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Sometimes you can't get a pregnancy By natural methods and future parents resort to fertility techniques. What are these techniques? What is the success rate? Who can use these methods?
The doctor Victoria Verdu, Coordinator of Gynecology at the Ginefiv assisted reproduction clinic and fertility expert at the Spanish Society of Gynecology and Obstetrics (SEGO), in this exclusive interview on our site, she answers the parents' questions about the methods and techniques of reproduction assisted.
1- Regarding in vitro fertilization. What does it consist of? Who is it recommended for?
The technique consists of stimulate the ovulation for eight to ten days. This stimulation is carried out with injections that are given to the patient subcutaneously, and at a certain moment, when follicles grow in the ovaries, a black wilt that we measure by ultrasound, we perform a puncture to remove these eggs. This is the first time that we are evaluating the oocyte quality and that same day the man delivers the semen sample to put eggs and sperm in contact. Usually, two or three days later, the transfer of the embryos obtained through the technique is carried out.
2-What is the pregnancy rate achieved with in vitro fertilization, both for young women and for those over 35 years of age?
Pregnancy rates in women between the ages of 35 and 40 are around 30% or 40%. Obviously, these are acceptable rates, but the problem is that as we get older, despite the pregnancy being achieved, the abortion rate.
Pregnancy rates above 40, up to 43 or 44 years old, which are the maximum ages at which we are working in assisted reproduction with the woman's own oocytes, is around 20% or 25%. The problem is that the abortion rate increases a lot, which is a reality that we have to be clear about when achieving a pregnancy with these techniques.
3-What are the risks of in vitro fertilization for the health of a woman in the short and long term?
The main problem we have to deal with every day is that there is a risk of ovarian hyperstimulation, that is, a medication is put so that the ovaries respond and give us a number of oocytes. Sometimes certain hormonal treatments can cause the ovaries to be too large and to have these complications of ovarian hyperstimulation.
Another of the main problems we encounter in the in vitro fertilization It is the risk of multiple gestation, so it is usually recommended to the couple, especially if they are young and with a good prognosis, to get one or two embryos. If it is true that the fact of having a twin pregnancy is not without risks.
Assisted reproductive techniques are made of very controlled and limited way. Usually, a couple who decides to undergo assisted reproduction treatment undergoes a very complete study that assesses not only fertility problems but also the general state of the couple and especially of the patient who is the one who is going to assume a pregnancy . Normally we carry out at most three or four cycles of IVF, so the long-term risks are very controlled.
4- What is sperm microejection? In what cases is it used? What is the pregnancy rate?
Spermatic microejection is an in vitro fertilization technique in which ovulation is stimulated. What is done is to select a good quality oocyte, a sperm that has good mobility and good shape and we microinject into that oocyte.
This technique is done because the quality of the semen sample is usually very low and we think that if we put eggs and sperm in contact to carry out a conventional in vitro fertilization, it might not happen. There are also occasions when this conventional in vitro fertilization has been done and we have seen that there has been a very low fertilization rate or that embryos are not generated, there is no spontaneous fertilization.
5- What is artificial insemination? What couples are eligible for this method? What is the pregnancy rate?
Artificial insemination is the simplest assisted reproductive technique. It simply consists of stimulating ovulation, by ultrasound we control the moment at which the woman is going to ovulate and how many eggs she is going to ovulate. By the time you are about to ovulate, you get a semen sample, it is trained, it is put in the best possible conditions, and that sample is introduced into the uterine cavity with a very fine cannula that hardly bothers and that can be carried out even in consultation.
It is a very simple technique. The chances of pregnancy also vary depending on the 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 be mothers? Who is this technique recommended for?
The embryo freezing it is a consequence of in vitro fertilization. We usually stimulate ovulation with the aim of having 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 that responds in a normal way and that when they fertilize, in a normal woman under 35 years of age, 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 are at high risk of ovarian hyperstimulation, we use protocols that allow us to obtain embryos and oocytes, we freeze them, we vitrify it and transfer it in a later cycle when there is a risk of zero hyperstimulation.
7- Regarding the failure of embryo implantations, is research continuing to find a solution to the problem?
At this time, extensive studies are being carried out to see if there are any problems that may affect the implantation. hematological studies, because there are times that alterations in coagulation can affect the possibility of an embryo implanting in the uterine cavity and studies are done regarding the capacity of the uterine cavity to accept that embryo.
You can read more articles similar to Assisted reproductive techniques, in the category of On-site fertility problems.