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. […]

Accumulation of oocytes in patients with a low response.

The number of oocytes retrieved is a key prognostic factor in In Vitro Fertilisation (IVF) treatments. Chances are greater the greater the number of retrieved oocytes is, until the moment when 6 to 8 oocytes have already been retrieved.
For this reason, care of patients with a Low Response should be especially thorough, both as regards the chosen protocol for ovarian stimulation and the processes of oocyte retrieval and management at the laboratory. In these cases, retrieving an extra oocyte may considerably increase the chances of success.
While many of these patients benefit from the implementation of specific stimulation protocols and the use of adjuvant therapies, some of them will be refractive and will yield a very poor response.
The appearance of vitrification as a successful technique to freeze both oocytes and embryos has stirred new expectations in patients with a low response at the possibility of accumulating vitrified oocytes from several stimulation cycles. This way, after performing a number of oocyte collection cycles and once collecting a number between 6 and 8 oocytes has been achieved, the processes of fertilisation begin. In this case, prognosis is more favourable, as patients now have more or less the same number of oocytes as those patients with a normal response. […]

Vitrification: the cold revolution

Vitrification is generally associated with delaying maternity. It involves preserving eggs at low temperatures so that they may be used in the future. This is, in itself, astounding since it enables gametes to be preserved by means of advanced and ultra-rapid cell freezing so that they may be used sometime in the future. The uses to which this technique may be put are so varied and numerous and have changed the work environment in the most prestigious of fertility clinics to such an extent that experts have no doubts about referring to vitrification as a ‘revolutionary’ procedure.
“We could say that cryopreservation is currently the most important aspect of any assisted reproduction clinic” assures Dr Jorge Ten, head of the Reproductive Biology Operational Unit at Instituto Bernabeu in Alicante. In the words of this expert, this technique “has changed enormously over the last 6 to 8 years”. Vitrification was initially carried out using “slow freezing techniques which caused cell damage” in the oocyte. This cell, “in the case of women, is the largest in the human body and has the greatest content in water. Therefore, when frozen, it produced poorer results due to the formation of ice crystals which damaged its structure”. The ice crystals which formed as a result of the aforementioned slow freezing and the high water content in the cell meant that survival rates were “between 20 and 30%. Almost no oocytes survived”. […]

Low ovarian reserve, a challenge with optimistic future in Instituto Bernabeu

The social changes in recent years have been highly beneficial to achieving rights and equalities, although it has also led to a significant increase in maternal age. But nature does not understand social change and the biological clock keeps ticking as usual. There are several consequences of this delay on female fertility and it depends on each woman, but it is a reality that as women age, the ovarian reserve diminishes and the egg quality lowers. […]

Genetic Health of the Embryo: Science Applied to Life

This is not science fiction, it’s reality. It is reproductive medicine and advanced genetics together to achieve healthy children who are free of diseases. Before, medicine focused on a person’s health. Now thanks to genetics and scientific research we are able to go one step further and take care of the embryo. […]

Why aren’t all embryos obtained from an IVF cycle suitable for freezing?

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. […]

Criteria for embryo classification

From 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. […]

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

The 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. […]

What is a Chemical Pregnancy?

 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? […]