Strictily speaking the definitions currently accepted are:
- Primary sterility: when the couple has not managed to achieve a pregnancy after having had unprotected intercourse for a year.
- Secondary sterility: When , after having had a first child, the couple has not manged to achieve a second pregnancy after having had unprotected intercourse for two three years.
- Primary infertility: When the couple achieves a pregnancy but is unable to maintain it long enough for it to lead to the birth of a baby.
- Secondary infertility: When the couple , after the first pregnancy and labour, does not manage to maintain a pregnancy long enough for it to lead to the birth of a baby.
In Spain around 800.000 couples have fertility problems. It has been estimated around 20% couples having problems to conceive a healthy child.
We can say it affects both of them. In men we can say there are different causes:: alterations in the testicular area, obstruction of tubes, prostate pathologies, alterations in ejaculation or erectile function or alterations in the semen. And for women: early menopause, endometriosis, obstructions or injuries of the fallopian tubes, uterine or cervical anomalies or ovulation problems. We prefer to speak about fertility problem in the couple , as in most cases there is a a mixture or a combination of causes in which both parties are responsible. We always prefer to speak about the causes or reasons of the couple as a whole because, whatever the problem, the cooperation of both parties is fundamental.
Ovulation or the fertile period of a woman occurs around half-way through each cycle, on roughly the fourteenth day in a supposed 28 day cycle. It has been proven that in the 24 hours that follow ovulation, base body temperature rises from 4 to 6 decimal points. This is the signal on which the control method is based, marking the days on which ovulation occurs. But anyway we know sperm lives 72 hours and the egg 48hours. So if a couple has intercourse around two three times per week, there is always probability to become pregnant without using ovulation, kits, or vaginal temperature… all these mthods promote stress and very low benefit.
If you would like to become pregnant and have not managed after trying for more than one year, or 6 months if you are over the age of 35, you should seek help from a reproductive health specialist.
We believe that age is the deciding factor; if you are young you can postpone seeking help for longer, but if you are over 35, you should know that from that age onwards fertility clearly declines.
It is a medical centre highly specialised in the methods of diagnosis and treatment of fertility problems. It is made up of modern facilities and highly qualified staff specialised in the latest Assisted Reproduction Techniques. It is better to seek help from gynaecologists specialised in reproduction because infertility studies include tests that are not carried out during routine gynaecological check-ups.
In our centre, we perform infertility investigation within one month. There is no waiting list for fertility couples , so it does not take long from the first thought of visiting a fertility centre, till the time when we can offer the most accurate treatment for this couple according to their specific characteristics.
We perform a basic study that involves, examination, ultrasound and medical history for the woman as well as examination, hormonal tests, sperm test and medical history for male. Once we have those , then we consider the need to check fallopian tubes patency. Doing things this way , we try to avoid too many tests, too many visits and too much inconvenience for the couples. Couples are always visiting same doctor.
Mother`s age and period of time spent for this couple in order to achieve a pregnancy are the most important factors. Treatment will not be same for a couple 39 years old woman and 10 years trying to become pregnant if we compare with another couple same diagnosis, but 26 years old and two years trying to conceive. For this second couple treatment will be much more simple.
If there is a clear diagnosis, treatment can start immediately. Anyway we will adjust treatment to the couple`s schedule . And for egg recipients it takes one or two months wait.
For insemination, we consider four attempts is enough as 90% pregnancies occur during the first four cycles. For in vitro fertilization or ICSI we never perform more than four attempts. And for egg donation is more difficult to stablish a limit, it will depend on psicological factors and economical factors as well.
Since the majority of treatments are no longer carried out under general anaesthetic, the risk of complications is very small . Despite the fact that the hormone medication does not involve any risks, the main problem that could arise is the ovarian hyperstimulation syndrome, which is caused by the hormone treatment. This syndrome occurs when women respond to the treatments by producing an excessive number of eggs, causing abdominal discomfort during a few days. If that occurs, we sometimes recommend cancelling the medication in order to avoid taking any risks. It only occurs in a small percentage of cases, and through regular check-ups your gynaecologist will be able to tell you whether or not you are at risk. In the worst case, the patient will have to spend a few days under medical supervision at the clinic.
During collection of eggs other complications can arise as infection, internal haemorrage,... anyway these complications are very rare and just happen less than one case per one thousand. br />
About hormones , we know they are safe and no relationship with ovarian cancer or breast cancer has been stablished.
In Spain 83% of babies born after fertility treatments were single, 14% were twins, and just 1% triples. And nowadays multiple pregnancies are less and less frequent.
In our centre we just transfer one or two embryos, if there are good quality spared embryos we freeze them. According to our law for assisted reproduction, we storage them for five years, after this period, couple will have to choose what to do: use them for themselves, donate them to another couple, donate them for reaserch, or just not storage them anymore.
Yes, there is only slightly higher miscarriage risk if we compare with general population.
Yes, there is no higher risk for fetal abnormalities, or chromosomic problems …these are same as general population. Only for children been born after ICSI because of male factor. Some of these patients are carriers of genetic disfunction and this can be inherited by their children, so that means, that these children will need assisted reproduction techniques to become parents themselves.
No. Spanish law just permits to do so for therapeutic reasons.
Yes. If these women have irreversible sterility and are under 40 years of age. Goverment will pay for their treatment. But for those ladies alone not been sterile or over 40 years of age, they will have to pay treatment themselves.
Yes, nowadays menopausal women can become pregnant with donated eggs. There is no age limit in this country, but we do not perform this treatment for women older than 50 years of age.
Privacy is their main concern , and that is absolutely guaranteed. They are also worried about health of the donors as well as physical appearance . In our clinic besides following all instructions stablished by our fertility law regarding tests and examinations for donors, we try to match physical appearance as much as we can.
Conceiving a child for an infertile couple can cost 800 euros to 6000 euros, depending on which technique we apply. It also depends on how many times they have to perform the treatment.
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