Human immunodeficiency virus (HIV), hepatitis C (HCV) and hepatitis B (HBV) are viruses that are transmitted through blood and body fluids as well as through vertical transmission (from the mother to the foetus). As a result, couples wishing to get pregnant in which one partner is a carrier of a virus are faced with the question of whether or not it is possible to do so without the other partner getting infected. If the male partner has one of these viruses and his female partner does not (serodiscordant couples), assisted reproduction technology (ART) can be used in order to avoid transmission. […]
Assisted Reproduction Techniques
Following in vitro fertilisation (IVF), the embryos obtained are evaluated in the laboratory before transfer to the patient’s uterus. A key question always comes up at this point: which and how many of those embryos should be transferred? […]
According to the World Health Organization (WHO), nowadays between 10 and 15% of couples have fertility issues and between 30 and 35% of the reasons for infertility can be found in the male partner. Therefore, improving semen quality is one of the main concerns amongst couples with reproduction issues. […]
From the very moment when sperm fertilises an ova, a new embryo starts developing and a large number of cell divisions take place. This embryo development is observed in an in vitro fertilisation laboratory up until the blastocyst stage (day 5 or 6 of development). Sometimes during the cell division process, fragments of the embryo become isolated between cells that have developed correctly. These fragments come from embryo cell remains and can stop the embryo from developing correctly. One of the negative impacts consists of issues reaching the blastocyst stage and the posterior impact on implantation in the uterus. In fact, embryo fragmentation is one of the most significant characteristics used to determine embryo quality. […]
Selection of the spermatozoon capable of fertilising an egg and generating a viable embryo is a subject that has been covered in a great number of studies aiming to provide this question with an answer.
Although assisted reproduction techniques have been used for dealing with fertility issues for many years, there is still room for improvement in terms of the results obtained. First of all, we need to fully determine the role of the spermatozoon because it tends to be thought of simply as the transporter of the father’s genetic material with no impact on later development. This idea has already been turned on its head and sperm does not only play a role in the fertilisation process. An abnormal spermatozoon can give rise to abnormal embryos and can even influence implantation failure. […]
Ovarian stimulation is key in results obtained as a results of assisted reproduction techniques. Daily clinical practice shows us that ovarian response can vary substantially from one woman to another. With this in mind, we can diagnose a patient as a poor responder when three eggs or less are obtained.
This situation affects more and more women every day. They require specialised healthcare and personalised protocols and, in response to this need, Instituto Bernabeu has a Poor Ovarian Response Unit that deals with multidisciplinary diagnosis and treatment.
For patients under this category, obtaining one or more eggs can mean the difference between failure and pregnancy and this makes any steps taken to increase the number of available eggs absolutely essential. […]
Assisted Human Reproduction is undoubtedly an area with ethical and moral implications. There are common issues that arise with the generation of new embryos when a couple undergoes ART and with transfers of previously frozen embryos. Some of the most frequent issues are: embryo manipulation and genetic diagnosis; the use of donor gametes and the possible coexistence of their legal children with the biological ones in the future; the option of discarding embryos by parents for no other purpose when they don’t wish to donate them to other couples with reproductive problems or for research purposes; the age of women accessing ART, along with a long list of legal, ethical and moral issues pertinent to each assisted reproduction centre. […]
There has been a lot of discussion about therapies aimed at improving pregnancy rates; especially in patients that have gone through several cycles of treatment without positive results.
This is one of the most frustrating situations that doctors and patients can possibly have.
The inevitable question is: What can we do to improve our chances? Isn’t there anything new?
We think that patients who have received 4 or more high quality embryos without any pregnancy should be thoroughly evaluated through an implantation failure study that should include the three fundamental elements for success: the female, male and embryo factors.