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The non-invasive prenatal test is a prenatal test that is performed on maternal blood and allows the detection of the most frequent chromosomal abnormalities (Down syndrome and other trisomies). This genetic analysis has a sensitivity close to 95% from 10 weeks of gestation.
If the patient has undergone assisted reproduction treatment in which PGD has been performed, the fetal chromosomes have been studied directly. For this reason, the study for the diagnosis of aneuploidy with another method would not be necessary
Azoospermia is defined as the absence of spermatozoa in the ejaculate. The testicle is the organ that produces spermatozoa after they are transported and stored in the seminal vesicle, a contiguous organ in intimate relationship with the prostate. Azoospermia may be due to a lack of production by the testicle or to an obstruction during its transport to the seminal vesicle.
Thus, the basic study for the diagnosis of azoospermia consists of a spermogram and a testicular biopsy.
Endometrial preparation requires the administration of estrogens and progesterone sequentially during the treatment cycle. A complete cycle may require approximately 6 mg/day of estradiol + 800 mg/day of micronized progesterone, which should not be more than 150 euros. However, if pregnancy is achieved, this medication should be extended until the 12th week of gestation.
The window of implantation is the period of time in which the endometrium presents the optimal conditions for embryo implantation to be possible. This period is usually between days 20 and 24 of a 28-day menstrual cycle.
To maximize the chances of pregnancy, embryo transfer in an assisted reproduction treatment should be performed at the optimal time within the implantation window, when the endometrium is most receptive.
In principle, we should not resort directly to a treatment with donor sperm without first trying in vitro fertilization techniques with your own sperm.
However, if it is a severe teratozoospermia or if gestation is not achieved using the patient's own sperm, the alternative would be to opt for donor sperm.
It is possible, but not recommended. Vitrification of eggs that have been previously thawed will only be performed in cases of force majeure, for example, when it has not been possible to obtain sperm for insemination. Normally, when eggs are thawed it is for use in an assisted reproduction treatment. These eggs will be inseminated and embryos will be created. These embryos can be re-vitrified without any problem.
Re-vitrifying an egg that has just been devitrified would increase the osmotic stress, and although it is possible to do so, it is also possible that an egg could be damaged in the process. It must be taken into account that the ovum is the largest cell in the human body, and therefore, the most sensitive in the vitrification and devitrification process.
Without a doubt, vitrification. This technique is the one that has really made it possible to offer the technique of female preservation with all the guarantees.
First of all it would be necessary to distinguish the two techniques and their history, as well as why the conventional freezing technique was relatively valid for embryos but not for oocytes.
With the conventional freezing technique, cryoprotectants are used in low concentration for a relatively long time and a slow progressive cooling. This sometimes results in the formation of crystals that are lethal to the cells. The larger the cell, the greater the possibility of crystals forming, and if we take into account that the egg is the largest cell in the human body, this explains why this technique has produced very poor results with eggs.
The vitrification technique consists of exposing embryos and oocytes to high concentrations of cryoprotectant in a relatively short time and ultra-fast cooling (in the order of 20,000 ºC/min). As a result of this process a vitreous mass is formed (hence the name vitrification) avoiding the formation of crystals that would damage the cell.
Therefore, vitrification of eggs is undoubtedly better than freezing. It is this technique that has really made it possible to offer the technique of female preservation in a standardized way with all the guarantees.
Endometrial or uterine polyps are usually glands in the endometrial tissue that, for some reason, grow abnormally. This abnormal growth can be complicated by the hormone therapy required for a stimulation cycle in assisted reproductive treatment.
It should be understood that in the first phase of the menstrual cycle there is the secretion of estrogens that cause proliferation of the endometrial glands. However, in the second phase of the cycle, after ovulation, progesterone is the predominant hormone that causes endometrial atrophy and consequently the menstrual outcome if pregnancy does not occur.
For this reason, sometimes menstruation itself is responsible for eliminating the polyps, but if they persist, surgical removal is necessary prior to assisted reproduction treatment. The vast majority of endometrial polyps are benign, but in perimenopausal women may be the expression of endometrial cancer, which makes histological evaluation of the endometrium necessary.
Varicocele in the male refers to dilatation of the spermatic vein and surgical correction consists of sealing the vein. This correction can be approached locally or by translaparoscopic surgery.
It is common that after varicocele surgery a transient inflammatory process is generated and fluid accumulates in the scrotum (hydrocele). For this reason, the man may have the sensation that the testicles have swollen.
Yes, cervical mucus changes its density, color and texture throughout the menstrual cycle, as it depends on hormonal variations. In addition, these changes in cervical mucus provide information about the period when pregnancy is most likely to occur.
The success of the ovodonation treatment depends mainly on an adequate synchronization between the embryo and the receptive endometrium, which will allow a correct nidation for the development of the pregnancy.
Ovodonation is an in vitro fertilization (IVF) treatment in which eggs from a healthy and young woman (donor) are used for a different woman (recipient) to receive them, in order to generate embryos. These embryos are then transferred into the uterus of the recipient woman.
IVF with ovodonation is indicated in cases in which the patient cannot or it is not advisable to use her own eggs for various reasons, such as absence of ovaries, low ovarian reserve, poor oocyte quality, genetic alterations, absence of pregnancy after several IVF cycles, etc.
The risk of testicular cancer is 3 to 10 times higher in patients with cryptorchidism than in patients with normodescent testes, and surgical intervention to lower the testicles (orchidopexy) does not prevent future malignancy. The need for follow-up in these patients is emphasized, and removal of the testicle (orchiectomy) is recommended in post-pubertal patients.
The highest risk cases are those in which the testicle has remained inside the abdomen. The lowest risk cases are those in which the testicle was already in the groin canal, almost in the pouch, and which have undergone surgery.
It is important to diagnose the disease early. To do this, testicular self-examination should be performed, palpating the testicles in search of nodules. It is recommended to visit the family doctor or urologist once a year to perform an analysis of tumor markers that can give the alarm signal of a tumor at birth. On many occasions an abnormal result may appear without there being a tumor, so the analysis should be repeated after a few weeks and, if the abnormality persists, an ultrasound scan of the testicles should be requested.
Delayed abortion, which we also know as missed abortion, is one that takes place during the first trimester of pregnancy. It is usually due to a situation where the fetus does not progress and stops growing during pregnancy.
After having performed three unsuccessful DAI (donor artificial insemination) cycles and having ruled out active tubal and endometrial pathology, constituting an entity without apparent cause, it is advisable to opt for in vitro fertilization (IVF). This reproductive option will provide accurate information on the quality of the eggs, fertilization and embryo evolution.
Endometrial hyperplasia is a condition of the endometrium characterized by exaggerated proliferation. This condition can affect the endometrium as a whole or in a focal form constituting the so-called endometrial polyps.
In any case, abnormal proliferations of the endometrial tissue should be observed and sometimes a biopsy is recommended to rule out complex pathologies.
The endometrium is the biological tissue where the embryo will nest. For this reason, an abnormal development of the endometrium will generate an extremely hostile and inadequate terrain for gestation to take place.
The most frequent complication is multiple pregnancy determined by the development of multiple follicles in intrauterine insemination (IUI) and the transfer of 2 or more embryos in in-vitro fertilization (IVF).
Ovarian hyperstimulation syndrome is a less frequent but potentially serious complication for which we detail prevention and clinical management strategies. In addition, complications arising from follicular aspiration such as hemorrhage and infection, among others, are discussed.
However, thanks to the development of new pharmacological and laboratory technologies, assisted reproductive procedures are performed within a framework of ample safety.
Pregnancies achieved with fertility treatments have no greater risk of complications than any other.
The precautions are no different from those of any pregnant woman, including the continuation of sexual activity. Once the embryo has implanted, the risks of a pregnancy achieved through IVF are no different than any other. In addition, the recommendations and special care will be more related to the woman's age, in cases of advanced age, and/or history of previous pathologies.
The clinical picture of oligoasthenozoospermia refers to a combination of several factors. Specifically, it refers to a decrease in the quantity, motility and morphological alterations of spermatozoa.
For this reason, the best option for treatment and achieving pregnancy would be in vitro fertilisation with optimal sperm selection, i.e. IVF-ICSI.
The advanced semen analysis is a test associated with the basic semen analysis to assess its quality reporting the amount of sperm with progressive motility in a sample of capacitated semen. Sometimes, this study allows defining the appropriate assisted reproduction treatment.
In vivo sperm production fluctuates over time, so it would be advisable to perform at least two functional tests within a reasonable period of time to establish an adequate diagnosis.
Hysterosalpingography is a gynecological imaging study that is performed with an iodinated contrast substance, so the administration of the same in patients with hyperthyroidism could complicate and aggravate this condition.
In these situations, a thorough study of thyroid function and a timely endocrinological consultation is recommended.
Elevated prolactin levels can influence the production of other hormones or their regulation, especially FSH and LH, hormones involved in follicular genesis and ovulation. Therefore, when there are high levels of prolactin, could lead to a lack of ovulation and often cycles without menstruation in women
These are the acronyms for the genetic studies that are performed on an embryo before it is transferred to the uterus. On the one hand, PGD refers to preimplantation genetic diagnosis; while PGT stands for Preimplantation Genetic Test.
Currently, the most commonly used term for this complementary technique is PGT.
Artificial insemination (AI) is a low-complexity assisted reproduction technique that consists of placing the partner's or donor's sperm into the woman's uterus. The most frequent indications are sterility without apparent cause and cases of male factor with slight alterations.
The decrease in ejaculate volume is called hypospermia and this happens when the volume of seminal fluid is below 1.5 ml. Among the most frequent causes of hypospermia is the age of the male, prostate surgery, inflammatory processes of the pelvis, and the male reproductive system.
Sometimes hypospermia is accompanied by a decrease in the concentration of sperm (oligozoospermia), which significantly reduces the chances of achieving a natural pregnancy and will require assisted reproduction treatments.
The epididymis is a tubular structure in charge of transporting sperm from the testicle to the seminal vesicle. Acute or chronic inflammation of the testicle is called epididymitis.
The most frequent causes of this condition are infectious, and the symptoms are recognized by testicular pain, increased scrotal size, urethral discharge, and even fever. Erectile dysfunctions in cases of epididymitis are secondary to the above-mentioned symptoms.
