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FERTILITY JOURNEYS

Meet IVF Spain’s second couple Alka and Rhod

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IVF Spain Couple

Every year, thanks to our participation in this wonderful initiative created by Fertility Road Magazine, we selected two couples to help them fulfil their dream of becoming parents.

At IVF Spain we welcome the opportunity to work again with Fertility Road and we love to have the chance to be a part of it year after year. Our first couple of 2017 were Kathryn Hobbs and Richard Clemens, who have already started their treatment and we will share their news with you from their journey.

We are pleased to announce our second selected couple from Fertility Road Magazine 2017: Alka and Rhod.

Each year all the applications we receive describe their own personal, emotive and moving stories. We would like to help everyone who applied and this makes the task of choosing which couple to work with even more difficult.

We immediately connected with Alka and Rhod’s story and as medical professionals, we had no doubts that we could help them complete their journey and fulfil their dreams of becoming parents for the second time.

This adorable couple’s story is admirable as despite all the obstacles, hardships and setbacks they faced they never lost sight of their dream of becoming parents again.

At IVF Spain, we are conscious of the emotional stress that a failed fertility treatment can have. During fertility treatment, we take care of every little detail, offering individualised care and personalising every aspect of the treatment to maximise chances of success.

Alka and Rhod had gone through 3 failed fertility treatments in the UK but their 4th round of fertility treatment was successful and they became parents for the first time. After having their first child they decided that they would like to be parents again. After trying unsuccessfully to conceive naturally for 3 years they decided to try IVF again. The cycles failed except for one which unfortunately ended in the loss of the child due to medical complications.

Having gone through so many failed fertility treatments in the UK they decided that egg donation would be a better option to help improve their chances of success and avoid the emotional and psychological pain of yet another failed attempt.

During their first visit to IVF Spain, they explained their situation to Dr Alicia Álvarez. After reviewing their medical history we are able to Alka and Rhod a personalised solution that is completely adapted to their specific needs and held the highest chance of success.

Dr Álvarez performed several tests on the couple which would help her develop the best possible strategy for them to conceive. She also analysed Alkakumari’s ovarian reserve (based both on her AMH levels and the ecographic image of her ovaries), which proved to be very low. She also looked at her egg’s viability but the results showed they were poor quality. Other analysis revealed that Alka’s endometrial thickness was negligible.

After discussing this with the couple Dr Álvarez recommended an egg donation treatment as the optimal and most adequate treatment option to achieve the long-desired pregnancy.

“I don’t understand why after so many failed IVF treatments they (the fertility specialists) didn’t change their approach or try to offer an alternative to this couple when even they admitted to being tired of repeating the same treatment with identical results. They also complained that the only options offered to them in the UK were a treatment with Alkakumari’s own eggs, (which according to the test results was the least advisable option), or an egg donation treatment with a minimum waiting list of 2 years in order to find a similar phenotype to hers.

Fortunately, IVF Spain counts on a vast egg bank of more than 500 donors that covers practically all phenotypes, therefore we have been able to offer Alkakumari and Rhodri a treatment adapted to their needs and with the maximum chance of success”.

After their consultation with Dr Álvarez we interviewed Alka and Rhod and asked them how they have been coping with their struggle to extend their family and what led them to apply to be part of Fertility Road Magazine’s Fertility Journey this year:

Why did you decide to travel abroad for treatment?

Over our 8-year fertility journey, and with repeated failure of IVF cycles, we wanted to investigate all options to complete our family. The waiting list for some services such as egg donation is very long in the UK, and even longer find a donor of Indian ethnicity.

So we broadened our search to include clinics outside of the UK to investigate all the options available to us.

How did you find IVF Spain?

There are so many fertility clinics worldwide and it can be overwhelming to begin to research them. We looked at websites that specialised in giving information about fertility clinics abroad. We narrowed it down to clinics that offered a wide range of services and looked at the statistics for that clinic. We then narrowed it down to the country that we wanted to travel to, based on ease of travel, and weighed up the options based on how much we liked the clinic.

With such a wide range of clinics and treatment options at your disposal, what made you put your hopes of becoming parents in IVF Spain?

IVF Spain offers a wide range of services and treatment options. The statistics of success for the clinic are great, and the patient testimonials are excellent. Everyone mentioned what a calm and relaxing atmosphere you encounter at IVF Spain. The whole fertility journey is so stressful, and it is comforting to find a clinic where you feel your anxieties being reduced from the minute you walk in and where you feel you are treated as an individual and not a patient number or statistic.

What are your fears and concerns of travelling abroad to start a family?

It is very daunting to start a new cycle of IVF, let alone go to a new clinic and especially one in a different country. You hope that the standard of health care will be equal to or even better than the country you reside in. There are fears about the language barrier and whether travelling to another country will be easy, or whether it will just add to the stress of the cycle.

What advice can you offer to couples in a similar situation to yours?

Travelling abroad for treatment was much easier than we thought. Consider where you are in your fertility journey and consider all your options, in your own country and also abroad.

How was this last year?

Every IVF cycle failure is hard, and when our 6th cycle of IVF failed, due to poor ovarian response, we knew our chances of success were limited.

There has been such heartache in our fertility journey, and it was hard to know if we should proceed and at a loss to know how to proceed. Our fertility clinic in the UK mentioned the idea of egg donation, but we were also informed of the 2-year waiting list for egg donors at the clinic and possibly longer if we wanted an egg donor of Indian ethnicity. We researched the options and decided to get more information about egg donation abroad where the waiting times were shorter and my physical characteristics could be more closely matched.

What did IVF Spain offer that clinics in the UK didn’t?

I would recommend IVF Spain. The range of services they offer is excellent and the emphasis they place on making you feel at ease, in control and calm during the treatment process is wonderful. They are also open to holistic treatments to aid the IVF process, which was not a big part of the treatment process in the clinics we attended in the UK.

How was your first visit to the clinic?

The first visit to IVF Spain was great. As soon as you enter the clinic, the calm, tranquil environment soothes your nerves and takes some of your stress away. All of the staff is very welcoming and speaks amazing English, amongst other languages. Every part of the process is explained in detail, which makes you feel in control. The consultation with Dr Alvarez was brilliant. She explained the process in great detail and in a way you can understand and her very human approach made you feel instantly at ease. The emphasis the clinic puts on achieving good quality embryos was fantastic. I was very impressed with the clinic and looking forward to starting our treatment.

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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 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.

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.

Laura and Ian IVF Spain

“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.”


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FERTILITY JOURNEYS

Laura & Ian Fertility Journey Couple 2018

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Laura and Ian IVF Spain

Laura and Ian are this year’s Fertility Road Magazine Runner-ups with IVF Spain. During their initial consultation with our specialist Dr. Herrera they were able to clarify all their doubts and were provided with a level of patient care, they had never experienced before throughout their 7-year-long journey. It was a completely different experience for Ian as well; this time he felt like a human being rather than a number.

You can find out more about their fertility journey here.

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FERTILITY JOURNEYS

Interview with Dimitrius Kavakas from Redia IVF Travel

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Redia IVF Travel

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.

Dimitris Kavakas

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.

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