What is assisted reproduction and is it the same as In Vitro Fertilization?
Assisted reproduction refers to those medical and laboratory procedures that involve fertilization of the egg outside the woman’s body. The most common are In Vitro Fertilization or In Vitro Fertilization (IVF) and Sperm Microinjection or ICSI. Sometimes more advanced techniques, such as genetic diagnosis of embryos or assisted hatching, must be associated with these techniques.
Artificial insemination is not strictly speaking an assisted reproduction technique but a low complexity fertility treatment.
What are the causes of infertility and can high prolactin levels prevent a woman from becoming pregnant?
There are many causes of infertility. Thus, there may be problems with the sperm or intercourse, alterations during ovulation, obstructions in the fallopian tubes, malformations or a tumor in the uterus… It is difficult to specify the cause, but there are treatments.
Prolactin is a type of hormone which, when very high, can cause ovulation problems. Sometimes it can be elevated if the patient is going through a stressful time. Other times an excess of prolactin can be caused by small tumors in a gland in the skull called the pituitary gland, and many times prolactin is increased by a defect in the thyroid gland. However, for prolactin disturbances to cause fertility problems they must be very serious and almost always involve disruptions in the menstrual cycle.
When is a woman’s most fertile time?
Women are most fertile between the ages of 18 and 30. The most fertile days are those that are close to ovulation, which occurs in the middle of the female cycle. Thus, in a woman with regular menses every 28-30 days, the most fertile days will be on days 14-15, counting from the day the period began.
When is it necessary to see a specialist? Why is it important “not to lose hope”?
It is important for patients with fertility problems not to despair. For this it is important to see a specialist in Assisted Reproduction and not to leave any doubt as to whether everything that “could be done” is being done.
With the correct treatment, gestation is achieved in 90% of patients, but we must be aware that it can be a long road. The treatments to be carried out in couples with fertility problems of unknown origin will depend on the length of time the couple has been trying to conceive, the result of previous treatments and the woman’s age. Depending on this, there will be from intrauterine insemination cycles to in vitro fertilization. Sometimes it will be necessary to resort to oocytes from a donor woman. In other cases, it will be necessary to rethink the diagnosis and perform surgical or genetic tests, such as hysteroscopy or laparoscopy.
It is important to be persevering, since fertility is something very easy to treat on some occasions, but on others it involves a lot of time and effort, both financially and emotionally. Today, however, there are few cases that have no solution.
Moreover, if “all is well” pregnancy can occur naturally. It is important that the treatment does not alter the patient’s life.
Is assisted reproduction safe? Can it have side effects on the fetus?
Currently millions of babies have come into the world through assisted reproduction and there is no increased risk of congenital diseases that are not associated with the same factors that cause disease in parents of the same age. It is important to note that the average age of women and men who require treatment is higher than that of couples who conceive spontaneously or naturally.
The only “problems” associated with assisted reproduction are prematurity associated with pregnancies and multiple births. Hence, more and more attempts are being made to avoid multiple pregnancies as much as possible, transferring fewer embryos while maintaining reasonable success rates.
Are assisted reproduction treatments expensive and how long will they last?
Depending on the cause of infertility, the costs will vary. Thus, on some occasions it will only be necessary to use a few medications that do not exceed 15 euros. At other times, on the other hand, scans, genetic tests, surgical interventions… may be required, the cost of which may be higher. What should never be done is to rely on treatments with no proven efficacy.
However, on the other hand, the most expensive treatments, if they are followed by the birth of a healthy child, are cheaper in the end because… is there a price for a child?
The treatments and their cycles are very varied. Thus, for example, an intrauterine insemination with a 12% chance of success costs, depending on the clinic, about 1,000 euros. IVF will cost around 6,000 euros, with success rates of 35-42% per attempt.
Egg donation, sperm banks, surgery for endometriosis or fibroids, preimplantation genetic diagnosis… there are many treatment possibilities and prices.
Who tends to have more fertility problems, men or women?
Infertility has a female origin in 40% of cases, a male origin in another 40% and, in 20% of cases, the cause is in both partners. However, it is important to bear in mind that, in women, the problems increase after the age of 35.
When can a couple detect that it is time to go to therapy, or that they may have a problem conceiving?
There are a number of factors that can lead to problems conceiving in women: a history of abdominal surgery, previous miscarriages (induced or spontaneous), menstrual cycle disorders or having had an IUD.
In men there are also a series of situations to take into account, which can be related to infertility: having suffered trauma to the testicles, hernias or cryptorchidism (having the testicles “up” when they were children). This is also compounded by the fact of taking steroids, in the case of bodybuilders, although this sterility is usually reversible.
Any couple that has been trying to get pregnant for more than a year without success should see a specialist.
Do assisted reproduction treatments hurt?
The discomfort of assisted reproduction treatments is mild. It involves a few skin injections (similar to insulin injections for diabetics) and a puncture that is usually performed under anesthesia. They are not painful treatments, in general.
What are the chances of success of fertility treatments?
In artificial insemination, the success rate per cycle is around 12-15%, with a maximum of 25% in 3 or 4 cycles. IVF has a 35% success rate per attempt and an 85% success rate in 3 cycles. With oocyte donation there is a 55% success rate per cycle. However, all these figures depend on the age of the woman and her particular problem.
In case of unsuccessful treatments, how many times can they be repeated?
In principle, no more than 3 or 4 inseminations and no more than 3 IVF cycles should be performed. If all of this fails, perhaps the treatment should be reconsidered and sperm or egg donation should be used, or adoption should be considered. The specialist will be able to give better advice on when a couple should not continue with the treatment because the possibilities are nil.
Is there an age limit for undergoing assisted reproduction treatments?
Artificial insemination is not indicated in patients over 37 years of age, since IVF is indicated for these cases, except in some cases. Nor will IVF be recommended in patients over 42 years of age unless, after explaining to them that their chances are minimal, they insist on doing it and it is not contraindicated for other reasons. In these cases and others, egg donation will be recommended which, in some selected cases, can be done up to the age of 50.
Is it possible to determine the sex of the baby before gestation?
The sex of the baby can only be determined in cases where sex-linked diseases, such as hemophilia, are to be avoided. In other cases it is not legal.