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Fertility Journeys

We Check In With IVF Spain’s Couple Laura & Ian

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Laura & Ian

After a well-deserved summer break, many couples decide to start or resume their journey to parenthood such as this year’s Fertility Journey runner-ups, Laura (41) and Ian (44), who recently had their embryo transfer at our clinic.

Laura and Ian have been trying for 5 years to form the family they always wished for, but Laura has unfortunately suffered 4 miscarriages and 1 ectopic pregnancy – issues that most were due to Laura’s immune system rejecting the transferred embryos. A situation which could only be addressed by carrying out specific tests to match a compatible donor to Laura such as the KIR-HLAC test.

During their last visit, the couple shared their views on the differences between IVF Spain and their patient journey experience in the UK.

“The major differences here have been that we’ve had additional tests, we had an endometrial biopsy here. I had actually been diagnosed with immune problems previously and we have had 4 miscarriages and 1 ectopic. So, we were given additional treatment here and additional tests to find out exactly what was going on with the immune system. The results showed raised NK cells in some areas and low in others. We’ve paid thousands and thousands of pounds in the UK and never had this level of information or a biopsy – tests were restricted to a blood test. We were then able to have the KIR which matched a donor with us. We have also been put on a special protocol which is granulocyte (GCSF in the UK) to help us keep the baby during pregnancy.”

Most of the patients who decide to start a fertility treatment abroad are concerned about the treatment process and the communication with the clinic. To make our patients feel taken care of throughout the whole process, at IVF Spain we focus on patient-centeredness and personalised treatments in their own language.

“We found the level of patient care absolutely amazing, every piece of communication we were given was reassuring and, unlike our treatments before, this consistent flow of communication took the pressure off us having to find out things for ourselves” – Laura and Ian.

In addition to open and clear communication, we are committed to always offering the best possible and empathic patient care, providing our patients with a relaxing and private atmosphere they need to increase their well-being and comfort.

“Absolutely everybody that we came into contact with has been reassuring, very confident. Nothing is too much trouble. We had a really smooth transfer; we had a beautiful room where we were able to relax in. The doctor was amazingly positive and all of the staff, the embryologists, the nurses… everybody is being consistently really nice and calm and reassuring. A very, very different experience to the ones that we’ve had in the UK.”

“One of the biggest concerns our patients have during their treatment is related to the selection of a suitable egg donor” explains Dr. Sergio Rogel, Director of the IVF Spain Donor Department.

“Choosing a donor is one of the most important aspects of an egg donation treatment. All candidates undergo thorough physical exams to verify an optimal condition, psychological exams to certify their mental health and a gynaecological exam to determine both the number and quality of the eggs along with several additional tests. Many of these medical exams and tests are legally required, but at IVF Spain we pride ourselves in giving our patients an extra level of assurance by testing all our donors on a genetic and immunological level. This allows us to discard more than 200 diseases, but more importantly, guarantee the health of all future babies.”

“When a candidate passes all the mentioned tests she will automatically enter our donor pool and enter a database until being matched to a patient with the optimal phenotypic resemblance,” says Dr. Sergio Rogel.

The fact that Laura and Ian couldn’t take part in the selection process of their donor was liberating. For them, taking part in this process would have only added more pressure and stress. They were relieved of IVF Spain’s donor department taking care of everything:

“In terms of finding the donor, we were able to give some indications regarding what was most important and sent some photographs across and then we didn’t have to do anything else so we found that particularly good for not having too much stress because it is almost out of your hands and that enabled us just to focus on relaxing and having a nice summer before we came for a treatment in September. Having it taken out our hands made the whole experience easier.”

From the IVF Spain laboratory, we received good news: the embryo transfer has been a success. All that is left for now is to wait 10 days to see if the transferred embryo was successfully implanted. We wish them the best of luck!

Victoria, Ross & Rex

We also had the pleasure of meeting Victoria (47) and Ross’s (39) little sunshine Rex. This lovely couple were eternally grateful to their egg donor for her wonderful gift and wanted to express their gratitude with this wonderful message:

“I would like to say to whoever you are and wherever you are in the world: THANK YOU! I don’t think you realise what you did for us as a family, and for me personally as a woman. It made Ross a dad; something that … he was already, he was already a stepdad to our daughter but he wasn’t a biological dad and I know that meant so much to him. It made my daughter a sister. She always wanted a sibling and I was trying for a very long time to give her that. So now she is, and she is the best big sister you would ever meet, and it’s a shame that you won’t know how well she is doing. And as for me as a woman… It was hard to come to terms with the fact that I needed an egg donor to help me but what you’ve done is given me the happy family I always wanted to have.”

Alka, Rhods David

Last but not least, we would like to welcome the newest member of the IVF Spain family. Little David, was born August 24th, weighing in at 7 lbs and 3oz. His mum and dad – 2017 runner-ups – Alka (44) and Rhodri (46) wanted to share this lovely message:

“Little David is such a joy, he gave us his first smile yesterday! We love being a family of four, and feel so thrilled and blessed that he has entered our lives. Our heartfelt thanks to the team at IVF Spain for making our dream a reality”

You can catch up with the other couples working with IVF Spain on their website ivf-spain.com

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Complementary Therapies

How to Rock Your Fertility Journey, Even if You’re Over 40

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Rick Your Fertility

This past weekend my son Charlie turned 5 years old.

I’ll be 49 in April.  You can do the math.

Charlie was conceived a month before my 43rd birthday, after a roller-coaster ride of miscarriage, doctors visits, testing, lots of negative pregnancy tests, and an emotional maelstrom during which I cursed myself for not trying to have a baby when I was younger.   

My doctor never said the words, “you’re too old” but it was implied when he explained that I didn’t have many eggs left because I was over 40.  When he said that the eggs that I did have were of “compromised quality” and that’s probably what led to my miscarriages. When he predicted that it was highly unlikely that I’d get pregnant with my own eggs and that donor egg IVF was my best chance of having a baby.

Conventional wisdom drives the doctor’s analysis and you’ve heard all this:  women are born with all the eggs that we’ll ever have and through 30+ years of having periods, as well as the natural aging process, cause our fertility to begin to decline in our early 30s, and take a big dive after age 35.  By the time we’re over 40, our fertility has practically fallen off a cliff. By the time we hit menopause, we may not have run out of eggs but the supply is scant and we’re no longer ovulating.

My test results bore this out.  My Follicle Stimulating Hormone (FSH) was high at 16.4, indicating that my ovaries had to work harder to stimulate follicle growth (and egg maturation) than the ovaries of a younger woman.  My Anti-Mullerian Hormone, which measures ovarian reserve, was very low at 0.15 and indicated “undetectable” egg supply. My Antral Follicle Count, which counts resting follicles in the first few days of the cycle and indicates how many follicles may have the potential to grow that cycle, was never higher than 5 (a “normal” or “good” is between 15-25).

My doctor looked at all of these numbers, and that information is what drove his diagnosis of my condition, and his grim prognosis for my success.

The reality, though, is that we are about so much more than our numbers.   

If it were just about the numbers, all the women with strong numbers would have their babies, and the women like me with sub-optimal numbers wouldn’t.  And we just know this is not the case. Read more about how I overcame the odds to get pregnant with my own eggs and without IVF.

Here’s what we know: fertility does decline as we get older.   And that’s all we know.

Luckily, we “older” women can have some tools in our arsenal to help us get pregnant and have a baby, if that’s what we want.  

Here are some things to keep in mind, as well as some tools for your toolkit, if you’re trying to get pregnant at an “advanced age”:

You do have time.  While age is correlated with fertility, it’s not like the minute you turn 40, or 35, or another age, you all of a sudden aren’t able to get pregnant.  Fertility is more of a continuum. Time may be of the essence, and you may need to act quickly, but you do have time.

Fertility in your 40s is going to look different than it did in your 20s.  You are not the same woman, physically, emotionally or spiritually than you were in your 20s.  Like the rest of you, your fertility has changed too. For example, it’s common as we age to produce less cervical fluid than we do when we’re younger.  Cervical fluid is important when trying to get pregnant, especially when trying naturally, so it’s important to be aware of.

In any area related to your fertility, you need to be able to do your research and find ways to mitigate the situation to account for your age.  This is true regardless of your age, but especially if you’re over 40 and trying to conceive.

5th Birthday

The tools in your arsenal are even more important when you’re older.  On your fertility journey, you’ve probably heard that the following things are important:

  • Nutrition
  • Exercise
  • Sleep
  • Knowing how to track your fertility signs and your menstrual cycles
  • Stress reduction
  • Mind/body connection

These things are crucial for anyone on a fertility journey, regardless of age and whether trying to conceive naturally or through treatment.  Being the healthiest you can be will help you achieve optimal fertility. This is especially crucial for you if you’re at an advanced age.

If you’re trying naturally, it’s important to keep in mind that generally speaking, middle-aged couples tend to have intercourse with less frequency than younger couples.  In trying to conceive, you don’t have to have intercourse all the time, but you do need to have it at the right time, and knowing your cycles will help you pinpoint with laser accuracy when that time is.  

Managing your stress will help you endure the trials and tribulations of fertility treatment, and cultivating a mind-body connection will help you silence the negative self-talk that tells you you’re too old or that your time has passed.   

The fertility journey can really mess with your physical body and your mind, and it’s important to have the tools to fight back.  My Big Little Fertility Toolkit gives you the exact tools that I used on my own successful fertility journey.

Listen to your intuition.  When my doctor told me that I likely wouldn’t get pregnant with my own eggs and that donor egg IVF was my best option, I didn’t disbelieve him.  I knew my numbers; I knew the situation was bad. But I also knew deep down that donor egg IVF wasn’t the right path for me to become a mom. This wasn’t based on any hard facts; I just intuitively knew that intrauterine insemination would work for me.  I knew that I had a good egg somewhere in my dwindling supply and that it was up to me to find it.

I encourage you to learn how to listen to your own intuition.  You’ve been with yourself every second of your life. YOU know yourself better than anybody else.  The answers are already within you, and when you take the time to tune in to yourself and to listen to what your intuition is telling you, those answers will always come to you.

Always keep in mind the end goal.  In our quest to get pregnant we can sometimes lose sight of the ultimate goal, which is not necessarily to be pregnant, but to be a mother. Motherhood can come in many shapes and forms – donor egg, sperm or embryo; surrogacy; adoption. As we get older, it’s increasingly important to keep all of those options in mind if your own natural fertility is compromised and the wellness tools in your toolbox aren’t helping.  

It’s a process to work through your feelings and emotions around the other avenues to motherhood, and it may take some time to do that.  But it may become important to do so, if you need to let go of the idea of a traditional pregnancy. We’re fortunate to live in a time with so many options for parenthood!

A good mantra to keep in mind for your journey is:

“Somehow, some way, I will be a mother.”  

You have power over your journey.   I know it may not seem like it, but you do.  You may be acutely aware every day of your age, and, if you’ve already experienced some setbacks in your fertility path, these weigh on you.  

While there’s so much that’s out of your control – like age, biology, egg supply, there’s still so much you can control.  Things like –

  • How you eat
  • How you move your body
  • How much you sleep
  • How you choose to manage your stress
  • How you interact with others
  • How you show up in the world

These things impact your fertility, and your well-being.

Another good mantra to keep in mind for your journey, and to help you feel and own the power that you have is:

“I am more than my numbers.  Infertility does not define me.”

Because there’s a huge grey area.  And while there have been so many medical and scientific advancements in the areas or fertility, pregnancy and birth, the reality is that there is still so much that we don’t know.  

And it’s this grey area, this area of the unknown, where magic can happen.  

Baby dust to you! xo


Also published on Medium.

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Fertility Journeys

Free IVF Treatment And 50 Free Initial Consultations With Gennet City Fertility Clinic

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Gennet City Fertility

At Gennet City Fertility we offer you bespoke fertility treatment using an individualised approach and cutting-edge technologies.

Our promise to you is that we will look thoroughly into your fertility difficulties; that we will use state of the art treatment protocols and technologies, and when appropriate, we will also ‘think outside the box’.

The members of the team at GENNET City Fertility were carefully chosen on the basis of their achievements while working in reputable units in London and overseas. Within our team, we share extensive experience of and vast knowledge in fertility medicine, assisted reproduction and the management of early pregnancy. Using this knowledge and experience we endeavour to provide you with the most expert advice and to guide you through a fertility journey that is caring, safe, professional and transparent.

At our clinic, we offer a number of fertility treatments:

  • Ovulation induction
  • IUI
  • IVF
  • ICSI
  • PICSI – IMSI
  • Egg donation
  • Sperm donation
  • Embryo donation
  • Surrogacy

We also offer many other services:

  • Joint, female or male fertility assessment
  • Egg freezing
  • Sperm freezing
  • Preimplantation genetic diagnosis
  • Preimplantation genetic screening
  • Urology and Andrology
  • Surgical sperm retrieval
  • Counselling
  • Psychosexual advice
  • Acupuncture
  • Nutritionist consultation
  • Support groups and support programs.

We are a proud partner of Access Fertility which is the largest provider of IVF Refund & Multi-Cycle Programmes and Fertility Finance in the UK.

Ramesan Navaratnarajah

WHAT ARE WE OFFERING TO FERTILITY ROAD READERS?

A FREE IVF TREATMENT DRAW & 50 FREE INITIAL CONSULTATIONS

We are offering a free fertility treatment (IVF/ICSI) including the medication to one lucky couple. In addition to this, we will select 50 couples for a free initial consultation with one of our fertility specialists worth £200.

TO APPLY

To enter the draw for the incredible free round of IVF/ICSI or a chance to have one of the 50 fully funded consultation appointments, please read the terms and conditions below and follow the link to the form to submit your application.

TERMS AND CONDITIONS

The fertility treatment prize includes initial consultation, pre-treatment tests (Antral follicle count scan, AMH blood test, semen assessment etc.), 1 cycle of IVF treatment, plus ICSI if required.

  • All medication
  • Medical and nursing appointments and care
  • All in-treatment laboratory tests and procedures
  • Monitoring and scanning costs
  • Egg Collection
  • Embryo transfer
  • Pregnancy serum test
  • Pregnancy ultrasound scan
  • Follow up consultation (if taken within three months of treatment completion)
  • Counselling
  • The prize does not include:
  • Cost of freezing embryos plus the storage of embryos.
  • Surgical sperm retrieval
  • Empirical treatments

This prize does not include any costs of having donor treatment. If the prize winner needs donor eggs or sperm we would deduct the costs of the above and the recipient would need to pay the additional costs.

The value of this prize is in excess of £6000.

This prize could not be used against surrogacy treatment.

THE ACTUAL PROCESS

We will contact the winner and aim to get them a consultation to start treatment as soon as possible, depending on their cycle.

Any offer of treatment is subject to the relevant Welfare of the Child checks. Patients would also need to have a BMI of less than 35 to undergo treatment.

If the applicant has travelled to a Zika affected country they would be required to wait the length of the relevant quarantine period before treatment could commence.

FREE IVF CYCLE SELECTION CRITERIA

The successful applicants that will be shortlisted for the free IVF treatment prize must be under the age of 38 years old and with a BMI that is 19 to 35.

This offer doesn’t apply to existing Gennet City Fertility patients who are currently undergoing treatment.

50 FREE INITIAL CONSULTATIONS SELECTION CRITERIA

The successful applicants who will be shortlisted for the 50 free consultation appointments must be under the age 50. The appointments will be offered according to the clinic’s availability.

This offer doesn’t apply to existing Gennet City Fertility patients who are currently undergoing treatment

The successful couple that will receive the free IVF cycle will not be included in the 50 free consultations draw.

TO APPLY PLEASE CLICK HERE

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Egg Donation

IVF Spain Update Us on Claire & David and Laura & Ian Progress

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Claire & David IVF Spain

During the first week of August, Claire (42) and David (35), the winners of this year’s Fertility Journey, visited our clinic for their first embryo transfer.

They were pleased to share with us the emotion and joy created by their short stay in Spain.

“We have spent some time in Alicante ahead of the transfer, relaxing in the area and preparing for our next visit to IVF Spain. Our experience with previous treatments with UK clinics has been very stressful but in Alicante, we have spent most of our time preparing for treatment by relaxing on the beach!”

Claire and David arrive at IVF Spain after having been trying to get pregnant for 7 long years and experienced 3 failed ICSI treatments with their own eggs. IVF Spain discovered that the quality of the embryos was poor and that they had always been transferred on day 3 of their development with a bad morphology. In order to increase their chances of getting pregnant, the clinic recommended an egg donation treatment – a fertility treatment which that greatly depends on matching the perfect donor to the patient.

To protect both patients and donors Spanish law requires that the donation process must be completely anonymous.  In addition, donors must be in good condition and younger than 35. Moreover, both donor and patient must share a phenotypical resemblance: hair colour, BMI, eye colour, and so on.

Dr Herea

Claire and David were grateful that so many women in Spain were willing to donate their own eggs, enabling others less fortunate, the chance of forming a family.

“We are really grateful that there are people willing to donate eggs. If we are being honest, it has taken a while for us to understand the Spanish anonymity rules for egg donors, but we have taken the time to consider this. It’s hard not having control or letting another person being in charge for something related to your baby. However, we even think now it is better that way, because the more you know, the more you want to know and we do prefer knowing nothing and leaving it in the clinic’s hands.”

There are other factors, however, that are crucial to achieving a successful pregnancy: the quality of the embryo and the microenvironment of the endometrial lining. This means that a successful pregnancy also depends on the successful communication between the embryo and the endometrial lining.

When we discovered that Claire didn’t have a single positive pregnancy test, we suggested to perform an endometrial biopsy to analyse the retrieved sample by means of the ER Map® test (Endometrial Receptivity Map) and accurately determine the receptivity of Claire’s endometrium during the window of implantation (the moment when the endometrial lining is receptive).

”The test results showed that Claire’s endometrium was post-receptive, meaning that a transfer performed on day 5.5 of progesterone (like in 70% of cases) would not end up in a successful pregnancy” explains Dr Natalia Szlarb.

“Before coming to IVF Spain, we had never heard of an endometrial study or ER Map. The fact that the endometrial study analyses the best time to transfer the embryo could make a big difference to our treatment. We were really impressed with the accuracy of the test. Our ER Map test result was post-receptive and although this was initially a concern, we later came around to the view that knowing the best time to transfer the embryo would increase the chances of success, and this might have been the reason our other treatments in the UK had failed” – Claire and David.

There are other key factors, however, to achieve a pregnancy such as the male factor. David suffers from teratospermia which implies that 96% of the ejaculate sperm cells have an abnormal morphology. Luckily, we were able to improve David’s sperm quality and fertilize the retrieved eggs.

We now wish them the best of luck!

Although it will not be until mid-September when Laura (41) and Ian (44), the 2018 runners-up visit us in Alicante for their embryo transfer, they already talked about the differences between IVF Spain and former clinics. They were impressed at how extensively their case had been studied by our fertility specialists.

“I think the longer you have treatment the more difficult it becomes. When you begin there’s a naivety along the lines of, ‘we’ll have one, maybe two goes at IVF and have a baby in our arms’. After 7 treatments (and lots of add-ons) the feelings completely change. You feel terrified that it won’t work, and you’ll never become parents. You’re scared it will work and you’ll lose the baby again (Laura and Ian have experienced 5 losses). You’re scared of physically going through the treatment as you’ve had so much. Each test and treatment creates fear – fear that it will hurt, be traumatizing, that it will give you more bad news. Then there’s the impact on your own mental health and emotional well-being. Can I handle this? What if the results say something’s wrong with me? Will I blame myself? It starts to really damage your mental health and well-being. Financially you start to feel that you’re risking everything, and it may not pay off.

For us we have renewed hope with IVF Spain. We have undergone tests that we’ve never had before (ERA, NK biopsy and KIR). We have paid for lots of very expensive blood tests and drugs but never received this kind of analysis. So, we feel as though the treatment is now specifically for us.

This creates more positivity, a feeling of being cared for and that maybe, just maybe, we’ll get to be parents.

Plus, we’re now using donor eggs. The hope starts to soar and with that comes excitement. Hope is the only thing that keeps you going and overcoming the fears I mentioned. This opportunity with IVF Spain has given us hope that we thought we’d lost.”

Laura is 41 years old and has already been through traumatic losses including an ectopic pregnancy. Due to this and to the fact that Laura suffers from recurrent miscarriage, our medical team at IVF Spain recommended an egg donation treatment to increase their chances.

The couple is thankful for the egg donation process being anonymous, as otherwise it would be really difficult to find a donor:

“For us, it’s taken some of the pressure away. I can’t imagine how difficult it would be to choose a donor ourselves. But putting your complete trust into someone else’s hands is hard.

We’ve explored whether it would be better for our future child to know the donor. I think that’s something we’ll never know. But we hope that he/she will understand our decision to choose an anonymous donor. It would be good to know a little more about the heritage of the donor but then we also know that we often don’t even know our own heritage. We’ll make sure Spain is a key part of their story.

It’s also really odd to not know who this person is. What they look like and personality. What’s motivating them to help us. One of the things I’ve been really consumed with is the gratitude you have for this person. I’d like to thank them but can’t.

Anonymity means we have a chance to become parents. Without it there’d be a shortage of donors like there is in the UK. For us, this makes it a wonderful gift – a chance to hopefully find a donor that is perfectly matched to us genetically (due to the KIR tests) as well as in physical looks.

I can’t stop thinking about what our future child will look like – but I think that’s quite normal” says Laura.

Immunologically speaking, finding a matching donor for Laura is certainly a challenging task, which is why IVF Spain suggested that we find out her KIR via a blood test. Ian was also tested for his HLA-C in order to determine whether the maternal – foetal interaction will be optimal or not.

Thanks to the KIR-HLA-C genotyping test it is possible to determine if the uterine KIR and the embryonic HLA-C will both be compatible. If so, the pregnancy will carry on successfully; if not, then the most probable outcome will be an unviable pregnancy and subsequent miscarriage.

“We carried out the KIR-HLA-C genotyping and concluded that the patient had a KIR AA. It is known that KIR expressed by the natural killer cells present in the maternal part and the HLA presented by the trophoblastic cells together will influence the outcome of the pregnancy. With Laura’s KIR AA variant, the sperm would have to be HLA C1 C1 and the HLA of the donor should be as well HLA C1 C1; as her husband has a HLA C1 C2 variant, we will treat her with a medication that reduces her immune-genetic reaction. We believe that not paying attention to this issue in the past is what may have caused the implantation to fail” suspects fertility specialist Dr Isabel Herrera.

We tend to recommend a single embryo transfer, as it has been proven that on patients with an immunological profile such as Laura’s, double embryo transfers would increase the immunogenetic reaction, hindering the achievement of a pregnancy” says Dr. Herrera.

It is also known that these cases tend to have a higher risk of pre-eclampsia, late spontaneous abortion or miscarriage.

Until their transfer day the couple will try to enjoy summer just as any other couple would;

“I’ve tried to just carry on as normal. Remain healthy, take pre-conception vitamins. Reach out and get support through the Donor Conception Network in the UK and connect with other people going down the DE route via online forums. It’s quite isolating and scary so it’s important to reach out and not feel so alone.

I’m trying to relax a little – not so easy with work but it’s a work in progress. I need to get that bit sorted now treatment is on the horizon.”

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