The treatment of infertility can range from simple advice to the use of Medically Assisted Procreation techniques. Below are described briefly some of these techniques: 

• Ovulation induction with gonadotropins

• Intrauterine insemination

• In-vitro fertilization (IVF) / intracytoplasmic sperm injection (ICSI)

• Use of donor sperm

• Use of oocyte donor

• Preimplantation genetic diagnosis

 

OVULATION INDUCTION WITH GONADOTROPINS

This treatment consists in the use of hormones (gonadotropins) so that a follicle develops until it reaches a diameter of more than 16mm. At this point another hormone is administered for triggering ovulation which will occur, generally, after 36 hours. Sexual relations are programmed for this time.

This treatment involves a daily injection of gonadotropins at a certain hour. It also implies do some ultrasounds to monitor the growth of follicles.

 

INTRAUTERINE INSEMINATION

Ovulation is induced in a similar way as described in the previous treatment. The only difference is that instead of having normal sexual relations at the time of ovulation, the spouse collects sperm, the sperm is treated in the laboratory and an active sample is injected directly into the uterus through a very fine catheter.

 

 IN-VITRO FERTILIZATION AND  INTRACYTOPLASMIC SPERM INJECTION

The IN-VITRO FERTILIZATION (IVF) is a technique that basically consists in the placement of oocytes and spermatozoa in a an appropriate culture medium in the laboratory, so that fertilization occurs. The resulting embryos (usually one or two) are then transferred to the uterus, to develop naturally.

 

The INTRACYTOPLASMIC SPERM INJECTION (ICSI) is a technique used in the context of an IVF cycle, in which a sperm is injected directly into the oocyte. Technical indications are fundamentally the serious shortcomings of spermatozoa and fertilization failure in the normal IVF.

IVF is the treatment of choice in cases of tubal obstruction and in some cases of endometriosis and certain problems of spermatozoa.

The success rate of IVF depends on several factors, the most important of which is the female. The success of IVF is less the greater the woman's age, especially after 35 years, following the natural decline in fertility.

The probability that a woman under 35 has to conceive an IVF cycle exceeds the probability that a normal couple has of getting pregnant in a given month, approaching 30%.

The IVF success rate increases with the number of attempts (up to four).

Of pregnancies resulting from IVF about 75% are single gestation,  23% are twins and 2% are triplets.

Children resulting from IVF have the same incidence of birth defects than children conceived naturally.

 

IN-VITRO FERTILIZATION (IVF) STEP BY STEP

The following steps correspond to the luteal long protocol.

 

 

USE OF DONOR SPERM

In case of absence of spermatozoa one of the hypotheses that it is possible equate is the use of donor sperm.

The most used technique is intrauterine insemination (described above), using the sperm of a donor whose characteristics are close to the male element of the couple.

USE OF DONOR EGGS

In certain situations (especially in premature menopause) in which there is no chance of collecting woman's eggs may be resorted to donor eggs.

PREIMPLANTION GENETIC DIAGNOSTIC 

The preimplantation genetic diagnosis is a technique that can be used in the context of an IVF to identify embryos that are not affected by specific genetic disease (paramyloidosis, hemophilia, chromosomal abnormalities, for example), thereby reducing the risk of a child born affected by these diseases.

Cryopreservation