All You Need to Know About Assisted Reproduction

Infertility refers to a couple’s inability to conceive naturally after attempting for a period of one year. If the woman is older than 35, then this time period decreases to 6 months of seeking to get pregnant.

Infertility may be primary if a woman has never managed to become pregnant. If a woman has managed to conceive in the past but is then unable to become pregnant again after 12-24 months, then sterility is secondary. 85% of couples that aren’t sterile conceive within a year’s time.

The causes of infertility

The causes of infertility affect men just as much as they do women. Therefore, when a couple is having a hard time conceiving, it’s important that both partners undergo analysis.

The main causes of infertility fall into the following categories:

• Ovarian.
• Tubarian.
• Uterine.
• Sperm disorders
• Defective fertilization.
• Problems with implantation.

Other factors that play a role in the increase of infertility cases are:

• Single-parent families.
• The changing role of women in society.
• Delays in the quest to become pregnant.
• Women seeking to have a baby at an older age.

What can I do if I can’t manage to get pregnant?

If you’ve been trying for over a year without being able to conceive, schedule a consult with your gynecologist to begin fertility testing. If you’re over the age of 35, then you should request testing after 6 months of attempting to conceive.

During your appointment, your doctor will identify possible pathologies and risk factors. He or she will also test for possible transmittable genetic anomalies and indicate what treatment strategy is best for you.

What is the process for diagnosing infertility?

In order to diagnose infertility, a specialist must first study the following factors:

• Make sure that there are no problems with the partner’s semen.
• Test to find out if the woman is ovulating and if her ovarian reserve is sufficient.
• Make sure her proper anatomic state and the correct functioning of her uterus and fallopian tubes.
• Complete physical exam.

What tests are necessary?

Below are some of the most common tests that take place during fertility testing:

Espermatograma

An espermatograma is an analysis of the male’s semen. The semen must be collected in a sterile plastic container after 3 to 5 days of sexual abstinence. It’s important not to expose the semen sample to extreme temperatures.

At the same time, no more than an hour should go by before the sample makes its way to the lab. If the espermatograma comes back as abnormal, then your doctor will request to repeat the analysis within 3 to 6 weeks.

An espermatograma analyzes various characteristics of semen on a macroscopic level. These characteristics include the appearance, volume, pH, and viscosity of the semen.

Also, on a microscopic level, it analyzes factors like the concentration of spermatozoa and their morphology, motility, vitality, ability to glutinate, and the unspecific aggregation of the sperm.

Additional testing may be necessary for males. This may include endocrine levels, urine analysis, and genetic studies.

Ovarian studies

When it comes to determining fertility, making sure a woman’s ovaries are functional is fundamental. In other words, a woman seeking to become pregnant must still ovulate and have a sufficient egg reserve.

Ovulation is the ovary’s ability to produce mature eggs that are susceptible to fertilization in order to produce a viable embryo. To make sure that a woman ovulates, there are several tests that women can undergo:

• Ovulation test.
• Measurement of basal body temperature.
• Postcoital evaluation of the cervical mucus.
• Biopsy of the endometrium during the luteal phase.
• Hormone determination through blood testing.
• An ultrasound of the ovaries.

Tubarian studies

Problems with a woman’s fallopian tubes are one of the main causes of feminine infertility. In order to study if a woman’s fallopian tubes are functioning correctly, there are several tests available:

• Hysterosalpingography (HSG). This consists of viewing the fallopian tubes and the uterus through X-rays. It involves introducing dye through the cervix.
• Laparascopy. This is a surgical intervention that allows for the viewing of the inside of a woman’s abdomen by means of small incisions.
• Ultrasound.

Uterine studies

On a uterine level, malformations can be a cause of infertility. These include both congenital malformations (tabicated uterus, etc) and acquired malformations (myomas, polyps, etc). Both make implantation of the fertilized egg difficult. One of the best tests for the study of the uterus is an ultrasound.

Specialists can also study the cervix, although it’s rare for it to be the sole cause of infertility. The cervix can be studied via hysteroscopy, which involves its viewing and the taking of samples.

Assisted reproduction techniques

Assisted reproduction techniques are a set of techniques whose purpose is to treat patients with infertility problems in hopes of producing a pregnancy.

The different types of assisted reproduction techniques include:

Artificial insemination – AI, a type of assisted reproduction

Artificial insemination – or AI – is an assisted reproduction technique that consists of artificially depositing spermatozoa into the feminine reproductive tract. The purpose is to attempt to shorten the distance that separates the egg from the sperm, thus facilitating the encounter between the two.

Depending on the origin of the semen, there are two types of AI. The first is homologous, or artificial insemination by the woman’s partner. The second type involves the use of semen from a donor.

The decision to employ semen from a partner or from a donor has to do with the origin of a woman’s infertility. Therefore, it’s important to study each case individually.

Artificial insemination involves several phases, which are the following:

1. Controlled ovarian stimulation.
2. The inducting of ovulation and programming of the AI.
3. Preparation of the semen.
4. Intrauterine insemination.
5. Support of the luteal phase, with hormones.

In Vitro Fertilization – IVF, another assisted reproduction technique

This method consists of attempting to get a sperm cell to fertilize the egg outside of a woman’s body, in a laboratory. Once this occurs, the embryo or embryos are transferred directly into the uterus in order to achieve pregnancy.

IVF takes place when artificial insemination has failed or isn’t an option. Professionals also recommend  IVF in the context of certain causes of fertility or when genetic preimplantation diagnosis (GPD) of the embryo is necessary.

The phases of this type of treatment are the following:

1. Controlled stimulation of the ovaries.
2. Puncture of the ovaries in order to extract ovules.
3. Harvesting and preparation of the semen.
4. Fertilization and cultivation of the embryos in a lab setting.
5. Preparation of the endometrium.
6. Transfer of the embryos.
7. Pregnancy test.

The embryos that haven’t been transferred can be frozen for use in future transfers.

Intracytoplasmic sperm injection – ICSI

This is a variation of classic in vitro fertilization. In this case, it consists of artificially introducing the head of a sperm cell into the cytoplasm of an egg in order to produce fertilization. In classic IVF, this contact occurs spontaneously by artificial means.

Professionals recommend this course of treatment in the most severe cases of infertility, especially male infertility. This is because it doesn’t require a high sperm quality.

The phases of treatment in ICSI are very similar to those of classic IVF. However, it consists of an additional process, which is the preparation of the sperm in a lab and fertilization before the implantation of the embryo.

In conclusion…

If you’re seeking to become pregnant and have been unsuccessful, don’t hesitate to talk to a health professional. He or she will help to answer your questions regarding assisted reproduction. In this day and age, there are many techniques and tests that keep infertility from being an obstacle when it comes to having children .