There are various assisted reproductive techniques, but all of them have a common goal: to help individuals/couples to have children.
Artificial insemination (AI), in vitro fertilization (IVF), oocyte donation, embryo adoption, and reception of the couple's oocytes (Reciprocal-IVF)) pursue this goal immediately or close to it.
Oocyte vitrification (fertility preservation) aims to freeze eggs in case they need to be used in the future.
This objective seems simple but we must qualify it. The goal is to achieve pregnancy as soon as possible and in the safest way possible for both mother and child.
First of all, an adequate evaluation of the patient who wants to gestate must be carried out and an assessment must be made to ensure that the pregnancy itself does not pose a risk to the patient. We can also carry out studies to minimize the chances of the offspring having any disease.
Secondly, we may think that with more eggs, we have more options. True, but with its risks. The doses of treatment that each patient needs must be assessed, since "ovarian hyperstimulation" can occur when the ovary reacts excessively to stimulation with gonadotropins. Currently, thanks to the experience and new guidelines, this complication is practically nonexistent and, if it does occur, we have several measures to minimize it.
We continue with the more-is-better theory, which is erroneous. More follicles in insemination or the transfer of more embryos give us more chances of pregnancy (some studies indicate that this is not always the case), but we risk producing multiple pregnancies. This entails more risk during pregnancy, both for the mother, who will have more possibilities of suffering hypertension, preeclampsia, gestational diabetes, cesarean section... and for the children, who are at greater risk of being premature with all its consequences.
Finally, many times patients come to our centers exhausted, disillusioned, with fear, uncertainty, doubts... it is also part of our job to calm, to accompany, and to give hope again.
