When a couple decides to have a baby and cannot achieve it naturally a state of alarm overcomes: Something is not working quite right!
When after several in vitro fertilisation (IVF) cycles they learn about the term “implantation failure” or what “repeated miscarriage” is, this is when the real problem arises. It is in these cases, the most complex ones, when it is recommended to seek the help of a specialised centre that counts on a competent investigation team and an innovative laboratory. Both teams must be able to implement the latest advances in assisted reproduction to achieve an increase in the pregnancy rates.
Among the different factors that can influence the failure of a pregnancy, the embryo quality is especially prominent, so that if it is not of optimum quality the pregnancy will not be achieved.
To check the quality of the embryos, in IVF Spain we perform a Pre-implantation Genetic Screening (PGS). Its role is to detect any chromosomal alterations, whether in number or in structure, with the aim of transferring the embryos with an adequate chromosomal content. The chromosomal alterations increase with age, therefore it is recommended to apply PGS to patients from 38 years of age.
Another study factor is the endometrial quality and microenvironment.
In order for the process to succeed, a molecular dialogue must take place between the embryo and the endometrial cells. Thanks to the endometrial receptivity test ER Map® we can evaluate the degree of endometrial receptivity during the implantation window.
On the other hand, but without leaving the endometrial environment, we must not forget the immunological factor. Sometimes the mother’s cells acquire an anomalous behaviour and act rejecting the embryo, since they detect sperm elements in it, therefore an implantation failure follows. This increased immunological response can be detected in the rise of the Natural Killer (NK) cells. To treat this in IVF Spain we administer intravenous immunoglobulins that are capable of decreasing the NK levels.
It seems studies focus only on female factors, but this is far from the truth. The male factor is responsible for more than 40% of all infertility cases.
From the first consultation in IVF Spain complex studies are performed to help detect sperm anomalies beyond concentration, mobility and morphology. This is done through an advanced spermiogram.
To continue with the advanced sperm analysis, apoptosis markers are evaluated, which determine the percentage of sperm cells that are about to initiate cellular death and therefore are not able to culminate the reproductive process. In the cases in which the cell death percentage is too elevated we turn to techniques that help select the sperm cells with fertilisation potential. Through all these processes, together with the DNA fragmentation, with which we determine whether there is damage to the genetic material, we attain a global view of the reproductive capacity of the patient’s sperm.
Sometimes embryos stop their development before the 5th day.
This sign suggests a failure in the male factor, that is, the sperm. In these cases we resort to testicular aspiration (TESA) with which we collect sperm cells that despite not being mature, increase the pregnancy rate.
In summary, in most cases having access to a multidisciplinary team able to implement the latest advances in reproductive medicine makes a great difference when it comes to achieving the desired pregnancy.
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