A test tube child, the answers to your doubts

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Marie-Ange Demory
@marie-angedemory
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There are many doubts about assisted fertilization techniques. How commonplaces and unmotivated fears abound that often hold back couples (and especially her, on which inevitably falls the task of 'remedying' a couple's infertility) making them waste precious time. We have tried to select the questions that all women generally ask themselves before facing their infertility problems in a 'medicalized' way.



 

  • Do hormonal stimulations have side effects? Is it true that they make you fat and cause mood swings? Hormonal stimulations can cause disturbances such as weight gain or mood swings. These are symptoms that vary from person to person and are closely related to the dosage. However, and it is not taken for granted that they will manifest themselves. In general, a condition of water retention is normal (which can give weight gain in the order of 1-1,5 kg). If the weight gained is greater it is because there may be changes in the deso / consumption of particular foods, such as carbohydrates.



  • Does the woman who undergoes MAP run any risks to her future health? How many cycles (with hormonal stimulation) can the body endure without dangerous consequences? The studies available on hormone-induced diseases are so far reassuring. But thousands of women are still needed to be followed over time to have numbers that confirm the data. As a precaution, it is not recommended to perform more than 5 super-stimulations (those in which more than 10 oocytes are recovered).

  • After 40, what are the success rates? Fertility in women gradually decreases up to the age of 40, but after that age the decline becomes sudden up to the age of 45 and therefore drastic from around 45 to 50. The chances of success of MAP are closely correlated with this decline and would improve with egg donation, a prohibited technique in the country. After the age of 45, MAP can be practiced, but the chances of success become slim.

  • Is MAP more stressful on a psycho-physical level after the age of 40? The stress of MAP after the age of 40 is certainly considerable. Maturity does not help to process failures and 'limited time' makes it more frustrating.

  • How many eggs does a woman have during her life? Can overproduction due to hormonal stimulation lead to premature menopause? The number of oocytes of each woman is genetically determined. That the hormonal stimulations of MAP can accelerate the 'consumption' of the follicles and therefore anticipate menopause is a widespread fear and in theory it could have a foundation. However, the studies carried out so far show that the average age at which menopause occurs in women who have also undergone several cycles of MAP is around 50 years and comparable with that of women never subjected to hormonal stimulation. Menopausal symptoms also appear unrelated to ovarian stimulation (Source: K Elder, T Mathews, E Kutner, E Kim, D Espenberg, M Faddy, R Gosden - Impact of gonadotrophin stimulation for assisted reproductive technology on ovarian aging and menopause - Reproductive BioMedicine Online 2008 Vol. 16 No. 5. 611).



  • How can you prepare for assisted fertilization? There are side therapies that can favor the outcome of an MAP. In particular, we recommend taking supplements such as folic acid and antioxidants. Even the practice of acupuncture (source: Paulus et al, Fert Ster 2002, 2003 Stener-Victorin Hum Repr 2003) seems to give positive effects in favoring the engraftment of the embryo. After the embryo has been implanted, even a diet without fermented foods (bread, pizza, sweets, etc.) can promote engraftment.

 

The questions and answers continue on the next page

 

  • Are there any drugs that interact negatively with MAP? Negative drug interactions are unlikely. Among those in common use, attention must be paid to those containing cortisone (for example some painkillers, bronchodilators, antihistamines). Anyone on regular treatment for particular pathologies (for example autoimmune diseases) must of course specify this before PMA.

  • What to do if after repeated attempts you do not get pregnant? If embryos are formed but do not take root, for example or something else ... After the failure of an implant, a hysteroscopic examination with endometrial biopsy is done to rule out anatomical or tissue obstacles. The pathologies of coagulation (thrombophilia), glucose tolerance and thyroid function are then investigated.

  • Can eggs be frozen? And how long do they last? It is possible and promising to freeze eggs. The Del Paese, also following the limits imposed by law 40 for the freezing of embryos, is at the forefront in this field and excellent results are being obtained with the 'vitrification' technique. This technique eliminates the water contained in the cell and replaces it with a special liquid before instant freezing in nitrogen. Thanks to this, the thawing survival rate is over 70%. Their use is recommended within 5 years of freezing.



  • Does the fact that the sperm that fertilizes the egg (especially with the Icsi technique) is chosen by the biologist by chance affect the health of the fetus? That is, are there greater risks of miscarriage, fetal problems, or of children with genetic problems with MAP? The percentage of congenital malformations is about 2%. Those born after ICSI have an increased relative risk of some malformative pathologies. This translates into an absolute risk increase of approximately 1.2% (i.e. rises to approximately 3.2%). On average, pregnancies are more prone to complications. The point is: is the technique that exposes you to the greatest risks? Or is it not rather the population in which the method is used that is at greatest risk? Probably the latter factor is the determining factor (just think of the average age of the patients, of the severe dyspremia due to which they could not reproduce, of the associated gynecological pathologies: myomas, dysmetabolisms, etc.).

  • Is it true that there are very high chances of having twins? Twin pregnancy is believed to be the most frequent complication in MAP. The data (source: ESHRE European Register on Assisted Conceptions) show that in Del Paese in 2001 out of 100 births from MAP, about 22% were twins and of these less than 3% were multi-twin (in normal pregnancies, twins are 1,25 %). But since 2004, the number of twins has increased significantly, following the prohibition of embryo freezing and the obligation of the simultaneous implantation of all the embryos obtained. A significant share of twins is not registered at the national register of MAP because they were born with the use of hormonal therapies carried out by non-specialized doctors (the simple induction of ovulation is not considered assistance to fertilization and therefore any doctor, in theory, it can administer the necessary hormones).

 

(With the collaboration of Luciana De Lauretis, head of the Medically Assisted Procreation Center of the Città Studi Clinical Institute)

 

  • Read also the article Assisted reproduction, how to choose the right center

  • Do you want to discuss fertility problems with other women? Join the community

 

TAG:
  • assisted fertilization
  • infertility
  • fertility
  • hormonal stimulations
  • weight gain
  • mood
  • spermatozoa
  • creativity and children
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