The reproductive system does not understand studies, work, mortgages or other day-to-day problems. It works on its own schedule, which often does not coincide with possibilities or expectations.
And it is that heConception is a complex process that depends on many factors. It requires “production of healthy sperm on the part of the man and healthy eggs on the part of the woman.”; unblocked fallopian tubes allowing sperm to reach the egg; ability of the sperm to fertilize the egg when they meet; the ability of the fertilized egg (embryo) to implant in the woman’s uterus and sufficient embryonic quality,” indicates the American Society for Reproductive Medicine (ASRM).
He adds that, For the pregnancy to reach term, the embryo must be healthy and the woman’s hormonal environment must be adequate for its development.. When even one of these factors is affected, infertility can occur. Therefore, if a couple has been having unprotected sexual relations for more than a year and a pregnancy does not occur, there may be problems of this type.
The causes of infertility are varied and are often combined. It is estimated that around 30% of cases are of female origin, another 30% are male, 30% are mixed and 10% are of unknown origin.according to Dr. Cristina Trilla Solà, gynecologist at the BeDona Clinic, in Esplugues de Llobregat (Barcelona), and member of Top Doctors Group.
“The most common cause in women is age, which causes a decrease in the quality of the eggs and significantly reduces the probability of pregnancy. Secondly, we find a decrease in the man’s semen quality, either due to lack of concentration, mobility or shapes of the sperm, genetic anomalies or fragmentation, which makes it difficult or impossible to generate a viable embryo. Thirdly, there are problems with tube obstruction, uterine malformations, endometrial dysfunctions or immunological problems, all of which are causes of implantation failure and/or abortions,” details the gynecologist.
On the other hand, specialists at the Cima Hospital in Barcelona point out that “the quality of the eggs is a determining factor in a woman’s ability to conceive. A quality egg is quality because it has the appropriate morphological characteristics and chromosomal complement to allow a successful pregnancy. The age of the woman is the most important factor when determining the quality of the eggs because, over time, the genetic load of the egg can be altered, although its morphology remains intact.
In this sense, they highlight that aneuploidies (alterations in the number of chromosomes) increase with age. Thus, they explain that “between 35 and 37 years of age, 30% of the eggs present aneuploidies; between 38 and 41, 40% of the eggs present them and, from 41, we can reach 60% or 70%”.
In addition to the quality of the eggs, their quantity also decreases with age. Normally, at birth, a woman has between one and two million eggs, which she will lose during childhood, so that when she reaches puberty, there are usually between 300,000 and 500,000 left.
“Of all of them, a woman will have around 400 mature eggs during her reproductive life, which will be released during the ovulation process. Although each month an egg descends through one of the fallopian tubes, there are between six and 12 more that are activated and lost without maturing. This means that, Around the age of 50, the ovarian reserve drops to zero, leading to menopause.”, say the doctors at the Cima Hospital in Barcelona.
Assisted reproduction
There is an increasing trend in appointments at fertility clinics, as reflected by data from the Top Doctors platform. Dr. Victoria Rey Caballero, specialist in gynecology, obstetrics and assisted reproduction, and member of Top Doctors Group, points out that each year the number of first reproduction treatments grows by around 5%.
“The delay in motherhood is, without a doubt, one of the factors that is causing this rise in assisted reproduction techniques. This stems from economic, work and professional factors, or a lack of interest in having children at younger ages. And the thing is that, after a woman turns 30, the probability of having difficulty conceiving begins to grow, which means that she needs more and more help from assisted reproduction,” says Dr. Rey.
The field of assisted reproduction is undergoing a profound technological transformation. In fact, artificial intelligence (AI) is already a real tool in the day-to-day life of these clinics.
“It is helping to make processes such as the collection of clinical data, the control of analytical values, the review of diagnostic tests, laboratory surveillance methods or embryo selection easier and safer,” he explains.
“All of this is improving both the time spent with patients and the safety, precision and personalization of treatments. It is still early to imagine how far robotic and AI-based technology can go, but it is quite likely that the artificial uterus will not take long to become a reality, or that part of the processes in a laboratory can be automated and facilitate daily work,” says the specialist.
