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What is the significance of FSH hormone levels in fertility?

Follicle-stimulating hormone (FSH) is essential to reproduction. It is produced by the pituitary gland situated just below the brain (behind the palate) and is released into the bloodstream. The hormone regulates the ovaries and is involved in the processes dealing with the growth and selection of the follicle which will later release the egg during ovulation.
Fluctuations in FSH levels are responsible for menstrual cycles and also for the fact that only one egg is produced during each cycle. It is essential, therefore, that there is constant dialogue between the ovaries and the pituitary gland so that the latter can consistently produce the correct quantity of FSH for a normal cycle.
This permanent exchange means that, in cases of poor ovarian function, the pituitary gland will try to compensate for this situation by increasing FSH excretion levels. It is for this reason that FSH levels in women going through the menopause are 20 times greater than in women whose ovaries are functioning normally. Therefore, when the ovary does not respond correctly, FSH increases significantly and systematically. […]

Embryo transfer on day 3 or day 5. The pros and cons.

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. […]

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. […]

State of the art technology in preimplantation embryo diagnosis: Array-CGH

Preimplantation Genetic Diagnosis (PGD) is the study of chromosomal and genetic abnormalities in embryos before they are transferred to the mother’s uterus by an In Vitro Fertilisation (IVF) technique. It seeks to ensure healthy offspring and stop transmission of a given disease. […]

Co-mother registration for lesbian couples

Last July, Act 19/2015 on administrative reforms in the field of Justice Administration and Civil Registration made changes to article 7.3 of Act 14/2006 on human assisted reproduction techniques, making it clearer than before and providing for equality between heterosexual and lesbian couples.
The new law states that ‘When a woman is married to another woman and there has been no legal or de facto separation, the latter, in accordance with the Law on Civil Registry, may agree to her parentage of the child born unto her partner.’ […]

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. […]

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”. […]