The egg reserve that women have decreases with age, however, there are women who face a more rapid decrease in that egg reserve, so the reference issue is always in relation to age, it is not the same. have 3, 4 eggs at age 40 than at 32, then it is important to have a good ultrasound and hormonal evaluation to be able to guide patients, for example: If we see 3, 4 oocytes at the beginning of the menstrual cycle or we have a hormone antimüllerian below 1 nanogram are signs that should alert the gynecologist, which should alert the patient, since that patient is going to face the diagnosis of low ovarian reserve, which will compromise her reproductive prognosis. One of the alternatives that we can offer our patients with low ovarian reserve is called oocyte accumulation. What does it consist of? We perform an ovarian stimulation, we take the patient to the puncture and those oocytes that we obtain, which are generally one or two oocytes, we can vitrify them, later we reach a second and sometimes even a third ovarian stimulation.

The idea is to vitrify oocytes until we have a “pool” that allows us to offer a cycle in better conditions. It is not the same to face an in vitro fertilization cycle with two oocytes than with 6, 7 or 8 oocytes, the more cells the more likely we will be to obtain those embryos with a good prognosis, which are what will really give you the opportunity to get pregnant. Not only do we have to take into account the clinical aspect, which is obviously more important, but also economically… It is not the same to pay for a single in vitro with two stimulations as it is to do two or three in vitros each with its respective stimulation, in short It will be much more economical to always perform a single in vitro fertilization cycle but with a greater number of eggs.

Once we perform the ovarian stimulation and vitrify the oocytes, the following stipulations can be in the subsequent months depending on the clinical conditions or the patient’s decision. The oocytes that are vitrified can be months or even years maintaining the same conditions that they had in the moment they were obtained, for example, the patient we are going to see today began her treatment cycle in October, that is, five months ago, a first stimulation cycle was done where we vitrified an oocyte, the following month we managed to do a second cycle where We obtained three more, then there was a rest period during December and January and finally in the third stimulation cycle we obtained the rest of the oocytes, in total we fertilized 7 eggs to obtain today 2 embryos on day 5 of development that look very good and It is the opportunity we are looking for.

Ok, if we got 7 oocytes… Why are we going to transfer 2 embryos? So, remember that we have on our platform a video by our biologist Luis Machorro, in which he explains what embryonic development is like and how to choose the embryos with the best prognosis to generate that opportunity for pregnancy. Not all fertilized eggs will end up being embryos that can be transferred, naturally it always happens that there are some that are blocked that stop in the process, in addition there are the concepts of embryonic quality and the prognosis associated with that concept, so the Having a certain number of eggs is important to have the opportunity to have 1 or 2 blastocysts with a good prognosis that provide the opportunity for pregnancy. Now we are going to move on to the operating room so that you can see how the embryo transfer is performed.

Lo primero que vamos a realizar es una limpieza del cuello uterino para retirar un poco del exceso de medicamentos. Vamos a pasar una torundita, vas a sentir un poco incómodo La idea es tener todo bien limpio, mientras tanto, los embriones están bien en el laboratorio.

-¡Hola! Vamos a transferir dos embriones femeninos.

– Ah, ¿Les hicieron estudio genético? Si, tienen DGP estos.

Vamos a tomar un poco de líquido de un medio de cultivo para limpiar el cuello uterino. La parte negra que se observa arriba es la vejiga, está completamente llena y por debajo el útero, la cánula va a entrar de este lado por el cuello uterino. Y buscamos depositar los embriones acá, justo en medio del útero.

-Se la paso, Doc.

Me están pasando la cánula con los embriones. Ahí vemos la cánula que está entrando en la cavidad. Vemos la punta a la mitad y va a aparecer un brillo… Ese brillo que aparececió ahí es la gota del medio de cultivo con los embriones. Ahora devolvemos la cánula al laboratorio para que los biólogos la revisen y confirmen que salieron.

-Lo que voy a hacer, voy a sacar el líquido. Parece que no hay nada…Reviso que no se haya quedado nada en la cánula. ¿Le puedes decir que todo bien?

– Doctor, todo bien.

Gracias. Ya confirmamos que los embriones no están en la cánula, por lo tanto están dentro del útero, así que hemos terminado. Bueno, ya realizamos la transferencia, ahora vamos a esperar 10 días para poder realizar la prueba embarazo y en definitiva saber el resultado.