Before you begin

What is the difference between sterility and infertility?

Strictly speaking, the currently supported definitions are:

  • Primary infertility: when the couple after a year of relationships without contraceptive control has not achieved a pregnancy.
  • Secondary sterility: when the couple, after obtaining the first child, does not achieve a new pregnancy after 1 year.
  • Primary infertility: when the couple achieves a pregnancy but does not reach term with a newborn.
  • Secondary infertility: when the couple, after pregnancy and childbirth, cannot achieve a new pregnancy at term with a newborn.

Should I go to a specialized center or can I wait to get pregnant on my own?

If you want to get pregnant and can’t get it after more than 1 year trying, or 6 months if you are over 35 years old, you should see a reproductive medicine specialist.

We believe that age is decisive, if you are young you can delay it longer, but if you are older than 35, it is not advisable to wait long, you should know that from that age fertility begins a clear descent.

Is it very common to have infertility problems?

Approximately 20% of couples of reproductive age have infertility problems. In Spain, some 800,000 couples suffer from fertility problems.

Is infertility a problem for women or men?

At IMF, we consider that infertility problems are a couple’s problem, and it is essential that both men and women are equally involved in all stages of diagnosis and treatment.

In any case, medical studies observe that the cause of infertility is attributed to women in 50% of cases and to men in 40%, although in many of these cases the causes they are mixed, that is, attributable to both.

In the remaining 10% of cases, it is stated that sterility is of unknown origin, even after performing all the diagnostic tests.

Can IVF and ovarian stimulation harm my ovaries?

There is no proven evidence that the ovaries decrease their follicular reserve or can be damaged by these techniques.

What is an assisted reproduction clinic?

It is a medical center highly specialized in methods of diagnosis and treatment of sterility problems. It is made up of modern facilities and highly qualified personnel to perform advanced Assisted Human Reproduction Techniques.

It is preferable to go to gynecologists specialized in reproduction, because the study of sterility includes tests that are not performed in the usual gynecological examinations.

Can the results of the studies confirm the fertility of the couple?

In general, studies can never ensure the fertility or infertility of women or men, since no test has an absolute value. But they give us a very precise and real approximation of the possibility of a pregnancy occurring.

Only the total absence of sperm, or the absence or reliable obstruction of the tubes allow us to absolutely affirm infertility.

Is there a waiting list? How long will it take to perform these techniques?

The current waiting list is about 8-10 days for the first consultation. If the diagnosis is clear, you can start treatments immediately. In any case, you can schedule these treatments for the month that best suits you (check with the nurses in this section).

If you are an egg recipient, the waiting list for our egg donation program is 2-3 months.

What are the chances of pregnancy?

The chances of fertilization and pregnancy vary depending on the conditions of each pairage, age, quality of gametes, etc. At this time, thanks to the evolution of assisted reproduction techniques, 87% of the cases we treat at MFI are solved.

To get your bearings you can consult our results.

My cycles and ovulations are not regular.

A common cause of infertility is ovulation disorders… In women with regular cycles (every 28–30 days), ovulation occurs in the middle of the cycle, approximately on day 12-14 of the cycle; but if, on the contrary, the intervals between menstruation are long, beyond 35 days, possibly, ovulation does not occur in a cycle, or it occurs 20-25 days after the rule.

The solution to this problem is the stimulation of ovulation with medications, always under strict ultrasound control, and if there is no other problem added to this cause, you can simply schedule sexual intercourse when the Ultrasound indicates that you are near ovulation.

My tubes are blocked.

The fallopian tubes are the meeting place of the ovum and the sperm, so if both the left and right tubes are obstructed it is almost impossible for a spontaneous pregnancy to occur. Long ago the solution was surgical recanalization of the tubes, but today in vitro fertilization (IVF) is much more effective.

I have been diagnosed with endometriosis

Endometriosis is a disease whose cause is unknown; it is endometrial tissue (which is tissue inside the uterus) located outside the uterus. It is not known with certainty how this tissue gets out of the uterus. This endometrium can be located in places other than the pelvic cavity. Sometimes it is operated and other times it is more prudent not to operate depending on the location and extent of the endometriosis.

My semen quality is poor.

Diagnostic tests (seminogram, sperm survival test, biochemistry or semen culture) provide us with information about the quality of your semen and the ability to fertilize it. These data, together with the results of the gynecological examination of the woman, allow the gynecologist to guide them about which assisted reproduction technique (Artificial Insemination, In Vitro Fertilization and Sperm Microinjection), is more appropriate in their case.

A woman who has endometriosis may have a more difficult time getting pregnant.

About 30 – 40% of women with endometriosis have fertility problems. The reason for infertility is not fully known, although it is believed that endometriosis triggers a hostile environment for the implantation of the embryo, in addition to sometimes causing mechanical problems such as adhesions and obstructions of the tubes. Some women with endometriosis will need fertility treatment in order to become pregnant.

I had a vasectomy or a tubal ligation but now I want to be a father or mother.

It is not strange that a man or a woman, who at the time decided to resort to surgery as a contraceptive method, now wants to have a child. In these cases, Assisted Reproduction Techniques emerge as an effective and fast option compared to the not always possible reconstructive surgery. Couples in this situation increasingly choose to resort to In Vitro Fertilization or Sperm Microinjection. The choice of one or the other technique depends on whether the couple has any other fertility problem, which will be diagnosed in the tests prior to treatment.

In the case of the man who underwent a vasectomy, it is necessary that he previously undergo a small surgical intervention known as TESA, which is a testicular biopsy with which it is intended to check if they continue to exist (as in the vast majority of cases) sperm in the testicle. If they do exist, they are frozen by the time the IVF cycle begins, so the biopsy is only necessary once.

The procedure is simple, is performed under local anesthesia and analgesia, does not require hospitalization and the patient can usually go back to work the day after the intervention.

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In Spanish legislation on Assisted Reproduction Techniques, the possibility that any woman without a male partner can use these techniques to become a mother is considered a right.

If the woman does not present any fertility problems, which is determined in the previous tests, the recommended assisted reproduction technique is Artificial Insemination with Donor semen. In the event that a fertility problem is detected, you can resort to In Vitro Fertilization, again with donor semen.

The legislation obliges the medical center to keep the donor and the recipient anonymous. Semen donors are strictly selected and subjected to rigorous psycho-sanitary controls.

I am a menopausal woman and I want to be a mother.

In order to achieve a pregnancy, it is necessary for eggs to come out of the ovaries. When the ovaries stop working earlier than expected, and menopause arrives, the only possibility of achieving pregnancy is by using eggs (or, failing that, embryos) from another woman. This in vitro fertilization technique with donated oocytes offers a high success rate, since the eggs come from young women with no known fertility problems. There are no limits set by law regarding the age of women.

Although pregnancies as old as 60 years are possible, in IMF, except in exceptional cases, we do not include women over 50 years of age, since they increase gestational and fetal complications, and also because we It worries that the newborn is raised by a woman of sufficient age, health and energy to face the all-important mission of raising and educating a child.

I had no sperm detected in my ejaculate.

Faced with a seminogram with absence of sperm, the first thing indicated is to confirm the diagnosis by repeating the seminogram, subjecting the sample to a vigorous centrifugation. If they are detected, a sperm capacitation test is carried out in case it is possible to isolate live sperm, even in a small quantity, and they are frozen.

In any case, and if the diagnosis of absence of sperm is confirmed, your urologist will carry out a study to determine the possible causes; In this study, a series of tests will be carried out, including a genetic study and hormonal analysis. If all these parameters are favorable, we will proceed to perform a testicular biopsy, in order to recover sperm from the testicular tissue and, if there are any, freeze them. From this moment on, we can try to achieve pregnancy through in vitro fertilization with sperm microinjection, using previously frozen sperm.

My partner is a carrier of a hereditary disease, could we have a non-carrier child?

Thanks to the Preimplantation Genetic diagnosis, it is possible to differentiate in many cases, the embryos carrying the defect, from the healthy ones, selecting the latter to be transferred to the uterus, with which the newborn will be free of the disease.

I have been diagnosed with a Varicocele.

The andrologist will assess your case. In most cases, it is not necessary to undergo surgery, since the effect on the improvement in mobility and sperm count is doubtful, and with assisted reproductive techniques, the possible problem can be solved more effectively of fertility that is usually associated with varicocele. Consult your case with an appointment and we will advise you.

My partner is HIV positive.

Do reproductive techniques reduce the risk of infection to the partner or offspring in seropositive men for viral diseases such as hepatitis and AIDS?

In men with viral diseases such as Hepatitis or HIV, with a positive viral load in plasma and semen, it is possible by means of washing and gradient techniques to make this viral load negative, which is verified prior to use of semen with polymerase chain reaction (PCR) techniques. In this way, the risk of transmission of these diseases to offspring is almost completely eliminated.

We’re already working on it

Will the same gynecologist always attend me?

At the IMF, one of the main objectives is personalized attention. The patient will have a referral doctor who will attend her regularly. But you must bear in mind that since visits and controls can be any day of the week, including weekends and at certain times, it will not always be possible to meet the same gynecologist

In any case, you should know that clinical sessions are held to monitor all cases by the entire medical team.

What are the main assisted reproductive techniques?

The main techniques of Assisted Reproduction are Artificial Insemination and In Vitro Fertilization. Within In Vitro Fertilization, it is possible to differentiate conventional In Vitro Fertilization and Sperm Microinjection. For more information visit our Treatments section.

Which technique is better, artificial insemination or in vitro fertilization?

These are different techniques and each one is indicated in certain cases. Artificial Insemination is simpler, it consists of depositing the sperm selected and trained in the laboratory, inside the woman’s uterus at the time of ovulation.

In Vitro Fertilization is more complex, because it first requires ovarian stimulation, puncture of the ovaries to extract the woman’s oocytes, which will be fertilized by the sperm in the laboratory, and after 2 After 3 days of development in special incubators, the resulting embryos will be transferred to the uterus, to continue the natural process of pregnancy.

If I don't get pregnant in the first cycle of treatment, how long do I have to wait to try again?

In the case of artificial insemination cycles, the cycles are usually made consecutive without any waiting. In IVF cycles it depends on the individual response of each woman, but it is usually expected 1-2 months.

How many times can I try?

There is no specific number. It will be decided by the physician and patient based on personalized circumstances. But in general, at least 3 cycles should be attempted, if pregnancy does not occur in this interval, the change in technique will be evaluated.

Are these treatments painful?

These are not particularly painful techniques, since the injections are administered subcutaneously with very fine needles, with the additional advantage of self-administration by the patient. The most annoying thing could be the puncture, but in MFI they are always performed with an anesthesia specialist, who will administer the necessary analgesia, so that the puncture IS ABSOLUTELY PAINLESS.

Does puncture of the ovary require hospital admission?

No admission is required, and after finishing the puncture after a short observation period of 30-60 minutes, the woman will go home to rest. It is not advisable to start work this day.

How long will the whole process take?

Since ovary stimulation begins, about two weeks, but we usually carry out a preparation period of about 15-20 days prior to the start of the cycle.

What time availability do these treatments require?

For Artificial Insemination:

During the cycle you must go to a consultation 3 to 5 times to perform controls. The duration of the consultation is usually about 15-30 minutes. On the day of Artificial Insemination, the husband, if applicable, must provide a sperm sample at least 1 hour before performing the technique. Artificial Insemination is a process that does not require rest, neither that day nor the following, so it can work without any problem. Violent efforts are not advised. Thanks to the breadth of our hours you can go to control visits and Artificial Insemination outside of your working hours.

For FIn Vitro foundation:

In the preparation phase, there are no controls to be carried out, but once stimulation begins, approximately every 3 days you have to come to a consultation for ultrasound control. An average of 3-7 controls are performed depending on the regimen used and the response of the ovary. The duration of the consultation is usually about 15-30 minutes. On the day of the egg retrieval, the husband provides a sperm sample, and the woman goes to the operating room for 30 minutes, being sedated during the intervention and being able to go home quietly afterwards. After 2-3 days, the woman must return to the clinic for the embryo transfer. It takes 15 minutes to do this and then a relative rest period of about 24-48 hours is recommended. Later, until you know whether or not you are pregnant (approximately 15 days), you can work normally.

** If you live outside of Madrid, know that it is not necessary for you to spend any night in Madrid. Cycle controls can be carried out in our center or by a gynecologist in your province who knows the treatments, so that they would only travel to Madrid on the day of the egg extraction and the embryo transfer day.

Is one oocyte always removed from each follicle?

No, it depends on each patient, but in general, in at least 60-70% of the follicles we are capable of recovering an egg. There is never more than 1 oocyte per follicle.

How many eggs do you usually come out and how many embryos should you get?

It is important that you know that not all punctured follicles necessarily have an egg inside, and that some of the eggs obtained will not be suitable for fertilization. The number of eggs obtained will vary depending on each case, sometimes it may happen that hardly any eggs are obtained, and in others the number of eggs obtained can be very high, it will depend on factors such as age, pathology and response to treatment. The average number of eggs or oocytes obtained is 5 to 10, and 3 to 6 embryos in women under 35 years of age. Even if we transfer a single embryo to the uterus, there is a possibility of pregnancy so you should not worry if the number of eggs obtained or the number of fertilized embryos is low.

I'm going through the whole fatal process, I'm very nervous, what can I do?

Assisted reproductive techniques are complex processes that condition a large number of aspects of your personal life and as a couple, doubts and fears may appear that run parallel with feelings of great illusion and impatience. IMF, offers its patients a monitoring and psychological support service that will help to prepare patients emotionally to face the treatment in the best possible way, teaching them relaxation techniques and reducing anxiety.

What risks are there?

The risk of complications is very low. Hormonal medication has no risks and side effects, unless ovarian hyperstimulation syndrome occurs. This syndrome occurs because the woman reacts to the treatments by producing an excessive number of eggs, which generates certain abdominal discomfort for a few days. In these cases, it is sometimes recommended to cancel the medication to avoid risks. In any case, the percentage of cases in which it occurs is low and your gynecologist will warn you during the controls if there is such a risk or not. If there is a risk, it is decided whether or not to continue with the treatment. If it is not continued, the syndrome will not appear, so the picture will never appear if the patient does not want to assume the potential risk of suffering from it. For your peace of mind, in more than 25 years of experience in Assisted Human Reproduction, we have not had any case with serious consequences for the patient, at most a few days of stay and control in a clinic.

Another risk to mention is the possibility of multiple pregnancy. In In Vitro Fertilization, if 3 embryos are transferred, the approximate percentage of twin pregnancies is 10-20% and of triplets 1-6%. If this possibility is not considered under any circumstances, you can voluntarily reduce the number of embryos to transfer even if your chances of pregnancy decrease. Thanks to the increasing efficiency of In Vitro Fertilization processes, the number of embryos that need to be transferred is lower, and therefore a decrease in the frequency of multiple pregnancies is detected.them. In any case, the couple decides whether to put 1, 2 or 3 embryos.

Finally, there are other types of risks, such as bleeding or infections, whose incidence is extremely low.

We can conclude, saying that assisted reproductive techniques are very safe, with a very low rate of complications, and most of them avoidable.

Can you have sex after IVF?

There is no fixed period, but we recommend a period of abstinence of 1 or 2 weeks. Uterine contractions associated with orgasm can interfere with the early stages of implantation. On the other hand, the micro trauma involved in penetrating a sensitive and hyperstimulated ovary can be annoying. In addition, it increases the risk of infections in a vagina with a vaginal flora and defenses possibly altered throughout the procedure.

How long after can I get back to my usual activity?

At IMF, we recommend an absolute rest period of 24-48 hours after embryo transfer. After this time, the woman can return to her usual activities, taking life in stride if possible. Violent sports and exercises should be avoided until we diagnose the pregnancy.

Why aren't all the embryos obtained transferred?

The current Assisted Human Reproduction law limits the maximum number of embryos to transfer to three.

Transferring more than three embryos does not guarantee a pregnancy and does increase the percentage of multiple pregnancy.

Can embryos to be implanted safely be selected?

Currently not possible. The only thing we can do is select those embryos that have the best quality from a morphological point of view. If the number of embryos is sufficient and appropriate for your particular case, you can opt for long embryo culture (blastocysts) or preimplantation diagnosis (PGD) to increase the chances of implantation.

About pregnancy

What chances of pregnancy does IVF offer me?

They depend to a great extent on the age of the woman, and on the concurrent causes that have determined the indication for treatment. In general, the average pregnancy per cycle is between 30-40%, although the deviations, depending on each case, from this average can range from 5% to 70%. The average cumulative pregnancy rate after 3 cycles is approximately 75%.

The abortion rate per cycle is approximately 15%. In the case of transferring thawed embryos, the average pregnancy rate is 20% for each attempt.

How long will it take to know if I am pregnant?

If we use Beta HCG blood determinations, it can be known 13 days after transfer. With a pharmacy urine test, we recommend waiting 15-16 days, and with ultrasound 21-30 days. If the pregnancy test is positive, you are pregnant. You must continue with the medication until the appointment is made. There we will check by ultrasound if indeed the pregnancy is located properly and if it progresses normally. We usually follow the controls for our peace of mind and that of the couple, until we check if there is a heartbeat in the fetus. If the test is negative, and you have not had a completely normal period, contact the Center before stopping the medication.

Are pregnancy and childbirth the same as if I had gotten pregnant naturally?

Yes, although there is a somewhat higher percentage of abortion than in the normal population, and there is a higher incidence of caesarean sections, since they are highly desired pregnancies and there is a tendency to overestimate fetal interest. p>

If I don't get pregnant in the first cycle of treatment, how long do I have to wait to try again?

In the case of artificial insemination cycles, the cycles are usually made consecutive without any waiting. In IVF cycles it depends on the individual response of each woman, but it is usually expected 1-2 months.

My rule has been lowered again, is it worth continuing?

Every time a treatment fails, a psychological depression and a logical loss of confidence in the technique and the equipment occurs. Consult the gynecologist, he will tell you if your case has a better or worse prognosis, if it can be better for you to change the technique, the treatment, or if you should abandon. Trust in the data we provide you on the effectiveness of the techniques, and know that after several attempts, the cumulative probability of pregnancy increases (visit the Our Results section).

Do you want more information ?

From IMF we will be happy to answer any type of doubt, why not try?

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