Nowadays, assisted reproduction treatment is, in addition to being a favorable option for starting a family, a renewed illusion for single people, same-sex couples and heterosexuals who do not achieve a natural pregnancy. Infertility affects one in six couples, according to the WHO. Dr. Georgina Percivale, gynecologist, specialist in reproductive medicine, discusses various aspects of the topic.
Infertility is currently considered a pathology that affects one in six heterosexual couples, and there are more than 100 million people in the world who suffer from it, according to the World Health Organization.
However, technical developments in the field of medicine have fortunately allowed, among many innovations, the ability to reproduce the human species in an alternative way.
Assisted fertilization techniques available in Argentina are, on the one hand, low-complexity methods that include ovulation induction and intrauterine insemination; and on the other hand, those of high complexity that cover fertilization IVFwithin which you can resort to the use of your own gametes – your own sperm and eggs – or with donated sperm and eggs.
These procedures are recommended by fertility specialists in couples under the age of 35 or without pathology, after an unsatisfactory search for one year, having sex without the use of contraceptive methods; and in couples over 35, after six months without conception. After the expiration of the prescribed periods, the examination of the infertile couple or the person in case of unmarried is resorted to.
Of course, like any treatment the patient undergoes, regardless of the cause, all the necessary information is provided by the responsible doctor regarding the process, expectations, pregnancy rate and, of course, the possible risks. With this in mind, the patient must agree and sign informed consents containing all the necessary information the patient needs.
These methods are sought after for various reasons, among the most common are the age of majority, the presence of existing pathologies, but also the social development of women. First of all, it is well known that women have a certain biological clock, which refers to the fact that the quality and quantity of eggs in their body begins to decline after they are close to 35 years of age. Second, there are circumstances in which non-reproductive pathologies prevent conception. Finally, this age group of women who decide to give priority to personal growth, for example in the workplace, and leave motherhood for another time in their lives.
Each assisted reproduction technique has its own indications and its application depends on each person or couple who need or want to have access to the techniques, ie their clinical history, origin and different characteristics of the people involved.
In the case of single women, they can perform treatment with bank semen, ie. donated semen; and then the technique, whether low or high complexity, will depend on the clinical history, previous cases, ovarian reserve and the whole study of this woman’s reproductive system. Subsequently, depending on the result of the study, it is indicated what treatment to carry out. Reproductive medicine is a custom-made suit according to the characteristics of the person who requires the technique, ”explains Dr. Georgina Percivale, a gynecologist who specializes in reproductive medicine.
When donating an egg or sperm, the donor is required to be physically similar to the parents of the desired baby. It is also important to note that children resemble their parents not only because of their genetic components, but also because of their behavior, as they often copy and adopt personality traits from their parents.
As regards the legal framework, Law 26 862 on Assisted Production, or better known as the National Assisted Fertilization Act, was adopted in 2013, guaranteeing full access for all adults, individually or as a couple, regardless of their gender, access to assisted reproduction methods. Which must be insured by the public or private sector through social or prepaid work.
“What to say? I accepted it as a cure for a disease, instead of trying to make a dream come true, and when that dream came true, it was like touching the sky with my hands, although I could not enjoy it one hundred percent because of the ever-present fear, that dream was interrupted “, commented Daniela, who after several years of fertility treatment with her partner, became Diego’s parents by donating eggs. He added: “From the time I heard about this 175 beta, which I enjoyed for about two minutes, until I saw the parameters at the end of the reviews, my life changed completely.”
Finally, she concludes: “Not everything is rosy, and although I deny it as crazy, I would not change anything I have experienced. This naughty, unbearable and earthquake bug that touched me is without a doubt the best thing in my life.
Causes of infertility
There are a number of causes associated with infertility, they are not one or two exclusively. In men, they may be associated with a lack or low number of sperm, decreased motility, shape associated with changes such as varicocele, testicular trauma, infectious processes, hormonal disorders. And among the female causes we can mention the reduction of ovarian reserve and the quality of pre-existing diseases such as endometriosis, polycystic ovaries. It may even be a combination of the two parts of the couple, where the two have some change and join.
Like any process in medicine, it can have side effects. “Within the framework of reproductive medicine, the most terrible is always a multiple pregnancy, which, however, is significantly reduced today. Although low-complexity techniques that force a woman to ovulate naturally and do not determine how many embryos are produced, the risk is higher. And with high complexity, such as fertilization IVF“There is a tendency for a single embryo transfer and thus reduces the risk of multiple pregnancies,” explains Georgina Percivale, adding: “In previous years, more embryos have been transferred and this has resulted in so many multiple pregnancies, but fortunately .
It is worth mentioning that multiple pregnancies lead to greater obstetric risks such as threats of premature pregnancy, risks of hypertension, prematurity, low birth weight.
As for access to fertilization methods in the city, the picture is completely sad and discouraging. Health professionals condemn the apparent lack of investment, lack of resources and the inability of institutions to accept patients, as they do not have the appropriate infrastructure to perform such delicate and special work. In fact, even the most basic drugs do not arrive at the local hospital, such as clomiphene, which is supplied to induce ovulation, a method of low complexity.
This will be a pending issue for the next few years …