Assisted Reproductive Technology, In Vitro Fertilization (IVF): When Pregnancy Needs a Helping Hand

Infertility: Why?

In medicine, a couple is considered infertile if they are unable to conceive after two years of trying. The causes of infertility within a couple can be male, female, or both.

On the female side, oocyte aging is a particularly significant factor in infertility. Older women's oocytes more often present genetic (chromosomal) abnormalities and, if fertilized, may give rise to embryos with malformations, which are often spontaneously aborted. Infections caused by sexually transmitted diseases also pose a reproductive problem: the main ones are syphilis, gonorrhea, and chlamydia.

Endometriosis is one of the most common causes of infertility. It consists of the presence of endometrium outside the uterine cavity, generally in the area of the female reproductive system, but also on the external genitalia and other internal organs. The presence of this tissue, which in healthy women is expelled each month with menstruation, generates chronic inflammation of the organs on which it has developed and can prevent their proper functioning.

On the male side, the number of sperm alone is not a proven indicator of fertility, as there is no certain correlation between sperm count and fertility, except in cases of severe oligozoospermia (reduced sperm count in seminal fluid) or azoospermia (absence of sperm in seminal fluid).

Certain working conditions that expose workers to radiation, toxic substances, or micro-traumas increase the risk of infertility. Exposure to urban traffic pollutants also has a negative effect. Smoking harms sperm: smokers often have more sperm with abnormal morphology. The same lifestyle, if excessively stressful, reduces fertility.

Strictly medical causes, on the other hand, include all pathologies that alter the structure and function of the testicle or penis (such as cryptorchidism, hypospadias, varicocele, pathologies unfortunately on the increase).

In Vitro Fertilization (IVF Pregnancy), Artificial Insemination... Assisted Reproductive Technology (ART) Solutions

Medications to Stimulate or Regulate Ovulation

To stimulate ovulation, clomiphene citrate can be used, administered at the beginning of the cycle. The undesirable side effect induced by these treatments is the possible alteration of cervical mucus, which implies the additional intake of estrogens or the addition of gonadotropins, for 6-12 days, in the first part of the cycle, and their use requires constant ultrasound monitoring of ovarian follicles possibly associated with hormone assays to avoid multifollicular stimulation leading to a risk of multiple pregnancies.

If clomiphene citrate does not yield results or is contraindicated, the doctor will suggest using medications based on other hormones, gonadotropins (LH and FSH equivalents).

Surgical Operations: In Women or Men

Laparoscopic surgery has successfully treated many women, mainly infertile patients whose infertility is secondary to adhesions, pelvic and ovarian endometriosis, hydrosalpinx, and polycystic ovarian syndrome resistant to medical treatment. Surgery also allows for diagnosis in many cases of unexplained infertility.

In the male partner, in cases of obstructive azoospermia and in some cases of secretory azoospermia, it is possible to retrieve sperm and testicular tissue, which can be used for assisted reproductive procedures and can be cryopreserved, using surgical techniques called TESE.

The Principle of Assisted Reproductive Technology (ART)

Artificial Insemination, or Intrauterine Insemination

Artificial insemination or intrauterine insemination is a simple procedure that involves placing sperm directly into the uterus, allowing healthy sperm to get closer to the egg.

In Vitro Fertilization (or IVF): Embryo Transfer

In vitro fertilization or IVF is an assisted reproductive technology technique that involves 4 main steps: ovulation induction, egg retrieval, fertilization, and embryo transfer. Before starting treatment, it is important to be well-informed about all the steps and to follow a series of recommendations to prepare physically and mentally in order to obtain a high success rate for the procedure. We review below the fundamental advice to keep in mind when preparing for in vitro fertilization.

Choosing the Right Sperm through IVF with Microinjection (ICSI)

ICSI (Intracytoplasmic sperm injection) is an assisted reproductive technology technique capable of initiating pregnancy even in the presence of very few sperm or in cases of azoospermia (absence of sperm in seminal fluid). This ART technique consists of injecting a selected sperm into the woman's egg, which is pharmacologically stimulated to produce better quality eggs. If fertilization is successful, it produces embryos that are then transferred to the uterus.

EXPRESS QUOTE

Would you like more information?

ART: And the Emotional Toll?

Seeking psychological support during the ART process can be very helpful. This is appropriate and possible at all stages of the diagnostic and therapeutic approach to infertility, and perhaps even after the end of the treatment process.

It is advisable to choose an experienced professional psychologist specializing in infertility, as specific skills are needed to work in this sensitive area of intervention, so that it is possible to accompany the couple through the different stages of the ART journey, to support the partners emotionally, to help them create optimal conditions, both personal and as a couple, to face the ART journey, and if the latter is unsuccessful, to explore another generative project for the couple.

What is the INAMI's Intervention for ART?

From an administrative point of view, in the case of IVF, the INAMI can cover 6 complete treatments for each patient under 43 years of age.

Traditional Pregnancy vs. ART Pregnancy: What Differences?

Physiologically, there is no difference between pregnancies resulting from assisted conception and those resulting from natural conception.

Literature data indicate an increased risk of malformations in ART births compared to births in the normal population; however, this increase seems to be more attributable to the infertility factor than to ART techniques. Indeed, in many cases, the condition of infertility involves abnormalities in gametes (oocytes and spermatozoa), which could affect the risk of malformations.

In the case of a spontaneous pregnancy or assisted conception, it is essential that the expectant mother undergoes the medical and ultrasound check-ups prescribed by her gynecologist on the scheduled dates.

[dt_sc_button title="Free Quote" size="medium" style="bordered" icon_type="" link="url:https%3A%2F%2F127.0.0.1/tds%2Fdevis%2F" textcolor="#ffffff" bgcolor="#0c73ba"]