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 arrives 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.

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 trisomy 22 syndrome, 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, a 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.”

While the doctors are busy assessing the couples that have applied for this truly wonderful offer of free treatment at their clinic in Crete we sat down with Dimitrius founder of Redia IVF Travel for a bit of Q&A.

Q: Redia Ltd has been a business consultancy for Fertility Clinics. What made you develop the IVF Travel Portal?

A: It was during my years of experience of trying to communicate with patients on behalf of fertility clinics that I realized what patients really look for. This is not just a treatment but the drive to make their dream come true. So the three main elements that concern patients, particularly in the UK, became our concerns in order to try to bring out solutions for them.

Q: Which are those elements you are talking about?

A: The main element is success. They get into a process that is not easy nor pleasant with the goal of becoming parents. The second element is affordability since they do not know how much they will keep on spending until they reach their goal. This unknown cost is really scary for many fertility patients. Finally, the third element is time. Fertility has a clock and is ticking fast. Being in an NHS waiting time may be detrimental to the patient’s fertility levels.

Q: So what does IVF Travel offer in response to these three elements?

A: What we do is offer multi-cycle refund guarantee IVF programmes so that we can either offer success, in which case the main goal of the patient is achieved at a set price that they know from the beginning, or we refund the cost of the programme up to 100% so as to take away the financial uncertainty from patients. In addition, we do that by offering affordable prices by having our patients travel to other countries where they can have low cost treatment without any waiting time.

Q: By offering lower cost than UK clinics do you not discount on quality also?

A: No, in actual fact, our partner clinics offer an equal and sometimes much better quality than UK clinics. What you find in countries such as Spain, Greece and Czech Republic, for example, is that clinics focus more on the individual and each patient feels that they are really taken care of. In addition, most of our partner clinics have lab infrastructures that can only be found in the most expensive UK private clinics.

Q: Do you have a way to screen clinics and ensure quality?

A: It is in our vested interest to do so. You see, we are risking paying refunds back to patients since our business model is like an insurance. We earn more when our patients have quick success. So that is why we make sure that we only work with clinics that deliver high quality of services and results.

Q: You talk about affordability; can you give us an idea of the cost?

A: The cost of the programmes would depend on many factors. One is the individual clinic and country of choice since prices of treatment fluctuate between clinics and between countries. In addition, the success rates of each clinic determine their prices. There is also a risk element that affects prices, so female patient’s age group is also one of the factors. Overall, I would say that on average, the cost of a 3 cycle IVF programme with all medication included as well as methods such as blastocyst culture, ICSI, IMSI, Macs, assisted hatching and embryoscope time lapse, including embryo freezing costs, would be similar or slightly more expensive than a single cycle of IVF at a UK private clinic.

Q: Are there conditions of eligibility to enter the programme?

A: Yes, there are conditions, however, in practice we accept almost 90% of interested patients. There are age conditions regarding the type of treatment and the refund percentage. Women up to 37 years of age can have a 100% refund guarantee. Women between 38 to 39 years old can become eligible but only with 50% refund. From 40 years and over, patients can only get into a 100% refund programme if they enroll in one of our Egg Donation or Embryo Donation programme, which have no age limit. In addition to the age criteria, there are a few basic medical conditions that patients should meet to enter into the programme. We ask for specific screening test which are assessed by our medical experts to evaluate eligibility. If everything is OK, they sign a contract and start treatment.

Q: What if there is a discomfort of patients at a particularly clinic they did the first cycle? Do they have to stick with that clinic for all the cycles of the programme?

A: No, patients have every right to change the clinic they have treatment at between cycles. If the cost of the programme at a clinic they wish to transfer is higher, they would just pay the difference.

Q: Do you offer any payment schedule to help patients with their payments for the treatment?

A: At the moment what we can do is spread the cost of the 50% of the payment over 6 equal monthly installments without any interest. We do ask however for a 50% deposit.

Q: Do you only work with UK patients and where are the most popular country destinations?

A: We work with patients globally, so no, we are not limiting our services to UK patients. Currently we work with clinics in Spain, Greece, Czech Republic, Cyprus, Turkey, India, Malaysia and Mexico. The popularity of a destination depends on the patient origin. UK patients prefer Spain, Greece and Czech Republic mainly, Australian patients prefer Malaysia and North American patients prefer Mexico.

More information on Redia IVF Travel can be found on their website www.ivftravel.com.

A lot has happened since our last Fertility Journey post. Claire and David, winners of the Fertility Journey 2018, had their first medical consultation; the list of this year’s runner-ups will be posted soon; the recent birth of a beautiful baby and the upcoming birth of one of our previous winners.

Claire (42) and David’s (35) first time at IVF Spain…

After 7 years trying to form a family, and thanks to the Fertility Journey Project, Claire and David decided to travel to Spain to be a little closer to their dream of becoming parents. On 14 May, the couple from Bristol visited the clinic and met their treating doctor, Natalia Szlarb, gynaecologist and Medical Director of IVF Spain. 

The couple had already been through 3 failed IVF cycles. Both suffer from medical conditions that make it impossible for them to conceive a child by natural means such as sperm morphology and motility defects, a genetic condition in the family history that increases implantation failure and miscarriage. As a result the couple decided to approach egg donation to achieve the long lasted pregnancy.

Spain has one of the most advanced and liberal laws on assisted reproduction in Europe, allowing the donation of gametes without disclosing the identity of the donors. This encourages many women to become donors and furthermore it allows reproduction clinics to have bigger donor pools compared to other European countries. Having large donor pools allows assisted reproduction clinics to meet the legal requirements set in Spanish Law: “donors and patients must be similar on a phenotypic level and be genetically compatible to ensure the health of future generations”

We asked Claire and David on their thoughts and impressions about IVF Spain during their visit. They were really impressed with the state-of-the-art technology and techniques that patients have at their disposal.

‘The testing process has been very thorough, there are things that we´ve never been offered in the UK and we didn’t know these were an option really. This was quite important for us. The first thing that we were shown when we arrived, was a time-lapse film of the embryo and, believe it or not, considering where we’ve come from and we´ve been through, we’ve never got to see that before and that is quite good for us, so that give a bit of confidence and that’s just very interesting to see what actually happens; the process when it gets to blastocyst stage’ said Claire and David.??At IVF Spain we are constantly striving to be at the forefront of medical advance. As such, we are able to offer our patients pregnancy rates well above the Spanish average (according to data submitted by the Spanish Fertility Association).

In the case of Claire and David we decided to perform specific tests that could provide us with additional information on why the embryos failed to implant. Among all tests that were carried out, the endometrial receptivity test proved to be decisive. This specific test determines the precise moment to carry out the embryo transfer, thus increasing the success rate.

The test results confirmed a “displaced window of implantation”. In other words, the best moment for transferring the embryo did not match with a woman’s normal cycle. As a result, Claire was prescribed a treatment to find out the best date to carry out the embryo transfer.

Both were very grateful with the received treatment; never before did they get that many information. They knew exactly what was going to happen during every phase of the treatment. “To feel to be taken care of gave us the assurance we needed”

We will be carrying out a second endometrial receptivity test during their upcoming visit to set the exact date for the embryo transfer.

And the runners-up are…

We also chose a runner-up couple for this year’s Fertility Journey: Laura (41) and Ian (44), from Kirklees, West Yorkshire. After five years trying to form a family they decided to put their trust in Dr. Szlarb’s broad experience and in our IVF Spain team.

Laura: ‘On our journey so far we’ve had 7 different rounds of IVF including frozen and fresh transfers and we sadly had 4 miscarriages. We’ve had a very difficult journey over the past few years to try and get pregnant and stay pregnant’.??The couple highlighted the dedication, empathetic approach and detailed information they received throughout their first medical consultation. They were able to clarify all their doubts with the doctor and received a much more professional treatment than in any other clinic.

Laura: Today we had a really thorough consultation with the doctor, much more thorough than we ever experienced in our seven previous attempts in the UK. We uncovered and discussed things we didn’t even understood or didn’t know that were a potential issue for us, which is quite surprising given that we are very experienced going through this.??It has also been a totally different experience for Ian. This time he did not feel like a number, but like a future dad.

Ian: In the UK it felt like we were being treated like a number rather than people. It was just one more case, pay the money and move on without getting a proper explanation. It has been a total different experience with IVF Spain.

Laura suffers from endometriosis and polycystic ovarian syndrome, but also suffered from immunological problems in previous treatments. At IVF Spain we wanted to be sure about what was causing Laura not to get pregnant, and decided to carry out an endometrial biopsy to check her immune system. The test results showed high levels of NK cells (Natural Killers) which required medication to regulate her bodies’ immunological response to the transferred embryo and prevent the miscarriage (several studies have linked high levels of NK cells to repeated implantation failure and miscarriage).

Laura and Ian will visit us again in September for their embryo transfer. We, of course, wish them the best of luck.

Updates…

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We are very happy to announce that our last year’s Fertility Journey winners, Kathryn and Richard, recently became parents of a beautiful baby girl named Efa Marie.

Kathryn: Efa is a dream. She’s tiny and was only 6lb 3.5oz born. She is a sleeper by day but awake all of most nights.

I can’t believe we actually have our miracle here. She’s the best thing that’s ever happened to us and I am so grateful to you all. Richard loves being a daddy. Very hands on and he was very sad going back to work, as will I too.

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We also would like to remind you all that Alka and Rhod will be giving birth in August. They wanted to share with us how they got the news of being pregnant and what has been going on since then.

Alka: ‘We discovered that I was pregnant when we were back in the U.K, 2 weeks after our treatment cycle at IVF Spain. The treatment had gone brilliantly. Three great quality blastocysts had developed, my uterine lining had been optimised, and one blastocyst was successfully transferred back into my uterus….It was Christmas Eve when we found out that the cycle had been successful, and we were ecstatic to hear the news! Oh my gosh!… It had worked… and first time too! It was the most amazing Christmas present we could ever have wished for! It was so hard keeping the news to ourselves… but after experiencing pregnancy losses before, we wanted to be sure that the first few months were going to be okay.

IVF Spain were delighted to hear the news and even though we were now in another country, they were very actively involved in our care. They kept a close eye on our blood test results and altered our medication accordingly to help support the pregnancy.

I experienced some bleeding at 6 weeks and with my history, I was terribly worried.

IVF Spain were amazing in their support. I was in touch with them by phone and by email, and they guided me on what actions I should be taking and what investigations would be needed. They were on hand whenever I needed advice, and they truly helped me to stay positive.

We went to our local hospital for a scan to check the viability of the pregnancy and were overjoyed to see the baby’s heartbeat. Everything was looking great! We were so relieved. Luckily the bleeding settled, and the next few months of pregnancy have gone well.  Words cannot describe how it has felt to see the baby moving on the ultrasound scans, hear the baby’s heartbeat…and to feel the baby kicking… Wow!’