Frequently asked questions about fertility and assisted reproduction (II)

As we mentioned in the first article of this series about common doubts in fertility and assisted reproduction, our medical director at URE Centro Gutenberg, Dr. Claudio Álvarez, answers many questions for the newspaper La Opinión de Málaga in the section “Ask a Specialist.”

Seeing the success of the first article, and given Dr. Álvarez’s ongoing participation in the newspaper, we promise to keep publishing some of the most frequently asked and interesting questions. Here are this month’s!

Can I choose to have twins when starting fertility treatment?

The natural incidence of twins in humans is about 1% of births. This is not random: twin pregnancies are high-risk because they have a higher rate of premature birth, preeclampsia, gestational diabetes, fetal growth restriction, delivery complications, and more.

The goal of fertility treatment is for the couple to have a healthy child at home. Following this logic and considering the above, twin pregnancies resulting from assisted reproduction treatments are considered a medical complication and should therefore be avoided.

Can I have sexual intercourse during assisted reproduction treatment?

In theory, there is no problem having sex during fertility treatment. However, it is generally not recommended during ovarian stimulation in an In Vitro Fertilization (IVF) cycle, as it can be uncomfortable for the woman and increase the risk of ovarian torsion.

During artificial insemination treatment, however, there is no contraindication to sexual intercourse.

A friend who got pregnant via IVF was prescribed different hormones than me. Why didn’t I receive the same medication?

Medical treatments, especially in fertility and assisted reproduction, must be highly personalized, evaluating each couple as unique based on their history (diagnosis, woman’s age and weight, stimulation protocol, etc.).

This means hormonal medication is tailored specifically to each couple’s case. Therefore, it is normal for women undergoing the same assisted reproduction treatment not to share the same medication. What worked for your friend might have different results for you.

After ovarian puncture in IVF, is bed rest necessary? What about after embryo transfer?

After ovarian puncture, as with any surgical intervention, relative rest for at least 24 hours is advisable.

After embryo transfer, rest has not been shown to improve the success rates of the technique, and normal daily activities do not reduce the chances either.

I have type 1 diabetes and have been recommended IVF. Do I have more complications because I’m diabetic?

The most important thing is to have optimal metabolic control before trying to get pregnant, whether spontaneously or through assisted reproduction.

There are situations where pregnancy is not advised, such as severe retinopathy and nephropathy. Ideally, there should be coordinated care between the endocrinologist and gynecologist. Prevention of multiple pregnancy is also recommended.

Can I continue drinking coffee during my fertility treatment?

Moderate caffeine consumption (about two cups per day or 200 mg) does not seem to alter reproductive capacity. Its effect on miscarriage risk or male fertility is inconclusive. In other words: like everything, consumption should be moderate within a balanced diet.

I was told I can’t undergo fertility treatment because I’m 52 years old. Why?

Advances in reproductive medicine are increasingly rapid, and at 52, IVF with egg donation is a very effective technique. There is no law regulating age limits for fertility treatment. However, the problem is different: the woman is no longer fully prepared to face a pregnancy, which would be associated with more complications.

Menopause occurs on average at age 50, marking the natural end of a woman’s reproductive age. For this reason, pregnancy is not recommended, though future developments might tell us otherwise.

I have always wanted to be a mother, but I don’t have a partner right now. Should I freeze my eggs? I’ve heard several famous women have done this.

Egg quality declines significantly after age 37. Vitrification of eggs is an efficient fertility preservation alternative, and the ideal age to do it is before 36-38 years.

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