Dr. Anton Baev, obstetrician-gynecologist and specialist in reproductive medicine. With over 20 years of experience, Dr. Anton Baev is an expert in assisted reproductive techniques, ultrasound diagnostics, laparoscopic and hysteroscopic surgeries. He works at the First Specialized Obstetrics and Gynecology Hospital for Active Treatment “Sveta Sofia”. Head of the In vitro team of the Afrodita Clinic in the period 2008-2022, worked in the in vitro team of the Malinov Clinic in 2023-2024.
From June 1, 2024, Dr. Baev opened the Dr. Baev Invitro Center, where he continues to help families achieve their dream of children. Since 2008, he has helped over 1000 babies to be conceived and born. Member of:
• The Bulgarian Society of Obstetrics and Gynecology
• The Bulgarian Sterility Association
• ESHRE (European Society for Human Reproduction and Embryology)
How did you get introduced to reproductive medicine and what inspired you to specialize in this field?
Even as a young obstetrician and gynecologist, I was captivated by the magic of reproductive medicine. There is no more important mission than helping a woman become a mother. Sometimes this path is very long and you have to hold her hand and support her so that she reaches a successful outcome. I am with my patients from the IVF procedure, through pregnancy to delivery. The most exciting moment is the appearance of the baby at the end. It gives me energy and momentum to keep going.
What news and innovations in assisted reproduction can you share with your patients?
Innovations in reproductive medicine are numerous, and we continually see changing recommendations. For example, new medications for ovarian stimulation are being introduced – the so-called long-acting gonadotropins, which allow for entire stimulation with just one injection. The method for examining embryos is changing – rather than embryonic biopsy for genetic testing, there is consideration for other less invasive tests to determine embryonic quality, such as the Embrace test. The use of Embryoscope technology, omics technologies, and others is becoming more prevalent. Various new tests are being developed to clarify the implantation window, competing with the original ERA test. Artificial intelligence is actively entering the field as a method for selecting the best embryo and determining the appropriate dosage and type of stimulation protocol for the woman. Biopsy of the uterine lining is used to check for chronic infections with the use of PCR tests for multiple pathogenic viruses and bacteria that can hinder implantation. The aim of all these tests is to analyze potential reasons for failure and increase the success rates of IVF procedures.
What are the most common challenges you face in your practice and how do you overcome them?
The psychological stress of a woman who cannot conceive is enormous. To ensure successful treatment, it is essential to reduce this stress as much as possible. With each unsuccessful IVF procedure, couples often feel a sense of weightlessness and despair, as if there is no hope. In such situations, we must seek solutions and new therapeutic approaches for success. The physician’s role is to instill courage and hope, providing a new impulse of energy to continue the treatment. Unfortunately, there is a 50% dropout rate on average across various countries, which reflects the percentage of couples who stop treatment and give up on having a baby after a failed IVF procedure.
As a specialist with over 20 years of experience, how have you seen the development of reproductive medicine over the years?
In the beginning, things were different—the freezing techniques were not as effective, and because of this, thawed embryos did not always have good quality, which is why we transferred 2, 3, or even 4 embryos in some cases. I had many pregnancies with twins and even triplets. This was very risky for both the mother and the babies, and most of them spent a long time in the pathology department for pregnancy. Often, we had to perform selective reduction during a successful twin or triplet pregnancy to reduce the risks. This was a terrible decision for me and for the pregnant women.
The risk of ovarian hyperstimulation syndrome during stimulation has also decreased over time. With the development of medications and experience with controlled ovarian hyperstimulation protocols, this most common complication of IVF is now rarely encountered.
Now, the main goal of the IVF methodology is to create one healthy embryo and transfer it on the right day into the uterus under optimal conditions, known as single embryo transfer.
What does the process of in vitro fertilization entail, and what steps does it include?
In vitro fertilization literally means conceiving new life in the laboratory, that is, outside the woman’s body. The first stage is diagnosing the cause of infertility. This is followed by mandatory examinations of both the man and woman. A stimulation program for the ovaries with the most suitable protocol and medications leads to obtaining an optimal number of eggs. The highest success rate is achieved when 10-15 mature eggs are collected during ovarian puncture. These eggs are then fertilized in the IVF laboratory with the man’s sperm, and the resulting embryos develop in incubators. Afterward, one or at most two embryos are selected and placed into the woman’s uterus under ultrasound control following appropriate hormonal therapy to support the pregnancy. A pregnancy test is performed 14 days later.
What advice would you give to couples trying to conceive but facing difficulties?
A healthy lifestyle is fundamental to success. The healthier an individual is, the healthier their reproductive cells will be. Healthy eating, vitamins that boost fertility, increased physical activity, and maintaining an optimal weight are crucial for success. Smoking and a high body mass index, for example, reduce the success rate of IVF procedures by half.
Every couple with unsuccessful attempts at conception after 6 months should consult a reproductive specialist. Fertility decreases with age for both women and men. Our main advice is not to delay the timing for having a baby. Egg freezing is now a realistic chance to have a healthy baby even later when your ovarian reserve is depleted.
What is the role of psychology in reproductive medicine, and how do you help patients deal with emotional stress?
Stress reduces the success rate. Working with a psychologist, acupuncture, massages, and physiotherapy aim to achieve overall relaxation, which is definitely helpful. The time that a doctor spends with the patient is also very important for their peace of mind. The patient should be well-informed about the treatment stages and their outcomes to remain calm and not worry about complications or failures.
What measures do you take to ensure the safety and well-being of your patients during treatment?
Continuous contact between the doctor and the patient is crucial for patient safety. This means ongoing monitoring of patients in the clinic during the procedure with active participation from an anesthesiologist, as well as constant monitoring of the condition following embryo transfer. When a patient can reach out to their treating physician at any moment regarding questions or medical issues, they feel calm and confident during their treatment.
What are patients’ expectations regarding the success of IVF procedures, and what advice do you give them in this regard?
Every patient wishes to become pregnant and give birth to a healthy baby after an IVF procedure. This is possible in over 90% of cases. Analyzing the reasons for failure holds the key to success in the next IVF cycle. Never give up and continue, because sometimes the journey that needs to be traveled is quite long.
What motivates you to continue working in this dynamic and challenging field of medicine?
The birth of new life after IVF is a true miracle. It is one of the most incredible achievements of modern medicine that no one can deny. If that doesn’t motivate us, nothing else will!
Wishing success to all the women fighting for their child!