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Instituto de Medicina Reproductiva (IMER) Sevilla 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): 0141001798

Get Answers from Instituto de Medicina Reproductiva (IMER) Sevilla

How do I know if I have uterine prolapse? What are the symptoms?
By Dr. Paloma de la Fuente Vaquero. Last Update: 01/27/2021

Uterine prolapse is the dropping of the uterus through the vagina, due to an alteration in the systems that hold the uterus to the pelvic wall (failure of ligaments and other supporting elements). Normally, the patient perceives a lump in the genitals that can be reduced with manual pressure.

It is important to differentiate it from bladder prolapse (descent of the bladder through the vagina) and rectal prolapse (descent of the rectum through the vagina). All of them together are called pelvic organ prolapse.

The main factor in triggering pelvic organ prolapse is previous vaginal delivery (especially instrumental delivery). In any case, all of them are susceptible to surgical intervention if a degree of descent is reached that affects the patient's quality of life, since it is a benign pathology.

Why doesn't my endometrium grow yet on estrogen and progesterone?
By Dr. Paloma de la Fuente Vaquero. Last Update: 11/26/2019

We know that correct endometrial perfusion is key to the growth of the endometrium and therefore to correct embryo implantation. If there is no correct blood supply to the endometrium, even if we administer exogenous hormones, they will never reach it properly. This is the reason why we administer drugs that promote the arrival of blood to the endometrium (sildenafil, pentoxifylline, vitamin A, vitamin E ...) when we are faced with refractory endometrios to treatment with estrogens and progesterone (those that do not grow despite the correct hormone intake).

Is it possible to preserve fertility in children with cancer?
By Dr. Paloma de la Fuente Vaquero. Last Update: 03/13/2019

Today, preservation of fertility is possible if the child has already reached sexual maturity. Once children have reached sexual maturity, it is possible to obtain ejaculate with sperm. In this way, the sample obtained could be frozen to be used in future assisted reproduction treatments.

Sexual maturity is usually attained around 13 years of age.

Is slow oocyte freezing still in use?
By Dr. Paloma de la Fuente Vaquero. Last Update: 02/04/2019

The slow freezing of oocytes was the first oocyte conservation technique to develop. Although it offers good results in sperm conservation, it does not show good survival results in oocytes. The crystals formed as a consequence of slow freezing damage the oocyte, decreasing the success rates in assisted reproduction treatments.

Since the last decade, oocyte vitrification has been the main technique of choice for the conservation of oocytes. Cryopreservation allows us an ultra-fast freezing, which prevents the formation of ice from the water contained in the cell in question (the oocyte), thus avoiding any deterioration. During the vitrification process, we introduce the oocyte into a liquid nitrogen solution and reach a temperature of -196 °C in less than one second. The rapid speed means that the water contained in the oocyte does not freeze and vitrify, becoming a state similar to that of a consistent gelatine.

Why are some people more prone to urinary tract infections?
By Dr. Paloma de la Fuente Vaquero. Last Update: 02/04/2019

Recurrent urinary tract infections (RUTIs) are a frequent affectation of the urinary tract, especially in sexually active young women, pregnant women, and postmenopausal patients (with genital atrophy due to estrogenic deficit) and women with urologic pathology.

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When should I start taking my Cetrotide shots?
By Dr. Paloma de la Fuente Vaquero. Last Update: 02/04/2019

Cetrotide is a drug included in the so-called antagonist drugs, its main function is to prevent spontaneous ovulation.

There are two protocols for the administration of the antagonist drugs. One consists of a single dose (3 mg subcutaneously) with the possibility of repeating it after 72 hours and the other involves a multiple dose (0.25 mg per day subcutaneously). In our environment, the most widely used protocol is the multiple dose.

The antagonist drug should be started on the sixth day of stimulation or when there is a follicle larger than 14 mm. Both protocols are valid and can be used in assisted reproduction treatments.

Is there any concrete symptom indicating that artificial insemination has been successful?
By Dr. Paloma de la Fuente Vaquero. Last Update: 01/23/2019

No, the symptoms are the general ones of any pregnancy and usually appear approximately 15 days after insemination. Among the most common are nausea or vomiting, fatigue, sleep ... but do not differ from those produced by a natural pregnancy.

Can I still undergo IVF when I'm allergic to Cetrotide?
By Dr. Paloma de la Fuente Vaquero. Last Update: 01/23/2019

Yes, there are different protocols in controlled ovarian stimulation. As for the protocol with antagonists (also called short protocol), the use of Cetrotride (cetrorelix acetate) is included, but other antagonist drugs such as Orgalutran (ganirelix) can also be used. As for the long protocol, for pituitary gland arrest, other drugs called agonists are used. Both protocols have demonstrated the same reproductive efficacy, but it is chosen according to the patient's profile.

How and when should Ovitrelle be administered?
By Dr. Paloma de la Fuente Vaquero. Last Update: 01/23/2019

Ovitrelle should always be administered subcutaneously and under medical supervision. The administration takes place once the optimal follicle size is reached to trigger ovulation, which coincides with the middle of the menstrual cycle.

What is embryo implantation?
By Dr. Paloma de la Fuente Vaquero. Last Update: 01/23/2019

Embryo implantation is the process by which the embryo joins the internal uterine wall known as the endometrium. The embryo is able to penetrate the uterus. From this moment on, the formation of the future placenta will begin, which will provide nutrition, sustenance and protection for the pregnancy.

Is acupuncture effective for the treatment of endometriosis?
By Sarai Arrones. Last Update: 11/28/2018

Acupuncture helps regulate hormonal imbalances and relieve pain. According to some experts, acupuncture, accompanied by phytotherapy (medicinal plants) and dietary supplements, is very useful for treating endometriosis naturally.

What symptoms may indicate that there is a complication with the pregnancy?
By Sarai Arrones. Last Update: 02/09/2016

Risk symptoms are less common throughout pregnancy and can alert a woman that something is wrong. If any of the following symptoms appear, the recommendation is to contact the gynecologist immediately to determine the cause and look for a solution.

  • Vaginal bleeding: slight bleeding may be normal, but an abundant one is worrisome as it may be a sign of abortion or ectopic pregnancy.
  • Pain or burning when urinating: may be signs of a urinary tract infection.
  • acute stomach pain.
  • Very severe headache.
  • Visual problems.
  • Sudden weight gain.
  • Hand and face swelling.
  • Fever.

Also, don't be alarmed at any unusual or uncommon symptoms. It is important to determine when it is something serious and when it is simply an effect of changes in the body. It is common for first-time pregnant women to see a specialist for any variation or discomfort.

Is hysterectomy the best treatment for endometriosis?
By Sarai Arrones. Last Update: 04/17/2014

Hysterectomy is the last resort for treatment of endometriosis. It is only performed in very specific cases and in those women who have already had children and does not guarantee the elimination of pain. There are other effective treatments for pain such as natural and hormonal therapies.

Can men have pregnancy symptoms?
By Sarai Arrones. Last Update: 08/21/2012

Yes, it is possible for a man to experience what is called empathic pregnancy or Couvade syndrome during his partner's gestation. It comes from the French word couver, which means incubate or create.

Men present symptoms similar to those of women, such as abdominal pain, mood swings, nausea, vomiting, fatigue and weight gain, among others. Symptoms often cease at the time of delivery, so the only cure is the birth of the baby.