Story of Laura and Marcus by Dr. Claudia Forteza

I remember perfectly the day I met Laura and Marcus

Laura told me about her teenage years with her irregular cycles and even entire periods without a period, it didn't concern her, she was young and carefree.

Today she is 32 years old and with her partner Marcus, the desire to have a baby at home grows every day. For the past 3 years, they have decided to do everything possible to achieve this.

They decide to see their gynecologist, who diagnoses Laura with polycystic ovary syndrome (see later what this means)

As she was a bit plump, the doctor asked her to change her lifestyle.

She started exercising, even lost some weight, and with Marcos, she did ovulation tests to increase the chances of pregnancy. But nothing works!

They return to see their gynecologist who decides to do 3 cycles with ovulation induction using Clomiphene, yet another failure.

They then decide to come see me at the NatuVitro clinic.

I review their medical history: For Laura, PCOS with a BMI close to obesity, a high level of male hormones, and for Marcos, aged 33, normal sperm and a healthy lifestyle.

Upon reading this history, we conduct an initial evaluation with a complete hormonal analysis and a transvaginal ultrasound.

The results, AMH of 5.8 ng/mL, an FSH of 4 UI/mL, an LH of 9.5 UI/mL, and a testosterone of 71 ng/dL confirm the diagnosis of PCOS and the ultrasound shows a good ovarian reserve (15 and 13 follicles in each ovary).

Julia, their personal assistant who works with me, quickly arranges an appointment for them to analyze the possible medical options, focusing on assisted reproductive techniques.

They opted for an artificial insemination cycle. Given her profile, I prescribed injections of 37.5 UI of rFSH per day. Of course, we monitored her closely with ultrasound and hormonal testing. Unfortunately, we had to cancel due to the growth of more than 3 follicles and an estradiol level of 810 pg/ml, to avoid the risk of hyperstimulation and multiple pregnancies.

After this canceled cycle, which affected them greatly, Laura and her partner decided to move to IVF in vitro fertilization to increase their success rates.

Laura followed a controlled ovarian stimulation protocol, which includes the administration of gonadotropins to stimulate the growth of multiple follicles. Frequent ultrasounds and hormonal tests are performed to monitor follicle development. When the follicles reach a sufficient size, a follicular aspiration is scheduled.

Twenty-five oocytes were retrieved, of which 18 are mature. These 18 oocytes were inseminated with the partner's sperm.

Fifteen fertilized, and the embryos were left in culture for 5 or 6 days to reach the blastocyst stage.

The best one was selected to be transferred into Laura's uterus during a later cycle to avoid the risk of ovarian hyperstimulation.

Due to her irregular menstrual cycles, a cycle of embryo cryotransfer with hormone replacement therapy was proposed to her.

Laura came back with her partner at the perfect time for her transfer, and they were both able to follow the journey of their embryo with the magical moment of its arrival in the transfer room with the biologist, the transfer itself which they could follow on a screen, and then a little moment of relaxation after these emotionally rich moments. The transfer was easy, and I was quite confident.

Fifteen days later, the pregnancy was confirmed by a blood test for BHCG, and a transvaginal ultrasound at 3 weeks confirmed the intrauterine gestation of 7 weeks.

Congratulations Laura and Marcus

Dr. Claudia Forteza