The 11 most frequently asked questions about infertility answered by an expert

When we decide to "go for the baby" everything is doubtful, especially if the pregnancy does not arrive in the first months. That is when we ask ourselves the dreaded question, will I have an infertility problem?

Many times the fear of the unknown plays a trick on us in this situation, which already affects 20% of Spanish couples. Professionals such as Dr. Rafaela González, director of the Almería clinic of the IVI assisted reproduction group meet daily in consultation with couples full of doubts. She solves us the most frequent.

1. What are the causes of infertility?

The causes of infertility are usually divided into three thirds: female, male and a combination of both. Among the female causes, the most common are related to problems in the ovaries, the uterus or the tubes. Of course, in women all pathologies are associated with the age component: from 35 years the reproductive potential decreases and after 40 years, the possibility of pregnancy is less than 10%. In the case of men there may be alterations in the testicles, obstruction of the ducts, pathologies in the prostate, alterations in ejaculation or erection and alterations in the semen.

2. What is the difference between infertility and sterility?

Infertility occurs when the woman has never become pregnant and infertility when she succeeds, but that pregnancy does not come to an end. The truth is that, although they are different concepts, today most professionals use both terms interchangeably.

3. When to go to a fertility clinic?

It must be understood that not all couples will get pregnant the first month they try. The general recommendation is to come to us after a year maintaining relationships on a regular basis (at least twice a week) without using any contraceptive method.

These deadlines change if the woman is over 38 years old or if there are additional pathologies such as polycystic ovary, endometriosis, if she has undergone any gynecological surgery ... In these cases the consultation has to be early and we talk about six months.

4. Is there a way to get pregnant more easily?

It is important to know how our menstrual cycle works to increase the chances of getting a pregnancy. In women with regular rules it is easy to calculate the most fertile moment, which coincides with ovulation. This happens 14 days before the rule goes down: the most fertile days would be the previous three or four and the subsequent three or four. Now there are many applications that calculate these deadlines and are quite useful, as long as we talk, as I said before, about women with stable periods.

5. What are the great enemies during the assisted reproduction process?

I would say that the great enemy is stress, the emotional burden that this whole process entails. He fear of facing something unknown and, above all, not being able to fulfill your goal that is to have a child.

In almost every clinic, psychological support is offered to couples undergoing assisted reproduction treatments. Personally, I think that the part that couples value most is the empathy they have with their doctor, that you are comfortable with him, that you have confidence in his professionalism. If empathy and the good relationship is adequate, that will favor the success of the treatment. The doctors who dedicate ourselves to reproduction, a very important part of the time we spend in consultation we dedicate to the part of emotional assistance to our patients. We do gynecologists, but we also do a bit of companions on the path of infertility, which is quite hard on many occasions.

6. Can I choose sex or any of my child's physical characteristics?

In Spain, choosing the sex of the baby is totally prohibited. It would only be allowed in very specific cases in which there was a paternal or maternal disease linked to sex chromosomes.

The doctors are in charge of choosing the most appropriate semen sample for each woman and a compatible sample will be chosen taking into account characteristics such as blood group, skin color, eyes or size.

7. Up to what age can you be a mother safely?

The law says that a woman can undergo fertility treatment while she is of reproductive age, but does not specify what that age is. In Spain, by consensus, most breeding centers We do not perform treatments above 50 years.

If, when we speak safely, we refer to the health of the mother and the baby, this will depend on the state of health of the patient at the time of seeking pregnancy. We have absolutely healthy 46-year-old patients who have great pregnancies. And there are also 30-year-old women with associated pathology, hypertension, diabetes ... all that will require more thorough control and can be decompensated. More than age is the state of health of the person who is going to be treated.

8. What are the chances of having a child with a chromosomal abnormality?

Women, as we get older, we are generating more embryos with abnormalities or chromosomal abnormalities such as Down Syndrome. Nature has its defense mechanisms: in most cases pregnancy does not occur or the body will reject it and produce an abortion. Thus, with age, the possibility of the embryo grasping decreases and the possibility of abortion increases.

Currently, patients have access to more specific treatments such as Preimplantation Genetic Diagnosis, which consists in genetically studying embryos before implanting them in women. From the age of 40 we usually recommend it.

9. How much does a fertility treatment cost?

It depends on the treatment. The basic price of artificial insemination can be 800 euros per attempt. If we talk about Fertilization in Vitro would be around 5,000 euros with the mother's eggs; if we have to resort to a donor's eggs we would be talking about 7,000 or 7,500 euros and the donor sperm also has an additional cost. Insemination with genetic diagnosis could cost about 8,000 euros, always per attempt.

10. Can it sometimes be necessary to resort to assisted reproduction for a second pregnancy even if fertilization occurred naturally the first time?

It is not usually the most common, but it happens. Many times it has to do with age. If you have already had the former at an advanced age, the second may cost you more because age is an important conditioner. In addition, as our health status changes, the same happens with our reproductive status. In men alike, man makes sperm almost every two months and the quality will depend on his diet, if he is stressed, if he consumes toxic ... There are many circumstances that influence fertility.

11. What are my chances of getting pregnant after treatment?

Today 90% of couples manage to have a baby if they undergo treatment an average of three times. The chance of getting a pregnancy at the first attempt is 50% and it increases as more attempts are made.

Via IVI

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