Recurrent pregnancy loss: an issue that does have a solution

Clearly one of the most difficult situations a couple trying for children may have to face is pregnancy loss. Suffering is even greater when, prior to this, the couple has gone through fertility treatment such as in vitro fertilisation, insemination or egg donation.
Pregnancy loss is not always the result of an illness or underlying abnormality. It can be the response nature provides in order to block the development of an abnormal embryo. In fact, when the tissue from the pregnancy loss is examined, a large number of chromosomal abnormalities can be detected. […]

Recommendations following embryo transfer

Transfer is undoubtedly one of the most important steps in assisted reproduction treatment.
When the patient steps out of the transfer room, a new beginning takes place and the experience will be totally different to what she has undergone up until that point. The embryos have now been transferred and the countdown to the pregnancy test has begun.
It’s important that patients understand that when they go to the toilet to urinate following embryo transfer, the embryos do not ‘fall out’ nor do they get lost since they are situated inside the uterus, a part of the body which is quite different to the one we use for urinating. […]

What does embryo biopsy involve?

Preimplantation Genetic Diagnosis (PGD) is a tool designed to “get to know” the embryos genetically before they are transferred into the mother’s uterus. Thanks to this technique, we can study their chromosome count and find out if they are carriers of a hereditary disease. This information helps us to select the embryos that will produce healthy babies. Yet, how can we find that information?
Today, the only way to find genetic information about embryos is by performing an embryo biopsy. What does embryo biopsy involve?
To explain the biopsy procedure we should keep in mind that our point of departure is EMBRYOS. Embryos are retrieved after performing an assisted reproduction cycle, preferably by Intracytoplasmic Sperm Injection (ICSI), and their development is assessed during the culture period until day 3 or day 5. […]

Usefulness of the Karyotype

The karyotype is the number of chromosomes in metaphase that we have. Chromosome count and therefore karyotype are characteristic to each species. Human beings have 46 chromosomes (23 pairs) in the nucleus of each cell in their body. These 23 pairs are organised into 22 pairs termed autosomes and one pair of sex chromosomes (X and Y) that differentiates both sexes (men XY and women XX). […]

Why does Comprehensive Chromosome Screening (CCS) by array-CGH reduce miscarriage rates?

Miscarriage rates in the general population with no fertility problems range around 15-20%. In other words, one out of every five couples who achieve pregnancy suffers a spontaneous miscarriage, and 5% of these couples suffer it more than once. Even when pregnancy is achieved with the help of assisted reproduction techniques, miscarriage rates do not vary. For this reason, it is important when couples come to our clinic seeking reproductive counselling to perform comprehensive testing and design an adequate protocol for their case to secure the best result, which is a healthy baby at home, minimising the chances of miscarriage. In order to do that, one should know that miscarriages and pregnancy losses are caused by different reasons (uterine problems, immunological problems, and so on), and yet in half the cases there are chromosomal abnormalities in the embryo that prevent pregnancies to progress, hence causing miscarriages. Normal embryos have two copies of each chromosome, one inherited from the father and the other from the mother, and the chromosomal anomalies they may suffer involve a change in the number of copies, producing an imbalance in their genetic load which might block embryo development. […]

Choosing a fertilisation technique when oocyte counts are poor. IVF or ICSI?

A low ovarian response is an increasingly common situation for clinicians. It is mainly associated with delayed motherhood and, accordingly, with lower ovarian reserves. In this type of patients, the number of oocytes retrieved after puncture is normally limited. In this situation, choosing the most adequate fertilisation technique, conventional IVF or Intracytoplasmic Sperm Injection (ICSI), may stir a little controversy (of course, provided that the sperm quality and the medical history lead us to consider conventional IVF as a reasonable option). […]

Instituto Bernabeu begins research on a new treatment for patients with poor ovarian response

From January 2016, Instituto Bernabeu will work on a clinical trial (free to participating patients) with the aim of evaluating the efficiency of a line of treatment in patients with poor response to ovarian stimulation.
The research, which has already been approved by the Spanish Drug Agency and has been published in the USA National Health Institute register, involves comparing ovarian response to two different stimulation protocols. One is conventional with drug administration starting at the beginning of the cycle. The other, new procedure carries out stimulation once it has been confirmed that the patient is ovulating. […]

Single mother by choice

The increase in new types of family units over the last few decades has been one of the world’s most significant changes. For various reasons, the single parent family is one of the most common of these new models.
We are talking, in this case, about single parent families in which a woman has taken the […]

Cryopreserved embryos: Does biobank storage time affect their subsequent viability?

It has been almost 30 years since the first pregnancy from cryopreserved embryos was achieved (Trounson and Mohr, 1983). Ever since then, numbers have been steadily growing at biobanks in assisted reproduction centres, mainly due to the optimisation of reproductive treatments. Our goal is to retrieve a satisfactory amount of good quality embryos (one that is enough for a fresh transfer and also for cryopreservation) by means of an ovarian stimulation cycle. These embryos may be used for future pregnancy attempts, although couples can choose to donate them for reproductive purposes, assign them to specific research projects or dispose of them. Yet, general evidence shows that many couples, mainly those that achieve pregnancy in their first fresh attempt, choose to keep them frozen without a specific end or plan in mind for the future. […]

When will my embryos be biopsied? Why?

During the performance of assisted reproduction procedures, the best embryo is selected for transfer into the mother’s uterus. The selection is based on the “look” of the embryo shortly before transfer. As a matter of fact, waiting time normally stretches until day 5 of embryo culture in order to enhance the potential of the selected embryo and its synchronisation with the endometrium.
Sometimes the selection is favoured by performing a Comprehensive Chromosome Screening (CCS) test. Thanks to this technique, we can find out if an embryo has all the chromosomes in their exact number, in other words, if it is chromosomally normal. In this way, the selection is both morphological (external look) and chromosomal (internal look).
To be able to analyse the embryo we must first biopsy it (take a cell sample) without affecting its development and subsequent implantation. Biopsy techniques have been evolving until the process has been optimised. […]