Sexual Medicine, Fertility, Urology and Andrology in Seville and Canary Isl.


What are assisted reproductive techniques (ART)?

These procedures aim to achieve fertilization and pregnancy by artificial means.  The sperm and egg are united to facilitate their merger, i.e. fertilization.

What is Artificial Insemination?

Artificial insemination (AI) is the deposition of sperm previously treated, i.e. selected and capacitated, inside the female genital tract. This technique can be performed with sperm from the couple, called artificial insemination by husband (AIH) or frozen sperm from an anonymous donor (cryopreserved), which is called artificial insemination by donor (AID).

What is In Vitro Fertilization (IVF)?

In Vitro Fertilization (IVF) is the fertilization of two gametes (sperm and eggs) outside the womb,  in the laboratory.  IVF requires:
– A pre ovarian stimulation to achieve a multiple follicular response
– Puncture of these follicles and oocytes uptake
– Washing, selection and sperm capacitation
– The union of gametes or fertilization in the laboratory
– Implanting the embryo in the uterus in order to achieve an evolutionary gestation.

What is ICSI?

It is a special type of FIV by injecting a single sperm into the oocyte. It is the intra-cytoplasmic micro-injection  of sperm. It is the most commonly used  reproduction technique and the most efficient in cases of infertility due to a male problem, as it takes very few normal sperm to achieve a pregnancy.

What are the success rates with assisted reproductive techniques?

Although techniques are effective and results can vary depending on the experience of the reproduction centre, the best success rates in cases of severe male factor infertility are those using ICSI techniques, and are generally around 50% of gestations. They are definitely not infallible techniques.

What is the role of the Urologist-Andrologist in these techniques?

The first objective will be to attempt to correct the problem in the male so that these techniques are not necessary. In the case where this is not possible, the first objective will be to retrieve sperm for reproduction and ensure that sperm are of the highest quality to achieve a better success rate using the technique. On the other hand, the male patient should be explored and studied  as far as possible to ensure that there are no secondary genetic abnormalities.

Are there other more modern techniques?

More recently, techniques have been developed that allow a better selection of sperm, such as IMSI with ICSI sperm selection using a high magnification microscope.

Dr. Natalio CruzJefe del servicio de Andrología
El Dr. Cruz, con 25 años de experiencia médica, ha sido hasta 2016 Jefe de la Unidad de Andrología en el Servicio de Urología del Hospital Virgen del Rocío de Sevilla, Coordinador Nacional de Andrología de la Asociación Española de Urología (AEU) y Secretario General de la ESSM, cargos que ha delgado para centrarse de lleno en el ilusionante proyecto de ofrecer una consulta médica privada de alto nivel en Sevilla.

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