Archive for the 'Reproductive biology' category

Assited Reproduction Techniques: FIV vs ICSI

01 Currently there are two main techniques used to achieve Assisted Reproduction IVF. These two techniques are conventional in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI). Continue Reading »

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Why not all embryos obtain from a cycle of in vitro fertilization are suitable for freezing?

01 Today, in In Vitro fertilization treatments, it is not extraordinary to find ourselves on the day of embryo transfer with a high number of good quality embryos. For a fresh transfer we shall be electing the embryo or embryos that morphologically and kinetically demonstrate greater development and ‘the other’ good quality ones can be cryopreserved. Continue Reading »

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Embryo normal and abnormal division

01 Since we can remember, we must assume that we belong to described canons. These canons are set based on an average population, such us; children in pediatric check-ups are asses by a percentile of height and weight. As adults we are asses around the body mass index. In both cases, we try to reach an “average” rate.

What we consider average?

This also happens at embryonic stage. The process of embryo division observation is established to assess whether or not embryos are normal. This observation should be performed in specific times, so each embryo is observed and evaluated daily.

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Criteria for embryo classification

01From fertilization and until the embryo transfer takes place in the womb, embryos follow a development that is valued by embryologists daily. Those embryos that have kept a correct evolution and are in better condition are selected to be transferred. Continue Reading »

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How many eggs on average are donated on an Egg Donation treatment at Instituto Bernabeu?

01 In Spain, we performed 40% of all egg donation cycles in Europe. The experience accumulated at Instituto Bernabeu for over 15 years, allows us to offer to our patients a high quality and personalized treatment.

When a patient decides to go for an Egg Donation treatment, a chain work is set in the organization, in which we guarantee a commitment of trust, reliability and professional quality.

Why an “x” number of eggs are donated? Why not only one?

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What is a Chemical Pregnancy?

01 There are times when we give patients the results of  in vitro fertilization, we tell them that the test is positive but that it is not good news, and that the chances that it evolves into an ongoing pregnancy are slim. It is a very difficult situation, emotionally, since it is very hard for patients to understand what has happened. If it really is positive, then why isn’t that good news? If it’s not good news, then why do I still have to take medication?

Most of these cases will show a negative result some days later, and it is considered a chemical pregnancy. What has happened is that there was implantation of the embryo (if not the  bHCG could not have come back positive) and the embryo stopped developing some days later. This is simply a very early miscarriage, so early that it cannot be confirmed via ultrasound, and is resolved without any medication or D&C.

This situation occurs in around 10% of IVF cycles. This means that around 1 in 10 embryo transfers, the pregnancy test is positive but the pregnancy will never be seen on an ultrasound. This is clearly linked to the  bHCG levels taken 8-10 days after embryo transfer, but must be confirmed a few days later with another test, as we explained previously.

These “chemical pregnancies” are not only in assisted reproduction, but also occur naturally in spontaneous pregnancies. The majority of them are undiagnosed, because women confuse them with delays in their period. However with new pregnancy tests, which are getting more sensitive, women more frequently are seeing unclear or positive results then are then negative a few days later. This should be seen as a natural part of reproduction: just as some embryos are unable to implant, others that do are not able to continue their development, and never seen on an ultrasound.

Patients are obviously full of doubts when this situation arises: what consequences does this have in the future? Is this an obstacle in trying to obtain a pregnancy? Does it lessen the chances in a future attempt?

02The answers we can give based on scientific evidence are quite positive. Couple who have a positive result have a better prognosis in future attempts. This has been proven in a number of publications  and should be explained to patients so that it is taken into account when making a decision.

Even though it does not mean anything negative in the reproductive future of a couple, many chemical pregnancies cause a sense of “loss” that adds to the emotional burden  already present for people with fertility problems. This is why we should always be present for any concerns that these patients may have, and give them all the necessary information that they need to overcome the situation and continue to try and reach their goal.

Dr. Joaquín Llácer, gynecologist for Instituto Bernabeu.

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More information on our website: www.institutobernabeu.com/en/ or www.ibbiotech.com

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Semen quality parameters according to the World Health Organisation (WHO)

01The spermiogram is a basic tool that provides us with some of the best information to assess male fertility. It is also very useful in order to formulate a personalized treatment plan for the couple.

The World Health Organisation (WHO) has published several editions of the “Manual for the Examination of Human Semen and Sperm-Cervical Mucus Interaction”, the last one in 2010. Those manuals help and guide andrology laboratories to determine sperm quality. Moreover, in recent years, the European Society for Human Reproduction and Embriology (ESHRE) in collaboration with the WHO have developed a program to improve standardization between laboratories in terms of sperm sample diagnosis and assessment criteria. Continue Reading »

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Embryonic arrest, why don’t all of my embryos develop equally?

01.Embrion-Humano-10-celulas_-Dia-3When one starts an in vitro fertilisation (IVF) treatment, one of the most frequent concerns is the number of high quality embryos that can be obtained.

This number is variable and depends on several factors such as the ovarian reserve and gamete quality (egg and sperm). Once the eggs are fertilised, they are considered embryos, which begins after their early division. The embryo division is observed in the IVF laboratory on a daily basis and is key information to determine the embryo quality. The Spanish Association of Reproductive Biology (ASEBIR) establishes a classification according to various observed morphological parameters, which indicate the embryo quality according to their capacity to implant in the womb. Continue Reading »

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Contamination, environmental toxins and fertility

Instituto BernabeuScientific evidence from the last 15 years shows that without a doubt, environmental toxins before conception and during pregnancy cause long-lasting effects on reproductive health. An example of this is the exposure to mercury, which causes cognitive impairment in children. Another example is the exposure to agricultural pesticides, which is associated with sperm quality alterations and higher incidence of testicular and prostate cancer for men, and in women it interferes with the development of puberty, ovulation, fertility and menopause. Continue Reading »

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Using Magnetic Fields to Select Healthy Sperm: MACS (Magnetic Activated Cell Sorting)

MACS Instituto BernabeuIt is well known that having the best possible sperm quality is important to the success of assisted reproduction techniques. To achieve this, the lab has to improve sperm quality based on its motility and morphology, selecting the sperm that is considered to be the best.

However in every ejaculate sperm with abnormal membranes are found, which are programmed to “die”. This process is called apoptosis, or programmed cell death.   Approximately 20% of sperm in subfertile patients are  thought to be in the process of “celular death”. Continue Reading »

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