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Instituto FIVIR clinic Support Group

Fertility Support Group
This clinic is part of the Fertility Support Group Program.
Health Center approved by the Spanish Ministry of Health - License number (CNN): 1046000819

Get Answers from Instituto FIVIR clinic

In which women is the preservation of ovarian tissue indicated?
By Dr. Marita Espejo Catena. Last Update: 03/09/2020

The freezing of ovarian tissue is part of the fertility preservation techniques that are currently available for those women who, in the face of oncological or surgical treatments, may put their reproductive capacity at risk.

The procedure consists of the surgical extraction of the most superficial layer of one of the ovaries and the conservation in liquid nitrogen with cellular protective means. Once the oncological or surgical process is over, that fragment of ovary will be placed again in the place from which it was extracted.

At present, the speed of programming ovarian stimulation cycles to obtain oocytes for cryopreservation means that the preservation of ovarian tissue is relegated to those cases in which oncological/surgical treatment must be applied immediately, when the patients are girls who have not yet had their first menstruation or in those patients with pathologies in which ovarian stimulation to obtain oocytes is contraindicated.

How can I get pregnant if my husband suffers from erectile dysfunction?
By Dr. Marita Espejo Catena. Last Update: 10/21/2019

The inability to deposit sperm in the vagina during sexual intercourse has traditionally been one of the absolute causes of infertility.

Until the introduction of the most complex assisted reproduction techniques, the only option that could be contemplated was the use of a donor sperm sample.

With the development of in vitro fertilization (IVF) techniques, and especially with oocyte insemination by means of sperm microinjection (ICSI), the possibility of conceiving with a scarce number of spermatozoa is feasible.
In patients suffering from impotence that is not a consequence of andrological or psychological medical treatment, an epididymal aspiration or testicular biopsy may be performed.

Epididymal aspiration consists of extracting the sperm stored in the epididymis using local anesthesia, where they acquire the ability to move after being generated in the seminal ducts.

Biopsy is reserved in cases of epididymal aspiration with negative results and requires access to mature sperm directly from the testicular tissue. Although it can be performed under local anesthesia, it can also be performed under anesthetic sedation, which allows the procedure to be performed at different points or on both testicles.

Are premature ovarian failure and early menopause the same thing?
By Dr. Marita Espejo Catena. Last Update: 06/26/2019

Menopause is defined as the absence of menstruation for at least one year, and this is a situation that usually occurs around the age of 51-52. We talk about early menopause when it occurs before the age of 40.
Although menopause is the final consequence of functional ovarian failure, and therefore it can be expected to happen over time, there may be a paradox that ovarian failure exists but that menstruations still occur with a certain regularity. It’s what we call occult ovarian failure.
Therefore, although related, both concepts cannot be confused since the definition of menopause is very specific and concrete.

Is seminal washing in men with HIV effective in achieving a pregnancy without risks for the mother and the foetus?
By Dr. Marita Espejo Catena. Last Update: 06/26/2019

One of the ways of transmission of the human immunodeficiency virus is sexual and, indeed, the seminal sample of an HIV+ male may contain a viral load that allows infection of his partner.
Seminal washing is a laboratory technique that is applied to couples in which the male may be affected by an HIV infection and also by hepatitis B or C virus. It is based on the fact that viruses are located in seminal plasma and non-sperm cells, but not in sperm.
When the spermatozoa are separated from both seminal components, we are sure that the risk of viral transmission has been reduced to the maximum and this is confirmed by the determination of the negative viral load in the treated sample in the laboratory, which shall be used for assisted reproduction.

What is the maximum BMI to be accepted for IVF treatment?
By Dr. Marita Espejo Catena. Last Update: 06/26/2019

Obesity has been shown to decrease the spontaneous fertility of a couple by altering the male factor, that is, by the seminal quality and also by altering the ovarian function.
In addition, gestation rates after assisted reproduction treatments are also reduced when this factor (obesity) is present.
It is probably the female factor that is most affected by a high BMI because alterations in the ovarian cycle are induced that lead to ovulatory dysfunctions and, in addition, a greater number of spontaneous abortions.
Although there is no standardised criterion, a BMI in women equal to or greater than 32 kg/m2 may to interfere with the achievement of gestation.

What reproductive options does a woman with infantile uterus have to become a mother?
By Dr. Marita Espejo Catena. Last Update: 06/26/2019

The infantile uterus is a congenital abnormality of the female genital tract included in the U1 group of the European Society of Reproduction and Embryology (ESHRE) and the European Society of Gynaecological Endoscopy (ESGE). This group to which it belongs is called the dysmorphic uterus and. More precisely, the infantile uterus, is defined as a uterus with a narrow but not thickened uterine cavity of the lateral walls and a 1/3 correlation of uterine body and 2/3 of cervix.
It can be differenciated from the hypoplastic uterus or "naïve uterus" which would include those cases of smaller uterus.
In either case, the chances of gestation remain intact because in the case of the infantile uterus of the ESHRE/ESGE classification, the uterine cavity is configured by a healthy tissue without areas of fibrosis, and because in the case of the hypoplastic uterus, this should be considered a variant of normality.

What is the maximum BMI to be accepted for IVF treatment?
By Dr. Marita Espejo Catena. Last Update: 06/25/2019

Obesity has been shown to decrease the spontaneous fertility of a couple by alteration of the male factor, that is to say, of the seminal quality and also by alteration of the ovarian function.

In addition, gestation rates after assisted reproduction treatments are also reduced when this factor (obesity) is present.

It is probably the female factor that is most intensely affected by a high BMI, since alterations are induced in the ovarian cycle leading to ovulatory dysfunctions and, in addition, a greater number of spontaneous abortions.

Although there is no standardised criterion, it is considered that a BMI in women equal to or greater than 30 may interfere with getting pregnant.

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