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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.
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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.
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. […]
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. […]
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. […]
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. […]
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). […]
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. […]
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). […]
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. […]