{"id":47787,"date":"2019-12-06T14:00:18","date_gmt":"2019-12-06T14:00:18","guid":{"rendered":"http:\/\/fertilityroad.com\/?p=47787"},"modified":"2022-09-29T12:58:43","modified_gmt":"2022-09-29T11:58:43","slug":"the-new-challenges-of-assisted-reproduction","status":"publish","type":"post","link":"https:\/\/fertilityroad.com\/da\/fertility-journeys-project\/the-new-challenges-of-assisted-reproduction\/","title":{"rendered":"The new challenges of assisted reproduction"},"content":{"rendered":"
Do you know what are currently the main infertility problems and the primary reasons why treatments fail? <\/strong><\/p>\n\n\n\n In this article, experts from the Dexeus Mujer centre in Barcelona address and answer these issues. <\/strong><\/p>\n\n\n\n Having children is not always easy, and the fact that many women delay their maternity complicates it even more, since from 35 years the quality of oocytes decreases, and the risks increase. <\/p>\n\n\n\n Currently, in Spain the law allows the donation of gametes and embryos anonymously, which has increased the chances of having children and the demand for treatments. However, despite this and the many advances that assisted reproduction has experienced in recent years, the expected results are not always obtained: sometimes things go well at first and sometimes not, and you have to keep trying or change strategy. The question is: why? <\/strong><\/p>\n\n\n\n At Dexeus Mujer we have extensive experience in treating elderly women difficult cases too. In fact, 25% of the patients who come to our centre have failed treatments in other centres, and that does not affect our success rate. However, each woman and her circumstances are different and there are many factors that can influence and ultimately determine the success or failure of a treatment. <\/p>\n\n\n\n In this article, Dr Beatriz \u00c1lvaro<\/strong>, an expert in assisted reproduction and Gynaecological Endocrinology, considers the main causes of infertility; the reasons which make it difficult to achieve a pregnancy and what options reproductive medicine can offer in each case.<\/p>\n\n\n\n This is an increasing problem because of advanced maternal age. The quantity and quality of our oocytes decreases progressively from the age of 35, and the chances of achieving a pregnancy as well. In fact, between the ages of 40 and 45 the chances of getting pregnant naturally do not exceed 5%.<\/p>\n\n\n\n Quality is mainly marked by age. The number of remaining oocytes or the ovarian reserve cannot be calculated exactly, but the markers of ovarian reserve (anti-mullerian hormone and count of antral follicles on ultrasound) can give us an approximate idea.<\/p>\n\n\n\n If the problem is quality or the patient gets a poor response to ovarian stimulation treatment, it is likely that it will be necessary to turn to a donor.<\/p>\n\n\n\n They can be caused by hormonal imbalances that affect the reproductive system, such as polycystic ovary syndrome, lack of ovulation due to hypothalamic-pituitary axis disorders (which is involved in the functioning of the reproductive system activating the process of maturation of the oocytes), and some diseases of the thyroid gland. Other possible causes are a decrease in ovarian reserve (in medical terms: premature ovarian failure) or an early menopause (when it occurs before the age of 40).<\/p>\n\n\n\n Through a hormonal study carried out by a specialist. <\/p>\n\n\n\n Many endocrine disorders can be controlled with hormonal treatments and do not prevent having children, but in these cases, it is important to make an early diagnosis and not delay motherhood. If the problem affects the ovarian reserve or is due to early menopause, it is advisable to consult an expert in reproductive medicine. In these cases, egg donation could be the most appropriate resource.<\/p>\n\n\n\n With age, the risk of miscarriage or of having an embryo with chromosomal abnormalities also increases, which can lead to developmental problems and difficulties in embryo implantation, leading to pregnancy loss. It depends on the cause of the problem. It is best to perform tests that help determine the cause and make the diagnosis to decide which is the best treatment option in each case. There are different options: embryonic selection of embryos, treatments to correct immune or coagulation problems, surgical hysteroscopy or surgery when abnormalities in the uterine cavity are discovered.<\/p>\n\n\n\n In more than 50% of cases, infertility is related to a problem of male origin, since, according to statistics, only 30% are due to a problem exclusively of female origin. If you have a partner, it is essential to have a complete review that includes physical examination, blood test and seminogram. The andrologist will indicate if any further tests are necessary. At Dexeus Mujer we have a specific unit for male sexual health to detect these problems.<\/p>\n\n\n\n Depending on the cause, the treatment varies: a pharmacological or surgical treatment (TESE, microTESE, vasovasostomy or microsurgical varicocelectomy) can be performed, and genetic advice and specific sperm selection tests, are among other measures.<\/p>\n\n\n\nPoor quality or insufficient oocytes production<\/strong><\/h2>\n\n\n\n
How it is detected<\/strong>?<\/h2>\n\n\n\n
What solutions are there?<\/strong> <\/h2>\n\n\n\n
Ovulation problems<\/strong><\/h2>\n\n\n\n
How it is detected<\/strong>?<\/h2>\n\n\n\n
What solutions are there?<\/strong> <\/strong><\/h2>\n\n\n\n
Implantation failures<\/strong><\/h2>\n\n\n\n
Although sometimes miscarriages also occur in young women. It is necessary to find out if the cause is chromosomal alterations of any member of the couple (or both) or disorders related to the immune system. They can also be caused by unnoticed structural problems of the reproductive system.<\/p>\n\n\n\nWhat solutions are there? <\/strong><\/h2>\n\n\n\n
Male factors<\/strong><\/h2>\n\n\n\n
In 30%, the problem is only male and in another 30% it is due to both female and male factors. In the remaining 10%, the cause is unknown. In general, the most frequent causes of male infertility are: poor semen quality, seminal duct obstructions, including agenesis of vas deferens associated with mutations of the CFTR gene (cystic fibrosis) or ejaculatory alterations, hereditary factors (chromosomal alterations or hereditary diseases ), idiopathic primary testicular failures, cryptorchidism, varicocele (varicose veins in the scrotum), hormonal disorders, chronic diseases such as obesity or diabetes, and infectious diseases.<\/p>\n\n\n\nHow they are detected?<\/strong><\/h2>\n\n\n\n
What solutions are there?<\/strong> <\/h2>\n\n\n\n
Structural problems in the reproductive system<\/strong><\/h2>\n\n\n\n