Advanced IVF techniques allowed this Baton Rouge couple to finally conceive a child.
In vitro fertilization wasn’t even on Elise and Britt’s radar as they were casually trying for a baby in 2018. But they both came to quickly realize that advanced IVF techniques would be the only logical option for them to build a family.
Both in the medical field, Elise and Britt first met in an operating room, she as a neuro nurse and he as a salesperson for a spine medical technology company. After being involved in many surgical cases together over the years, their relationship naturally progressed and they fell in love, marrying in 2017.
Being in their early 30s, they decided not to wait long to start trying for a baby. But after attempting to get pregnant on their own for almost a year, they were consistently striking out month after month. Still not overly concerned, Elise decided it would be wise to get some basic blood work and tests done on herself and Britt just to make sure everything was okay.
Elise’s alarm bells went off, however, when her OB/Gyn’s nurse called with the test results and a direct referral to Dr. Neil Chappell, a reproductive endocrinologist at Fertility Answers. Their tests indicated issues so severe that Dr. Chappell’s notes on the referral recommended they go straight to IVF.
Alarmed and upset at first that everything seemed to be happening so fast, they felt reassured after their first visit with Dr. Chappell who explained their chances of conception on their own were very low, only about 2-3%.
“I was genuinely upset for a few days after that,” says Elise. “But the silver lining was that our path was pretty clear and we knew what we needed to do given the diagnoses we had received.” They decided to dive straight into IVF starting in January 2019 with an egg retrieval and fertilization that resulted in five embryos.
Preimplantation genetic testing, one of many advanced IVF techniques, can determine an embryo’s chromosomal viability
They also decided to go the extra step of testing each embryo for any chromosomal abnormalities using the advanced IVF technique of preimplantation genetic testing, or PGT. A major reason IVF can fail is due to an embryo not receiving the correct number of chromosomes from both partners at fertilization. Testing samples of each embryo using PGT gave Elise and Britt more information on their embryos’ viability: three were normal, one was abnormal, and another was characterized as mosaic, meaning it has a mix of normal and abnormal cells.
With this information, the couple underwent their IVF transfer in May 2019 choosing one of the embryos that tested chromosomally normal. “We were really confident this transfer was going to work,” says Elise given that they had gone the extra step with PGT. But they soon found out the embryo had not implanted and Elise was not pregnant.
One reason IVF can fail is if the endometrial lining of the uterus is not ideal at the time of transfer
Sitting down with Dr. Chappell after this huge disappointment, they discussed the reasons why their embryo failed to implant. Elise had responded well to the medication and the embryo had tested normal. Why had they not been successful?
“When we have couples with ideal IVF conditions fail IVF, such as Elise and Britt, one of the things we look into next is endometrial receptivity,” says Dr. Chappell. About 3 in every 10 in vitro fertilization patients experience a condition where their endometrium, or the lining of the uterus, is more receptive to embryo implantation on days either before or after what is normal treatment protocol. For patients with lean PCOS, like Elise, there is also a possible link between PCOS and endometrial receptivity.
Endometrial receptivity analysis, or ERA, is another advanced IVF technique that looks at the function of the endometrium at the molecular level to determine when the endometrial lining is most receptive to implantation. Specifically, endometrial receptivity analysis can determine the best day and hour for an embryo transfer by identifying the moment the uterine lining is most receptive. In Elise’s case, ERA testing indicated that she needed an extra 24 hours of progesterone leading up to her transfer.
Armed with this new information, Elise and Britt went into their second IVF transfer on Friday, September 13th. “I remember there was a full moon the night before our transfer on a Friday the 13th. I wasn’t sure whether to take that as a good or bad omen,” joked Elise.
But when they got the call from Dr. Chappell two weeks later reporting that she was pregnant, Elise was convinced it was a good sign after all. “All the extra testing we did was definitely worth it,” says Elise. “As a nurse, knowing the status of each of our embryos and the scientific reasons for creating the best environment for those embryos gave me incredible peace of mind.” Baby Jack was born in June 2020.
