WE CAN FULFILL YOUR DREAM OF BEING PARENTS, EMBRACE LIFE

Memorial in Vitro Fertilization (IVF) Centers try to find solutions for many different issues by means of their medical specialist team, from failed IVF cases to elderly women becoming mothers, from severe male infertility to recurrent miscarriages. Our IVF Centers can diagnose many genetically transmitted diseases such as thalassemia, muscle diseases and hemophilia in embryos and thus help healthy children be born.

Implantation Failure

The treatment of implantation failure requires a specialized approach, which at Memorial Fertility Center we take care of from a specific multidisciplinary unit.

It is defined as the failure to achieve a viable pregnancy after IVF treatments. It includes patients who do not gestate and those who have suffered early abortion.

Some causes are maternal but most are embryonic.

The treatment of embryonic implantation failure requires a multidisciplinary assessment; for this reason, at the Memorial Center, we created a working group specializing in these disorders.

Treatments

There are a number of treatment methods that can solve these problems, and improve chance of implantation success. A simple aspirin can be used for any problems with blood clotting discovered through the thrombophilia screen.

Endometrial scratch is a method of stimulating the womb prior to implantation that has been shown to improve implantation outcomes in those that had previously suffered with repeated implantation failure. Embryo selection techniques can help to overcome certain causes of cycle failure, such as a genetic screen of embryos, and using an embryoscope to monitor development of the embryo using time lapse technology.

At the same time, another technique that has shown its benefits in carefully selected cases is the intrauterine application of platelet-rich plasma (PRP). Recent studies have shown good results on the role of platelets in the repair and regeneration of different tissues in patients with recurrent embryo implantation failure and in women with refractory endometrium. The use of platelet-rich plasma from the patient herself could improve endometrial receptivity and, consequently, implantation.

Irregular Cycle

One of the main questions we see on a daily basis in gynecological consultations is associated with irregular menstrual cycles. There’re various causes and/or factors that influence the menstrual cycle irregularity. With regard to hormonal factors as such, we can mention the following:

• Polycystic Ovary Syndrome
• Hyperprolactinemia (increased prolactine).
• Thyroid disorders
• Ovarian insufficiency

There are other factors that can affect menstrual regularity such as:

• Coagulation disorders
• Presence of polyps, fibroids, endometriosis, etc.
• Stress
• Eating disorders (anorexia)
• Obesity
• Intense physical exercise.

Most patients with irregular cycles do not ovulate, which means the egg is not released into the fallopian tube and fertilization does not occur. However, some patients with irregular cycles may have an occasional ovulatory cycle and achieve the desired pregnancy. In the case of patients with irregular cycles who are seeking pregnancy and the couple has a normal previous study, we can offer treatment to help achieve ovulatory cycles.

Treatments

Many of these couples can benefit from Directed Coitus using oral ovulation inducers, such as oral ovulation stimulants, or using Gonadotrophins subcutaneously at low doses. This type of treatment requires monitoring from the beginning, to assess follicular development and hormone levels ultrasonographically. This treatment aims to generate ovulatory cycles and schedule sexual relations at home when the ultrasound and hormonal criteria are met to trigger ovulation.

Artificial Insemination (AI) is another technique that can be indicated in cases of patients with irregular cycles. In order to carry out this technique, a previous study of the couple is required. As with directed coitus, the aim of this technique is to achieve an ovulatory cycle and trigger ovulation when ultrasound and/or analytical criteria are met. We can schedule the insemination 36-38 hours later at our clinic, previously preparing the seminal sample (capacitation).

In vitro Fertilization (IVF) is one of the techniques that could be indicated in cases of irregular cycles, such as those associated with maternal age, alteration of the fallopian tubes (obstruction), alterations in the seminogram, or failure of previous treatments (directed intercourse, artificial insemination).

Low Ovarian Reserve

Women are born with the entire amount of oocytes that they will have during their whole life. As time passes by, these oocytes will be lost until they completely run out with the onset of menopause.

The ovarian reserve is defined as the total quantity of suitable oocytes available in a woman’s ovaries at any given time, which shall determine the number of oocytes that can be obtained during IVF treatment.

To measure ovarian reserve, we use the antral follicle count by ultrasound and the Anti Mullerian Hormone (AMH).

As previously indicated, ovarian reserves reduce progressively with age until they completely run out. The main cause of low ovarian reserve is age. However, reserves can greatly vary even among women of the same age, with some women showing a low reserve earlier than others.

Treatments

Over the last few years, our Unit has developed and perfected the most innovative stimulation protocols. From adjuvant therapies to improve ovarian tenderness to luteal phase stimulation, including the accumulation of vitrified oocytes and the use of soft protocols, all the above techniques have been implemented in order to obtain promising results in patients who would otherwise be required to find an oocyte donor.

Male Factor

Recent researchers have shown that 47% of infertility cases in a couple are down to an issue with the man. The most common issues amongst men are “changes in the sperm with no apparent cause”. That is a low number of sperm, poor sperm mobility, or abnormal morphology. Additionally, there may be more concrete and identifiable reasons for changes in sperm such as obstruction issues, infection, diseases, or genetic reasons which impede egg fertilization or which affect embryo quality. Sometimes during the analysis process, an associated pathology is detected in the man and which may be caused by infertility but we also find a related illness that may be the cause or effect of that infertility.

It’s essential to consult a specialist in order to determine the specific tests and most appropriate steps for each patient. During that visit with the doctor, the possible common sterility issues, possible exposure to toxins, lifestyle, etc. are analyzed. An appointment with an andrologist is also essential. He/she will carry out exploration and analysis and will recommend the best technique for obtaining sperm. The two main types of way to obtain it is by testicle biopsies which can be carried out for sperm removal are MESA and TESE.

Treatments

For the treatment, the ideal technique is ICSI (Intra-Cytoplasmic Sperm Injection) when the male factor is moderate or severe. If sperm abnormality is light, other techniques may be used like AIH.

Unexplained Infertility

Nowadays, basic sterility studies are unable to detect the exact cause of over 25% of all cases, which doesn’t mean that it can’t be diagnosed with specific tests or that a case with an unknown cause can’t be properly treated. It is important for the couple to improve their reproductive health and create a favorable environment for conception by eliminating toxic substances such as tobacco and illegal drugs that affect the quality of reproductive cells, being aware of the most fertile days of the cycle, including antioxidants and certain vitamins in the diet, correcting unbalances in body weight and finally, improving and adjusting their sexual technique.

Diagnosis and Treatments

In many cases, the diagnosis and treatment come together. Thus, In Vitro Fertilization allows us for the first time to see the quality of the eggs (female reproductive cells), since we don’t know anything about them until they are collected from the ovaries. We also study the interrelationship with sperm. If fertilization takes place naturally or there is a failure due to abnormal egg/sperm interaction (which is often called “incompatibility” and successfully treated through IVF). Lastly, we can also learn about the key player: the embryo, since the cause of the problem often does not lie in either the man or the woman, but rather in the embryo.