Sterility is defined as the inability of a couple to get pregnant after one year of having sex without using contraceptive methods.
It is estimated that between 10% and 15% of couples of childbearing age will have some difficulty in conceiving (approximately between 600 and 700,000 couples in Spain), which is an increase of a 25% compared to what happened 10 years ago.
Despite the increase of the number of couples who consult, the rate of infertility has hardly changed. What has undergone an intense change has been the demography of couples of reproductive age. There is, without doubt, a social change that leads to postpone fertility in the couple.
In our consultation we will be able to start the study to diagnose the couple’s sterility and perform the techniques that are necessary to achieve your objective.
The treatment is absolutely personalized, fleeing of crowded waiting rooms and being visited always by the same doctor, because we believe that having a valid interlocutor in this stressful situation is very helpful and important. Obviously not giving up the help of all the professionals required for the process. In addition the wide opening hours may respond to the couple needs to alter their work life, always respecting the utmost discretion..
After a first study the problem is evaluated and the couple is informed on the most appropriate treatment or technique for their case.
During the study we will carry out:
1.- A complete gynecological examination to the woman.
2.- A spermiogram of the man and an analytical karyotype.
3.- A general and hormonal analysis of the woman including the karyotype.
4.- A hysterosalpingography: a contrast radiograph of the uterine cavity and the tubes.
5.- In some cases it is advisable to perform a diagnostic laparoscopy to the woman when it is suspected the presence of an endometriosis and/or adhesions in the tubes. The test consists of inserting an optic into the abdomen to see the fallopian tubes and ovaries, which is performed in the operating room under anesthesia.
Techniques and treatments:
1- Induction of ovulation.
It is done with medication, in patients with very long cycles or no ovulation at all.
2- Inseminations with the partner’s semen (CAI)
Performed with spontaneous ovulation, or, in case of wanting more effectiveness, with ovulation induction. The appropriate day, the properly prepared semen is introduced on inside of the uterus, ate day, the semen is prepared and deposited on the bottom Of the uterus with which we avoid its passage through the cervical mucus that, in some occasions, hinders its ascent, allowing to increase the possibility of pregnancy.
3-Inseminations with donor semen (DAI):
Like the one explained in the previous section, but needed in the absence of a male partner, or in cases of not having viable spermatozoa. In this case the sperm donor has had a clinical and analytical history including serologies and spermiogram, to discard as far as possible any kind of disease that can be transmitted to the fetus.
The techniques described so far are carried out in the consultation (sperm training is carried out in the andrology laboratory of CIRH with which the consultation has signed a collaboration agreement).
4- IVF-ICSI (In vitro fertilization with or without spermatic microinjection):
In this case a controlled ovarian hyperstimulation is induced to obtain ovules by puncture of the ovarian follicles through the vagina with ultrasound control and under sedation. Once obtained, they are fertilized in the laboratory with the semen of the couple and once we obtain embryos, these are introduced into the uterus through its neck. Fertilization can be done by contacting the egg with the sperm in a glass plate (In Vitro), or by picking the sperm one by one with a micro-needle with microscopic control and then by puncturing the egg and depositing the sperm inside it to obtain the fertilization (ICSI).
5- Egg donation:
In this case, a donor is encouraged to perform the same controls as the sperm donor, and the eggs obtained will be fertilized with the sperm of the couple. Once the embryos have been obtained, they will be transferred to the patient who has been properly prepared for reception.
6- Reception of donated embryos:
This is used when it is needed a donation of an embryo that is not either of none of the partners. These embryos are the result of the donation of a couple who will not receive the transfer.
7- Freezing of embryos:
In the case of IVF, the number of embryos obtained is higher than the number of embryos to be transferred, so it is possible to freeze them and use them once the couple wishes it again (if she does not become pregnant, or after a few years if she has been pregnant in the first transfer to have a second child).
8- Vitrification of eggs.
We can use this technique for a woman that needs to take chemotherapy and / or radiotherapy and wants to keep her eggs without being affected by such therapies. Nowadays we have the option of preserving the eggs to use them once the disease has been cured. Likewise, a woman who wants to keep her vitrified eggs for a later use, may benefit from this technique too.
Also the techniques that require an operating room, are carried out at the Corachán Clinic in Barcelona, a referential center of Dr. Samaranch.
