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Next Fertility Valencia 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): 1046001581

Get Answers from Next Fertility Valencia

How is FUR and PPF calculated in an IVF treatment?
By Antonio Forgiarini. Last Update: 08/20/2024

The date of the last menstrual period (LMP) in an IVF treatment with fresh embryo transfer can be known by subtracting 14 days from the day of the ovarian puncture.

In the case of an embryo devitrification cycle, the LMP is calculated by subtracting 17 days from the day of transfer if the embryo is 3 days old or by subtracting 19 days if it is a blastocyst transfer.

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Is the PICSI or ICSI technique better?
By Luis Quintero Espinel. Last Update: 08/06/2024

Sperm selection and subsequent microinjection techniques, such as IMSI and/or PICSI, have not demonstrated any superiority to the usual ICSI technique. For this reason, their use in routine clinical practice is not recommended at present.

The PICSI technique, which stands for Physiological Intracytoplasmic Sperm Injection (PICSI), means "Physiological ICSI". The procedure is based on trying to select a sperm that is physiologically apt to fertilize an oocyte and allow normal embryonic development, for which the selection is made by exposing the sperm to substances similar to those found on the surface of the oocyte and assessing their compatibility. However, it has not been demonstrated that its use leads to better results and adds another step to the ICSI process, which could even be detrimental to the technique, in addition to the fact that the exposure of the spermatozoa to exogenous substances could lead to undesired and not always risk-free results.

Imagen: icsi-picsi-imsi-faq

PICSI has not been the only technique used to try to increase the performance of ICSI, but there have been others. It is worth mentioning the IMSI technique (Intracytoplasmic Morphologically Selected Sperm Injection, also known as "Super-ICSI"), in which a high magnification microscope (6,000 X) was used to select a morphologically perfect spermatozoon. However, since it has not been shown to be superior to classic ICSI, and taking into account the high costs involved in its application, it is currently in disuse.

Can transvaginal ultrasound affect embryo implantation?
By Antonio Forgiarini. Last Update: 02/19/2024

Antonio Forgiarini, gynaecologist at the Next Fertility clinic in Valencia answers us in this video:

No, there is no reason to think that it could happen. We use transvaginal ultrasound normally with a recent pregnancy or during the controls, in the first ecography after the the embryo transfer or sometimes while we do the transfer. It's a a very hard moment but, if we cannot see the uterus with transabdominal ecography, we can use the transvaginal one and we have absolutely good results as pregnancies.

Can diabetes be a cause of teratozoospermia?
By Antonio Forgiarini. Last Update: 01/18/2024

Antonio Forgiarini, gynaecologist at Next Fertility Valencia, talks to us about this issue in the following video:

Yes, sometimes it could, especially when we cannot treat properly the diabetes, so we have higher levels of glucemia in the blood during long time, so it can cause some hormonal alteration and could be a cause of teratozoospermia.

Why can't I have a baby if my semen analysis results are normal?
By Luis Quintero Espinel. Last Update: 01/11/2024

In order to have a child, many factors are involved, in addition to the spermatozoa. In order to achieve pregnancy, it is necessary to have a good ovarian reserve and a correct ovulatory process. There must also be a correct anatomical structure of the female reproductive system, which after all is where fertilization and the development of the pregnancy will take place.

On the other hand, it is important that a spermiogram evaluates aspects of the semen, but not all of them. There are specific cases that require special sperm studies, which are requested on a case-by-case basis.

For the reasons mentioned above, it is very important to perform a complete study on both members of a couple. This should include the necessary tests to determine the cause or causes capable of producing difficulties in the reproductive process, since having a clear diagnosis of the problem will indicate the most appropriate treatment to solve the problem or problems and thus offer the best chance of success, which is none other than having a healthy baby, which is the ultimate goal of every couple seeking advice when they have difficulty conceiving.

What is the importance of hormonal analysis in the diagnosis of oligozoospermia?
By Luis Quintero Espinel. Last Update: 01/11/2024

It is essential to look for the reason for the oligozoospermia, since knowing the origin, it will be possible to establish the treatment. This is especially useful in hormonal disorders, which justifies performing hormonal determinations in cases of low sperm count to try to find the cause of this problem and solve it.

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Is natural pregnancy possible spontaneously if there is unknown infertility?
By Antonio Forgiarini. Last Update: 12/11/2023

Antonio Forgiarini, gynaecologist at Next Fertility Valencia, tells us in this video if natural pregnancy is possible spontaneously if there is unknown infertility:

Yes, of course, it's possible. If we don't know the problem, maybe that is not a problem. So, it is possible to achieve a normal pregnancy. So, I always recommend to any couple that is in the waiting list for a treatment they are ready to start a treatment, to continue looking for a normal pregnancy and sometimes it happens that a couple can achieve a good pregnancy when they're waiting to start a treatment.

What is infertility of unknown origin?
By Antonio Forgiarini. Last Update: 12/11/2023

Antonio Forgiarini, gynaecologist at Next Fertility Valencia, tells us about infertility of unknown origin:

Well, unexplained sterility I think it's 25%-30% more or less of all the sterility causes. And it's when we don't know, initially, the cause of the sterility. So, we do all our visits or we run the normal test that we run in the first/second visit of a sterile couple and, really, we don't know why this couple cannot conceive.

Why does sterility occur without apparent cause?
By Antonio Forgiarini. Last Update: 12/11/2023

Antonio Forgiarini, gynaecologist at Next Fertility Valencia, tells us in this video why sterility occur without apparent cause:

Well, we don't know really the cause of the unexplained infertility, because if not, it wasn't an unexplained infertility. So, in these cases I think it's a very good option to do a fertility treatment so we can run more test and, especially, we can see in the laboratory what should happen in the body. So, we can control it and we can give a name to this sterility, a reason for the sterility.

How is infertility of unknown origin diagnosed?
By Antonio Forgiarini. Last Update: 12/11/2023

Antonio Forgiarini, gynaecologist at Next Fertility Valencia, tells us in this video how is infertility of unknown origin diagnosed:

We do our visit, we run all the test, we asure that we have a good ovarian reserve, a good number of oocytes... at least what we expect. We expect good ovarian quality because we are talking about young women, because elder women they already have a cause of the sterility. And we asure that the uterus is normal, in the shape, the endometrium is growing well during the menstrual cycle, we have no tubal problems with the Fallopian tubes, the semen is normal... So, when all these things are okay and are normal, we can talk about an unexplained infertility.

How can pregnancy be achieved when there is infertility of unknown origin?
By Antonio Forgiarini. Last Update: 12/11/2023

Antonio Forgiarini, gynaecologist at Next Fertility Valencia, tells us in this video how pregnancy can be achieved when there is infertility of unknown origin:

Normally, I advise to realize in IVF, an in vitro fertilisation. Sometimes, when we have good prognosis couples, young couples without any pathology where everything seems working perfectly, we can have the temptation to do an artificial insemination, but in these cases we really don't know where is the problem so we are not solving the problem. I don't think it helps a lot in these cases. With an invitro fertilisation we can see all the mechanism that can lead to a pregnancy, we can control them, we can see how they work because we are seeing them in the laboratory, so we can know which are the problems and then we how we can solve them.

Is pregnancy with luteal phase insufficiency possible?
By Antonio Forgiarini. Last Update: 09/27/2023

Antonio Forgiarini, gynaecologist at Next Fertility Valencia, explains in this video whether it is possible to achieve a pregnancy despite an insufficient luteal phase:

Yes it's possible, especially because we don't know if luteal insufficiency is a real problem or not, especially in natural cycle because they are very variable. Normally, when we suspect this problem we can add progesterone. Progesterone is the principal hormone during the lutal phase, so we can add it during the second phase of the menstrual cycle in a natural cycle or after a reproductive treatment we usually always add progesterone during the lutal phase.

Is it dangerous to do IVF after overcoming a hormonal cancer?
By Antonio Forgiarini. Last Update: 09/01/2023

The ovarian stimulation phase of fertility treatment is the most frightening for patients, especially if they have had hormone-dependent cancer.

However, it is always necessary to wait until enough time has passed so that no malignant cells can be detected in the body. At this point IVF could be performed.

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Can there be oxidative stress in spermatozoa if the seminogram is normal?
By Antonio Forgiarini. Last Update: 08/03/2023

Antonio Forgiarini from Next Fertility Valencia tells us whether oxidative stress may be present even though the results of the semen analysis are normal:

Well it's not usual. Normally if we ask or if we have oxidative stress, it will reflect in the seminal parameter, so we have a few spermatozoa or they're not moving correctly, but sometimes it could happen. We can suspect that we have some problem of oxidative stress so some damage in the DNA chain of the spermatozoa when we have bad results with a normal semen and good or sides so a low fertilization so the embryo will not develop correctly to blastocyst or we have some problem like miscarriages when we don't know any other cause so sometimes it's the case to investigate about this reason.

Is it advisable to do the embryo transfer with an endometrial thickness of 6 mm?
By Antonio Forgiarini. Last Update: 05/17/2023

When the endometrium is less than 7 mm thick, fewer pregnancies may occur and the risk of miscarriage increases. However, this does not mean that it is not possible, as pregnancies have been achieved with endometrial thicknesses of up to 4 mm.

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Is oocyte quality the same as oocyte quantity?
By Antonio Forgiarini. Last Update: 05/12/2023

Antonio Forgiarini, gynaecologist at Next Fertility Valencia, tells us in this video whether oocyte quality is the same as oocyte quantity:

No. It's not exactly the same. In most of cases, quality and quantity goes in a parallel way. So, normally, they're related to the age of the woman. All women start, from the adolescence to the menopause, with a certain number of oocytes and they are losing them during the years. And the quality of the oocytes is also going worse during the years. But there's some cases like an early menopause, for example, where we have young women with good quality of oocytes, but a very low quantity, so they've few oocytes but of a good quality. And on the other side, for example, polycystic women, they can have 40-41 years so, normally, we expect low quantity but, for their condition, they have a lot of oocytes. But these oocytes are of bad quality. So, in this cases, they're not the same. So we need more oocytes to have a good pregnancy.

What is oocyte quality?
By Antonio Forgiarini. Last Update: 05/12/2023

Antonio Forgiarini, gynaecologist at Next Fertility Valencia, talks to us about oocyte quality:

Well, we can define the quality of the oocytes as the possibility to achieve a good pregnancy and a healthy baby. So, the ability of the oocyte to fertilize, to develop a good embryo and this embryo to implant and give a a normal pregnancy.

How is egg quality assessed?
By Antonio Forgiarini. Last Update: 05/12/2023

Antonio Forgiarini, gynaecologist at Next Fertility Valencia, tells us in this video how egg quality is assessed:

It's not easy to evaluate the quality. I could say the best form to evaluate the quality of the oocyte is to see how they fertilize and how the embryo will develop, how the embryo will grow and, obviously, the result of the transfer and the pregnancy. So it depends not only on the oocyte but also on the sperm and on the ability of the biologist and the technique that is used in the laboratory, but most of all it depends on the quality of the oocyte.

What are the causes of poor oocyte quality?
By Antonio Forgiarini. Last Update: 05/12/2023

Antonio Forgiarini, gynaecologist at Next Fertility Valencia, tells us in this video what are the causes of poor oocyte quality:

Causes could be different and a lot of them. I think the principal cause is the time. Oocytes are cells that they don't rejuvenate, they don't regenerate, so we start our life with these cells and they follow through the years to the menopause, so they're exposed to pollution, to oxidative stress, to radiations, to a lot of damage that can lower the quality. Obviously, there's some pathologies (like endometriosis or like some cancers, chemotherapy or radiation) that could lower more and more and more this quality.

How can egg quality be improved?
By Antonio Forgiarini. Last Update: 05/12/2023

Antonio Forgiarini, gynaecologist at Next Fertility Valencia, tells us in this video how egg quality can be improved:

It's very hard to improve it. Uhm, I think the best option is to prevent the loss of quality. So, having a normal life, normal habit, a good diet for example, avoid any kind of contamination, pollution... (what we can, obviously). And then we can use some vitamins and antioxidant products that will restore just a little the quality of the oocytes so to they can lower the effect of the oxidative stress.

Is it bad to have nausea and vomiting in IVF beta wait?
By Antonio Forgiarini. Last Update: 04/06/2023

Antonio Forgiarini, gynaecologist at Next Fertility Valencia, gives us the answer in the following video:

Well, it could be a good thing and a bad thing. Obviously it's a bad thing because nobody wants to have nausea and vomit and feel sick obviously, but normally it's cause by the beta hCG (by the pregnancy hormone), so it means that the pregnancy is going well and the embryo is growing and is producing its hormone.

Why are fallopian tubes important?
By Antonio Forgiarini. Last Update: 02/16/2023

Antonio Forgiarini, gynaecologist at Next Fertility Valencia, talks to us in this video about the importance of the fallopian tubes in women. As the doctor tells us:

Well, Fallopian Tubes are fundamental to achieve a normal pregnancy or a pregnancy with an artificial insemination because they're like pipes that connect the ovaries to the uterus, so they let the oocyte (that is ovulated from the ovary) to enter through the uterus and to meet the spermatozoa climbing from the uterus to the fallopian tubes. So, in this case, they let the fertilization. If we have no fallopian tubes it is impossible that the spermatozoa reach the oocyte, so we need to perform an IVF.

What are the causes of a tubal factor?
By Antonio Forgiarini. Last Update: 02/16/2023

Antonio Forgiarini, gynaecologist at Next Fertility Valencia, tells us about the possible causes of female infertility due to tubal factor:

We can have a lot of causes. I think the most frequent are adhesions from infections, from pelvic infections or from endometriosis for example. So, these are pathologies that causes inflammation in the pelvis, some scars, some adhesions that can block the tubes and can close them. We have a lot of other causes that are very rare like agenesia, some women can be birth without the Fallopian tubes for example or they cannot function properly, but I think the two most important causes are endometriosis and infections.

How is a tubal obstruction diagnosed?
By Antonio Forgiarini. Last Update: 02/16/2023

Antonio Forgiarini, gynaecologist at Next Fertility Valencia, tells us about the process to diagnose a possible obstruction of the fallopian tubes:

We can use some diagnostic tests like hysterosalpingography or hysterosalpingosonography. They consist in putting some contrast medium in the uterus with a certain pressure. So, we can push this medium the liquid through the uterus and the Fallopian tubes to the pelvis. In this moment, we can perform an ultrasound scan or a radiography and see that the the contrast medium comes out from the tubes and goes to the pelvis, so in this case we can say that the Fallopian tubes are open. If we cannot see that the medium passes to the pelvis, it remains in the uterus or in the first part of the tubes, we can say that they are closed.

Is there a cure for tubal obstruction?
By Antonio Forgiarini. Last Update: 02/16/2023

Antonio Forgiarini, gynaecologist at Next Fertility Valencia, answers this question:

This is very difficult. In some cases we have just a small light occlusion, so with the pressure of the contrast medium that we use to do the hysterosalpingography, for example, we can open them, but in some cases is not possible. We can try sometimes with surgery, with micro surgery, but it's a very complicated one and in the most cases it produces some scars that will close again these the tubes.

Can pregnancy be achieved if the tubes are blocked?
By Antonio Forgiarini. Last Update: 02/16/2023

Antonio Forgiarini, gynaecologist at Next Fertility Valencia, tells us if pregnancy is possible in women with tubal obstruction:

Yes. Certainly it won't be a natural pregnancy. We need to perform an IVF (an in vitro fertilization), so we can retrieve your oocyte, fertilize them with a sperm in the laboratory, we can develop the embryos, select the embryos we want to transfer and put it in the uterus. So, in this case, the embryo is fertilized, it stays in the uterus (where it has to implant) and we don't need the fallopian tubes.

Is it possible to have sexual intercourse during an IVF pregnancy?
By Antonio Forgiarini. Last Update: 02/03/2023

Dr. Antonio Forgiarini, gynecologist at Next Fertility Valencia, answers us in this video. As the doctor tells us:

Yes, of course. Generally, we advise to avoid sexual intercourses during the first two weeks after the embryo transfer, okay? Because, if we stimulate the uterus, the uterus will contract and it can make the implantation harder, but normally it's not a problem and if the woman is healthy (she's not bleeding, she's not having any problem) it's possible to maintain sexual intercourses.