Sometimes a pregnancy can not be achieved by natural methods and future parents resort to fertility techniques. What are these techniques? What success rate does it have? Can you use these methods? The Doctor Victoria Verdú , gynecology coordinator of the genetically assisted reproduction clinic and
Sometimes a pregnancy can not be achieved by natural methods and future parents resort to fertility techniques. What are these techniques? What success rate does it have? Can you use these methods?
The Doctor Victoria Verdú, gynecology coordinator of the genetically assisted reproduction clinic and fertility expert of the Spanish Society of Gynecology and Obstetrics (SEGO), in this exclusive interview with GuiaInfantil.com, answers the parents' doubts about the methods and techniques of assisted reproduction.
Assisted reproduction methods
1- Regarding in vitro fertilization. What does it consist of? For whom is it recommended?
The technique involves stimulating ovulation for eight or ten days. This stimulation is done with injections that are given to the patient subcutaneously, and at a certain time, when in the ovaries grow some follicles, a wilted black that we measure by ultrasound, we perform a puncture to extract these ovules. This is the first time that we are evaluating the oocyte quality and that same day the man delivers the semen sample to put ovules and sperm in contact. Usually, two or three days later, the embryos obtained through the technique are transferred.
2-What is the pregnancy rate achieved with in vitro fertilization, both for young women and those over 35?
Pregnancy rates in women between 35 and 40 years old are around 30% or 40%. Obviously they are acceptable rates, but the problem is that as we are getting older, even though pregnancy is achieved, the abortion rate increases a bit. Pregnancy rates above 40, up to 43 or 44 years, which are the maximum ages in which we are working on assisted reproduction with oocytes from the lady herself, is around 20% or 25%. The problem is that the rate of abortion is quite high, which is a reality that we have to be clear about when getting pregnant with these techniques.
3-What are the risks of in vitro fertilization for a woman's health in the short and long term?
The main problem with which we have to fight every day is that there is a risk of ovarian hyperstimulation, that is, a medication is placed so that the ovaries respond and give us a number of oocytes. Sometimes certain hormone treatments can make the ovaries too large and there are these complications of ovarian hyperstimulation.
Another of the main problems with which we are in in vitro fertilization is the risk of multiple gestation, so it is usually recommended to the couple, especially if young and with good prognosis, to put one or two embryos. Yes, it is true that the fact of having a twin gestation is not without risks.
Assisted reproduction techniques are done in a very controlled and limited way. Usually, a couple who decides to perform an assisted reproduction treatment is given a very complete study that assesses not only fertility problems but also the general state of the couple and especially the patient who is going to assume a pregnancy . Normally we carry out, at most, three or four in vitro fertilization cycles, so that the long-term risks are very controlled.
4- What is sperm microejection? In what cases is it used? What is the pregnancy rate?
Spherical microejection is an in vitro fertilization technique in which stimulation of ovulation is carried out. What is done is to select an oocyte of good quality, a sperm that has good mobility and good shape and we microinject it into that oocyte.
This technique is done because usually the quality of the sample of semen is very low and we think that if we put ovules and sperm in contact to make a conventional in vitro fertilization it could not occur. There are also occasions in which conventional in vitro fertilization has been done and we have seen that there has been a very low rate of fertilization or that embryos are not generated, there is no spontaneous fertilization.
5- What is artificial insemination? Which couples can opt for this method? What is the pregnancy rate?
Artificial insemination is the simplest assisted reproduction technique. Simply it consists of stimulating the ovulation, by ultrasound we are controlling the moment in which the woman is going to ovulate and how many ovules she is going to ovulate. The moment you are about to ovulate, you get a sample of semen, you train, you put yourself in the best possible conditions, and that sample is introduced into the uterine cavity with a very finite cannula that barely bothers you and that You can perform even in consultation.
It is a very simple technique. The chances of pregnancy also vary depending on maternal age. In women under 35 years of age, pregnancy rates are around 15% or 17%.
6- What are the advantages of freezing embryos for women who decide to become mothers? Who is recommended this technique?
Embryo freezing is a consequence of in vitro fertilization. We usually stimulate ovulation in order to have a reasonable number of oocytes to be able to work and have embryos. The normal thing is that we have between 5 and 10 ovules in a woman who responds in a normal way and that when they fertilize den, in a woman of less than 35 years normal, between 2 and 6 embryos two or three days after having performed the puncture, when we do the embryo transfer.
We are very happy with the performance of freezing and even in patients who have a high risk of ovarian hyperstimulation, we use protocols that allow us to get oocytes and embryos, freeze them, vitrify them and transfer them in a later cycle when there is a risk of zero hyperstimulation.
7- Regarding the failure of embryo implantations, is research being carried out to find a solution to the problem?
At this time, extensive studies are carried out to see if there are any problems that may affect the implantation, hematological studies are carried out, because there are times when alterations in the coagulation can affect the possibility that an embryo is implanted in the uterine cavity and studies are made as to the ability of the uterine cavity to accept that embryo.
Doctor Victoria Verdú Gynecologist Gynecology and Obstetrics Coordinator in Ginefiv