What are follicles? Number, growth and other characteristics

What are ovarian follicles?

To start with, let’s state that the follicles are not. The follicles are not oocytes (eggs). Many patients confuse these terms believing that follicle equals oocyte.

The female gamete is the egg, and the sperm is the male gamete. These are the cells involved in embryos obtained after fertilization. Continue Reading »

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Can we avoid the Genetic Ammiocentesis?

01 Genetic Amniocentesis is a prenatal diagnostic technique aimed at obtaining fetal karyotype. The karyotype is the number of chromosomes that are endowed with all people. Normal people we have 46 chromosomes distributed in 23 pairs (22 pairs of chromosomes called autosomes and 1 pair of sex chromosomes, XX or XY, which determine the sex of the fetus). Down syndrome or trisomy 21 is the most common chromosomal abnormality in new born infants; in this case, the individual has 47 chromosomes, and the alteration is that there are 3 21 chromosomes rather than two. 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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Anembryonic gestation

01 The anembryonic pregnancy or blighted ovum” is a specific type of miscarriage in which the fertilized egg implants in the uterus but the embryo does not develop. It is a relatively common problem: 10-15% of clinically detected pregnancies are lost spontaneously and one third of them are blighted ovum.

After fertilization, that is, after the union of sperm and egg, begin a series of cell divisions that lead to the formation of the gestational sac  surrounded by a “shell” or cover called trophoblast (which is the one that will lead to future placenta); inside the gestational sac the embryo will develop. In the case of anembryonic pregnancy the gestational sac is formed with the trophoblastic cover but the embryo is not displayed because it has stopped developing at a very early stage, before reaching a millimeter in size, so it cannot be detected with an ultrasound. Continue Reading »

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Blocked fallopian tube. The involvement of “tubal factor” in fertility

01The Fallopian tubes are trumpet-shaped structures that begin in the uterine cavity and end up opening by the ovaries. After ovulation, the fallopian tubes collect the released egg that is fertilized on the first portion, which is the closest part to the ovary. For this, the spermatozoa travel through the vagina, the cervix, the uterine cavity, and finally the route to the end of the tube. After fertilization occurs, the embryo (fertilized egg) launches its first divisions and travels through the fallopian tube towards the uterus where implantation occur and thus the establishment of pregnancy. Continue Reading »

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Difference between identical and fraternal twins

Apr 17 2014 Published by under Genetics, Gynaecology, News, Pregnancy

01Before establishing the biological origin differences between identical and fraternal twins, let’s make a quick note on the etymology of both words.

Etymologically both terms have the same origin (Latin gemellicium) and were used interchangeably to refer to children born in the same delivery. The only difference was the use of the term fraternal twin in the popular speech twin and identical twin in the cultivated speech. However, the semantic evolution of both words has been accompanied by the numerous advances in the field of genetics and knowledge of the development of the human embryo. In fact, since they differ in the latest edition of the dictionary of the RAE: 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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