If you paid attention to the introduction, you will have noticed that under the phrase #KnowIsPower it says that a doctor is as good as his patient and very often they ask us: What does this mean? In short, it means that even if a doctor is excellent, if the patient does not follow his instructions, the treatment will not work.

Here is an example that will sound a little ridiculous but is actually super common: Let’s say that the doctor has already examined you and he tells you that you are going to need three vials of medication to stimulate your ovulation, but since you want to improve your chances of getting pregnant you decide put 6 vials of medicine on you… No! This usually causes ovarian hyperstimulation, the ovaries swell and begin to hurt a couple of weeks after starting the treatment, but the worst thing is that in the end two things can happen: One is that the ovary closes and stops producing eggs. , another is that it releases too many eggs.

Usually 10 are more than enough but 12, 15 or more than 20 could be released and in the end many of those are going to be immature and it is basically a waste, however, we also have patients who do the opposite, either because the medication It makes it expensive for them or because a friend told them that they were going to get pimples or that they were going to get a headache if they took the medication… In short, any excuse to not take the medication, and of course, in the end if there is no ovarian stimulation we are only going to have 1 or 2 eggs to do In Vitro Fertilization and if they do not mature well it would not be worth transferring them to the uterus.

We receive many patients who had an in vitro procedure that was not successful and they tell us that only two or three days passed from the extraction of the eggs to the implantation. At Creafam we know that this is not ideal, but there are many reproductive centers. experts in selling a 3-day In Vitro Fertilization with nice names like “natural IVF” or “maternal IVF” or simply “economic IVF”, although in reality the savings are minimal since the rate of a natural pregnancy in patients with fertility problems Fertility is at most 10% compared to the pregnancy rate of IVF in Creafam, which is more than 90%, which is why we incubate the vast majority of embryos until day 5. Only in certain cases and with certain criteria We do it in less time.

When we talk about nutrition and fertility, most patients think that we are going to put them on a diet because that is the first thing they are told everywhere: If you want to get pregnant, you have to go on a diet… And yes, weight has an influence. But the most important thing is to ensure that there is a perfect balance of 4 nutrients, which are vitamin D, coenzyme Q-10 and antioxidants.

For decades we have known that vitamin D is produced in the skin with the influence of the sun’s rays and that it helps to have healthy bones and teeth, but we usually ignore it and give more importance to vitamin C, vitamin A or other nutrients, Even the scientific community had relegated it but little by little we have discovered that it influences hormonal processes and even the quality of sperm and eggs. It is so important that in recent years the recommended daily dose of vitamin D has been doubled globally, from 300 units to 600 units for adults with a limit of 2000 international units per day and here comes the most interesting part: Fat absorbs the vitamin. D and that is why overweight people have low levels of vitamin D. In fact, women with polycystic ovaries also tend to have low levels of vitamin D and in both cases the regularity of periods and the quality of the eggs or eggs can be improved. sperm in men with something as simple as vitamin D supplements.

If we focus on assisted reproduction, adequate vitamin D supplementation has five benefits: It improves the quality of eggs and sperm, so that successful fertilizations are achieved, but it also helps prevent endometriosis and even improves endometrial receptivity. that there are more embryos that implant well in the uterus and if that were not enough, the rates of abortions, losses and complications in pregnant women are reduced. You just have to be careful, it’s not about going to the pharmacy and buying all the vitamin D supplements you can find, usually this supplementation is done for only a few months because having too high levels of vitamin D for prolonged periods also causes blood loss problems. fertility. If you like, come for a consultation and we can find your ideal levels.

Now let’s talk about antioxidants, just as the human body ages over the years, the cells in our body age and die in a matter of weeks. Basically, producing energy burns and wears them out quickly. Just as a car burns gasoline and releases smog, cells burn oxygen and release free radicals that are toxic to cells. It is a normal process but when free radicals are produced in excess it is known as oxidative stress.

The big problem with oxidative stress is that it expands and affects other cells around it, it is as if we put a rotten apple in a basket of fruit and then in 1 or 2 days the rest of the fruits will rot. So, in fertility it is a problem because it ends up affecting the eggs, sperm, ovaries, fallopian tubes, seminal ducts, the uterus and can even inflame the abdomen and reduces the possibility of the embryo developing. The first way to reduce oxidative stress is not to smoke, not drink and avoid processed or high-calorie foods, the second way is to consume antioxidants, this way you can lengthen the life of the cells and of course, this increases the quality of the sperm and of the eggs. Vitamin C is probably the most popular antioxidant, but the best antioxidant out there is liposomal glutathione.

Glutathione is a tripeptide made up of three amino acids: glutamic acid, cysteine and glycine. The wonder of this molecule is that it can disintegrate free radicals but also improves the metabolism and growth of cells while reducing cell death. Without a doubt, it is the best cell protector that exists. Finally, coenzyme Q10 is very interesting, everywhere they sell the supplement as an antioxidant to prevent aging, but the coolest thing about this molecule is that it lives in the mitochondria and the mitochondria are responsible for producing energy in each cell, its deficiency causes heart problems and low energy levels in each cell inside and outside the body… And I say outside the body, because when there are deficiencies of this enzyme the sperm almost do not move, they are as if dead and in the same way a fertilized egg It has problems growing and dividing due to lack of energy.

At Creafam we can check your levels and provide you with supplements of these nutrients, but I also recommend that you watch the video of our nutritionist, Mrs. Marisol Navarrete, about foods that improve fertility, so you can prepare from this moment and little by little improve your chances of success.

Human beings are social creatures, we need that contact and closeness with others to be well and it is incredible but this need becomes palpable from conception. Traditionally we put each fertilized egg in a droplet full of nutrients and put them in the incubator, this way it is easier to identify each embryo and assess its development, but in several countries we have been experimenting and obtaining excellent results with the group culture technique.

Basically, if an embryo is growing well we leave it alone, but if we see that there are two embryos that are not growing as well as we would like, we can put them together in the same droplet and they begin to grow better. It seems like magic and it’s hard to believe, but it works. Perhaps it is due to the exchange of nutrients or slight alterations in temperature and it does not work in all cases but when it does, it is truly wonderful to see them grow.

Yes, avoiding sexual activity can improve fertility. There are two reasons why it is important to avoid sexual activity before performing an ovarian puncture: The first is that if the woman has an orgasm there is the possibility that some of the mature eggs will be released, so in the end we would have fewer eggs to fertilize and the second is that if the man ejaculates the number of sperm in his semen sample will be lower. Sperm quality is probably not affected but we could obtain half or a third of the sperm that were expected, so the recommendation is to avoid all sexual activity three days before performing the ovarian puncture.

The PH or potential of hydrogen. In the in vitro laboratory there are many variables that we can easily control such as nutrients, temperature and incubation time, but the PH or acidity in which the embryo is located is the most difficult to control, especially because the temperature You control it like a thermostat and that’s it. The time, you set it is the clock and that’s it, but the pH changes depending on the nutrients you have placed and how fast the embryo is growing, the temperature also modifies it and even every time you take a measurement you are altering the PH. So in other clinics it happens that the work day ends, they go home and when they return in the morning the embryos are atretic, that is, dead.

Fortunately at Creafam we have systems such as Primo Vision and Timelapse to automate the regulation of PH and even provide the patient with a complete report with the growth rate, temperature and PH throughout the incubation.

As I said at the beginning, ovarian hyperstimulation can affect the number of eggs obtained on the day of follicular aspiration, but it can also affect the health of the mother and therefore the chances of success when the transfer is performed, therefore, while embryos are incubating, it is worth paying attention to the symptoms of ovarian hyperstimulation.

The main sign is extreme swelling, the area near the ovaries becomes inflamed and there may be fluid retention so that the patient gains a kilo of weight in less than a day. Other less obvious symptoms include shortness of breath or difficulty breathing, nausea, persistent vomiting, or decreased urine output. If the problem is serious, it would be worth freezing the mature embryos and waiting a few weeks before continuing with the treatment.

When we talk about in vitro there are two main techniques, the first is what is popularly known as IVF and it is about doing fertilization in the most physiological or natural way possible, that is, of course we extract the eggs and train the sperm. ! But the only thing we do is place some sperm in a droplet next to the egg with all its accumulation, that is, all the tissue that surrounds it naturally and this accumulation prevents the sperm from reaching the egg and helps only the strongest one to penetrate the egg, but of course, in the end it no longer has to pass through the entire vagina, uterus and fallopian tubes, so in a matter of minutes it will be able to cross the cumulus.

The second technique is more complicated and is the typical image that many have seen of the syringe injecting a sperm directly into the egg, it is known as ICSI and means intracytoplasmic sperm injection. For this technique we do remove the cumulus from the eggs and inject a single sperm, but there is a very important detail that I have seen that they do not do elsewhere and that is that when a sperm enters the egg naturally, its tail It falls and only penetrates the head, but if you inject a complete sperm into the egg it will try to continue swimming and may end up destroying the egg from the inside, so, before injecting each sperm we must cut or immobilize the tail.

Although IVF and ICSI are already complex procedures, there are still more advanced techniques such as performing a testicular biopsy, that is, we extract sperm directly from the testicle tissue and inject them into the egg. It is generally performed when the man has a vasectomy or has cryptorchidism, that is, the testicles did not descend properly or even when the semen sample does not have sperm… Many men think that this means that he cannot produce sperm but the safest thing is that for some reason get stuck inside the testicle.

Likewise, we can perform PGD or preimplantation genetic diagnosis where a blastomere is extracted from embryos on day 3 or day 5, that is, 1 or 5 cells of the trophectoderm to genetically analyze these embryos, thus we can rule out genetic diseases and even We can know if they are male or female.

After transferring 1 or 2 embryos to the uterus, there comes the stage of waiting 10 days to perform the pregnancy test, but during this time we have some recommendations for the couple. The first is for her to start taking her folic acid. Remember that it is half a milligram daily from the moment she is trying to get pregnant and throughout the first trimester. The second is to start taking care of your diet, particularly avoiding processed and canned foods since they may contain Bisphenol-A and this chemical alters hormonal function. In theory, you can return to your daily routine and even exercise, but please try to take it lightly and not make extreme efforts, maintain an appropriate level of activity.

I hope this series has allowed you to know everything about in vitro fertilization and do not hesitate to contact us to help you have your dream come true.

If you are interested in knowing more about this topic, we invite you to read our answers to frequently asked questions about In Vitro Fertilization.

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