Embryo culture in incubators with low oxygen concentration

Embryo culture in incubators with low oxygen concentration

By Ana del Mar Crespillo

Under the physiological conditions (in vivo) of the human uterus the oxygen tension is between 2-8%; however, in the vast majority of assisted reproduction laboratories, human embryo culture in vitro is done in incubators with an atmosphere of 6% CO2 and 20% O2. These conditions might compromise the viability of the embryo since high oxygen concentrations can cause the formation of reactive oxygen species (ROS). ROS are molecules derived from O2, superoxide anion, hydrogen peroxide, or hydroxyl radical which can act as powerful oxidizing agents triggering oxidative stress and ultimately, capable of altering the function and structure of many molecules. As a consequence there might be negative effects on the outcome of assisted reproductive techniques.

Fertia Clinic has added a new incubator for in vitro culture designed to maintain culture conditions similar to the womb. With this new incubator is possible to maintain an atmosphere with low oxygen concentration, at around 5%, resulting in a decrease of ROS in the environment surrounding the embryo and therefore, in an improvement of embryo quality and higher success rates of pregnancy.

The candidates that can benefit of this technique are those patients with worse prognosis, as those who have suffered repeated implantation failures or those that respond minimally to stimulation protocols, resulting in a low number of oocytes (poor responders).

 

Clínica Fertia is specialized in the diagnosis and treatment of female and male infertility

The pursuit of parenthood can be an unexpected challenge for some couples; it is estimated that one in seven couples have problems in conceiving, and the incidence is similar in most countries independently of the level of the country’s development.

The impossibility to conceive creates changes in the relationship that can create feelings of anger and guilty. Infertility can be caused by either male or female, and in some cases it arises from the combination of different conditions in both. However, quite a few cases are relatively easy to treat with assisted reproduction techniques at the fertilization clinics, where proper counseling, medical examinations and the ensuing treatment often alleviates the stress caused by this situation.

The most common causes of female infertility include ovarian failure, polycystic ovarian syndrome, thyroid dysfunction, endometriosis, uterine and Fallopian tube problems etc. Male infertility is due to the inability to produce healthy sperm affecting the quality and quantity of the sperm and it represents 40% of cases of infertility. Additional lifestyle factors such as smoking, alcohol consumption, caffeine intake, drug misuse, weight issues (underweight or overweight) and stress are amongst some that can affect both male and female fertility.

On the other hand, there are also an increasing number of single women opting for artificial insemination by donor, which is considered to be a viable option for single and partnered women.

Clínica Fertia (CF)  is specialized in the diagnosis and treatment of female and male infertility and where tailored programs are developed in an efficient caring manner for each couple.

CF incorporates state-of-the-art techniques to ensure successful rates in viable pregnancies. Basic examinations to determine the cause for infertility are carried out fairly quickly. After which, an individual treatment plan is drafted depending on each specific case. The techniques used at the reproduction clinic include ovulation induction, artificial insemination, IVF, DNA fragmentation, ISCI, embryo biopsy, blastocyst culture, embryo cryopreservation, embryo and egg vitrification, pre-implantation genetic diagnostics as well as donor egg program.

When pregnancy is achieved, the follow-up and antenatal care is normally planned according to individual needs, with the incorporation of 3D and 4D ultrasound scans for fetal monitoring.

SUMMARY: CF welcomes those who need help in infertility and provides international experience and modern techniques to provide solution to any problems of  reproductive issue.

 

Hyperprolactinemic Amenorrhea-Bromocriptine As Fertility Medication For This Cause Of Infertility

When Bromocriptine Could Be Prescribed
One of the less common causes of infertility is hyperprolactinemic amenorrhea.  This condition is caused by a benign tumour on the pituitary gland, which will cause the secretion of too much prolactin.  Prolactin is a hormone which can inhibit ovulation as it reduces oestrogen levels.  If a doctor diagnoses it is likely that bromocriptine will be prescribed.

Bromocriptine can also be prescribed for the male partner if his infertility issues can be linked to his pituitary gland.

How Bromocriptine Works
Bromocriptine works by reducing prolactin levels.  Typically treatment will take a few months until the levels have reached what are considered to be within the normal range, and the patient’s periods have returned.

Bromocriptine can be taken either as a pessary or a pill.  It is considered to be safe to take this fertility medication for several years.  It will be taken two to three times per day.  Many couples will conceive after the woman’s periods have returned after a course of bromocriptine without any additional type of fertility treatment.  B-crip, Parlodel and Proctinal, are the names that you may find for this medication.

90% of women will start to ovulate again whilst taking this fertility medication.  Unlike Clomifene and other fertility medication, there is no extra risk of multiple births with this fertility drug.

Some studies have shown that it can also reduce the chance of miscarriage for those women who have prolactin levels which are too high.  Women who have an over-abundance of prolactin circulating in their system can experience a greater incidence of multiple miscarriages.

Bromocriptine-What Are The Possible Side Effects?
It is recommended to avoid taking grapefruit juice and alcohol while on bromocriptine.  There are a range of common side effects associated with is but these should go after a few weeks, once you have stopped taking it.

The common side effects include fatigue, headaches, indigestions, a higher sensitivity to the cold in toes and fingers especially, dry mouth, diarrhoea, dizziness, drowsiness, stuffy nose, stomach cramps, nausea, loss of appetite and light headedness.

There are also some women who may not be resistant to it or not able to tolerate it, in which case they will be offered Cabergoline.

Some of the more extreme possible side effects are anaphylaxis, blood clots and strokes, which would be a very rare side effect.

If anaphylaxis occurs, get urgent medical help straight away.  Anaphylaxis is a sudden allergic reaction which can occur with other medication also, and it is recognisable by extreme systems such as difficulty in breathing or swallowing, and swelling of the throat, lips, tongue and mouth.

Blood clots are a risk factor for any medication which changes the hormonal balance in the body.  There is a risk that these can be fatal.  Depending on the location of a blood clot, the symptoms can be different.  Any symptoms should not be ignored and medical help should be sought urgently.

There is a slight elevation of the risk of stroke when taking bromocriptine and it is a very rare side effect.  Symptoms of stroke include drooping of one side the face, a feeling of heaviness on one side of the body, sudden headache, loss of vision-partially or fully, tremor and slurred speech.   Do not hesitate for a moment, and call an ambulance immediately.

Anyone who wishes to become pregnant will benefit from leading a healthy lifestyle and for those who need to take bromocriptine or any form of fertility medication, this will be very important.  It will help both you to deal with side effects, which can even be reduced by leading a healthy lifestyle.  It will of course help your changes of a healthy pregnancy if and when you do conceive.

Infertility Treatment And Issues – 7 Top Tips For Dealing With Emotional Stress

Each month, hormone levels rise and fall, especially around the time when conception is likely. However, as hormones rise, so does stress when a couple is trying unsuccessfully to get pregnant.  Infertility can cause great sadness every month that passes without getting pregnant.  Depression among women having trouble conceiving a baby is equal to those people who have cancer or heart disease.  Women are not the only ones who get depressed, as men also feel depression.  In fact, infertility can place a great strain on even the most solid of marriages.

Infertility treatments can interfere with work and relationships. Marriage is tested by intercourse that is scheduled and anxiety over the high cost of treatment.  Spending time with family and friends with babies can be hard and may lead to isolation.  It is important to stay social because comfort is greatly needed at this difficult time.

The endless cycle of hope and despair that comes each month after trying to conceive a child can place great stress on a couple.  This stress can be a leading cause of infertility in the first place.  There is no medical evidence to support this fact, yet many infertile couples believe there is a high correlation between the two.   Stress can have a negative effect on a woman’s hormones, especially those responsible for reproduction.  High stress levels can also lead to low sperm production in males and spasms in a female’s fallopian tubes.

Increased stress may further impair the possibility of getting pregnant and causes more anxiety.  This is why it is essential to learn how to properly cope and manage stress in a proficient manner.

Ending The Infertility Stress Cycle

Managing the anxiety that comes along with infertility can help a person regain a feeling of control.  As depression and anxiety lessen, a person will be better able to make treatment decisions.

To break the stress cycle, there are a few tips to help a person relax and enjoy life again:

  1. Join a support group to learn more about infertility.  Research and discuss available options of treatment.
  2. Find professional guidance to help cope with emotional issues associated with infertility.  A mental health professional that is familiar with the emotional aspect of infertility can be extremely helpful.
  3. Take advantage of therapies for relaxation like massage, yoga, and acupuncture.
  4. Do something nice for yourself.  Perhaps a weekend getaway will be able to take the mind off of the situation.
  5. It may be helpful to take a break from treatments.  This may remove some of the tension that is building and add a renewed energy to later treatments.
  6. Maintain a healthy diet.  A balanced diet that is filled with nutrition will help a woman stay at an appropriate weight and provide the vitamins necessary to conceive or maintain a pregnancy.
  7. Follow a regular exercise routine.  Taking a walk or bike ride may be able to free the brain.

There is no doubt that infertility causes a great strain on personal life.  Couples must mentally brace themselves for the roller coaster ride and embrace the strength in each other to get past the anxiety that comes along with the situation and not succumb to infertility depression.

IVF Abroad – 3 Reasons Why It Could Be A Good Choice

For anyone who is thinking of the possibility of IVF abroad, the following three reasons from Clinica Fertia may help your decision process.

These three reasons why IVF abroad, or any fertility treatment abroad, at the right clinic are based upon both the experience of this fertility clinic in Spain, as well as findings of the Transrep team.

The Transrep team is a study on cross border reproductive care, at Leicester’s de Montford University, led by Professor Lorraine Culley.  The study is exploring the reasons why more and more couples from the United Kingdom are travelling abroad to centres such as Clinica Fertia in Spain for IVF abroad. The report highlighted some of the reasons why this is becoming an ever more popular choice.

1. Individualised Care

The first reason cited in the report is the level of personal care patients receive at clinics like Clinica Fertia. No patient is just a number. Many participants in the study claimed that even in private clinics in the UK they weren’t treated as individuals and often would see different staff at each visit. By far and away, Spain comes out on top as destination of choice for UK patients seeking IVF abroad. Clinica Fertia prides itself on treating each patient as an individual and guiding them through the choice of treatments and the IVF process itself.

2. Timing

Although up to three cycles of IVF are available on the NHS, in practice few people will meet the strict criteria to qualify for it. Those that do often find themselves added to long waiting lists. The anxiety caused by waiting can put undue stress on a relationship and certainly does not aid fertility. In many cases, by the time they would reach the top of that list they are no longer eligible for IVF due to age or the progress of an underlying fertility problem. At Clinica Fertia there are no waiting lists and as it is proved time and again timely medical interventions have greater chances of success.

3. Choice

Not all couples requiring IVF can use their own sperm or egg cells. In this case, donated cells are required. A shortage of donors, especially egg cell donors increases the amount of time patients have to wait for IVF and making the time lag between IVF cycles difficult, if not impossible, to predict. The number of egg donors and sperm donors in the UK has fallen rapidly since they are no longer allowed to donate anonymously.

Laws in Spain protect the identity of donors and compensate them more generously so more willingly come forward. The availability of eggs and sperm for those requiring these is far greater in Spain than in the UK and across much of Europe in general giving it somewhat of a reputation for being Europe’s egg cell centre. Clinica Fertia offers IVF using donor eggs, donor sperm or both without having to wait for new donors to come forward.

Cost

Patients travelling to Spain for IVF at Clinica Fertia may be embarking on their first round of IVF or may have been through one or more IVF cycles before coming. The cost of IVF in private clinics in the UK can be prohibitive. Choosing a clinic with as enviable a success rate as Clinica Fertia will reduce the costs of IVF even with travel expenses factored into the equation as fewer cycles are likely to be required. The emotional saving of speedier success is, of course, immeasurable.

Fertility Drugs-What Is Clomiphene? How It Works And Its Potential Side Effects

One of the most widely used fertility drugs, Clomiphene is used to stimulate brain hormones in order to cause the release of an egg, or eggs, every month. If you are familiar with fertility drugs, you have most likely seen this under the brand names  of Clomid and Serophene.

Clomifene-How Does It Clomifene Work?
Basically what Clomifene/Clomiphene does is that is sends signals to receptors which in turn tell the body to cease making oestrogen, as there may have been levels of oestrogen which inhibited menstruation.   Once these levels are reduced then the pituitary gland should increase the production of follicle stimulating hormone (FSH) and this encourages the ovaries to ripen eggs making them ready to be released.  This then results in higher levels of lutenising hormone which is the hormone which commands the ovaries to release, which in turn leads to a period being stimulated.

The actual name of the active ingredient is 2-[4-(2-chloro-1,2-diphenylethenyl]phenoxy)-N,N-diethyl-ethanamine.  Clomifene is what is known as
a SERM – selective oestrogen receptor modifier.

The aim of this fertility drug is therefore to bring the woman’s cycle into one that is regular.  A woman’s fertile time lasts for about three days each month, which is when the egg cell has been released from one of her ovaries and then makes its journey down the fallopian tube to the woman’s womb (uterus).  By making a woman’s cycle more predictable and regular, her chances of conception are greatly increased.

With Clomifene achieving this can take on average, between four to six menstrual cycles.  Ovulation tests can also be used in order to know when an egg has been released.  These tests are little sticks, quite like pregnancy tests, where they are tested with a small amount of the woman’s urine.

Possible Side Effects of Clomifene
Clomifene can frequently cause the ovaries to release more eggs, each time, rather than just one single egg.  This means that the chances of twins or multiples being conceived are greatly increased.  Of course some people may consider this a good thing rather than a side effect.  There are couples and women who see it as an opportunity to complete their family sooner rather than later.

However multiple pregnancies are considered to carry higher risks.  This said, the vast majority of multiple pregnancies do result in the delivery of healthy babies.  This type of fertility drug may not be suitable in cases however where the possible mother to be has certain health problems which may add to the risk factors associated with multiple pregnancies.

In general Clomifene has been used for over 30 years for the treatment of female infertility and has a robust safety record.

Other side effects that may be experienced when taking Clomifene are similiar to PMT and menopausal symptoms.  These include bloating, abdominal cramps, hot flushes, visual issues such as blurring and depth perception changes.

Some women may develop ovarian cysts while taking Clomifene but these normally heal after the drug has been ceased.  There are rarer side effects also such as spotting, nausea, vomiting and alopecia.

Fertility Drugs-An Introduction To Fertility Medication

Fertility Drugs- What Are They?
Fertility drugs are medications which may be prescribed to women who are not ovulating properly.  These medications aim to trigger the production of eggs and it is possible for women to become pregnant using fertility drugs only.

They are also prescribed alongside other fertility treatments such as IVF and intrauterine insemination (IUI).

For men, fertility drugs do not play such a big part in infertility treatment, although some medications may be prescribed.

A Little About Human Reproduction
When human reproduction occurs, the human being is created by a sperm cell and an egg cell.  These reproductive cells are known as gametes.  Problems with gametes can be a central cause of infertility issues.

In the case of the egg cells, there are three predominant issues that can occur.  Firstly some women may not release eggs even though they are having their periods, and secondly some women may not be menstruating at all, due to some health issue or age.  Thirdly it is possible that there are too few eggs, or finally, that even though the eggs are being released that they are not of sufficient quality to result in a viable pregnancy.

In the issues of low quality and low quantity eggs, it is unlikely that fertility medication can help.  A woman’s eggs develop while she is still in her own mother’s womb and like her other body cells they also age.   Whereas a man produces sperm cells right throughout his life.

Period Problems
It is often the case that women who go to fertility clinics are surprised to be told that even though they are having regular periods they are not releasing eggs.  Other women have period problems which are more apparent, in so far as they may have infrequent or unpredictable periods, or they may have stopped completely.

It is in cases like these that fertility drugs will be used and as mentioned, this may be a sufficient course of treatment which results in a viable pregnancy for some women.

Some Widely Used Fertility Drugs
Nowadays many fertility drugs have been used successfully and safely for more than thirty years.   Let’s take a look at some of the widely used fertility drugs.

Clomiphene is used to stimulate hormones in a woman’s brain to get one or more eggs ready to be released each month.  It comes under the brand names Clomid and Serophene.

Gonadotropins are used to directly stimulate the ovaries to produce one or more eggs each month.  Brands are: Fertinex, Follistim, Gonal F, Menogon (Europe only), Novarel, Ovidrel, Pergonal, Pregnyl, Profasi, Puregon (Europe only), Repronex.

Bromocriptine is used in the more unusual case of pituitary adenoma being the cause of infertility.

Fertility Treatments Spain-Why Malaga Is One Of The Most Popular Destinations

For many decades the Costa del Sol has been a popular holiday destination with foreign tourists who are searching for warm sunshine, a glittering blue sea and that lovely feeling of sand between their toes.  These foreign visitors have also enjoyed the heritage, the culture, the fiestas, the endless relaxation and many aspects that make the Costa del Sol a popular destination.  Yet these days Malaga, the capital of the Costa del Sol, has become popular for another, perhaps less obvious reason: it is a prestigious destination for those who seek fertility treatments.

European Fertility Society Statistics
Statistics supplied by the European Fertility Society state that around 25,000 women travel to avail of assisted reproduction treatment in other countries each year.  Out of these about 33% of them come to Spain, with the majority of these going to Barcelona, the Costa del Sol, Levante and Madrid.  In some clinics in the province of Malaga, this demand for fertility treatments from foreigners far outweighs that of local residents.  Some clinics stated that 70% of their patients came from other countries and other clinics were even higher with 80%.

Prestigious Fertility Clinics Spain
Then it is no wonder that this influx of this “new type of tourist” has been labelled as fertility tourism, which is a term that is not well-liked by the specialists; understandably.  Many clinics in Malaga have built up excellent reputations over the years and it is their prestige, and of course results, that encourages foreign couples to choose Malaga for their fertility treatments.

The Spanish legislation also lends itself to the situation, as it is quite lenient.  In Spain the only assisted reproduction techniques which are not allowed are gender selection and commercial surrogacy.  Egg donation is legal.

One clinic stated that of the 500 patients who visit his clinic on average each year, and receiver eggs, 80% are foreigners.  The average cost for this fertility treatment comes in around 5,000 euros, however this is a ball park figure and can differ depending on the clinic, medications and other aspects of the treatment.

There is no doubt that this is a lot of money to most people however when you are looking at success rates of between 60 and 70%, it has a high chance of being money which is well invested.

A biologist from another clinic said that from every 30 eggs which are donated, only 2 go to Spanish women.  Those who donate their eggs are often doing so for altruistic reasons.  The Spanish women are aware that there is a high demand, and many of the donors are already mothers, some donors are not but do feel that solidarity with other women who have had fertility challenges.  The donors or volunteers are given a 900 euros compensation for the inconvenience.

Who Goes For Fertility Treatments In Spain?
Those who avail of these fertility treatments including egg donation are generally over 40 and have an average age of 43.  The majority of foreigners who come to Malaga for fertility treatment are heterosexual but there are also homosexuals and single women.  The majority of patients come from the United Kingdom, but they also come from France, Belgium, Norway, Germany, and even as far afield as USA and Australia.  After the United Kingdom the majority come from Italy, as Berlusconi’s government banned both the donation of semen and eggs in 2004.

As well as the successful track record, excellent reputation for caring professional clinics, the destination of the province of Malaga often offers that extra comfort of lovely weather.  As undergoing fertility treatments can be stressful for lots of reasons, being able to relax in a nice, warm environment can also be helpful.

Preparing For IVF – How To Feel As Prepared As Humanly Possible

The decision to undergo an in vitro fertilisation procedure is a significant choice which has a major impact on the woman’s life, as well as the couple, if she is in a relationship.  As many people expect that becoming pregnant will be relatively easy, the road travelled to reach the point of seeking IVF has no doubt been a bumpy and difficult one. Now that you have reached that turn in the crossroads, you will appreciate that it will help to be aware of the emotional and physical aspects to preparing for IVF.

In preparing for the IVF journey, knowing what you can expect and what you should consider before the process will help you to feel more comfortable and familiar with the procedure overall. To best prepare for in vitro fertilisation, keeping some of the following elements in mind will help you to be more aware physically and emotionally.

In terms of preparing physically, your doctor will give you guidelines of what you should and should not do before your in vitro fertilisation procedure. You may have to stop taking certain medications the day before the procedure. It is also recommended that you stop smoking or avoid it since smoking delays the healing of any wounds and can cause breathing problems during the procedure.  Some doctors may also request that begin to drink clear liquids or clean your colon and intestines before you get the procedure done.

Since recovery is also a factor afterward, you will need someone to drive you home from the hospital and also help you with some basic care. Most women return to their normal activities after a few days, but sexual activity should also be refrained from for at least 2 weeks after the procedure.

Because in vitro fertilisation can have such a large role in helping a woman to become pregnant and start a family, it is understandable that it can be a very emotional experience. This is even more so true for women who have been trying to conceive for an extended time without any results. Your doctor will likely discuss statistics with you and remind you that not all in vitro procedures are successful the first time. It’s important to understand that the procedure may not initially result in a pregnancy and that you may have to try again a few times before you find success.

Another common emotional issue related to in vitro fertilisation is embarrassment. Some women are embarrassed that they need to use in vitro procedures to become pregnant in contrast to natural conception via intercourse. However, conception via in vitro fertilisation is completely normal and actually very common. The procedure has helped a large percentage of women to become pregnant and start on the pathway towards motherhood.

IVF In Spain-Why Choose A Private IVF Clinic In Spain

When would be the perfect time to start a family? Biologically, a woman is in her reproductive prime in her late teens and early twenties. It is easier to conceive at this age plus the body recovers from pregnancy and birth more quickly. Unfortunately, biology, the overriding factor in making this life changing decision isn’t the only one that must be taken into account. Being able to provide for a child financially and emotionally, offering it stability in its formative years is essential. It’s these social reasons, among others, that lead more and more couples to try to conceive later in life and for many, this can prove difficult.

Infertility is an increasingly common problem

It is estimated that around 14% of Europeans have problems conceiving. The demand for fertility treatments such as IVF is increasing. In the UK, the NHS will provide up to three cycles of IVF provided strict criteria are met. In practice few couples wishing to try IVF meet these and with the additional restrictions put in place by individual primary care trusts there is a perception of there being a ‘postcode lottery’. Some couples on extremely long waiting lists for treatment become ineligible for treatment before their turn comes around. There is always the option to seek treatment privately at home or abroad. There is a selection of Spanish fertility clinics which offer a wide range of fertility treatments including IVF with an enviable success rate.

Why go to a private clinic?

Trying to conceive a child is an emotionally charged endeavour. If all does not go to plan, the initial excitement and anticipation can quickly morph into anxiety and even despair. This will not increase the chances of conception and many couples have reported that having to wait for fertility treatment fuels anxiety and puts a huge strain on their relationships. In medical terms, having to wait for treatment will decrease the likelihood of its success as age increases and underlying fertility problems may progress.

Why go abroad?

In a recent study for Transrep at de Montford University, one of the main reasons cited why patients travel abroad to clinics in countries, like, is not having to wait. Of course, timely treatment at a good clinic increases the chances of success. First time couples and those who have already had IVF and wish to try again have good reasons for taking the private option: perhaps they do not, or no longer, meet their national criteria for IVF. They increasingly choose to look abroad to clinics that will offer them a much greater chance of success than local clinics.

When deciding to embark on IVF at a private clinic, one of the main points to take into account is its success rate.  Be sure to check this out as well as making sure you feel comfortable with the clinic you choose.

Clinica Fertia has a healthy success rate. 56% of women under 35 who received treatment at Clinic Fertia achieve an ongoing pregnancy. This outstrips the NHS results by more than 20% and is coupled to an outstanding quality of very personalised care that is second to none.