Frequently Asked Questions

If you have been having frequent unprotected sex for a year to try to get pregnant and you are not able to get pregnant, we recommend that you see a fertility specialist to assess your case. However, if you are over 35 years old, this time is reduced to 6 months of unsuccessful pregnancy search, since from that age onwards there is a physiological decline in fertility, which is even greater from the age of 38 onwards.

If you are a single woman or in the case of female couples, it is recommended that you consult a specialist in assisted reproduction at the moment you wish to become pregnant.

Causes that affect fertility usually do so by decreasing the probability of spontaneous pregnancy. This is why it is preferable to speak of a causal factor to define the disorders that may be responsible for an alteration in reproductive capacity. Although there are some disorders such as the absence of spermatozoa or fallopian tubes that limit reproductive capacity absolutely.

The main factors are: male factor (25-35%), tubal factor (refers to the fallopian tubes and their environment) (17-20%), endometriosis (5-15%), ovulatory factor (35%), infertility of unknown origin (20%). It is common to find more than one factor even if one of them is the dominant one, in this case we speak of sterility of mixed cause (20-60%).

The Basic Fertility Study is a set of diagnostic tests to assess the factors that may be causing the failure to achieve a pregnancy naturally.

It begins with a complete medical history that includes personal, couple and family medical history, environmental and occupational factors, consumption of toxic substances and eating habits, followed by a complete analysis of both members of the couple, including a basic blood test (Rh and coagulation, complete biochemistry and serology to rule out infectious diseases).

In women, a gynecological ultrasound is also performed to check the uterus, ovaries and fallopian tubes and to rule out abnormalities. An antral follicle count is also performed to obtain information on a woman’s egg reserve. In addition, a basal hormone analysis is performed to assess possible hormonal imbalances that may affect ovulation.

In men, a seminogram is performed to analyse the seminal characteristics and detect possible alterations in the number, mobility and morphology of the spermatozoa, which may reduce the probability of achieving a pregnancy naturally.

A semen analysis is a diagnostic test that we perform in the andrology laboratory. It is used to evaluate the quality of a semen sample by analysing the seminal characteristics of appearance, pH, viscosity, number, motility and morphology of the spermatozoa.

This is a basic analysis. For a more complete reproductive diagnosis, we recommend performing a semen analysis with REM, i.e. capacitation of the spermatozoa to imitate what they do in nature. With the capacitation we select the spermatozoa that move best and this gives us information on how these spermatozoa have the capacity to fertilise.

Seminogram alterations are variable and are related to the probability of achieving a pregnancy naturally.

It is advisable to perform two seminograms to confirm the diagnosis, as testicular tissue is renewed approximately every 72 days. This is essential if there is a large time difference between the seminograms or if one of them is very altered.

It is also important to assess the patient’s history and rule out any recent factors that may have affected the quality of the semen analysed (fever, medication, stress, etc.).

Artificial insemination and in vitro fertilisation are two assisted reproductive treatments. The difference lies in the way the embryos are generated. In Artificial Insemination, the sperm are introduced into the vagina and follow their natural course. Fertilisation takes place inside the woman. Whereas in In Vitro Fertilisation, the eggs are extracted to be fertilised in the laboratory and generate embryos. These embryos will be introduced into the uterus to follow their natural evolution.

The quality of embryos is established on the basis of morphological characteristics and division rates. This quality determines the probability of pregnancy. In the embryology laboratory we work with the ASEBIR criteria, establishing four categories according to their quality: A, B, C and D. Embryos of quality A have the highest probability of achieving a pregnancy, while those of quality D have a minimum probability.

Yes, with the testicular biopsy technique we can extract sperm directly from the testicle to carry out an in vitro fertilisation treatment. With these spermatozoa, a sperm microinjection or ICSI is performed to inseminate the eggs and produce an embryo that can lead to pregnancy.

Embryo transfer is a short and painless process. Although it does not require sedation, it is usually performed in the operating room due to its proximity to the embryology laboratory. There, the gynecologist will introduce a fine catheter into the uterus and the embryologist will deposit the embryo or embryos at the bottom. Once in the uterus, the embryos will follow their natural evolution to become pregnant.

After the transfer, you will have a short rest in the operating room. Afterwards, you can go about your normal life with certain precautions, such as not lifting heavy weights or making excessive efforts. It is not necessary to have total rest. It has been seen that women who continue with their normal lifestyle after the transfer have a better chance of implantation because the movement helps the embryo to settle in the right place for its development.

The selection of sperm and egg donors is carried out by the medical team of our centre. Blood group compatibility and physical characteristics are taken into account when choosing a donor. We always choose those who have a resemblance to the recipient and/or her family. If a genetic compatibility test is available, it must also be carried out on the couple in order to select a donor who is genetically compatible.

The male factor is responsible for 30-40% of fertility problems, while 15-20% are of mixed cause. It is important to study both men and women because infertility is not an isolated problem of one or the other, but a couple’s problem and should be studied as such.

Yes, pregnancy rates are similar to those of fresh transfers. In some cases, these rates are even higher, as the medication of the IVF treatment can influence the size of the uterus and it is preferable to let it rest and stimulate it independently.

Egg quality is affected by age. From the age of 35 onwards, the decline in quality is more pronounced, so it is advisable to freeze eggs before this age. Freezing the eggs before the age of 35 will increase the survival and pregnancy rate when used in in vitro fertilisation treatment.

Yes, in vitro fertilisation treatment is necessary because the fallopian tubes are no longer well connected to the uterus and the eggs cannot descend through them. If there is no problem with the ovaries, they can be stimulated with medication. Afterwards, embryos will be generated in the laboratory and transferred to the uterus to become pregnant.

Donor sperm is recommended when there is azoospermia or total absence of sperm in the semen, or if there is a severe male factor with no desire for IVF-ICSI. Also in the case of a young woman who has no male partner or a homosexual couple with a reproductive desire. It serves to prevent the transmission of genetic diseases to the descendants (with dominant character and which, at present, are not possible to diagnose by Preimplantational Genetic Diagnosis). Donor sperm is also suitable for men with infectious diseases (HIV) who do not want to resort to sperm washing.

The use of donor eggs is appropriate for women who do not produce their own eggs due to advanced age. Also in the case of early ovarian failure secondary to surgery, treatment (chemotherapy or radiotherapy) or disease. Donor eggs are indicated for pre-menopausal or menopausal women, and for those who suffer from a serious genetic disease. It is also recommended if there have been previous failures of assisted reproduction techniques due to lack of ovarian response to stimulation.

This is because gamete donation is anonymous in Spain. In the ROPA method, what is being done is a non-anonymous donation from a woman to her partner. It is something that is on a par with the donation that is done in cases of heterosexual couples. It is necessary to be legally married in order for the child to be registered in the Civil Registry as the legitimate child of both partners.

The first option is always to use fresh semen on the day of artificial insemination or follicular puncture in the in vitro fertilisation treatments. In the event that the semen sample cannot be obtained on that day or the sample comes from a testicular biopsy, or is of poor quality, the frozen sample should be used.

It is advisable to undergo oocyte preservation treatment before starting chemotherapy or radiotherapy. Ovarian stimulation will be performed depending on the type of tumour and in coordination with the oncology team.