Dr. Segura, specialist in Assisted Reproduction in Barcelona, explains in which cases it is advisable for a couple to resort to fertility techniques, which is the most indicated in each case and what a fertility study consists of.
When is it advisable for a couple to resort to fertility techniques?
Usually, and according to the protocols, we recommend that when a couple has been looking for pregnancy for more than 1 year, a fertility study should be performed, and in couples where the woman is between 35 and 37 years old, it is recommended that this study be performed 6 months after the couple has been looking for pregnancy.
What does a fertility study consist of?
A fertility study consists of the assessment of fertility in the 2 components of the couple. In men, what is initially done are 2 seminograms, then an andrological evaluation can be made depending on the results, while in women a study of the different levels of the genital apparatus is made, an evaluation of the ovaries is made, specifically hormonal, then an evaluation of the tubes is made to assess their permeability, and then a general evaluation of the entire genital apparatus by ultrasound, assessing whether there are possible tumors or nodules in the wall of the uterus, in the uterine cavity, ovarian cysts, and what we call the antral follicle count is also done, which is a very accurate test to assess fertility. Then from here other studies can be done, but basically it consists of this.
Which Assisted Reproduction technique is the most advisable in each case?
There are 2 main techniques of assisted reproduction: artificial insemination with sperm from a partner or from a sperm bank and then in vitro fertilization. The 2 techniques could be indicated in the vast majority of cases of infertility. Insemination would be more indicated for cases in which we have a semen analysis with a somewhat reduced quality in terms of mobility and number, but not excessively, or when the woman is having irregular cycles and does not ovulate correctly. These cases could also be tributary to perform in vitro fertilization.
In vitro fertilization is indicated for all other cases of sterility, ranging from ovarian failure, gynecological diseases such as endometriosis, sterility of unknown origin when no apparent cause has been found for more than 2 years and the couple has not become pregnant; basically these would be these cases.
Which of them has a higher success rate?
Well, there are two techniques, insemination and in vitro fertilization. In insemination the pregnancy rate is a little below the fertility rate of the human species, around 22-24%, and in in vitro fertilization the pregnancy rate is much higher than the spontaneous pregnancy rate, reaching 40-50%.