On 4th June, several initiatives were carried out at Ovoclinic for the World Infertility Awareness Month. Every year in the month of June, we highlight the pathologies and difficulties that many women and couples have to face when trying to conceive. As an information activity, we discussed the topic of fertility later in life with the gynaecologist Micaela Fernández, a specialist in assisted reproduction and complex treatments at Ovoclinic Marbella.
FOR DIFFERENT REASONS, WHETHER PERSONAL OR SOCIOLOGICAL, WOMEN AND COUPLES ARE POSTPONING STARTING A FAMILY. FROM YOUR EXPERIENCE IN ASSISTED REPRODUCTION, WHAT’S THE AVERAGE AGE OF PATIENTS STARTING TREATMENT?
In my experience, the average age in the last decade is 38-40 years old. In most cases, because it’s the time of life associated with economic, professional and personal stability for both men and women. However, we also see women or couples who’ve been trying for years to conceive the natural way, but haven’t been able to do so for reasons that have to be diagnosed by a fertility specialist.
WHEN IS IT RECOMMENDED TO CONSULT A FERTILITY SPECIALIST?
Consultation with a specialist is recommended for any couple under the age of 35 who haven’t managed to get pregnant after having unprotected sex for a year. If the couple is over 35 and have been trying unsuccessfully for six months, they should also consult a specialist in assisted reproduction.
However, there are other circumstances to consider, such as:
- Women with irregular menstrual cycles
- Women who’ve had two or more miscarriages
- Men with a history of varicocele, or who’ve had surgery or testicular trauma
- Either partner has undergone gynaecological surgery
- Either partner has had an oncological disease
- Either partner has a genetic disease
DIMINISHED OVARIAN RESERVE IS THE MOST COMMON CAUSE OF INFERTILITY OVER THE AGE OF 35, BUT WHAT OTHER REPRODUCTIVE PATHOLOGIES ARE THERE?
It’s true that from the age of 35 upwards, diminished ovarian reserve and egg quality are two of the most common issues, and not only when it comes to conceiving. Once pregnancy has been achieved, these pathologies can also cause miscarriages, or a greater risk of developing embryos with genetic alterations. Thanks to assisted reproduction treatments and various embryo analysis techniques, such as Preimplantation Genetic Diagnosis (PGD), it’s possible to get pregnant and have a healthy baby.
OVODONATION IS ONE OF THE TREATMENTS WITH THE HIGHEST SUCCESS RATES, BECAUSE IVF IS CARRIED OUT WITH EGGS FROM A YOUNG, HEALTHY DONOR. IN WHICH CASES SHOULD OOCYTE DONATION BE USED?
Making the transition from IVF to egg donation is clear in the case of patients who’ve previously undergone unsuccessful IVF treatments, such as implantation failures or recurrent miscarriages; patients with a recognised genetic risk due to a genetic disease; or patients with age-related or premature ovarian failure.
ENDOMETRIOSIS IS AN INCREASINGLY COMMON CONDITION OF THE FEMALE REPRODUCTIVE ORGANS. IT TYPICALLY AFFECTS THE OVARIES, FALLOPIAN TUBES, AND THE PELVIC CAVITY IN GENERAL. AT WHAT AGE IS IT MOST COMMONLY DIAGNOSED, AND HOW CAN ASSISTED REPRODUCTION HELP?
Endometriosis is the most common cause of pelvic pain during menstruation, and in some cases, throughout the whole month. It can also cause pain or discomfort during sexual intercourse. Usually appearing during a woman’s childbearing years, between the ages of 25-40, it can cause changes in the pelvic cavity, among other issues. Thanks to various assisted reproduction treatments, many patients are able to overcome the obstacles presented by the disease, such as the presence of ovarian cysts, which can lead to diminished ovarian reserve, or the presence of adhesions formed by the endometriosis itself, and which sometimes directly affect fertilisation.
IF A WOMAN’S IN THE MENOPAUSAL TRANSITION (PERIMENOPAUSE), CAN SHE BECOME A MOTHER THROUGH ASSISTED REPRODUCTION?
Yes, in this particular case, the assisted reproduction treatment that would help her to become a mother would be oocyte donation. The procedure is similar to IVF, but with the difference that fertilisation is carried out with eggs from an anonymous donor. At Ovoclinic we collaborate with Ovobank Egg Bank to find the ideal donor for each patient. The success rate of this treatment is around 80% at the first attempt.