Frequently asked questions about fertility and assisted reproduction (VII)

At URE Centro Gutenberg, we often receive questions about fertility and assisted reproduction, especially from patients navigating complex diagnoses or facing difficulties conceiving. Below, we address some of the most frequently asked questions we hear in consultations.

I’m 32 and have endometriosis. What tests are done to assess the progression of the disease?

Monitoring and evaluating endometriosis depends on associated symptoms, the stage of the condition, and how it presents. Each patient is unique and requires a personalized evaluation and monitoring plan based on her situation.

How many intrauterine inseminations (IUIs) are recommended before moving to in vitro fertilization (IVF)?

Generally, if pregnancy isn’t achieved after 3 or 4 cycles of IUI, IVF is recommended. However, this decision also depends on the woman’s age, the couple’s diagnosis, and any related conditions, which could shorten the number of suggested IUI attempts.

What are the risks associated with assisted reproductive treatments?

Risks vary depending on the technique used. The two most significant risks are ovarian hyperstimulation syndrome—now almost entirely preventable—and multiple pregnancies, which have been greatly reduced thanks to improved protocols and success rates.

What are the risks of receiving donated embryos?

If the legal requirements set out in the Spanish Assisted Reproduction Law are met, the risks are those of any pregnancy and are mostly related to the recipient’s age.

What is the best course of action for a uterine fibroid?

Regular gynecological checkups are essential. Treatment—whether medical or surgical—will depend on the size, location, and symptoms caused by the fibroid.

Do techniques like elevating the legs after intercourse help with getting pregnant?

There is no scientific evidence that specific sexual positions or post-intercourse techniques improve the chances of conception. However, it is proven that having sex at least two to three times a week increases the likelihood of pregnancy.

My anti-Müllerian hormone (AMH) is on the low-normal side. Can it change in future tests? Can I improve my ovarian reserve?

AMH levels can fluctuate due to factors like lab handling, medication use, or testing methods. However, ovarian reserve cannot be increased and continues to decline over time.

My partner and I are both 35 and have been trying for a year. When should we seek treatment?

If pregnancy hasn’t been achieved after 12 months of trying, it’s recommended to see a fertility specialist, who can advise on the best diagnostic and treatment options.

I’m 43 and have had several failed IVF attempts. Should I consider egg donation? Are there contraindications?

At 43, and after multiple unsuccessful IVF cycles, the most effective option is egg donation. This significantly increases the chances of a successful and ongoing pregnancy.

My wife has an underdeveloped uterus. How could this affect her fertility?

It depends on the severity of the uterine hypoplasia and whether the endometrial lining is affected. In severe cases, it may result in infertility, miscarriage, or preterm birth.

Is weight important when starting fertility treatment?

Yes. Obesity can negatively impact fertility by lowering egg and sperm quality, as well as embryo development and implantation potential. It is also linked to pregnancy complications such as miscarriage, hypertension, and gestational diabetes.

I have high sperm DNA fragmentation. What should I do?

First, it’s important to rule out external factors like smoking, alcohol, and environmental toxins. There are medical treatments available that may reduce DNA fragmentation to safer levels.

What are my chances of pregnancy with adenomyosis?

Adenomyosis is the presence of endometrial tissue within the uterine wall. It may cause uterine enlargement, cysts, or abnormal menstrual bleeding and pain. While its impact on fertility is still being studied, it may reduce the likelihood of pregnancy.