When and why to undergo an endometrial biopsy

As specialists in assisted reproduction we are continuously researching new techniques to improve treatment success rates. Today we are going to talk about the benefits of an endometrial biopsy.

What is the endometrium?

Simply speaking, the endometrium is the active layer which lines the inner walls of the uterus. When stimulated by hormones (either from the ovary or external hormones from medication), the endometrium grows and prepares to receive the embryo which will develop there throughout pregnancy.

What is an endometrial biopsy?

It is a procedure which is performed in the doctor’s consultation room without sedation or anaesthesia. After placing the speculum, the cervix is visualised and a thin tube is inserted to collect some endometrial tissue. The procedure allows us to obtain a sample to send off to the laboratory for different types of analyses. Read more ›

Posted in Assisted Reproduction, Fertility, Gynaecology

Increasing pregnancy rates per transfer: the Time Lapse technique

This new visualisation system is key to the monitoring of embryo development.

Timelapse

As biologists we are faced with a dilemma when it comes to evaluating the development of embryos obtained through assisted reproduction treatment. Viewing them through a microscope – to see the number of cells, fragmentation and other morphological indicators – allows us to classify qualitative data with the purpose of selecting the embryos with the greatest chances of implantation for the transfer.

However, this way of viewing the embryos means that we have to remove them from their controlled culture conditions: a change in temperature and humidity and exposure to concentrated atmospheric oxygen and light radiation; these are all factors which can have a negative impact on embryo development.

This is the reason why embryos are observed and evaluated only when strictly necessary. In turn, however, this means that the information we have on embryo development –information which is necessary for selection of the best embryo to transfer- is very limited.

The development of image-capturing systems integrated in incubators, known as Time Lapse monitoring systems, has changed the way we see embryos. These systems take a series of photographs at specific time intervals, usually every 5 to 15 minutes. The images are viewed like a video which allows us to observe embryo development in real time and, essentially, analyse certain morphological events that are key to embryo development. Determining how and when these key elements in embryo development occur is called morphokinetic analysis, and it allows us to develop new algorithms for embryo classification. Read more ›

Posted in Assisted Reproduction, Fertility

How do pesticide residues in food affect semen quality?

 “Fruit and vegetables with high levels of pesticide residues are associated with a lower total sperm count, a lower percentage of morphologically normal sperm and a decreased volume of ejaculate among men presenting to a fertility clinic.”

These are the conclusions drawn from a study carried out by Chiu et al., and published in Human Reproduction in 2015. It is the first study to deal with the relationship between the presence of pesticides in food and sperm quality, others only having evaluated the presence of environmental or work related pesticides (occupational contamination). Read more ›

Posted in Assisted Reproduction, Fertility

Becoming parents with HIV: a reality

Acquired immunodeficiency syndrome (AIDS) is considered one of the most serious and tragic epidemics of the twentieth century. It is caused by the HIV virus and affects both men and women. It possible to contract it through sexual relations, blood, and, on occasions, a mother can pass this on to her child during birth.

Thanks to research and improvements in treatment, which are becoming more and more personalised, HIV has become a chronic and controllable disease. This has led to an improvement in the patients’ quality of life and life expectancy. Quality of life meaning, the ability to follow life’s normal path without their daily lives being constantly restricted by the illness. This, in turn, leads to the desire to think about the future and have children. Read more ›

Posted in Assisted Reproduction, Fertility, Obstetrics

Why do we use a hysteroscopy in assisted reproduction?

The hysteroscopy is a useful tool both for the diagnosis and the treatment of many gynaecological diseases and conditions. This is the traditional standpoint, yet for some time now it has been considered that it is the field of infertility which can benefit most from this type of technique.

It is widely known that submucosal fibroids affect implantation; however, other pathologies such as polyps, adhesions (Asherman syndrome) and a uterine septum can also make conceiving a pregnancy difficult. Read more ›

Posted in Assisted Reproduction, Fertility

Assisted Reproduction without Hormones

Despite the fact that treatments have improved, both in terms of efficiency and safety, the hormone medication required by treatments is still a source of concern and fear for many patients. Ginemed’s research into assisted reproduction has meant that, in certain cases, we have been able to carry out in vitro fertilisation treatment without hormones. As this respects the natural ovulatory cycle of the woman, it is also known as a pure natural cycle.

What is a natural cycle?

Naturally, women produce one egg in every ovarian cycle; as the development of this egg has not been forced or altered (the egg’s natural selection has been respected) it benefits from having reached optimum maturity. While there is one downside, that we only obtain one egg per cycle, the excellent quality of this egg balances out this disadvantage. Read more ›

Posted in Assisted Reproduction, Fertility

How important is the thickness of my endometrium?

The endometrium: the tissue that lines the inside of the uterus, acts as a “bed” or “cradle” for the embryos during the implantation process.

Apposition: the first moment when the embryo finds “its spot” in the endometrial cavity, is the first step in the implantation process.  After this follows adhesion, the moment when the embryo makes contact with the endometrium, and finally, the trophoblasts invasion.

We all know, that in order to conceive a pregnancy, it is essential for this “bed” to be well-made and that this is why the sex hormones (estradiol and progesterone) act to prepare the endometrium, making it its most receptive during this period.

It is hardly surprising therefore, that assisted reproduction treatments have placed such importance on the appearance of the endometrium and why we aim to ensure that it is adequately prepared; either using exogenous hormones (oestrogens and progesterone); or using the woman´s own ovulatory cycle, to achieve the optimum endometrium for the embryo transfer.  Read more ›

Posted in Assisted Reproduction, Fertility

The path to motherhood: why do I sometimes feel like I can´t go on?

This is a question that is asked by many patients at some stage, both before and during pregnancy. Don´t worry, you are not alone. This “transient” feeling doesn´t come out of the blue; it is the product of a number of different factors that are found on the road to motherhood. Today, even the decision to become a mother is a complicated one:

  • The actual moment in which we decide to become a mother.
  • The different ways of conceiving this sought-after pregnancy.
  • The decision to be a single mother.
  • The decision to become a mother with another woman.
  • The decision to become a mother after the age of 40.
  • Being a mother thanks to egg or embryo donation
  • Etc.

The different possibilities available today when it comes to having a family highlight the fact that, above all, having a child is a choice; yet whatever your family might look like, there is always a common element: love. Read more ›

Posted in Assisted Reproduction, Fertility

Infertility tests: Why doesn´t every clinic ask for the same?

I am often asked during consultations why we ask for certain tests that other clinics have not asked for, or indeed why those other clinics did not ask for that test, something which might have meant a successful outcome in the first cycle.

At times, it is difficult to explain why, but one important factor to consider is that public and private reproduction clinics are very different, and that not every patient needs or is looking for the same thing.

When thinking about infertility tests, the majority of which are very expensive, we must consider the fact that public reproduction centres are reliant on public funds and therefore have to try and ensure that their services reach as much of the population as possible. Although they are aware that they could carry out more tests and that these tests might improve results, it is a balancing act.

Often we look to the karyotype (a study of the chromosome map) as an example. Despite the fact that approximately 1% of infertile couples have an alteration in their karyotype many public centres prefer not to carry this test out; they know that they are overlooking this 1% of the population, but if they can save on chromosomal tests, it is possible to treat more families.

Thus, we find ourselves facing the first obstacle: infertility tests are expensive and the public health service´s primary aim is to reach as many patients as possible and to ensure that as many people as possible have the opportunity to receive treatment.   Read more ›

Posted in Uncategorized

Genetic Matching: Preventing hereditary diseases.

As the Spanish singer, Serrat says…. our children often look like us. Something that humanity has and will always take great pride in. We have genetics to thank for this, in both the best and worst possible senses.

I say the worst, because just as our children can inherit our hair, our eyes, the colour of our skin, genetics goes beyond mere physical features, and at times, this can be something less desirable.

This is true where hereditary diseases are concerned, and although they are known as rare illnesses because they are, in essence, rare, they result in severe disabilities and have a negative impact on our quality of life.

Yet, if we have always been healthy, how do we pass on a genetic disorder to our children? Read more ›

Posted in Assisted Reproduction, Fertility