A more reliable technique for detecting anti-Mullerian hormone and estimate ovarian reserve

_SAR0477-lowWe have built a new much more reliable, rapid technique (in 3 days the result is obtained) and as we do it directly in our laboratories the price is reduced to 50€. Only requires a blood test that can be performed in our clinics or send the sample by courier.

The determination of AMH levels in the woman’s blood helps us to assess the ovarian reserve and, together with the completion of an ultrasound to count antral follicles, provides information about their reproductive future and if there is or not a need to rush in getting pregnant. 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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First Pregnancy Scan after IVF Treatment

01 Confirming pregnancy after IVF and Egg Donation . The first ultrasound in which we can see the pregnancy  is a very emotional time for the parents, especially for patients who have gone through  treatments for assisted reproduction. For these patients, after having a positive pregnancy test , their anxiety does not go away but gets stronger until the pregnancy is seen to develop normally. Therefore it is very important to know what happens during this exploration, and what to expect.

When is it done?

It should be carried out  between week 5 and 7 of pregnancy, therefore between 3 and 5 weeks after  embryo transfer. To calculate the pregnancy after IVF, we always set a theoretical last mentrual period date 14 days before egg retrieval.

Exactly one month after the embryo transfer is a great time to carry out the scan and see clearly if the pregnancy is progressing or not. If this is done sooner, we can create confusion and uncertainty since most of the time it will not be conclusive.

How is it done?02

The ultrasound must be done vaginally. This shows the images more clearly, and it is more precise in showing that everything is evolving correctly. We know that carrying out the ultrasound this way does not negatively affect the pregnancy.

 Why is it important to do an ultrasound in the 6th or 7th week?

  1. We can confirm that the pregnancy is in the uterus, and rule out ectopic pregnancy (found outside the uterus).
  2. We can see if it is a single or a multiple pregnancy.
  3. It allows us to evaluate whether or not the pregnancy evolution is as it should be. If it is not evolving well, it can give us an idea as to why.

What will we see in the scan?

In the first scan after IVF carried out in week 6 or 7 of pregnancy we can see the following structures:

  1. Gestational Sac. This is the earliest structure seen. It is a dark image, surrounded by a halo, found within the uterus (in the endometrium, which we observed growing during the ovarian stimulation). The average size at week 6 is around 14mm, but this varies greatly can sacs that are much smaller and much bigger are not considered abnormal.
  2. Yolk Sac.  This is a vestigial structure that is seen at the start of embryonic development. Its round, white shape, resembling the follicles during stimulation. It measures around 3-4mm, and if it is larger than 6mm it is considered a poor prognosis.
  3. Heart beat. Tends to appear around week 6. The heart rate at this time is between 90 and 110 beats per minute, and will increase in the coming weeks.
  4. Embryo. The cell mass that has all of the embryos organs. It is a structure attached to the yolk sac. In week 6 sometimes it is not seen yet, as its size is between 2-8mm. this varies greatly, and will grow very quickly (around 1mm daily).

In case these structures are not seen, or their sizes are not as expected, does this mean the pregnancy is lost?

We msut be cautious in interpreting the ultrasound findings at this time, since there are a number of factors that can lead to an incorrect diagnosis:

  1. The variations in normal embryo development. Even though it is very early on in the pregnancy, there are many variation in the appearance of ultrasound findings. Therefore any diagnosis must be confirmed a few days later.
  2. Differences in the quality of the image depending on the patient. Every patient is different, and their tissues pass the ultrasounds waves in different ways. Images can be unclear if the transmission is not good.
  3. Placement of uterus and location of gestational sac. Depending on the distance between the ultrasound probe and the gestational sac, the image can be more or less clear. This can mean that the diagnosis is inconclusive.

Dr. Joaquín Llácer, Co-Medical Director of Assisted rReproduction at  Instituto Bernabeu.

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You can arrange an online consultation or book an appointment at Instituto Bernabeu.

More information on our website: For further information, consult our website: www.institutobernabeu.com/en/ or www.ibbiotech.com

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What is the endometrium?

01endometriosisThe uterus, the organ where pregnancy takes place, has a cavity inside where implantation occurs.  This cavity is covered by a soft tissue called endometrium, the “nest” that the uterus prepares every month for a possible embryo.

During the menstrual cycle the endometrium goes through 3 main phases:  menstrual phase, when it is shed in order to grow again, follicular phase or preovulatory, when it grows, and luteal phase or postovulatory when it reaches the proper state in which to produce implantation.  These phases of the cycle are easily seen in an ultrasound. Continue Reading »

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Is it beneficial to rest after the embryo transfer?

reposoWithout a doubt, one of the most emotionally stressful stages a patient undergoing IVF has to face is the period between the embryo transfer and the pregnancy test result.

It is a natural instinct for someone in this situation to want to do everything in her power to increase the chances of success, which is why she is extra sensitive to any messages she receives from family members, friends, the internet, etc. This leads to a confusing situation because oftentimes the advice received is contradictory. As if that weren’t enough, the vast majority is unfounded and not validated by any scientific evidence. Their question is often “should I rest or not?Continue Reading »

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If I take antioxidants, can I improve my chances of pregnancy?

 

embarazo4r

This is a question that patients often ask their doctors in consultation and other patients in online forums. As usual, many things have been said without any scientific basis.

Fortunately, a study was recently published that collected 28 studies involving a total of 3,548 women who have gone to fertility centers. Continue Reading »

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Instituto Bernabeu Shared Risk Program: serious commitment to the result

“WE’RE NOT TALKING ABOUT STATISTICS, WE ENSURE YOUR PREGNANCY.”

Instituto Bernabeu has always been loyal to its patient care philosophy, and is even more so now in these current hard times, by planning and implementing new projects and services aimed at helping couples achieve their dream of parenthood.

We want to share your efforts and risk by promising to back up every activity with the latest equipment, innovative techniques and cutting-edge technology alongside our entire team’s professionalism, experience, warmth and dedication. Continue Reading »

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ROPA method: Shared Maternity

Metodo ROPA

ROPA (Reception of Oocytes from PArtner, or Partner Assisted Reproduction) is a treatment in reproductive medicine that allows married same sex female couples to both participate in the important act of creating a family.

This treatment allows one of the women in the couple to give her eggs (the genetic material that is passed on to the baby), and the other woman will carry the pregnancy. Continue Reading »

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Chromosomal alterations in repeated miscarriages

Imagen9-e1297356992948Couples who get pregnant, either naturally or through assisted reproductive techniques, are especially worried about the successful outcome of the pregnancy.

Unfortunately, some pregnancies end in miscarriage or fetal loss in the week 20 of pregnancy, when the fetus is not able to survive outside of the maternal uterus. Continue Reading »

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Becoming a mother after 40

Nowadays, we all know that maternity is being postponed, currently standing at 31 years of age, according to the National Statistics Institute.

This basically means that the average woman has her first child at the age of 31. Continue Reading »

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