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Ovoclinic Responds

Ovoclinic responds to the FAQs about Fertility Treatments

FAQ

What is Endometrosis?

Endometriosis is a condition that affects an increasing number of women during their reproductive years. This disease is typically very painful, because the tissue that lines the uterus, called the endometrium, implants outside the uterus.

Thanks to assisted reproduction treatments, many women with endometriosis are able to get pregnant.

What is the ROPA Method?

The ROPA method is a fertility treatment that helps a same-sex female couple to have a baby. It works like IVF (In Vitro Fertilisation), and uses the egg of one of the women and sperm from an anonymous donor to create an embryo that is then transferred to the other woman’s uterus.

What is EmbryoDonation?

Embryo donation, or embryo adoption, consists of an assisted reproduction treatment using embryos donated by patients who do not need them for their own treatment, and who wish to help other people become parents. In embryo adoption, we skip the process of fertilising the egg and the incubation period, as the embryos are vitrified beforehand and are ready to be transferred to the patient.

What types of assisted reproduction treatments are there?

Depending on each patient’s medical history and situation, there are different types of assisted reproductive treatments available. They include artificial insemination (AI), in vitro fertilisation (IVF), oocyte donation (or double donation) and embryo adoption.

IS PREGNANCY WITH ASSISTED REPRODUCTION THE SAME AS A NATURAL PREGNANCY?

A pregnancy achieved with an assisted reproduction treatment occurs in the same way as a natural pregnancy. The only difference between the two is that in assisted reproduction, fertilisation is performed in the laboratory (IVF, egg donation). Once the embryo is implanted in the patient’s uterus, the symptoms, feelings, and development of the baby for nine months are exactly the same as if it were a natural conception pregnancy.

What is a Genetic Compatibility Test for?

Genetic Compatibility Testing serves to reduce the chances of transmitting diseases to your offspring. Most healthy people have some recessive mutation in their genes, but do not manifest it. This is called being a carrier. If your partner has the same mutation, there is a 25% chance that your child will carry it, and a 50% chance that they will be a carrier. Although rare, recessive diseases are usually serious and incurable. The Genetic Compatibility Test is used to detect them.

WHAT IS PROGESTERONE?

Progesterone is one of the hormones necessary for a healthy pregnancy. High levels of progesterone stop the uterus from contracting and triggering early labour. The placenta makes most of the progesterone that the mother and baby require. In assisted reproduction, it should be noted that progesterone levels rise after ovulation, which prepares the endometrium for the embryo to implant. If this does not occur, progesterone levels decrease, so they can regenerate in the following menstrual cycle.

WHAT IS SECONDARY INFERTILITY?

Secondary infertility occurs when pregnancy is not achieved or the patient suffers several miscarriages after having given birth previously. Many couples or women turn to fertility treatments to have a second child, despite having conceived their first child naturally.

WHAT IS IN VITRO FERTILISATION (IVF)?

In Vitro Fertilisation (IVF) is a highly complex assisted reproduction treatment. The union of egg and sperm is done in vitro, in the laboratory, in order to obtain embryos of optimum quality and then transfer them to the patient’s uterus. Pregnancy is achieved when the embryo implants correctly in the uterus.

WHEN IS IN VITRO FERTILISATION (IVF) RECOMMENDED?

In Vitro Fertilisation (IVF) is recommended in the following cases:

  • Patients with previous failures in artificial insemination (AI) treatments.
  • Older women with poor quality eggs.
  • Women without fallopian tubes, or with lesions.
  • Women with severe endometriosis.
  • Couples in which the male partner has poor semen quality.
  • Patients who need a pre-implantation genetic diagnosis.

WHEN IS IN VITRO FERTILISATION (IVF) RECOMMENDED?

In Vitro Fertilisation (IVF) is recommended in the following cases:

  • Patients with previous failures in artificial insemination (AI) treatments.
  • Older women with poor quality eggs.
  • Women without fallopian tubes, or with lesions.
  • Women with severe endometriosis.
  • Couples in which the male partner has poor semen quality.
  • Patients who need a pre-implantation genetic diagnosis.

WHAT DOES A FERTILITY DIAGNOSIS FOR COUPLES INCLUDE?

A Fertility Diagnosis for Couples includes:

  • Initial medical appointment
  • Gynaecological examination and ultrasound scan
  • Anti-Müllerian Hormone Test (to determine ovarian reserve)
  • Semen analysis (to determine sperm quality)
  • Consultation for results

WHAT IS COVERED BY THE OVOCLINIC PREGNANCY AND LIVE BIRTH GUARANTEE?

The Pregnancy and Live Birth Guarantee includes:

  • Initial medical assessment to determine the most appropriate treatment for each patient.
  • Ultrasound check-ups, blood and pregnancy tests.
  • Unlimited attempts at embryo transfers for the duration of the guarantee.
  • These plans have a duration of 24 months, extendable for a further six months if the Medical Team so advises.
  • If the treatment is unsuccessful, 100% refund of the cost of the selected plan.

WHERE ARE THE OVOCLINIC CENTRES LOCATED?

Our clinics are located in Madrid, Seville, Marbella and Ceuta.

WHAT IS BETA-HCG AND WHY IS IT REFERRED TO AS "THE PREGNANCY HORMONE"?

Human chorionic gonadotropin, more commonly known as Beta-hCG, is a glycoprotein synthesised by embryonic tissues. This hormone is released by the embryo when it implants in the mother’s uterus, hence the name “pregnancy hormone.” Beta hCG is detectable in both urine and blood samples from approximately 10 days of gestation when the embryo starts to develop. For this reason, at Ovoclinic we carry out a blood test to measure the levels of this hormone and determine the existence of pregnancy following the embryo transfer, ten days later.

HOW ARE EMBRYOS CLASSIFIED?

Embryos are classified according to their quality in order to select the one to be transferred to the mother’s uterus in assisted reproduction treatments such as egg donation or IVF. Certain parameters are taken into account, such as the number of cells and their symmetry, the type and percentage of cell fragmentation, and the rate at which the embryo divides, among others.

They are classified as A, B, C and D:

– Category A: embryos of optimal quality and maximum implantation capacity.

– Category B: embryos of good quality and implantation capacity.

– Category C: Embryos of medium quality and implantation capacity.

– Category D: Embryos of low quality and implantation capacity.

When our embryologists analyse the embryos before carrying out the transfer, they select A or B category embryos, as these are the ones that are most likely to implant and achieve the expected positive beta. The remaining embryos of other qualities can be vitrified for future attempts or donated to couples who need them for treatments (embryo donation).

CAN I GET PREGNANT IF I HAVE HAD MY TUBES TIED?

Tubal ligation is a permanent method of contraception because it makes it impossible to get pregnant naturally. However, even if your tubes are tied, there are two ways to get pregnant:

  • In vitro fertilisation (IVF): a method where the egg and sperm are combined in the laboratory and then transferred to the woman’s womb.
  • Tubal ligation reversal: this is a surgical procedure to reunite the ‘closed’ ends of the fallopian tubes, although it does not guarantee 100% fertility.

WHAT IS THE INVOCELL DEVICE?

The INVOcell device is the first and only medical device for intravaginal culture that allows embryo development to take place inside the prospective mother’s body, as it would naturally occur. Depending on the case and the quality of the sperm, either eggs and sperm are transferred (conventional IVF) or the eggs are transferred after microinjection of the sperm (IVF/ICSI). The INVOcell is then inserted into the vagina below the cervix and held in place by the retention device. In this way, the development of the embryo takes place inside the woman’s body and the embryo is with her from day one.

What is ICSI?

ICSI stands for Intracytoplasmic Sperm Injection, and it is the most precise fertilisation technique available. The embryologist selects a single sperm from a sperm sample in the laboratory and inserts it into the egg using a micropipette (a special micro-needle). This allows the selection of the sperm with the best conditions (morphology and motility).

This is now the most common fertilisation technique for all types of treatments requiring laboratory fertilisation. It is particularly indicated for couples where the man has been diagnosed with poor sperm quality (low sperm concentration, poor motility or morphology), couples with cryopreserved (frozen) semen samples, men with azoospermia (almost no sperm) or who have had a vasectomy, or women without a male partner who want to undergo a treatment with donor sperm.

I’M OVER 30 AND I WANT TO FREEZE MY EGGS. HOW DOES THE PROCESS WORK?

If you’re over 30 years old, you can freeze eggs by means of egg cryopreservation, which allows you to have the option of becoming a mother at a later date. The steps to follow during the process are as follows:

  1. Ovarian stimulation: to promote the development of multiple ovarian follicles.
  2. Ovarian puncture: A small intervention to extract the eggs.
  3. Freezing in liquid nitrogen: The extracted eggs are immersed in liquid nitrogen for preservation.
  4. These eggs will be stored until you decide to take the step without their quality being affected.

HOW CAN IMPLANTATION FAILURE BE RESOLVED?

In order to resolve implantation failure or prevent its recurrence, the cause must be studied and treated using one of the following techniques: culture to blastocyst, PGD (Preimplantation Genetic Diagnosis), Endometrial Receptivity Test (ERA), Assisted Hatching, among others.

WHAT IS IMPLANTATION FAILURE?

Implantation failure occurs when pregnancy is not achieved after three good quality embryo transfers.

Implantation failure can be due to:

  • Embryonic causes: if the embryo has a genetic alteration from the egg or sperm.
  • Uterine causes: those that affect the endometrial receptivity (endometrial problems, polyps or implantation abnormalities).
  • Systemic causes: those not directly related to the reproductive system, such as immune system or blood clotting disorders.

WHAT IS DENUDATION?

Oocyte denudation is the process of removing the cumulus cells surrounding the egg after follicular puncture and before IVF-ICSI.

WHAT ARE SPERM RETRIEVAL TECHNIQUES?

Sperm retrieval techniques are a range of procedures for men who have no sperm in their ejaculate. or who’ve had a vasectomy. Sperm can be retrieved from the epididymis (a narrow, elongated tube at the back of the testicle) or from the patient’s testicle itself using different, more complex techniques.

UP TO WHAT AGE CAN I BECOME A MOTHER?

The pace of modern life is pushing back the age at which women are getting pregnant, so many couples and single women are asking themselves what the age limit is for having children. After the age of 35, the chances of conceiving naturally decrease due to the decline in ovarian reserve and egg quality. This decline increases from the age of 40 as the menopause approaches. Thanks to current assisted reproduction techniques, it is no longer impossible to become pregnant at an advanced maternal age, although it is recommended that you do not become a mother after the age of 50, as the risk of complications increases.

WHAT IS AN EMBRYO BIOPSY?

An embryo biopsy is a technique carried out in the IVF laboratory to determine the genetic or chromosomal information in order to select the best quality embryo for transfer.

WHAT IS OVARIAN RESERVE?

Ovarian reserve is the number of eggs in your ovaries at a given time. This can be measured by various tests, such as a follicle count using a vaginal ultrasound, or a blood test that measures anti-Müllerian hormone (AMH), which tells us whether your ovarian reserve is normal, high or low, depending on your age. Knowing your ovarian reserve allows you to plan your maternity and, if necessary, opt for egg cryopreservation, which allows you to choose the most suitable time to become a mother.

WHEN IS AN EMBRYO BIOPSY RECOMMENDED?

An embryo biopsy is recommended when the couple are carriers of karyotype abnormalities that may result in babies born with a rare disease. It is also recommended for women who have suffered recurrent miscarriages, implantation failure or are of advanced age, and for men with significant sperm abnormalities.

HOW IS AN EMBRYO BIOPSY CARRIED OUT?

An embryo biopsy is carried after the embryo has developed to the blastocyst stage (day 5). So as to reduce the risk of damaging the embryo, cells that would form part of the placental structures, and not the embryo, are removed. These cells are analysed in the laboratory to ensure that the embryo to be transferred has the greatest potential to produce a healthy baby.

WHAT IS CONVENTIONAL IVF?

Conventional in vitro fertilisation (IVF) is a very complex form of assisted reproduction. In conventional IVF, the egg and sperm are combined in a glass dish. The egg is placed next to a drop of thousands of sperm cells, followed by a wait of 24 hours for fertilisation to occur naturally.

WHEN IS ARTIFICIAL INSEMINATION (AI) RECOMMENDED?

Artificial insemination (AI) is recommended for women up to the age of 37, as the chances of pregnancy are low after this age. For same-sex female couples, or women without a partner who want to use donor sperm, it may be possible to try at the age of 38 or 39. Artificial insemination using the partner’s sperm is only recommended for couples who have been trying for a short time and where the male partner has a motile sperm count above 5 million/ml.

IF I BECOME A MOTHER THROUGH EGG DONATION, WILL THE BABY LOOK LIKE ME?

From the extensive database of available donors, the one who most resembles you physically will be selected.

WHEN SHOULD WE SEE A SPECIALIST IF WE CAN’T GET PREGNANT?

The general recommendation is to see a reproductive specialist when there are no positive results after a year of having unprotected sex on the woman’s fertile days, although these times may vary depending on each individual case.

WHAT’S THE DIFFERENCE BETWEEN STERILITY AND INFERTILITY?

  • Sterility: The failure to achieve pregnancy after one year of regular sexual intercourse without using contraception.
  • Infertility: The inability to carry a pregnancy to term, i.e. the inability to have a healthy baby.

WHAT IS THE MACS TECHNIQUE?

The MACS (Magnetic Activated Cell Sorting)  technique, also known as triple sperm selection, is one of the most advanced techniques in assisted reproduction. It allows embryologists to select sperm which do not show signs of apoptosis for use in fertilisation.

IF IN VITRO FERTILISATION (IVF) IS UNSUCCESSFUL, HOW LONG DO I HAVE TO WAIT BEFORE STARTING A NEW TREATMENT?

After a negative pregnancy test and the first menstrual cycle following the test, a new IVF treatment can be started. At Ovoclinic, we make sure that our patients are physically and psychologically healthy before we start a new treatment.

WHAT IS GENETIC GRIEF?

Genetic grief is an emotional reaction that some couples experience when using donated gametes (whether sperm or eggs) and which can take the form of anxiety, sadness or difficulty in accepting that their child will not have the same genetic material as them. It’s perfectly normal to experience these feelings, and it’s advisable to talk openly about your doubts with professionals, maintain communication with your partner and, if necessary, seek professional support to help accept these feelings, regain your hope, and get back on the road to parenthood.

WHEN IS FERTILITY TESTING RECOMMENDED?

Fertility testing is recommended in the following cases:

  • If the woman is under 35 years of age and hasn’t achieved pregnancy after trying for a year.
  • If the woman is over 35 and hasn’t become pregnant after trying for six months.
  • Women of any age who’ve been trying to get pregnant for more than six months and who have previous risk factors such as endometriosis, polycystic ovary syndrome, miscarriages, etc.
  • In the case of the male partner, consultation is advisable if pregnancy isn’t achieved in one year of normal sexual relations with his partner, or in six months, in the case of having had surgery on the genital apparatus, or erectile difficulties, as well as in the case of obesity, hypertension or diabetes.

THE GENETIC MOTHER AND THE BIOLOGICAL MOTHER – WHAT ROLE DOES EACH PLAY IN THE ROPA METHOD?

  • The genetic mother is the woman who provides the eggs, and who undergoes hormonal treatment of programmed ovarian stimulation for the subsequent egg retrieval.
  • The biological mother or gestational mother is the woman who will carry the baby. She will also undergo hormonal treatment to prepare her uterus for better implantation of the embryo.

WILL I BE ABLE TO LEAD A NORMAL LIFE DURING IVF TREATMENT?

During In Vitro Fertilisation (IVF) treatment, you may experience abdominal discomfort and bloating, but most patients can continue with their normal routine. The only day when it’s advisable to rest is the day of the follicular puncture, as this procedure requires sedation. You can go back to work the following day.

WHEN IS FROZEN EMBRYO TRANSFER RECOMMENDED?

Frozen embryo transfer is recommended for

  • Couples who have frozen embryos from previous cycles.
  • Donated embryo adoption.
  • Genetic diagnosis with delayed transfer.
  • Women with abnormal levels of oestradiol and progesterone.
  • Women with endometrial thickness above or below optimal levels.

WHAT IS THE SWIM-OUT TECHNIQUE?

The swim-out technique consists of placing the patient’s sperm sample directly on the ICSI plate without any type of treatment.

WHAT IS THE EGG VITRIFICATION PROCESS?

The egg vitrification process is as follows:

  1. Controlled ovarian stimulation
  2. Follicular puncture
  3. Vitrification of the eggs in liquid nitrogen
  4. Preservation and maintenance

WHAT ARE THE PROBABILITIES OF A TWIN PREGNANCY WITH ARTIFICIAL SEMINATION (AI)?

There’s a higher chance of a twin pregnancy with AI treatment, because the ovary is normally stimulated to produce between 1 and 4 good quality eggs. If there’s more than one egg, a risk of multiple pregnancy exists, although the chance of twins is around 8%. If the patient doesn’t wish to take this risk, it’s possible to carry out artificial insemination (AI) with a very low dose so that only one follicle grows, or even in a natural cycle, although it must be considered that this will reduce the probabilities of pregnancy.

WHAT IS OVARIAN RESERVE TESTING?

The term “ovarian reserve” describes the functional potential of the ovary, i.e. the ability of the ovary to produce eggs of sufficient quality to achieve pregnancy. Among the tests a patient must undergo before undergoing assisted reproduction treatment, ovarian reserve (OR) testing is undoubtedly one of the most effective. Antral follicle count (AFC) and anti-Müllerian hormone are two tests that determine ovarian reserve.

WHAT IS PGD?

PGD stands for Preimplantation Genetic Diagnosis. It’s an examination of the genetic and chromosomal changes in the embryo which is carried out before the embryo is transferred to the mother to ensure healthy offspring.

WHAT DOES THE FIRST FERTILITY APPOINTMENT INVOLVE?

The first fertility appointment consists of an assessment of the patient or couple. A series of questions are asked so as to establish their medical and reproductive history, as well as the treatments they have received or are currently undergoing, in order to determine the cause of their fertility problems. Based on this information, additional tests are requested in order to provide the most appropriate treatment for each individual patient.

WHAT ARE THE ADVANTAGES OF EGG FREEZING?

Egg freezing is a technique that involves extracting and vitrifying a woman’s eggs during her most fertile years. This technique allows the eggs to be preserved indefinitely until she decides to become a mother. Some of the advantages are:

  • Quick, easy treatment
  • Indefinite preservation
  • Prevention of health problems
  • Greater chance of achieving a successful pregnancy