> My doctor in the Netherlands told me that US studies showed that sometimes chromosome abnormalities can fix themselves in early stages of development. Which means that genetic testing could potentially rule out embryos that could lead to pregnancies. Is it true?\t\t\t\t<\/h4>\n\t\t\t<\/div>\n\t\t\t<div class=\"qe-toggle-content\">\n\t\t\t\t<p><span style=\"font-weight: 400\">It is true, embryos are dynamic structures and&nbsp;can change all the way. But&nbsp;the probability of PGT-A testing being wrong is pretty low, below 1-2%. But&nbsp;the benefit of testing is obvious in&nbsp;the older group of patients &#8211; you have much less chance that&nbsp;the pregnancy will not happen or&nbsp;that it will stop, leading to possible complications for&nbsp;the uterus and&nbsp;jeopardising your future chances for&nbsp;a baby, not to mention the psychological burden of that. Here I will be on&nbsp;the mother&#8217;s side, even&nbsp;if&nbsp;it means not giving a chance for&nbsp;some potential babies. But&nbsp;this is a highly disputable topic nowadays, you can find arguments both pro and&nbsp;contra.<\/span><\/p>\n<p><em><span style=\"font-weight: 400\">Dr. Anna Gusareva<\/span><\/em><\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div id=\"qaef-12834\" class=\"qe-faq-toggle pgt-a\">\n\t\t\t<div class=\"qe-toggle-title\">\n\t\t\t\t<h4>\n\t\t\t\t\t<i class=\"fa fa-minus-circle\"><\/i> In what genetic lab the PGT-A will be performed? Is it the Igenomix Laboratory in Spain? Will you perform the regular PGT-A or the new one from Igenomix called &#8220;Embrace&#8221;, where only the culture environment is analysed?\t\t\t\t<\/h4>\n\t\t\t<\/div>\n\t\t\t<div class=\"qe-toggle-content\">\n\t\t\t\t<p><span style=\"font-weight: 400\">Usually PGT-A by NGS method is conducted in&nbsp;the Igenomix laboratory in&nbsp;Russia or&nbsp;Genetico lab also in&nbsp;Russia. We use these providers for&nbsp;a long period of time and&nbsp;are quite satisfied with the results. Blastocysts will be biopsied and&nbsp;frozen subsequently, the result we expect in&nbsp;2 weeks. &#8220;Normal&#8221; PGT-A is the most reliable at&nbsp;the moment. Unfortunately Embrace results (testing of the spent culture media) are not so&nbsp;concordant with the real molecular karyotype of the embryo for&nbsp;now. We hope it will become more reliable in&nbsp;future but&nbsp;the current reality leaves us with only choice &#8211; if&nbsp;we need THE answer, trophectoderm biopsy + NGS is the best available approach. Our embryologists are very skilled in&nbsp;performing biopsy, we do it a lot, so&nbsp;you shouldn&#8217;t worry about us harming the embryo in&nbsp;any way or&nbsp;diminishing its potential.<\/span><\/p>\n<p><em>Dr. Anna Gusareva<\/em><\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div id=\"qaef-12846\" class=\"qe-faq-toggle pgt-a\">\n\t\t\t<div class=\"qe-toggle-title\">\n\t\t\t\t<h4>\n\t\t\t\t\t<i class=\"fa fa-minus-circle\"><\/i> I wonder if you can see in his sperm if there\u2019s any defective genes coming from the sperm, for example ADHD or Asperger\u2019s syndrome? I have read that the autism  spectrum increases in the offspring the older the father is.\t\t\t\t<\/h4>\n\t\t\t<\/div>\n\t\t\t<div class=\"qe-toggle-content\">\n\t\t\t\t<p>Unfortunately current level of science doesn\u2019t give an opportunity to check spermatozoa for&nbsp;mutations before&nbsp;the fertilization. The checking could only be done on&nbsp;an embryo but&nbsp;only in&nbsp;such cases when&nbsp;we know that&nbsp;potential parents are known carriers of certain gene mutations. To check mutations in&nbsp;general is impossible for&nbsp;now.<\/p>\n<p><em>Dr. Anna Gusareva<\/em><\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t            <\/div>\n\t\t<\/div>\n<p class=\"getcons\">\nHave questions?<\/p>\n<p class=\"getcons\"><a class=\"button contactus ui large\" href=\"#footerform\">Get a Free Consultation!<\/a><\/p>\n<h2>\nII. Maternal reasons for&nbsp;pregnancy loss and&nbsp;IVF\u00a0failure<\/h2>\n<p>Maternal reasons for\u00a0pregnancy loss and\u00a0IVF failure can be of hormonal, inflammatory or\u00a0immune nature. The reasons may be related to the state of the organs of the reproductive system or\u00a0other organs and\u00a0systems of the body. Often our patients have several reasons why&nbsp;an on-going pregnancy and\u00a0live birth have not yet\u00a0been achieved.<\/p>\n<h3>II.1. Missing the implantation window \u2014 the main reason of implantation failure in\u00a0fresh IVF cycles<\/h3>\n<p>The process of embryo \u201csticking\u201d, attaching in&nbsp;the uterus, is called implantation. Implantation starts with recognition of certain <span class=\"tooltip\">receptors<span class=\"tooltip-text\"><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> on&nbsp;the surface of the endometrium by receptors on&nbsp;the surface of the hatched embryo.<\/p>\n<p>The implantation window is the time frame in\u00a0which these receptors are present in\u00a0the endometrium, which\u00a0is usually 5-7 days after&nbsp;the beginning of <span class=\"tooltip\">Progesterone<span class=\"tooltip-text\"><strong>Progesterone<\/strong> \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> production by the ovulated follicle.<\/p>\n<p>Normally, in\u00a0a natural cycle, Progesterone production starts from the day of\u00a0ovulation. Thus, usually the receptors on\u00a0the endometrial cells are ready to meet with the embryo 5-7 days after\u00a0ovulation. At\u00a0the same time, the embryo, having carried out the process of hatching (coming out from the shell), is ready to meet the endometrial receptors 5-7 days after\u00a0ovulation \u2014 on\u00a0the 5-7th day of its development.<\/p>\n<h4>Nature has synchronized these two processes of embryonic and&nbsp;endometrial readiness for&nbsp;implantation very cleverly:<\/h4>\n<ul>\n<li>The Embryo is ready to implant 5-7 days after&nbsp;ovulation (Picture 3).<\/li>\n<li>The Endometrium is ready for&nbsp;implantation 5-7 days after&nbsp;ovulation (Picture 4).<\/li>\n<\/ul>\n<h4>Picture 3. The Embryo is ready to implant 5-7 days after&nbsp;ovulation<br \/>\n<img loading=\"lazy\" decoding=\"async\" width=\"1200\" height=\"794\" class=\"w80p ac noroundbor noshadow alignnone wp-image-2201 size-full\" src=\"https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/iStock-648793246-1.png\" alt=\"The Embryo is ready to implant 5-7 days after&nbsp;ovulation\" srcset=\"https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/iStock-648793246-1.png 1200w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/iStock-648793246-1-300x198.png 300w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/iStock-648793246-1-1024x677.png 1024w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/iStock-648793246-1-768x508.png 768w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/iStock-648793246-1-1536x1016.png 1536w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/iStock-648793246-1-270x180.png 270w\" sizes=\"(max-width: 1200px) 100vw, 1200px\" \/><\/h4>\n<h4>\nPicture 4. The Endometrium is ready for&nbsp;implantation 5-7 days after&nbsp;ovulation<\/h4>\n<h6><img loading=\"lazy\" decoding=\"async\" width=\"799\" height=\"799\" class=\"w50p noroundbor noshadow alignleft wp-image-2191 size-full\" src=\"https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/PIC.jpg\" alt=\"The Endometrium is ready for&nbsp;implantation 5-7 days after&nbsp;ovulation\" srcset=\"https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/PIC.jpg 799w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/PIC-300x300.jpg 300w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/PIC-150x150.jpg 150w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/PIC-768x768.jpg 768w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/PIC-370x370.jpg 370w\" sizes=\"(max-width: 799px) 100vw, 799px\" \/>Picture 4 illustrates how cleverly the nature synchronized process in&nbsp;the ovaries and&nbsp;uterus in&nbsp;a natural menstrual cycle.<\/h6>\n<p>FSH stimulates follicular growth from day 4 to 14<\/p>\n<p>A follicle (a bubble with an egg inside) grows and&nbsp;produces Estrogen<\/p>\n<p>Estrogen grows the lining in&nbsp;the uterus<\/p>\n<p>Ovulation releases an egg and&nbsp;times the implantation window<\/p>\n<p>Normally, Progesterone production starts immediately after&nbsp;ovulation<\/p>\n<p>Progesterone is responsible for&nbsp;making the endometrium receptive to the embryo<\/p>\n<p>Normally, the endometrium becomes receptive to the embryo 5-7 days after&nbsp;Progesterone production begins<\/p>\n<p>The period when&nbsp;the endometrium is ready to recognize and&nbsp;receive the embryo is called the implantation window<\/p>\n<p>The moment of the start of Progesterone production determines the implantation window.<\/p>\n<p>\nHowever, ovarian stimulation may desynchronize these 2 processes: the readiness for&nbsp;implantation of the embryo and&nbsp;the endometrium. This happens due to supra-physiological levels of hormones in&nbsp;the body. In&nbsp;many stimulated cycles Progesterone production starts too early \u2014 already several days before&nbsp;egg retrieval (which is the equivalent of ovulation).<\/p>\n<p>Should Progesterone productions start earlier than&nbsp;the day of embryo creation (egg retrieval or&nbsp;ovulation day), the receptors in&nbsp;the endometrium, which&nbsp;could have recognized the embryo, would be present earlier. When&nbsp;the embryo reaches the blastocyst <span class=\"tooltip\">hatching<span class=\"tooltip-text\"><strong>Hatching<\/strong> \u2014 a process of embryo leaving the eggshell. After\u00a0hatching, a chicken would be able to simply walk away and\u00a0take care of itself. A blastocyst takes care of itself in\u00a0its own way too: its receptors look for\u00a0receptors in\u00a0the endometrium to attach to, in\u00a0order to be able to continue living. <\/span><\/span> stage, the receptors in\u00a0the endometrium will no longer be there and\u00a0this dialogue between the embryo and\u00a0the endometrium will not be possible. Implantation will not take place!<\/p>\n<h5>Picture 5. Desynchronization of the embryo\u2019s and&nbsp;endometrium\u2019s readiness for&nbsp;implantation is one of the most frequent reasons for&nbsp;implantation failure in&nbsp;fresh IVF cycles<img loading=\"lazy\" decoding=\"async\" class=\"w80p noshadow alignnone wp-image-2192 size-full\" src=\"https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/Picture_4.png\" alt=\"Desynchronization of the embryo\u2019s and&nbsp;endometrium\u2019s readiness for&nbsp;implantation is one of the most frequent reasons for&nbsp;implantation failure in&nbsp;fresh IVF cycles\" width=\"1200\" height=\"534\" srcset=\"https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/Picture_4.png 1200w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/Picture_4-300x133.png 300w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/Picture_4-1024x456.png 1024w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/Picture_4-768x342.png 768w, https:\/\/olgafertilityclinic.com\/wp-content\/uploads\/2020\/03\/Picture_4-1536x683.png 1536w\" sizes=\"(max-width: 1200px) 100vw, 1200px\" \/><\/h5>\n<h3>II.2. Restoring the dialogue between the embryo and&nbsp;the uterus by taking it one step at&nbsp;a time in&nbsp;your IVF process<\/h3>\n<p>This absence of dialogue between the embryo and\u00a0the endometrium can be avoided by carrying out one task at\u00a0a time.<\/p>\n<p>The first step is to create competent eggs and\u00a0viable embryos by using an individually tailored stimulation process. During this stimulation, we must focus only on\u00a0the follicles, eggs and\u00a0embryos. It is not possible to take care of the endometrium just yet.<\/p>\n<p>When\u00a0the blastocysts are ready, we stop time for\u00a0them by freezing them gently. When\u00a0we have stopped time for\u00a0the embryos, we can then move our focus to the optimal preparation of the uterus ready for\u00a0the embryo transfer.<\/p>\n<p>For&nbsp;the embryo transfer we will choose a separate cycle in&nbsp;which we will focus on&nbsp;the endometrium: to transfer an embryo into the most optimal endometrium at&nbsp;the most optimal time. Usually, 1 menstrual cycle is necessary after&nbsp;the stimulated cycle for&nbsp;ovaries to stop producing residual amounts of Progesterone. Therefore, we recommend a one cycle break between the egg retrieval and&nbsp;embryo transfer.<\/p>\n<p class=\"pic\">\nDiagram 5. <b>Cumulative live birth rate in&nbsp;all groups of patients who&nbsp;received embryo transfers within 1131 consecutive embryo transfers at&nbsp;O.L.G.A. Fertility (from 2019 to 2021)<\/b><\/p>\n<p><img decoding=\"async\" class=\"w80p size-full\" src=\"\/wp-content\/uploads\/2022\/06\/diag5b.png\" alt=\"\" \/><\/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\u00a0<\/li>\n<\/ul>\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>You can read more about our <a href=\"\/ivf-process\/\"><strong>IVF Process<\/strong> in&nbsp;the following chapter \u2192<\/a><\/p>\n<p class=\"getcons\">\nHave questions?<\/p>\n<p class=\"getcons\"><a class=\"button contactus ui large\" href=\"#footerform\">Get a Free Consultation!<\/a><\/p>\n<h3>II.3. 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=\"#maternal-factors\" data-filter=\".maternal-factors\">Maternal Factors<\/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=\"maternal-factors\">\n\t\t\t\t\t\t<a href=\"#qaef-12860\">Are autoimmune diseases in the mother can be the reason for pregnancy loss?<\/a>\n\t\t\t\t\t<\/li>\n\n\t\t\t\t\n\t\t\t\t\t<li class=\"maternal-factors\">\n\t\t\t\t\t\t<a href=\"#qaef-12861\">In case of egg donation, is there a higher risk of pregnancy loss due to immunologic reasons as the egg is not own but &#8220;foreign material&#8221;?<\/a>\n\t\t\t\t\t<\/li>\n\n\t\t\t\t\n\t\t\t\t\t<li class=\"maternal-factors\">\n\t\t\t\t\t\t<a href=\"#qaef-12862\">I wonder why don\u2019t the embryo \/ blastocyst attach to the uterus?<\/a>\n\t\t\t\t\t<\/li>\n\n\t\t\t\t\n\t\t\t\t\t<li class=\"maternal-factors\">\n\t\t\t\t\t\t<a href=\"#qaef-12866\">I have gotten one child through stimulation via egg follicles and then I got naturally pregnant. I got a planned cesarean. If I want to have a baby again by embryo adoption due to my age of 46, do you think I have scar tissue after the cesarean? What is the chance you need to do a hysteroscopy of my uterus? Is it something I should plan to do before the first embryo adoption attempt?<\/a>\n\t\t\t\t\t<\/li>\n\n\t\t\t\t\n\t\t\t\t\t<li class=\"maternal-factors\">\n\t\t\t\t\t\t<a href=\"#qaef-12867\">Hello, can this ERA Test be done in the Test cycle locally at my gyn doctor or in a fertility clinic in Germany? It seems to be a key to the right timing!<\/a>\n\t\t\t\t\t<\/li>\n\n\t\t\t\t\n\t\t\t\t\t<li class=\"maternal-factors\">\n\t\t\t\t\t\t<a href=\"#qaef-12868\">If a hysteroscopy is recommended before any treatment, how much does it cost and\/or is it part of a treatment plan?<\/a>\n\t\t\t\t\t<\/li>\n\n\t\t\t\t\n\t\t\t\t\t<li class=\"maternal-factors\">\n\t\t\t\t\t\t<a href=\"#qaef-12870\">I am wondering if there are any nutritional suggestions for us that have multiple failed implantations and miscarriages on the ones that do implant.<\/a>\n\t\t\t\t\t<\/li>\n\n\t\t\t\t\n\t\t\t\t\t<li class=\"maternal-factors\">\n\t\t\t\t\t\t<a href=\"#qaef-12871\">Do you always wait another cycle after extracting the egg before implanting it? Some fertility clinics want to do the implant on the same cycle. Why does this differ between different clinics and why do you choose not to do it in the same cycle?<\/a>\n\t\t\t\t\t<\/li>\n\n\t\t\t\t\n\t\t\t\t\t<li class=\"maternal-factors\">\n\t\t\t\t\t\t<a href=\"#qaef-12872\">Research in how Covid-19 can affect an embryo. I had a miscarriage in early pregnancy and most likely I was infected by the virus.<\/a>\n\t\t\t\t\t<\/li>\n\n\t\t\t\t<\/div><\/ol>\t\t<div id=\"qaef-12860\" class=\"qe-faq-list maternal-factors\">\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> Are autoimmune diseases in the mother can be the reason for pregnancy loss?\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, maternal autoimmune diseases do increase the likelihood of losing a pregnancy. But&nbsp;this does not mean that&nbsp;nothing can be done. We recommend planning a pregnancy when&nbsp;an autoimmune disease is stable, not in&nbsp;the acute stage. We also recommend additional medicine to minimize the aggressive effect of autoantibodies on&nbsp;trophoblast (future placenta). This supporting therapy has to be selected individually for&nbsp;each patient.<\/p>\n<p><em>Dr. Elena Lapina<\/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-12861\" class=\"qe-faq-list maternal-factors\">\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 case of egg donation, is there a higher risk of pregnancy loss due to immunologic reasons as the egg is not own but &#8220;foreign material&#8221;?\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>Embryos are always \u201cforeign\u201d for&nbsp;the mother\u2019s body, and&nbsp;it doesn\u2019t matter if&nbsp;we use the mother\u2019s eggs or&nbsp;not. The embryo is a completely new organism with its own unique set of characteristics. The incidence of spontaneous pregnancy loss in&nbsp;patients under 35 years of age (when using their own eggs) and&nbsp;the incidence of spontaneous pregnancy loss in&nbsp;older women using donor eggs (with donor\u2019s age up to 35 years) is the same. With own eggs in&nbsp;women under 35, the miscarriage rate is \u2014 10&nbsp;%, with donor oocytes \u2014 9.2% (our clinic\u2019s own data).<\/p>\n<p><em>Dr. Elena Lapina<\/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-12862\" class=\"qe-faq-list maternal-factors\">\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> I wonder why don\u2019t the embryo \/ blastocyst attach to the uterus?\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 can be several reasons for&nbsp;implantation failure. Firstly, the embryo may have a wrong chromosome set, which&nbsp;makes the embryo\u2019s development stop (for example right after&nbsp;getting into the uterus). Secondly, in&nbsp;the uterine cavity, there is often a specific issue that&nbsp;reduces endometrial receptivity (such as&nbsp;adenomyosis, inflammation, etc.). Often, these causes are not visible with just ultrasound. Thirdly, the dialogue between the embryo and&nbsp;the endometrium may be impaired. The embryo might be wonderful and&nbsp;the endometrium might be overall ready, but&nbsp;not at&nbsp;the specific time when&nbsp;the embryo transfer took place. Instead, it might be a little earlier or&nbsp;a little later. In&nbsp;each individual case, these causes may occur as&nbsp;just one, or&nbsp;as&nbsp;a combination of them. Studying the patient\u2019s history of previous conception attempts, we can suspect one or&nbsp;another.<\/p>\n<p><em>Dr. Elena Lapina<\/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-12866\" class=\"qe-faq-list maternal-factors\">\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> I have gotten one child through stimulation via egg follicles and then I got naturally pregnant. I got a planned cesarean. If I want to have a baby again by embryo adoption due to my age of 46, do you think I have scar tissue after the cesarean? What is the chance you need to do a hysteroscopy of my uterus? Is it something I should plan to do before the first embryo adoption attempt?\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>Scarring does not always occur after&nbsp;cesarean section. A big problem for&nbsp;subsequent implantation is a cesarean scar defect, or&nbsp;niche. Menstrual blood accumulates in&nbsp;this niche and&nbsp;stays there for&nbsp;quite some time, sometimes even&nbsp;until&nbsp;ovulation. This remaining blood causes inflammatory changes in&nbsp;the endometrium and&nbsp;changes endometrial receptivity. Fortunately, it is fairly easy to notice on&nbsp;an ultrasound scan that&nbsp;a niche has formed after&nbsp;the cesarean section.<\/p>\n<p>You can confirm its presence with hysteroscopy as&nbsp;well, and, quite often, with hysteroscopy, you can also improve the outflow of menstrual blood from a niche by removing scarring around. In&nbsp;just 2 months after&nbsp;such hysteroscopy, it is possible to schedule an embryo transfer. I want to emphasize once&nbsp;again that&nbsp;the history of a C-section does not always affect endometrial receptivity. After&nbsp;analyzing the results of ultrasound examination and&nbsp;finding out the specifics of your menstrual cycle, we can give you an individual recommendation on&nbsp;the necessity for&nbsp;hysteroscopy.<\/p>\n<p><em>Dr. Elena Lapina<\/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-12867\" class=\"qe-faq-list maternal-factors\">\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, can this ERA Test be done in the Test cycle locally at my gyn doctor or in a fertility clinic in Germany? It seems to be a key to the right timing!\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>We are ready to take into account the results of the ERA test performed in&nbsp;other clinics. If&nbsp;you are planning to undergo fertility treatment in&nbsp;our clinic, please check with your doctor at&nbsp;our clinic what you need to do to prepare for&nbsp;the ERA test. This is very important because&nbsp;the ERA test has to be done under the same conditions as&nbsp;the future embryo transfer.<\/p>\n<p><em>Dr. Elena Lapina<\/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-12868\" class=\"qe-faq-list maternal-factors\">\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 a hysteroscopy is recommended before any treatment, how much does it cost and\/or is it part of a treatment plan?\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>We recommend hysteroscopy individually if&nbsp;we suspect an abnormality after&nbsp;doing an ultrasound or&nbsp;when analyzing your medical history; we may suspect an abnormality based on&nbsp;your history analysis even&nbsp;despite good ultrasound pictures. Depending on&nbsp;the treatment packages hysteroscopy may be included or&nbsp;cost extra.<\/p>\n<p><em>Dr. Elena Lapina<\/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-12870\" class=\"qe-faq-list maternal-factors\">\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> I am wondering if there are any nutritional suggestions for us that have multiple failed implantations and miscarriages on the ones that do implant.\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>We recommend taking folic acid as&nbsp;it helps control homocysteine levels. With high homocysteine levels, pregnancy loss is more likely due to the formation of tiny blood clots in&nbsp;small arteries (micro-thrombosis). Besides, please look into taking Omega 3 and&nbsp;Vitamin D. They are immune-modulators that&nbsp;help in&nbsp;normalizing the implantation process.<\/p>\n<p><em>Dr. Elena Lapina<\/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-12871\" class=\"qe-faq-list maternal-factors\">\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> Do you always wait another cycle after extracting the egg before implanting it? Some fertility clinics want to do the implant on the same cycle. Why does this differ between different clinics and why do you choose not to do it in the same cycle?\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>When&nbsp;stimulation is prolonged for&nbsp;the sake of a competent egg, endometrium may become too old and&nbsp;lose its interest in&nbsp;implantation. You cannot have everything at&nbsp;once. Sometimes you need to split a complex project in&nbsp;several steps. We prefer the step-by-step approach &#8211; first optimized stimulation protocol with egg retrieval and&nbsp;creation of embryos. Second \u2014 correct assessment and&nbsp;preparation of your endometrium to achieve best implantation potential. The third \u2013 transfer of a competent embryo into an optimally prepared endometrium.<\/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-12872\" class=\"qe-faq-list maternal-factors\">\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> Research in how Covid-19 can affect an embryo. I had a miscarriage in early pregnancy and most likely I was infected by the virus.\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 am so&nbsp;very sorry that&nbsp;such a sad thing happened. But&nbsp;there is not enough data for&nbsp;now to give a correct answer to your question. We simply don&#8217;t possess the information about the influence of COVID-19 on&nbsp;early stages of pregnancy. It seems that&nbsp;those women who&nbsp;were in&nbsp;their third trimester of pregnancy and&nbsp;become infected with the virus don&#8217;t pass the virus to their babies, they were born healthy. And&nbsp;pregnancy doesn&#8217;t affect the chances of a woman to be cured. But&nbsp;the medicines which&nbsp;are currently used for&nbsp;the treatment of COVID-19 are not recommended during pregnancy, so&nbsp;treatment itself can have a negative impact on&nbsp;the baby.<\/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            <\/div>\n\t\t<\/div>\n","protected":false},"excerpt":{"rendered":"<p>\u00a0 To find a solution to how to increase IVF success, we need to know and\u00a0understand the reasons of IVF failure. Our patients often have more than&nbsp;one reason why&nbsp;their pregnancies haven\u2019t happened yet&nbsp;or haven\u2019t progressed to the full term. Otherwise, first IVF attempts at&nbsp;their local clinics would have already led to a result, and&nbsp;we would<\/p>\n","protected":false},"author":1,"featured_media":2218,"parent":0,"menu_order":39,"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>How to defeat IVF failures? - O.L.G.A. Fertility<\/title>\n<meta name=\"description\" content=\"To overcome IVF failures we need to understand the reasons that can be provoked by embryonic and maternal factors. Genetic testing (PGT-A) aids to select euploid embryos, synchronization of endometrium and embryo readiness favors successful implantation. Achieve your dream of a baby with tailored treatment and expert care at O.L.G.A. 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