Svetlana Shiyanova, please tell us what influenced your choice of profession – an obstetrician-gynecologist and fertility specialist – and how did your association with ISIDA come about?
It seems that the choice was made by destiny, it simply could not have happened otherwise. While a student, I came to the realisation that medicine was really my calling. After the internship, I was working in the women’s health clinic at the maternity hospital, and some of my colleagues started cooperating with ISIDA. Working at that clinic became my dream. However, senior colleagues would say, “You’re still young for such a prestigious organisation”. But I already had five years’ track record and experience, a great desire to work and a hope that ISIDA would help unlock my potential. I managed to get an interview, and they believed in my potential! Initially, I worked in the outpatient department for two years, then, having mastered the specifics of fertility as a specialty, for the last eight years I’ve been helping couples to become parents. Eighteen months ago, I was appointed head of the department for infertility treatment, and I very much hope that I’m worthily and responsibly fulfilling my primary mission – providing competent care for patients visiting the department.
What helps you cope with the medical and administrative load?
Without any doubt, it is our great team. And such a statement is not just subjective, it’s the result of analysis and observations. There is a wonderful atmosphere here. All of our doctors are versatile professionals. Each employee is able to provide comprehensive care for our patients at every stage of the cycle. For example, if a doctor in charge sees reasons that hinder the success of IVF, he becomes an operating gynecologist; he also selects the optimal treatment programme. Our embryologists are also skilled in providing support for the complete cycle: fertilisation, embryo culture, diagnosis of its development.
In addition to the high professionalism of the doctors, what benefits of ISIDA would you like to highlight specifically?
The holistic and comprehensive care that the clinic provides. Our acquaintance with patients begins with the first free consultation, at which we, with maximum objectivity, try to assess the chance of motherhood, to find out whether female, male, or a combination of several factors are an obstacle to pregnancy. Depending on the individual circumstances, treatment is then selected, either allowing for conceiving independently or in preparation for IVF.
In cases where conception is successfully achieved, we provide prenatal care, birth and paediatric support. What sets us apart from other medical facilities is the around-the-clock nature of the clinic – in case of an emergency there is no need to seek alternative gynaecological support.
On the subject of holistic care, it is worth mentioning the psychological support that the clinic offers. Each fertility specialist is a psychologist, and although the clinic’s approach is to investigate all medical and physiological causes of infertility in the first instance, they fully recognise the important role that psychology plays in the treatment process.
Is a positive attitude really important in the use of reproductive technologies?
Without any doubt. I’m often asked why there is a perception that the second IVF attempt is more effective. It seems, the fact is, that women already have the answers to many questions and therefore have less fear. Another example that supports this is that a considerable number of women become mothers again after IVF, but without our help. For them, the new pregnancy comes about as a result of overcoming psychological barriers.
Yet, we must remember that we cannot provide guarantees, although we do everything in our power to realise the chance of a pregnancy. Problems with conception are determined by a number of factors, and in 6% of cases, science is simply unable to explain the reason behind the failure. Of course, it all depends on the specific situation. An important parameter is age, because after 40 years of age, female fertility declines dramatically.
After all, nature cannot be cheated?
It’s not about cheating. Modern technologies that are used in our clinic, allow high-quality diagnostics and analyses to be conducted. A very important test is the test of ovarian reserve. If a woman has signs of a declining stock of oocytes, and is not considering a pregnancy at that moment in time, we can freeze oocytes for use in the future. We can also freeze embryos for couples. To resort to such a procedure, or not, is a private matter, but women should certainly be aware of this possibility. After all, a lot of patients come to us and exclaim, “How come we did not know about this 5 years ago?!” Therefore, awareness is a must!
You are using the most advanced technologies. Things that just yesterday seemed impossible, are now a routine thing for ISIDA. But are there any innovations that never cease to amaze?
Probably the most impressive is the process of cryocycling. Before the IVF procedure, we stimulate the maturation of oocytes; they are selected by a puncture and then, with the help of a tiny needle, sperm cells are inserted and we obtain embryos. The uterus is planted with one to three “crumbs”, and the remaining embryos go through vitrification, i.e. we use the most secure method of rapid freezing. After defrosting, these embryos have nearly the same capacity for implantation in the uterus, as in a conventional IVF. We imitate the natural cycle, or control the time of ovulation and plant the embryo in the uterus. The potential of this method, in which the embryo consists of several cells, is simply amazing! Pregnancy rates are slightly lower than in the standard procedure, but we can avoid the problems associated with overloading the female body with stimulating hormone, avoid multiple pregnancies and make a more accurate prognosis of the embryo selection.
Certainly, your work is connected with great emotional stresses…
Many of our patients walk a very difficult path. But when we see a tiny dot on the ultrasound after the embryo is transferred into the uterus, and then the parents come to us with pictures of their wonderful kids – believe me, one could not help but cry tears of joy!
Patients are grateful, and we, in turn, want to kiss them back because they are not afraid of difficulties and found the strength despite the obstacles, to become happy mums and dads.
ISIDA in Kiev in the largest women’s infertility and health clinic in Ukraine. With over 24 years’ experience in the field of assisted reproduction, the clinic has welcomed over 12,000 babies and has excellent fertility success rates. With a specialist infertility treatment department, an embryo ward, operating rooms, dedicated laboratories for genetic studies and PGD, maternity and neonatal departments, and a counselling centre, ISIDA is committed to comprehensive care for all individuals and couples hoping to become parents.