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A more reliable means of detecting anti-Müllerian hormone and evaluating ovarian reserve

A new, much more reliable, faster technique (results are obtained in 3 days) has been incorporated into our clinic and, since it is carried out directly in our laboratories, it has brought the price down to €50. The technique is carried out on a blood sample which can be taken at our clinics or a sample can be sent to us by courier.
Determining anti-Müllerian hormone levels in a woman’s blood helps us to evaluate ovarian reserve and, along with a transvaginal ultrasound used to carry out an antral follicle count, this provides us with information about her reproductive future and whether or not trying for a child is a matter of urgency.
It can also be used in order to personalise fertility treatment and to help predict how successful it is likely to be.
Cases of couples in clinics in which the female has impaired ovarian reserve are more and more common. A reduction in ovarian reserve of this kind might be expected in older women but not so in younger women, particularly when her menstrual cycles have not been irregular. […]

A boy or a girl: can I choose my baby’s gender?

Whilst it is technically possible to choose a child’s gender using pre-implantation genetic diagnosis, Spanish law prohibits selecting a baby’s sex, except with a view to avoiding the transmission of genetic diseases associated with the X chromosome. Such is the case, for example, of haemophilia A.
Law 14/2006 indicates that pre-implantation genetic diagnosis may only be used in order to detect serious genetic diseases or those which compromise the viability of an embryo. Therefore, this technique may not be used in order to select a future baby’s gender. Any other use of this technique is a serious offence which is punishable by law. […]

The endometrial receptivity array (ERA) test

Embryo implantation is the least well known phase of reproduction within the field of reproductive medicine. This fact is of special relevance if we also take into account that the human embryo is not very efficient when compared to other closely-related species in the evolution timeline.
We currently know that pregnancy is based upon three basic pillars: the embryo, the endometrium and the tolerance of the mother’s immune system. Not only is it essential that all three function correctly, but there needs to be optimum interaction between them. We have already covered the role of the embryo and the immune system in detail. Therefore, we will now concentrate on the endometrium and, more specifically, on studying endometrial receptivity. […]

Cytomegalovirus (CMV): What is it? How is it transmitted? What are its symptoms? How can it be treated?

Cytomegalovirus (CMV) is a virus from the family Herpesviridae. We also find the chickenpox virus, herpes simplex and the mononucleosis virus in this family.
Infection with CMV is very common since it is present worldwide and can affect anyone. On the whole, it is an infection which does not usually cause any serious health issues. Once the virus has infected a person, it will remain in that person’s body for the remainder of his or her life. In fact, it is usually inactive or latent for a long time and it does not tend to reactivate unless the person’s defence system (immune system) is affected. Most people who are infected by the virus and who do not have serious health issues do not, on the whole, have any symptoms which might cause them to believe that they are infected with CMV. People who do develop some symptoms may suffer from a high temperature, swollen lymph glands, muscle pain or tiredness.
However, in the case of babies infected with the virus during pregnancy or childbirth and in people with a weak immune system, it is considered to be a significant public health problem since it can cause serious illnesses. […]

Can I choose the sex of my embryos when I undergo embryo transfer?

The human genome consists of 46 chromosomes: 23 of these are inherited from our father and the other 23 are inherited from our mother. Our organism’s entire genetic make-up is stored in these chromosomes. The 23 pairs are organised as follows: 22 pairs, known as autosomes, and one pair of sex chromosomes (X and Y) which differentiate the two sexes (XY for males and XX for females).
From a technical point of view, using pre-implantation genetic diagnosis, we have the means of analysing an embryo’s entire chromosomal make-up. This technique, which is known as CCS (Comprehensive Chromosome Screening), means additional or a lack of any chromosomes in the embryo can be detected. Therefore, we can use CCS to analyse the entire make-up of the embryo and determine that there are neither DNA excesses nor deficiencies which will stop the embryo from developing properly. But, if we focus on the sex chromosomes, we can also determine if the analysed embryo has two X chromosomes and will, therefore, be a girl (XX) or one X chromosome and one Y chromosome (XY) and will be a boy. […]

What is the significance of FSH hormone levels in fertility?

Follicle-stimulating hormone (FSH) is essential to reproduction. It is produced by the pituitary gland situated just below the brain (behind the palate) and is released into the bloodstream. The hormone regulates the ovaries and is involved in the processes dealing with the growth and selection of the follicle which will later release the egg during ovulation.
Fluctuations in FSH levels are responsible for menstrual cycles and also for the fact that only one egg is produced during each cycle. It is essential, therefore, that there is constant dialogue between the ovaries and the pituitary gland so that the latter can consistently produce the correct quantity of FSH for a normal cycle.
This permanent exchange means that, in cases of poor ovarian function, the pituitary gland will try to compensate for this situation by increasing FSH excretion levels. It is for this reason that FSH levels in women going through the menopause are 20 times greater than in women whose ovaries are functioning normally. Therefore, when the ovary does not respond correctly, FSH increases significantly and systematically. […]

Reduced mobility and fertility

Reproduction issues always need to be dealt with with a degree of sensitivity. When there is also a disability within the couple, the emotional side of things calls for even greater care and steps should be taken in order to deal adequately with any implications the disability in question has from a medical point of view.
In 2006, the United Nations (UN) published guidelines on the rights of people with reduced mobility. These guidelines indicate disabled people’s rights across all levels of society and include the right to have children and access to sexual health.
At Instituto Bernabeu, we aim to comply with the aforementioned guidelines and provide our patients with the means and solutions they need and which adapt to the circumstances of each physical disability. This covers disabilities resulting from a genetic condition (hereditary), disease or an accident and, from a fertility point of view, each case is given personalised treatment. […]

Beta hCG (β-hCG) result table

β-hCG (human chorionic gonadotropin) is a glycoprotein that is initially secreted by trophoblast cells in the embryo shortly after it implants in the uterus. The rapid increase in serum levels of hCG following conception means it is an excellent early indicator of pregnancy. It’s also a parameter which is widely used for monitoring that a pregnancy is progressing correctly.
On a physiological level, hCG triggers the corpus luteum and thus facilitates progesterone and oestrogen synthesis. Progesterone stimulates the maturing of blood and capillary vessels that help the foetus to develop correctly.
hCG levels can be measured in blood or in urine.
Urine tests have a detection limit of 20 to 100 mUI/ml depending on the brand. If the measurement is to be taken in urine, a sample of the first urine of the day is recommended. This is particularly true during the early days of pregnancy because, if the urine is too diluted, the test can return incorrect negative results.
hCG levels in blood can be used to detect levels as low as 5 mUI/ml and the concentration levels of the hormone can therefore be calculated.
hCG levels in multiple pregnancies are 30-50 % higher than in pregnancies where there is only one foetus. However, a multiple pregnancy should be confirmed by means of an ultrasound.

Ovarian stimulation: What is it? Are there any risks involved?

During the first few days of a period, a complex process takes place in the ovaries. The first step is to gather and initiate development in several follicles that contain eggs. Following this, only one egg is selected and it then develops. A mature egg is released during ovulation.

Embryo transfer on day 3 or day 5. The pros and cons.

Determining the ideal day for embryo transfer has always been a controversial issue and there are, even today, still a number of doubts surrounding this issue.
Embryo culture is, basically, a selection process. Each embryo’s progress is evaluated throughout and a decision is taken on which is most likely to implant successfully. […]