Initial Consultation Schedule
The Initial Consultation
Most of our patients come for an Initial Consultation visit before returning to AVA-Peter for their Embryo Transfer. This enables us to meet you in person, carry out the necessary medical tests, and discuss your wishes before we match you with an egg and sperm donor.
Initial Consultation Schedule
The treatment of patients who come for an Initial Consultation and then an Embryo Transfer at AVA-Peter can be summarized in 10 clear steps:
1. Please fill in our questionnaire. We will contact you to discuss any questions and to arrange a date for your Initial Consultation appointment. You need only one day for this appointment, but we suggest that you do not fly in and out on the same day, in order to avoid stress and rushing. Many of our patients choose to come for their Initial Consultation on a Monday or Friday in order to arrange an enjoyable weekend stay in St. Petersburg.
2. You need to arrange a visa, flights and a hotel corresponding to these dates.
3 You arrive at AVA-Peter and meet the doctor who has been personally assigned to you. You need to bring with you your passport, any medical test results and reports about previous infertility treatments, plus several colour photographs of yourself (taken either recently or when you were in your 20s or 30s). These should include 2 clear photographs of your head and face (1 looking into the camera and 1 of your profile) plus another full-length photograph of you standing. The doctor discusses your wishes with you and carries out a number of medical tests. This enables us to assess whether you need treatment to clear up any problems before you are treated. Under Russian law, some of the tests need to be valid to the point when you start your Embryo Transfer treatment cycle so some will need to be carried out again in your home country before you return.
The following tests will be required for the female partner for the Embryo Transfer:
- Blood group
- HIV, Hepatitis B and C, Lues (valid 3 months)
- Clinical blood count (valid 1 month): RBC (red blood cells); WBC (white blood cells including count of their fractions: lymphocytes, neutrophils, basophils, eosynophils); haemoglobin
- Biochemical parameters in blood: glucose, kreatinin, bilirubine, ALAT, ASAT, general protein (valid 1 month)
- Bacteriology smear (valid 1 month)
- PAP smear
- TSH Prolactin
- A letter from a general practitioner from your home country about your state of general health and stating that there are no contraindications to pregnancy.
4. We discuss when you wish to start treatment. We can be flexible and always aim to fit treatment around your own schedule.
During your Initial Consultation, we discuss, plan and fix the schedule of your next visit, which will be for the Embryo Transfer itself. We also discuss your preferences in terms of choosing an egg and sperm donor, and will start looking to match you with the most suitable person who is available to donate eggs within the timeframe most convenient for you (unless you are using frozen embryos from our embryo bank). We also create an individual treatment plan for you and give you a prescription for your medication. You can buy this medication in our on-site pharmacy. Alternatively, you may prefer to use the medication details we provide to ask your local doctor to provide a prescription for you. This is only possible if you are confident that your local doctor will be willing and able to do this. If there is any doubt, we advise you to buy the medication at our on-site pharmacy as we cannot send you medication from Russia.
5. You return to your home country and remain in contact with us while we match you with the best donors. You will receive non-identifying information about your donors, including relevant medical details and physical characteristics. If you agree to use these donors, we confirm that all parties are ready to go ahead with treatment. If you would prefer another donor, we look through our databank again.
6. Only after you have accepted the donors and the dates, we e-mail you the applications for your signature and the invoice for your payment. The payment should be made by money transfer not later than 2 weeks before the donor starts taking medication (the ‘stimulation phase’) if you are using fresh embryos. If you are using frozen embryos, the payment should be made at least 3 weeks before Embryo Transfer.
7. If using fresh embryos, you usually start to take oral contraceptive tablets (prescribed by our doctor) in order to synchronize your menstrual cycle with that of the egg donor. One week before taking the last tablet, you may have a single injection of a ‘down-regulating’ drug. This will allow optimal synchronization with your donor by ensuring your ovaries remain inactive until after the Embryo Transfer. After finishing the tablets on the date agreed, you stop and a ‘withdrawal bleed’ (a period) follows a few days later. If you are using frozen embryos, no synchronization is necessary but you will still need to take medication to prepare your uterus and to ensure your ovaries remain inactive.
8. The dates of your second visit (for Embryo Transfer) will already have been agreed and fixed at your initial visit, and you will have received a detailed individual treatment plan. Please ensure you arrange a visa, flights and a hotel corresponding to these dates. If using fresh embryos, we advise you to arrive in St. Petersburg 2 days before the planned date of the Embryo Transfer. The exact date of Egg Collection for the donor depends on the donor’s response to her medication, and can therefore be up to two days earlier or later than planned. The exact date of the Egg Collection (and therefore the date of the Embryo Transfer) will be known only 3-4 days beforehand, but it is definitely not advisable to wait until this stage to arrange your visa, flights and hotel. Your visit will last 5 days (the day of the Embryo Transfer +/- 2 days).
If you are using frozen embryos, you should arrive in St. Petersburg the day before Embryo Transfer. You will have a short meeting with your doctor either on the day that you arrive or in the morning of the following day. Once your doctor has confirmed that you are well prepared, that your tests show normal results and your documents have been correctly filled in, the embryos will be defrosted several hours before the Embryo Transfer. Your visit will last 2 days.
9. After your ‘withdrawal bleed’, you follow our instructions (which we discussed and wrote down for you during the Initial Consulation) to prepare for the Embryo Transfer. This typically involves having a scan one week after the last contraceptive tablet (i.e. a few days after your ‘withdrawal bleed’ has started) to confirm that your womb lining is thin. You need to ensure you have a doctor able to do this, and you need to tell us the result of the scan. Oestrogen treatment then begins. This usually involves taking oestrogens in the form of tablets, patches and/or gel. You start taking progesterone (usually in the form of vaginal pessaries or cream) 5 days before the planned Embryo Transfer.
10. You return to St. Petersburg. If you are using fresh embryos, the exact date of the Egg Collection will be known 3-4 days beforehand. Once fertilized, the eggs become embryos and are grown in our laboratory for three or (more usually) five days. After five days, they are known as blastocysts. If you are using frozen embryos, these are already at the blastocyst stage. We transfer one or two of the best embryos into the womb of the egg recipient, according to how many embryos you want to have replaced. If you have chosen to use ‘personal’ egg and sperm donors, we can freeze any good-quality embryos remaining for your own personal use later on. If you are using ‘clinic donors’, you only receive the one or two embryos that are transferred during this cycle. Any remaining embryos belong to the clinc and will be placed in our embryo donor bank.
In 2008-2011, we had a 72% pregnancy rate when replacing two fresh embryos at blastocyst stage.
We wish you successful treatment and a positive result in our clinic!
Very kind regards,
Your AVA-Peter team
Interested in embryo donation at AVA-Peter?
Please first fill in our questionnaire This will be assessed by one of our experienced patient coordinators, who will then get in touch with you using your preferred contact method.
If you have any questions, an English-speaking receptionist is available to take your call on 007 812 600 7812 between 07:00-14:00 Central European time (06.00-13.00 UK time). You can also reach us by e-mail at info@clinic.avapeter.com
We are looking forward to hearing from you!
Very kind regards,
Your AVA-Peter team
