The importance of finding the right fertility team

Pregnancy loss

Miscarriage affects roughly one in five pregnancies and can be a devastating experience. Losing a baby at any stage of pregnancy can be extremely difficult and the couple decided to take a short break from trying to conceive.

A couple of months later, in January 2023, Zoe and Giorgio went on their honeymoon to India and the Maldives and decided to try again. Soon, Zoe became pregnant, but then, in February, she experienced another miscarriage.

At this point, Zoe became concerned that something might be wrong. Understandably upset at their situation and wanting answers, Zoe and Giorgio went to see a consultant obstetrician and gynaecologist. Unfortunately, the consultation didn’t go as the couple hoped. The consultant told Zoe that she would need to lose weight before she would carry out any tests and advised the couple to keep trying.

Zoe again fell pregnant quickly, but had a third miscarriage. A couple of months later, Zoe and Giorgio went to see another consultant at a different hospital, where further investigative tests was carried out.

Although Zoe’s fertility tests came back as normal, further investigations revealed she had a blood clotting mutation. Zoe was prescribed heparin (blood thinning) injections to reduce the risk of clotting, as well as a course of progesterone pessaries to take when she next became pregnant, as the hormone supports conception and pregnancy. Zoe fell pregnant again, but miscarried shortly afterwards.

Undeterred, the couple tried again. Sadly, this pregnancy also ended in early miscarriage. They had now gone through four miscarriages in eight months, which was heartbreaking and emotionally draining. What’s more, they had no real explanation as to why each pregnancy was ending in miscarriage.

Finding a solution

The couple were told by their consultant that IVF was the only option left to them. They visited three fertility clinics, but each said Zoe’s BMI was too high and it wasn’t safe for her to undergo IVF treatment. They were told that any IVF would need to be carried out at a hospital in case of complications. It was then they decided to go to Lister Fertility Clinic at The Portland Hospital.

Zoe and Giorgio met with Mr Rehan Salim, Consultant Gynaecologist and Subspecialist in Reproductive Medicine, who explained that Zoe’s BMI wouldn’t be a problem and that although the egg collection is usually carried out at the hospital and the embryo transfer is carried out in the clinic, they would carry out both procedures at The Portland Hospital.

After discussing various treatment options, Dr Salim recommended that IVF with PGT-A was the best course of action. PGT-A, or Pre-implantation Genetic Testing for Aneuploidy, is carried out on embryos at blastocyst stage at around day five or six after fertilisation. This is to check for any chromosomal or developmental abnormalities that may affect the progression and success of a pregnancy.

PGT-A has little effect on the successful development of the embryo, as the cells that are removed are the trophectoderm cells, which go on to form the placenta – leaving the embryo unharmed.

The couple started treatment two weeks later.

Embryo testing and transfer

During egg collection, Zoe had 13 eggs retrieved. Eight of the eggs then developed into embryos. During the PGT-A treatment, all eight embryos were tested and five were found to be chromosomally normal.

The PGT-A treatment testing gave the couple much-needed peace of mind, as they knew that the likelihood of a successful pregnancy may have been increased.

In preparation for the embryo transfer, Mr Salim gave Zoe an autoimmune steroid to manage her blood clotting mutation. Zoe found Mr Salim’s support and reassurance throughout her treatment incredibly helpful and she knew she could directly contact him by email if she had any concerns.

The embryo transfer, which was carried out by Mr Salim, was a success. Two weeks later, Zoe got a positive pregnancy test. Because the team had made her and her husband so comfortable, it was an easy decision for them to continue with Zoe’s maternity care at The Portland Hospital.

Expert care and attention

Mr Salim handed Zoe’s care over to Consultant Obstetrician and Gynaecologist Dr Alison Wright, who carried out extra scans to provide Zoe and Giorgio with reassurance and to ensure the pregnancy was progressing as expected. Zoe scheduled an elective Caesarean section summer 2024.

Walking into theatre that August, Zoe said everyone on the team was incredible and reassured her and Giorgio. Their beautiful baby boy, Livio, had slight fluid on his lungs when he was born so he had to spend the night and day in NICU. The staff took Zoe in a wheelchair to see him whenever she wanted. Livio recovered well, and Zoe and Giorgio were delighted to welcome their new family member.

Zoe and her family are happy and healthy, and she says she’s forever grateful to the team at Lister Fertility Clinic at The Portland Hospital. Following her positive experience, she’s about to undergo her second IVF treatment with Mr Rehan using one of the remaining frozen embryos. We wish Zoe and Giorgio the very best.