About Infertility and Assisted Reproduction
Sterility is the inability to become pregnant after a period of 1 year of unprotected sexual intercourse. While infertility is the inability to carry a pregnancy to term.
It is a diagnosis that is given after having performed basic fertility tests, without having found the cause of the failure to achieve embryo implantation, and therefore, pregnancy is not achieved.
As a general rule, for women of childbearing age (18-35 years) it is recommended to visit if after 12 months of unprotected sex, pregnancy has not been achieved. For women over 35 years of age, or if there is any known pathology, this period is shortened to 6 months.
In in vitro fertilization treatments in which ovarian stimulation is performed, there is a risk of ovarian hyperstimulation syndrome. But the incidence is very low, less than 10 per 10,000 treatments.
Other risks associated with fertility treatments are controllable today thanks to technological advances, as well as the medication used and the safety protocols used in our clinics, so they occur very rarely (genital infections, bleeding or complications arising from anesthesia).
Other risks such as the possibility of multiple pregnancy are solved with the transfer of a single embryo, thanks to the progress in prolonged culture for the selection of the best embryo. The risk of ectopic pregnancy is about 3%, similar to pregnancies achieved naturally.
Success rates vary depending on the treatment performed, as well as the age of the patient, especially in cases of artificial insemination and in vitro fertilization. We invite you to request your individualized diagnosis to know the success rate for your specific case, as well as to consult our success rates section.
Gestations achieved through treatment are exactly the same as pregnancies achieved spontaneously. Therefore, the symptoms do not differ. The most frequent are: breast enlargement, nausea or vomiting and tiredness in the first weeks.
Here we are talking about both physical and emotional care. Although you will be able to lead a completely normal life, we recommend not to do strenuous exercise, but not to avoid physical exercise either, as it provides many advantages. During the ovarian stimulation phase, you may feel more uncomfortable as the ovaries may increase in size and slowing down may help you to cope.
After the ovarian puncture, relative rest is recommended for 24 hours after the intervention, which does not require hospitalization as it is a minor surgery.
Regarding the embryo transfer, there is no physical recommendation as it is a painless procedure and compatible with a normal life. We will recommend you not to have sexual intercourse after the transfer to avoid uterine contractions.
Once the pregnancy test is done, the beta-waiting begins, those 2 weeks of waiting that can be difficult. At this time, emotional care takes on special importance in order to face this period of uncertainty without stress and with a positive attitude. It is important to keep the mind busy and thus reduce the anxiety caused by waiting until the result of the pregnancy test is known.
About the first visit
Whichever way is easiest for you: through the forms on our website, by phone or by email. Our Patient Care department will contact you as soon as possible. Please check your spam folder in case our message has fallen into your spam folder. Our response time is less than 24 hours.
Nowadays, advances in telemedicine allow us to carry out very thorough medical consultations online. For patients who do not reside in Spain, online consultations are a fantastic opportunity for a first contact where a diagnosis can be established and the next steps defined. Any online consultation is usually followed by a face-to-face consultation at the appropriate time, always subject to your availability.
For those who prefer it, the face-to-face consultation is always available. It will be organized so that in a single visit you can gather all the information you need to make one of the most important decisions of your life, as well as complete the tests or analyses that our fertility specialists recommend for your particular case and design the best therapeutic strategy.
At Vida Fertility Institute we do not have waiting lists, neither for first visits nor for the beginning of treatment. The times are set by you and we adapt to them.
Depending on your specific case, we will recommend a series of tests that you can bring to your first visit or perform during the same. Our Patient Care staff will inform you in detail so that you can plan everything well in advance.
The first visit is a very important moment in your treatment. In this first appointment, we welcome you to tell us your life story and analyze the steps you have taken to get here. With all this information, we will complete your diagnosis, which will allow us to design your treatment and assess the best techniques for your case.
We will also elaborate the medication plan that will accompany your preparation from home. You will meet our entire team, from the patient care staff, the laboratory staff as you will be able to talk to our embryologists and of course, our fertility gynecologists. We will give you all the documentation and information you need, as well as a personal budget.
At Vida we do not believe in standardized formulas and we adapt each medication regimen to each specific case. We elaborate totally individualized medication plans based on a personalized study of your case.
Just as not all treatments are suitable for everyone, budgets should also be customized, to collect only those services that fit your case and you can know in advance the final price of your treatment. We work with closed prices.
We know that sometimes things don’t go right the first time, that’s why we have exclusive warranty programs to save you unnecessary stress. All this is possible because we are confident in our work and our results and we are totally committed to offer you the best options to help you achieve pregnancy.
About my treatment
The duration of your stay in Spain will depend on the type of treatment you undergo. As a general rule, you will have to travel twice: the first time for your first visit if you go in person and a second time for the final part of your treatment (ovarian puncture, embryo transfer, as appropriate). In any case, we have a specific protocol for you to follow up your treatment from your country of residence, so we will plan all the steps taking into account your availability to travel to Spain.
We will also help you with all the logistics for you to plan your stay in our country, since we have agreements with hotels, information about transportation and our clinics are very well located, so moving around for your visits will be very easy.
Se recomienda practicar actividades suaves que además te ayudarán a aumentar tu bienestar. Actividades en las que controlas la respiración, como son el yoga, caminar, nadar sin duda tendrán un efecto beneficioso para ti ya que reducen el estrés.
All the professionals at our clinics will be available to answer any questions or concerns you may have during your treatment. As a general rule, we channel communication through our patient care staff. You will have your personal assistant who will communicate with you in your language and who will be your liaison, guide and accompany you during all phases of your treatment. By email, phone or in person we will always be available to make your experience with us as positive as possible.
Inside the laboratory
A blastocyst is an embryo at day 5 or 6 of development after fertilization. It is an advanced stage of development where the embryo has approximately 200 cells. In contrast, a day 3 embryo has between 8-10 cells, a much earlier stage.
In our clinics we prioritize the transfer of embryos at the blastocyst stage, in order to gather more information, which allows us to select the embryos with the best prognosis and therefore offer more guarantees in our treatments.
Conventional IVF or in vitro fertilization consists of placing the eggs on a plate together with the spermatozoa inside the laboratory incubator so that the union between the two gametes can take place. In contrast, in ICSI or intracytoplasmic injection we introduce the sperm into the egg to obtain fertilization. It is a technique of greater precision and better results, and is obligatory in patients with severe male factors.
The quality of the gametes, especially the sperm is what will make us decide to use one technique or another.
Embryo selection consists of choosing the best embryo to transfer to the maternal uterus. Normally, in in vitro fertilization processes, we obtain more than one fertilized oocyte and more than one divided embryo. Therefore, we leave them in cultivation inside the incubator in the laboratory where we have optimal conditions for their development that are very similar to those we find inside the uterus. In this way, we can observe their development day by day thanks to the sophisticated incubators and culturing means we use that maintain a controlled and stable environment.
Embryologists observe these embryos taking into account the division times, the synchrony of the divisions, the degree of fragmentation, and other events that will help us to categorize them in order to prioritize the embryo for transfer.
Embryo transfer is a key moment in in vitro fertilization treatment. It normally takes place on the 5th and 6th days of embryo development, when the embryo is in the blastocyst stage. The previously selected embryo is deposited in the patient’s uterus by using a flexible cannula introduced through the cervix (neck of the uterus).
This procedure is performed in the operating room to maintain aseptic conditions, but does not require anesthesia as it is a painless and simple procedure. It lasts approximately 10-15 minutes and the patient, following some very simple instructions about taking medication, can lead a normal life after the procedure.
Endocrinology, fertility and nutrition
PCOS or PCOS stands for polycystic ovary syndrome. It is a reproductive and hormonal problem that affects about 5% of women and can cause problems in conceiving because it often causes lack of ovulation or makes ovulation irregular and unpredictable.
Thyroid hormones play a key role in a woman’s reproductive system. Too much or too little thyroid hormones can cause problems in achieving pregnancy. It is important to perform studies on the TSH hormone in order to address the problem and prescribe the necessary medication to have adequate levels of this hormone.
Although not much is said about the male biological clock, paternal age also plays an important role in the achievement of pregnancy. Aging of the male reproductive organ can cause a slow, yet progressive reduction in the percentage of higher motility sperm.
Teratozoospermia is a cause of male infertility because it is characterized by the presence of amorphous spermatozoa that hinder their ability to fertilize the egg.
These are breaks or lesions in the genetic material of the sperm. The greater the number of these lesions, the lower the integrity of the genetic material and therefore the lower the chances of a viable pregnancy.
Genetics and Immunology for Fertility
PGT stands for Preimplantation Genetic Test and is used to detect genetic and chromosomal abnormalities in embryos to prevent the transmission of serious hereditary diseases. There are 3 variants depending on the alteration to be detected:
· PGT-A for the detection of aneuploidy, e.g. trisomy 21.
· PGT-M for the detection of monogenic diseases, e.g. cystic fibrosis.
· PGT-S, for the detection of structural alterations, such as translocations or deletions, among others.
It is a test that allows us to reduce the transmission of diseases to offspring, since it allows us to observe the genetic risks that could arise from the union between egg and sperm.
This test studies the number of chromosomes, their size and shape in order to determine if there is any genetic defect. It consists of a blood test where a lymphocyte culture is performed to study under the microscope the number of chromosomes and their structure. The human being has 22 pairs of autosomal chromosomes and one pair of sex chromosomes. The normal female karyotype contains two X chromosomes, called 46 XX, and the normal male karyotype contains one X and one Y chromosome, called 46 XY.
Preparation of my endometrium
The endometrial receptivity test informs us about the ideal moment to transfer the embryo and is associated with the specific number of hours for the intake of progesterone that gives way to the opening of the implantation window. The test is crucial to determine if the window of implantation is altered and, therefore, the hours for progesterone intake must be modified prior to performing the embryo transfer.
It is the period of time in which the endometrium (tissue that lines the inside of the uterus) presents the optimal conditions for the implantation of the embryo and making possible the development of gestation.
The pregnancy test consists of a blood test to determine the presence of the hormone beta-HCG (human chorionic gonadotropin), which is the hormone responsible for the development of pregnancy. This test gives us qualitative and quantitative information with respect to confirming whether pregnancy has occurred and the levels of this hormone. It is usually performed 10-14 days after the embryo transfer.
When is the result considered positive? A value above 5 mIU/ml is considered positive. However, when values lower than 10mIU/ml are obtained, these are doubtful signs of possible pregnancy. In these cases, we recommend repeating the blood test and watching the evolution of the beta-hCG hormone. The value should double every 48 hours, this being a sign that the pregnancy is evolving.
A biochemical pregnancy, or early miscarriage, occurs when the development of the embryo stops within a few days of a positive pregnancy test.