What is surrogacy? Cases in which this procedure should be resorted to
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Surrogacy, also known as gestational surrogacy or misnamed “surrogate motherhood”, is a reproductive arrangement in which a woman (the gestational carrier) carries a pregnancy to term for another person or couple (the intended parents), who will become the legal parents of the child at birth. The gestational carrier has no genetic link to the baby, as the embryo is created using the eggs and sperm of the intended parents or donors.

Cases in which surrogacy is the alternative

Surrogacy is considered an option when a woman is unable to gestate a pregnancy for a variety of reasons, including:

  • Absent uterus: women who have been born without a uterus (Rokitansky Syndrome) or who have had a uterus surgically removed (hysterectomy) due to diseases such as cancer or uterine fibroids.
  • Uterine malformations: conditions that prevent implantation or normal development of pregnancy, such as bicornuate or septate uterus.
  • Diseases that prevent gestation: certain chronic diseases, such as severe heart disease or autoimmune diseases, can make pregnancy high-risk or even impossible for the woman.
  • Repeated implantation failure: when several unsuccessful IVF cycles have been performed and it is suspected that the problem lies in the capacity of the uterus to receive the embryo.
  • Recurrent miscarriages: in cases of recurrent miscarriages with no apparent cause, surrogacy may be an option to achieve a full-term pregnancy.
  • Risk to the woman’s health: when the pregnancy represents a serious risk to the woman’s health or life.

Legal and ethical aspects of surrogacy

Surrogacy is a complex issue with legal and ethical implications that vary significantly between countries. In some countries it is legal and regulated, while in others it is illegal or in a legal vacuum. It is essential to be informed about the specific legislation in the country where the process is taking place.

If you are considering surrogacy, it is crucial to seek specialized legal and medical advice. A lawyer specializing in assisted reproduction will inform you about the legal aspects of the process, while a fertility specialist will guide you on the medical aspects. 

Surrogacy can be a viable option for starting a family, but it is important to make an informed and responsible decision, taking into account all aspects involved.

Why do women freeze eggs and what is it for?
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Egg freezing, technically known as oocyte vitrification, is a procedure that preserves a woman’s fertility by cryopreserving her eggs. The eggs are retrieved, vitrified (an ultra-rapid freezing method) and stored in liquid nitrogen at extremely low temperatures, maintaining their viability for years.

Why are eggs frozen?

There are several reasons why a woman may choose to freeze her eggs. These include medical and social reasons:

  • Cancer treatment: chemotherapy and radiation therapy can affect fertility, so freezing eggs before treatment preserves the possibility of having children in the future.
  • Surgery that affects ovarian reserve: some gynecological surgeries can damage the ovaries and reduce ovarian reserve.
  • Autoimmune diseases: some autoimmune diseases can affect fertility.
  • Endometriosis: endometriosis can decrease ovarian reserve and compromise egg quality.
  • Postponing childbearing: women who wish to delay childbearing for professional, personal or educational reasons can freeze their eggs to preserve their fertility at a younger age.
  • Absence of a partner: single women who wish to have children in the future may choose to freeze their eggs.
  • Fertility preservation for other reasons: some women may choose to freeze their eggs as a preventive measure against the natural decline in fertility with age.

What is egg freezing for?

Egg freezing is used for the following purposes:

  • Preserve fertility: it offers the possibility of having biological children in the future, when circumstances are more favorable.
  • Increase the chances of success in fertility treatments: in some cases, egg freezing can improve IVF success rates, since it allows for a greater number of good quality eggs to be available.
  • Avoiding egg donation: Egg freezing allows women to use their own eggs in the future, avoiding the need for egg donation.
  • Provide peace of mind and control over fertility: it gives women more control over their reproductive future and reduces the social and biological pressure associated with age and fertility.

Egg freezing is a safe and effective technique that has revolutionized reproductive medicine. If you are considering freezing your eggs, it is important to consult with a fertility specialist to learn about the procedure, risks, benefits and costs. The doctor will evaluate your individual situation and help you make the best decision for your reproductive future.

What is In Vitro Fertilization (IVF)? Advantages and disadvantages
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In Vitro Fertilization (IVF) is an assisted reproductive technique that involves the fertilization of the egg by the sperm outside the woman’s body, in a specialized laboratory. The resulting embryo is cultured for a few days and then transferred into the woman’s uterus in the hope that it will implant and a pregnancy will develop. It is a more complex procedure than artificial insemination and is reserved for more severe cases of infertility.

Advantages of IVF

  • High success rate: it offers one of the highest success rates among fertility treatments, especially in women under 35 years of age.
  • Solution for different types of infertility: it can be effective in cases of fallopian tube obstruction, severe endometriosis, low ovarian reserve, severe male fertility problems and unexplained infertility.
  • Preimplantation genetic diagnosis (PGD): allows for PGD, a technique that analyzes embryos before implantation to detect genetic and chromosomal abnormalities.
  • Greater control over the process: it allows control over various factors that influence conception, such as the quality of the eggs and sperm, and embryo development.

Disadvantages of IVF

  • High cost: it is an expensive treatment that may not be affordable for all couples.
  • Invasive procedure: requires the administration of drugs for ovarian stimulation, ovarian puncture to extract the eggs and embryo transfer, which can be uncomfortable or painful.
  • Risk of multiple pregnancy: increases the risk of multiple pregnancies, leading to increased risks for the mother and babies.
  • Ovarian hyperstimulation syndrome (OHSS): ovarian stimulation can lead to OHSS, a complication that can be serious in some cases.
  • Emotional stress: the process can be emotionally demanding for couples, due to uncertainty, expectations and the possibility of failure.
  • It does not guarantee success: despite being an effective treatment, IVF does not guarantee pregnancy in all cases.

IVF procedure

This assisted reproduction treatment consists of the following five steps prior to the pregnancy test:

  • Ovarian stimulation: hormonal drugs are administered to stimulate the production of multiple mature eggs.
  • Egg retrieval: an ultrasound-guided ovarian puncture is performed to extract the mature eggs.
  • Fertilization: the eggs are fertilized with sperm in a laboratory, either by conventional IVF or intracytoplasmic sperm injection (ICSI).
  • Embryo culture: the resulting embryos are cultured in the laboratory for several days.
  • Embryo transfer: one or more embryos are transferred into the woman’s uterus through a thin catheter.

Approximately two weeks after the embryo transfer, a pregnancy test is performed to determine if the treatment has been successful.

Best time to consider IVF

What is egg donation? Standards and procedures to be met
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Egg donation is an altruistic act by which a woman donates her eggs so that another woman or couple can conceive a child. It is a fundamental process for women who cannot use their own eggs due to various reasons, such as premature ovarian failure, early menopause, genetic diseases, aggressive medical treatments (chemotherapy or radiotherapy) or low ovarian reserve.

Who can donate eggs?

The requirements to be an egg donor vary slightly depending on the clinic and the legislation of each country, but generally include the following criteria:

  • Age: most clinics set an age range between 18 and 30 years old, although some accept donors up to 35 years old. This age range is considered optimal for egg quality and quantity.
  • Good physical and mental health: donors must be in good general health, with no history of genetic, infectious or chronic diseases that could be transmitted to the future baby. A psychological evaluation is also performed to ensure the donor’s emotional stability and understanding of the process.
  • Family medical history: a thorough review of the family medical history is performed to rule out inherited genetic diseases.
  • Healthy lifestyle: donors are required to be non-smokers, drug-free and have a moderate consumption of alcohol. A balanced diet and regular exercise are also valued.
  • Compatibility with the recipient: in some cases, a certain physical compatibility between donor and recipient is sought, such as blood group, Rh and general physical characteristics. However, this is not always a prerequisite.
  • Medical tests: donors must undergo a series of medical tests, including blood tests for infectious diseases (HIV, hepatitis B and C, syphilis), genetic testing, vaginal ultrasounds to assess ovarian reserve, and a complete gynecological examination.

Standards to be met to become a donor

In addition to the above requirements, donors must meet certain ethical and legal standards:

  • Anonymity: in most countries, egg donation is anonymous, meaning that the donor and recipient do not know each other. However, in some cases, known donation is allowed, usually between family members or friends.
  • Informed consent: the donor must sign an informed consent form detailing all aspects of the process, including the risks, benefits and her rights.
  • Commitment to the process: the donor must commit to follow medical indications, attend scheduled appointments and take the prescribed medication for ovarian stimulation.

Egg donation is a complex process that requires a significant commitment from the donor. If you are considering donating your eggs, it is important to become adequately informed about the process and requirements in your country. Contact a specialized fertility clinic for more information and to resolve all your doubts.

What is Artificial Insemination and when is it best to undergo this treatment?
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Artificial insemination (AI) is an assisted reproductive technique that involves the introduction of sperm, previously prepared in a laboratory, directly into the woman’s uterus. Unlike in vitro fertilization (IVF), fertilization occurs inside the woman’s body. It is a less invasive procedure than IVF and is often the first choice for many couples facing difficulty conceiving.

How does artificial insemination work?

The AI process generally involves the following steps:

  1. Ovarian stimulation: medications are administered to the woman to stimulate the production of multiple mature eggs, increasing the chances of fertilization.
  2. Cycle monitoring: transvaginal ultrasounds and blood tests are performed to monitor follicle development and determine the optimal time for insemination.
  3. Sperm preparation: the semen is processed in a laboratory to concentrate the most motile and healthy sperm, eliminating seminal fluid and other impurities.
  4. Insemination: at the time of ovulation, the prepared sperm is introduced into the uterus through a thin catheter passed through the cervix. The procedure is quick and painless, similar to a Pap smear.
  5. Pregnancy test: approximately two weeks after insemination, a pregnancy test is performed to determine if the procedure has been successful.

Advantages of artificial insemination:

  • Less invasive than IVF: it is a simpler, less expensive procedure with fewer side effects than IVF.
  • Increases the chances of pregnancy: AI facilitates the arrival of sperm to the egg, overcoming barriers such as hostile cervical mucus or ejaculation problems.
  • Option for same-sex couples or single women: allows single women and lesbian couples to conceive using donor sperm.
  • Preserves the natural experience of conception: unlike IVF, fertilization occurs inside the woman’s body.

Disadvantages of artificial insemination:

  • Not effective in all cases: AI is not recommended for women with blocked fallopian tubes or severe male fertility problems.
  • Possibility of multiple pregnancy: ovarian stimulation may increase the risk of multiple pregnancies, leading to greater risks for the mother and babies.
  • Cost: Although less expensive than IVF, AI can still represent a significant financial investment.
  • Emotional stress: the AI process can be emotionally challenging for some couples, especially if more than one cycle is required.

When is the best time to go for artificial insemination?

It is recommended to consider AI after trying to conceive naturally for a year without success, especially if the woman is over 35 years old. It is also a good option in the following cases:

  • Unexplained infertility: when no specific cause for infertility is found.
  • Mild male fertility problems: such as low sperm concentration or motility.
  • Hostile cervical mucus: when the cervical mucus impedes the passage of sperm.
  • Ejaculation problems: such as retrograde ejaculation.
  • Mild endometriosis: in some cases of mild endometriosis, AI may be a viable option.

If you are considering artificial insemination, it is important to consult with a fertility specialist to evaluate your individual situation and determine if it is the best option for you. The doctor will explain the procedure in detail, the potential risks and the likelihood of success. AI can be a valuable tool to help couples achieve their dream of having a child.