Assisted reproduction techniques at the service of a dream
The Women's Unit is a leading center in the field of assisted reproductive technologies. Our specialists offer support from diagnosis to delivery, aiming to make this complex process easier and more rewarding, even though it can be challenging.
For diagnosis , the first step is to take a complete medical history of both partners. Then, the focus shifts to the woman, which includes a gynecological examination, a transvaginal ultrasound, hormone tests, and an X-ray of the fallopian tubes and uterus, a procedure known as hysterosalpingography. The man will undergo a semen analysis and comprehensive blood work.
The two main Assisted Reproduction techniques are: artificial insemination , which can be done either with the partner's sperm (IAC) or donor sperm, and in vitro fertilization (IVF) , which, in turn, can also be done with donated eggs or egg donation.
Assisted reproduction
1. Assisted reproduction techniques: Artificial insemination with partner's semen
When it is indicated and requirements depending on the patient's sex:
- Man
– It is indicated for mild alterations in semen.
– A minimum count of recovered motile sperm is required.
- Woman
– It is indicated for ovulation defects, endometriosis, or infertility of unknown origin.
– The ability to ovulate spontaneously or with treatment and at least one patent tube are required.
Procedure
The procedure typically begins with gentle ovulation stimulation to obtain a maximum of two follicles. Once the dominant follicle reaches 17-20 mm, its maturation is encouraged through the injection of human chorionic gonadotropin (hCG). After 35 to 37 hours, the sperm sample is introduced into the woman's uterus.
Once the process is complete, progesterone should be prescribed to promote implantation, and a pregnancy test is performed 2 weeks later.
Success rate
10-15% per cycle (2 to 4 cycles are performed).
2. Assisted reproduction techniques: Artificial insemination with donor semen
When it is indicated
- Man
– It is indicated when there is a risk of transmitting genetic diseases or when there is no sperm.
- Woman
– It is indicated when there is a desire to conceive without a male partner.
Procedure
The same procedure is performed as in artificial insemination with semen.
Success rate
15-20% per cycle (4 cycles are performed).
3. Assisted reproduction techniques: In vitro fertilization
When indicated and requirements:
- Woman
– It is indicated when there is a suitable uterus and a favorable ovarian response to stimulation.
Procedure
Contact between the egg and sperm occurs outside the woman's body and there are two modalities.
Conventional IVF involves extracting eggs and fertilizing them with sperm in a test tube, requiring a minimum of 50.000 sperm. Intrauterine insemination (ICSI) is performed using a single sperm . The latter is currently the most widely used method. Both techniques require the presence of 7 to 10 follicles, whose growth is stimulated by subcutaneous injections of pituitary gonadotropins. Once the follicle reaches approximately 20 mm in size, the hormone hCG is injected to complete egg maturation.
After 36 hours, the eggs are extracted and taken to the laboratory for selection and classification.
After processing the semen sample, IVF or ICSI is performed. The transfer of a maximum of three embryos into the uterus takes place 3 to 2 days after the puncture.
The remaining embryos are vitrified in case they are needed for future interventions.
Success rate
The success rate of IVF depends on the woman's age and the quality of the transferred embryos, although it is usually around 40%.
If pregnancy has not been achieved after 3 attempts, treatment should be reconsidered.
Does bed rest increase the effectiveness of IVF?
Complications and additional information
- Multiple gestation.
- Ovarian hyperstimulation.
- Infections and bleeding after puncture (minimal risk).
- Sometimes, after IVF, it's advisable to perform a biopsy on embryos to select those that haven't been affected by genetic or chromosomal abnormalities. This procedure is called preimplantation genetic diagnosis (PGD).
4. Assisted reproduction techniques: Egg donation
When indicated and requirements:
- Woman who wishes to conceive:
– It is indicated when a woman does not have ovaries but does have a uterus, her ovaries are of poor quality, she has undergone IVF with an unsuccessful outcome, or if it is impossible to perform a preimplantation genetic diagnosis if there are genetic diseases that could be transmitted to the future baby.
– You will not be able to renounce the parentage of children born through this technique.
- Donor:
– The donor must be between 18 and 35 years old, be in good physical and mental condition, bear a certain physical resemblance to the recipient, and previously agree to the donation commitment.
– The donation will be anonymous and altruistic.
– Donors will have no rights or obligations regarding the pregnancy or the future child.
Procedure
The process begins with hormone replacement therapy to prepare the expectant mother's endometrium, while simultaneously stimulating the donor's ovulation. When the donor's follicles reach a size of about 17-20 mm, the eggs are extracted using follicular puncture, and a semen sample is prepared. They are then fertilized, and after 3 to 5 days, the embryo(s) are transferred to the recipient's uterus.
Success rate
65% per transfer, regardless of the age of the recipient woman.
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If you found this article interesting and would like to be seen by a specialist in Gynecology and Obstetrics, the Women's Unit at Ruber International Hospital has a specialized department in this area. You can request more information by calling 91 387 51 72/73/74 or schedule an in-person appointment with top specialists.