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Ginemed Madrid Center Support Group

Fertility Support Group
This clinic is part of the Fertility Support Group Program.
Health Center approved by the Spanish Ministry of Health with the Standardized Center Code (CCN): CS0595

Get Answers from Ginemed Madrid Center

Does quitting smoking have advantages for assisted reproduction?
By Guillermo Quea Campos. Last Update: 12/13/2022

Yes. By quitting smoking, the reproductive future of couples or patients who want to have a baby will improve.

Does smoking affect artificial insemination?
By Guillermo Quea Campos. Last Update: 12/13/2022

In the case of reproduction, virtually all studies support the fact that smoking has a negative impact on the reproductive future. When women smokers are compared to non-smokers, the infertility rate and the time to conception is longer in women who smoke than in non-smokers. Smoking appears to accelerate the loss of eggs and reproductive function and may accelerate the time to menopause by several years.

In relation to men, those who smoke have a lower sperm count, lower motility and fewer normal forms in seminograms. However, the effects of smoking on male fertility have not been conclusive.

Imagen: effects-of-tobacco-on-ia-faq

Therefore, in cases in which Artificial Insemination treatments are indicated, if we have a semen sample with decreased concentration, motility and morphology, this treatment could not be indicated. In the case of women who smoke, as the quality and quantity of eggs decreases, pregnancy rates in this type of treatment will also be compromised.

What effects does coffee have on male fertility?
By Guillermo Quea Campos. Last Update: 11/15/2022

Generally, specialists recommend a decrease in coffee consumption in men who are seeking to achieve pregnancy. This is because caffeine can alter the metabolism of Sertoli cells involved in sperm formation and thus spermatogenesis.

One study confirmed that IVF rates decrease by approximately 30% in men who consume more than one cup of coffee a day. However, it is important to note that coffee consumption will decrease sperm motility but not sperm quality. However, further studies are needed to confirm these findings.

Can I have anovulation due to lack of progesterone?
By Guillermo Quea Campos. Last Update: 11/08/2022

No. The lack of progesterone is conditioned by the lack of ovulation, not the other way around.

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Is it possible to have a high AMH and a low AFC?
By Guillermo Quea Campos. Last Update: 10/25/2022

In principle, this would not be possible. Nevertheless, it can happen and you should be guided by what is visualized in the ultrasound to determine the state of the ovarian reserve.

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Is there any treatment to achieve natural pregnancy with oligozoospermia?
By Guillermo Quea Campos. Last Update: 10/04/2022

Decreased sperm concentration (Oligozoospermia) could be one of the reasons why pregnancy cannot be achieved in a natural way.

In the clinic we always request a sperm capacitation apart from a semen analysis. In this way we can decide if this sample is suitable for intrauterine insemination (IUI), in vitro fertilization (IVF) or ICSI cycles.

Do I need IVF after 10 months of trying for a natural pregnancy without success?
By Guillermo Quea Campos. Last Update: 09/26/2022

Sterility is defined as the inability of a couple to achieve pregnancy after 12 months of active sexual life without the use of contraceptive methods. However, this definition decreases as the woman's age advances and is reduced to 6 months after the age of 35.

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Is the man's BMI also taken into account for IVF and AI?
By Guillermo Quea Campos. Last Update: 09/14/2022

There is very limited information about the effects of obesity and overweight in the male and the results of fertility treatments.

Most studies conclude that there is no relationship between high male BMI and semen quality.

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Can ovulation timing vary with age?
By Guillermo Quea Campos. Last Update: 09/13/2022

Yes, the timing of ovulation changes with age. During reproductive life, women usually have regular menstrual cycles and ovulate each month. These eggs mature during the menstrual cycle until ovulation occurs. This process, although very simple to explain, is quite complex because many substances are involved that will favor recruitment and dominance selection, causing the ovarian reserve to decrease throughout the reproductive life.

We know that the ovarian reserve begins to decrease from the age of 35 years. From 38-39 years of age, in addition to the decrease in ovarian reserve, the quality of the eggs also decreases. Therefore, the chances of pregnancy are compromised.

Because of this, the time of ovulation will change with age according to the ovarian reserve, in some cases becoming anovulatory cycles and finally disappearing menstruation and entering the menopausal/climacteric period.

When will my period come after cancellation of an IVF cycle?
By Guillermo Quea Campos. Last Update: 08/04/2022

After cancelling an IVF, usually the cycle continues normally and the menstrual period will come at the time it should occur. This is as long as the IVF cancelled before reaching the puncture, to avoid the risk of hyperstimulation, because there has not been a correct fertilization or embryo development.

However, when the cycle is cancelled, there is the possibility of administering progesterone in such a way as to provoke a period by deprivation, so that the period will come on about 5 days after the suspension of progesterone.

What can pink discharge after embryo transfer indicate?
By Guillermo Quea Campos. Last Update: 07/29/2022

Once the embryo transfer has been performed, and up to the moment when the pregnancy test has to be done 10 days after the transfer (beta wait), there may be some discomfort that is usually normal.

One of these discomforts is bleeding, which is spotting that is less than a period and can range from pink to dark brown and is limited to two or three days after the transfer. This spotting is usually due to the cleaning of the cervix prior to the canalization or due to the canalization itself with the transfer cannula to enter the uterine cavity and leave the embryo inside the uterus.

However, as mentioned above, this is a spotting that is less than a period and is limited to itself, but if it occurs, it is necessary to contact your doctor who will give you the necessary indications to continue with the treatment.

Is menstrual pain related to fertility?
By Guillermo Quea Campos. Last Update: 04/27/2022

Many women have painful menstrual cycles, also called Dysmenorrhea, which is usually due to the contractions that the uterus produces for the detachment of the endometrium and its expulsion through the vagina.

There are two types of dysmenorrhea:

Primary dysmenorrhea
is the most common type and there is no associated cause. This type, as mentioned above, is due to contractions of the uterine musculature by an overproduction of substances called "Prostaglandins". This pain may begin one or two days before the menstrual period and usually has a very short duration. Primary dysmenorrhea usually begins in youth, just after the first menstruation (menarche) and becomes self-limiting as age advances and even disappears in some cases after the first childbirth.
Secondary dysmenorrhea
usually starts some years later and is caused by diseases affecting the uterus, such as endometriosis or uterine myomatosis. In addition, it is common for this pain to worsen over time. Secondary dysmenorrhea could be a cause of infertility depending on the underlying diagnosis.
Imagen: menstrual-pain-fertility-dysmenorrhea-faq
What tests are included in the repeat miscarriage study?
By Guillermo Quea Campos. Last Update: 04/05/2022

Normally, the study of repeated miscarriages consists of an analysis of the Antiphospholipid Syndrome, genetic testing, assessment of thrombophilias, hysteroscopy, and transvaginal ultrasound to study anatomy.

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Is it advisable to perform AI in women with polycystic ovaries?
By Guillermo Quea Campos. Last Update: 03/04/2022

Polycystic or multicystic ovaries are those that have several follicles and it is important to distinguish them from polycystic ovary syndrome (PCOS), since they are different alterations.

In the case of women with polycystic ovaries, it is possible that there is some alteration in menstruation and difficulty in releasing the egg, that is, for ovulation to occur. This is why a controlled ovarian stimulation can be performed, regulating ovulation and scheduling the performance of the artificial insemination (AI) cycle.

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Are there other medications for ectopic pregnancy besides methotrexate?
By Guillermo Quea Campos. Last Update: 03/02/2022

An ectopic pregnancy is the implantation of the fertilized egg outside the uterine cavity. Other medical treatment options such as Prostaglandins, Actinomycin D, Potassium Chloride, Hyperosmolar Glucose, Monoclonal Antibodies or simple aspiration have been used, but none of these have shown more efficacy than the use of Methotrexate.

Is it possible to perform the puncture if there is an endometrioma?
By Guillermo Quea Campos. Last Update: 02/16/2022

Follicular puncture is a simple procedure performed to extract eggs from patients undergoing controlled ovarian stimulation in assisted reproduction treatments. It is a procedure that is performed under sedation and on an outpatient basis.

Previously, the patient will have attended her check-ups during the stimulation and, once her doctor finds that the follicles that have developed during the cycle have reached a mature size (18-20 mm), the puncture will be scheduled. On this day, the patient will come to the clinic on an empty stomach so that once in the operating room, the anesthesiologist can proceed with the sedation and, by ultrasound, perform the follicular aspiration procedure.

When the follicular puncture is performed by ultrasound, the doctor in charge of performing it will observe if any image compatible with endometrioma is evident, avoiding puncturing this image and proceeding to the aspiration of all the follicles that grew during the stimulation.