Frequently asked questions about assisted reproduction: everything you need to know at INEBIR
At INEBIR, we understand that the assisted reproduction process can raise many questions. That's why we've prepared this FAQ section to help you make informed decisions about your reproductive health. Our team of experts and advanced technologies are here to support you every step of the way.
infertility and sterility
Sterility is the inability of an individual or a couple to conceive naturally.
Infertility prevents a couple who achieves a pregnancy from carrying the pregnancy to term with a healthy newborn.
primary sterility
When a couple does not achieve pregnancy after a year of relationship.
Secondary sterility
When a couple, after having their first child, does not achieve a new pregnancy in the following 2-3 years.
Primary infertility: when the couple achieves a pregnancy but it does not reach term with a healthy newborn.
Secondary infertility: when the couple, after a pregnancy and childbirth, does not achieve a new full-term pregnancy with a healthy newborn.
Causes of infertility
It has been shown that women's fertility decreases with age. There are several reasons for this:
- The age of her own oocytes. A woman is born with a fixed number of eggs that do not divide. Therefore, as time passes, the possibility increases that the oocytes will be of poorer quality, which, subsequently, leads to embryos that do not develop correctly.
- It increases the likelihood of developing embryos that lead to implantation failure, and therefore, the increase in the number of miscarriages.
- With age, the number of follicles and eggs gradually decreases.
- There is a higher probability of endometriosis and fibroids with increasing age, which are two of the main causes of infertility.
As for men, they too become less fertile with age. However, this decline is less pronounced than in women and generally occurs after age 50.
This pathology is characterized by an endocrine dysfunction that is characterized by irregular menstrual cycles or even lack of menstruation, increased body hair and characteristic ovarian ultrasound images.
An anovulatory cycle is one in which an egg is not released from the ovary, either because it has not yet formed or because it has not reached the necessary maturity. Therefore, ovulation does not occur, and consequently, there is no possibility of pregnancy. Approximately 35% of women experience anovulation at some point in their lives. The origin of this hormonal imbalance can be in the hypothalamus, the pituitary gland, or the ovary itself.
Factors that influence fertility
Men with a Body Mass Index (BMI) below 20 are at risk of impaired sperm production and male infertility. A BMI above the recommended level (28) can also impair male fertility, resulting in a sperm count that is 22% lower than the average. Sperm count is one of the leading factors contributing to male infertility.
Women with a low BMI are likely to experience pauses in their menstrual cycles or irregular periods, which can cause infertility. Gaining weight to achieve a BMI within a healthy range will regulate menstruation in most women.
Just as being underweight can harm fertility in the short term, so can a high BMI. Women with a high BMI frequently experience changes in their menstrual cycle; nearly 30-40% of women with a higher body mass index have problems with ovulation.
In the case of women, virtually all studies support the conclusion that smoking has an adverse impact on fertility. When smokers are compared to non-smokers, the prevalence of infertility is higher, and the time to conceive is longer. Active smoking by either partner has adverse effects, and the impact of secondhand smoke is only slightly less than that of active smoking. Smoking appears to accelerate the loss of eggs and reproductive function and can bring forward the onset of menopause by several years.
Regarding men, they exhibit lower sperm counts, reduced motility, and more abnormalities in sperm shape and function. The effect of smoking on male fertility is more difficult to discern because it is not easy to conduct studies that address this issue. Although the effects of smoking on male fertility are not conclusive, the harmful effects of secondhand smoke on the fertility of female partners and the evidence that smoking negatively affects sperm quality suggest that smoking in men should be considered a risk factor for infertility.
According to various studies, significant alcohol consumption can lead to lower sperm counts, reduced testosterone levels, and increased estrogen levels. In women, alcohol consumption can cause irregular menstrual cycles and anovulatory periods (menstruation that occurs without ovulation).
The tests that our doctors will request in order to begin studying each case include a complete medical history and physical examination of the patients, which, although they will vary depending on each specific case, generally include the following analyses and tests:
- In the case of women, the basic tests include a blood test, a hormone test, an ultrasound, the transfer test, and a hysterosalpingography.
- In the case of men, in addition to blood tests, a semen analysis will be necessary, which checks the number, activity and shape of the sperm.
This test involves obtaining a semen sample, preferably through masturbation, from the man. The sample is then collected by our laboratory staff and sent to them for analysis. Before providing the sample, the man must have abstained from sex for 3-5 days.
This technique involves injecting a small amount of contrast dye into the uterus, allowing it to flow into the fallopian tubes. Under X-ray guidance, it can be determined whether the tubes are blocked by checking if the fluid can reach them. The radiation required for this test is minimal and poses no risk. Anesthesia is not necessary, and the patient will experience minimal discomfort and can resume her normal activities immediately afterward.
First appointment
There is no set time from which it is advisable to start a reproduction treatment, nor is there any stipulated age limit to carry it out.
However, since the average fertility rate for a couple is 25% each month, more than half will become pregnant within 6 months and most within the first year, it is recommended that, after several months of trying to become parents naturally, the couple attend a first fertility visit within a maximum of one year.
The aim of this initial consultation is to understand the couple's current situation and past history, as well as to conduct a thorough examination and any necessary diagnostic tests to gather sufficient information to begin studying their case. At the end of this visit, we will assign the couple to one of our working groups, comprised of various specialists whose expertise will depend on the specifics of their case. This group will guide them throughout the entire process and serve as their point of contact for any questions that may arise during the evaluation and treatment.
During the first visit to Inebir, you must bring all the test results or reports you have from previous fertility cycles, along with your ID. In the case of men, regarding the semen analysis, you will be asked to have it done again, even if you have had one previously.
From your first consultation, you'll receive warm and professional care. We'll answer all your questions about assisted reproduction and support you every step of the way toward achieving your dream of starting a family.
Treatments
Yes, it is a legal requirement that patients sign a specific consent form for the Assisted Reproduction technique they will undergo and for certain specific tests that require explicit consent. By signing these forms, they declare that they have been properly informed of the medical, biological, and legal aspects of the treatments, and that they understand and accept them.
Furthermore, prior to the treatment, you will be given a detailed estimate outlining all the phases included. This estimate must also be signed and submitted to you.
In general, the risk to the patient is very low, although it is necessary to point out the main risks:
Ovarian hyperstimulation syndrome (OHSS). This syndrome occurs when a woman reacts to the treatments by producing an excessive number of eggs, which causes abdominal discomfort for several days. In any case, our gynecologists will inform you during your endocrinological check-up about the possibility of this risk. In the worst-case scenario, the gynecologist will discontinue the treatment.
Another risk worth mentioning is multiple pregnancy. With fertility treatments, if three embryos are transferred, the chance of twins is 20-25%, and the chance of triplets is 4%. If patients do not wish to risk this possibility under any circumstances, they can inform their gynecologist when deciding on the number of embryos to transfer. In cases where a multiple pregnancy occurs and poses a risk to the patient, embryo reduction may be performed.
It consists of inducing multiple ovulation in the patient through hormonal medications with the aim of obtaining more than one oocyte per cycle, and thus being able to transfer more than one embryo.
Furthermore, it allows us to guarantee and anticipate the exact moment of ovulation as well as the correct maturation of the egg. This phase usually lasts an average of 12-14 days.
During ovarian stimulation, the patient will need to come to our center approximately every day or every two days to have a blood test to determine the levels of estradiol, which is the hormone produced by growing follicles, and a vaginal ultrasound to observe how many follicles are developing in the ovaries and what size they are.
Depending on the results of these tests, which will be known on the same day, our gynecologists will evaluate the progress of your treatment and adjust the medication dosage for the best possible development of your follicles.
Our medical team truly works as a team, and while we will always strive to have the same gynecologist see you throughout your treatment, for the patient's convenience and to avoid wasting time, certain appointments may be attended by another of our specialists. In any case, we must emphasize that at the end of each day, our team of doctors meets to review and evaluate the progress of each patient's treatment, ensuring that all our gynecologists are fully informed about each patient's case.
Once the oocytes have been retrieved and transferred to the laboratory, all the follicular fluids are analyzed and, within a few minutes, the patients are informed of the number of oocytes obtained.
Not all oocytes obtained are of the same quality, obviously, just as not all follicles develop in the same way during ovarian stimulation.
After oocyte retrieval, both mature oocytes and immature oocytes or oocytes with abnormal morphology can be distinguished, which cannot be used in treatment.
The sample is generally obtained by masturbation, in a sterile container, after washing hands and genitals. Once the patient has ejaculated, our biologists will collect the sample, which will be labeled and processed to improve its quality as much as possible. Semen samples are typically collected at our clinic, but for patients who have difficulty obtaining the sample, we offer the option of bringing it from home, provided that no more than 45 minutes elapse between collection and delivery.
In cases where patients have difficulty obtaining a sample, they may return home to attempt collection, bringing the sample back provided no more than 45 minutes elapse between collection and delivery. Furthermore, for patients who, after the semen analysis performed as part of the fertility study, are found to have difficulty obtaining a sample, or simply for those who are unable to produce a sample on the indicated days for any reason, freezing a sample prior to treatment is recommended.
Not all retrieved follicles contain an egg, and some of these eggs, once in the laboratory, will be found to be unsuitable for fertilization. The number of eggs retrieved will depend on factors such as the patient's age, medical conditions, and response to treatment. On average, 5 to 10 eggs or oocytes are retrieved, and 3 to 6 embryos are fertilized in women under 35. A single embryo is sufficient for a possible pregnancy, so there is no need to worry if the number of eggs retrieved or the number of fertilized embryos is low.
As is obvious, the highest quality embryos are usually transferred. Depending on the patient's age, medical history, embryo quality, and the patient's wishes, one, two, or up to a maximum of three embryos may be transferred.
Good quality embryos that are not transferred or those that are kept in sequential culture and develop to blastocyst stage will be cryopreserved for future use.
Intrauterine insemination
During the cycle, the patient will need to attend appointments an average of 4 or 5 times for check-ups. Each check-up lasts 10 minutes.
Insemination is a process that takes another 10 minutes. Afterward, the patient should rest for 15 minutes in the consultation room, after which she can resume her normal activities.
In Vitro Fertilization
During the cycle, the patient will attend appointments for check-ups an average of 10-12 days, approximately every 48 hours. Each check-up usually lasts 10 minutes.
The egg retrieval procedure lasts 30 minutes, and after an average of 3-4 hours of rest in one of the hospital beds, the patient will be able to return home without any problems.
Within 3 to 5 days after egg retrieval, the patient must return to our clinic for the embryo transfer. This procedure takes 30 minutes, followed by 15 minutes of rest before the patient can return home.
Egg Donation
During the treatment cycle, the patient will need to attend appointments for check-ups to monitor her progress. She will need to attend an average of three appointments, approximately every week, with the first appointment at the start of treatment.
Within 3 to 5 days after the last check-up, the patient must return to our clinic for the embryo transfer. This procedure takes 30 minutes, plus 15 minutes of rest before the patient can return home.
If patients come from outside Seville, or are unable to attend routine check-ups at our clinic, these check-ups can be performed by another gynecologist in their province or near their place of residence with whom we have been in contact and to whom you have explained the treatment. In this way, they would only need to come to our center on the day of egg retrieval and the day of embryo transfer.
Eleven days after the embryo transfer, we will perform a blood test called a beta-hCG hormone test. If it is positive, you are pregnant, and you will be informed immediately.
No, there is absolutely no difference. The pregnancy progresses in the same way as a natural pregnancy. The weeks of embryonic development are the same as in a natural pregnancy; there is neither a delay nor an advance in the baby's growth due to the use of assisted reproductive technology.
Assisted reproduction treatments and success rates at Inebir
Assisted reproduction includes a set of medical techniques designed to help couples conceive. These treatments are intended for couples with fertility problems, single women, or individuals with medical conditions that affect their reproductive capacity. At INEBIR, we evaluate each case individually to offer the best solution.
Ovulation induction is a treatment that stimulates the ovaries to release eggs during the menstrual cycle. It is ideal for women with irregular cycles or difficulty ovulating naturally. At INEBIR, we use personalized protocols that guarantee safety and effectiveness in every treatment.
Artificial insemination is a simple technique that increases the chances of pregnancy by introducing prepared sperm into the uterus during the fertile period. At INEBIR, this procedure follows these steps:
- Sperm preparation in the laboratory.
- Insertion into the uterus at the ideal time of the cycle. This treatment is suitable for couples with mild infertility or women who wish to become single mothers.
Fertilization vitro In vitro fertilization (IVF) is an advanced technique in which fertilization occurs outside the body in a laboratory, and the embryos are subsequently transferred to the uterus. It is especially useful in complex cases, such as previous failed artificial insemination or severe fertility problems. At INEBIR, we perform this procedure using state-of-the-art technology and a humane, personalized approach.
The fertilization process vitro INEBIR includes four main stages:
- Ovarian stimulation to obtain multiple eggs.
- Egg retrieval using a minimally invasive procedure.
- Laboratory fertilization with sperm.
- Embryo transfer to the uterus. Every step is designed to maximize the chances of success, prioritizing patient comfort.
Egg donation involves using eggs donated by young, healthy women for women who have problems with the quality or quantity of their own eggs. It is a hopeful option for many patients who wish to start a family. At INEBIR, we manage a rigorous selection process to guarantee safety and compatibility.
To be an egg donor at INEBIR, candidates must meet certain criteria:
- Be 18 to 30 years old.
- Enjoy good physical and mental health.
- No history of genetic diseases. This process is completely anonymous and ethical, and emotional and medical support is guaranteed.
INEBIR offers several techniques to preserve fertility:
- Egg vitrification: ideal for women who wish to postpone motherhood.
- Semen cryopreservation: for men facing medical treatments that could affect their fertility.
- Embryo freezing: for couples who wish to ensure their reproductive capacity in the future.
Zymot ICSI is an innovative device that we use in our assisted reproduction laboratories to optimize sperm selection in treatments such as in-vitro fertilization. vitro (IVF). This device allows us to identify and select the sperm with the best quality and motility, increasing the chances of successful treatment. Thanks to this technology, we can offer our patients an advanced and personalized approach, maximizing their chances of achieving pregnancy.
Most treatments, such as artificial insemination, are painless. Other procedures, such as egg retrieval in in vitro fertilization, may cause mild discomfort that can be managed with medication. At INEBIR, we guarantee your comfort at every stage of the process.
Before starting any treatment, we conduct a complete study that includes:
- Hormonal analysis to assess reproductive status.
- Ultrasound scans to examine the reproductive organs.
- Specific fertility tests, such as semen analysis or ovarian reserve.
The time varies depending on the treatment:
- Artificial insemination: a few weeks.
- Fertilization vitro: between 4 and 6 weeks for a complete cycle.
Success rates depend on factors such as the patient's age and health status. At INEBIR, our figures exceed national standards thanks to a personalized approach and advanced technology.
INEBIR combines medical expertise, advanced technology, and personalized care. Our clinic, strategically located in Seville, is a leading center for local and international patients.
ROPA method
The ROPA method, known as "Reception of Oocytes from the Partner," is an assisted reproductive technology specifically designed for female couples. This method allows both women to actively share motherhood: one as the genetic mother (providing the eggs) and the other as the gestational mother (carrying the pregnancy).
The ROPA method follows the steps of fertilization vitro (IVF) and develops as follows:
- Ovarian stimulationThe woman who provides the eggs receives hormonal medication to stimulate the production of mature eggs.
- Egg retrievalThe eggs are extracted using a simple and safe technique known as ovarian puncture.
- Laboratory fertilizationThe eggs are fertilized in the laboratory with sperm from an anonymous donor, in compliance with current regulations.
- embryo transferOne or more embryos are transferred to the uterus of the woman who will carry the pregnancy.
The ROPA method is suitable for female couples who wish to share the motherhood process. It can also be an option for couples in which one of the women has a medical condition that prevents her from completing the entire process, such as:
- Ovarian problems in one of the women.
- Desire to actively share the biological and gestational bond.
Regarding men, they exhibit lower sperm counts, reduced motility, and more abnormalities in sperm shape and function. The effect of smoking on male fertility is more difficult to discern because it is not easy to conduct studies that address this issue. Although the effects of smoking on male fertility are not conclusive, the harmful effects of secondhand smoke on the fertility of female partners and the evidence that smoking negatively affects sperm quality suggest that smoking in men should be considered a risk factor for infertility.
Egg donation (recipient)
Egg donation is a procedure regulated by Spanish law since 1988, guaranteeing at all times the ethics of the medical and biological processes involved, as well as the health of both the donors and the resulting embryo. Egg donation is voluntary, altruistic, and anonymous. Egg donors must be between 18 and 35 years of age.
The sale of eggs, sperm, and embryos is prohibited under Spanish law; eggs must be used exclusively to help a woman have the child she desires. The National Commission for Assisted Human Reproduction, the body established to advise on the implementation of the law, recommends that donors receive financial compensation for the dedication and time required to complete the donation.
Furthermore, the law specifies that there can be no prior knowledge of the recipient and donor, either now or in the future. This means that the woman will never be able to meet, see, or choose the individuals who will donate her gametes.
The tests to be carried out on donors are regulated by Law 14/2006 on assisted human reproduction techniques and in Royal Decrees 412/1996 and 1301/2006.
The selection of the right donor for each patient is the responsibility of our clinic's medical team, in conjunction with the nursing staff. When making this decision, our team takes into account the donors' phenotypic characteristics, physical build, eye color, skin color, and hair color and type, as well as their blood type and Rh factor.
Yes, just as we check their family history. For a person to be eligible for our donation program, they must pass a series of rigorous controls, reviews, and evaluations, including:
– Informative interview where you will learn about your rights and duties as a donor.
– Psychological study for the evaluation of your mental health.
– Interview with the doctor to confirm the absence of genetic diseases in personal or family history.
– Blood tests.
– Serologies (hepatitis B and C, HIV and syphilis, rubella).
– Blood group determination.
– Performing a karyotype to rule out chromosomal abnormalities.
– Genetic analysis to rule out cystic fibrosis carriers and hemoglobin electrophoresis to rule out some hereditary anemias.
– Additional complementary genetic exploration and testing in special cases.
Gynecological examinations:
– Cytology
– Cervical cultures
– Gynecological ultrasound.
– Interview with the nursing team to explain how to perform the treatment.
No, the donor selection process at INEBIR is anonymous and based on medical criteria to ensure genetic compatibility and the ethics of the treatment.
No, the recipient patient only receives treatment with transdermal estrogen patches and vaginal progesterone tablets that allows her to synchronize her cycle, until the embryo transfer is performed.
Treatments
and units
There are many variables that can influence each case, and it's not always the case that matters. Assisted reproduction It's the only solution. At Inebir, we want you to have access to all the possibilities that reproductive medicine currently offers and to be able to address your problem from different perspectives. Furthermore, we have our own research program to contribute to the advancement of medicine and embryology.
Units
Polycystic Ovary Syndrome Unit
Ambulatory major surgery
Gynecology Unit
Endometriosis Unit
Pelvic pain unit
Multidisciplinary Pelvic Floor Unit
Unit for assistance to transgender people and gender identity
High-complexity diagnostic unit
Human Genetics Unit
Andrology Unit
Cryobiology Unit
Psychology Unit
R&D&I Unit
We dream
with helping you