In this webinar, Dr. Antonio Gosálvez Vega, a Director of the Assisted Reproduction Unit at Quirónsalud Madrid, is discussing things you can do to have a successful IVF outcome.
If you look at the slide on my screen right now, there’s a red line, that’s the possibility of having and genetically abnormal embryo and how such possibility increases with the patient’s age. When you look at 44 years old, you see that 90% of embryos are genetically abnormal. So, a good blastocyst in a 42-year-old lady has about 30% possibilities of not implanting or being an unhealthy embryo. So what can be done – keep on trying, do more transfers, do a PGD testing, so genetic studies to avoid those bad embryos. It’s going to be difficult because you’re also a little bit of low responder, it’s only 1 embryo and 2-3 cycles, so it is maybe better to start thinking about other options.
We have been eating dairy for around six million years, so it’s good for us. If you think about Africa, they just take dairy and some vegetables, and that’s it. So don’t think, that this is something important, and it’s a common thing that you are not going to change anything, your results depending on your diet, there is no magic in the diet to take or not to take specific elements.
From the last 20 years, it was invented in the 80s, and from the 90s people started using different products that came, and they went. We started using aspirin for anyone at the end we stopped because it was s good for nothing. Corticoids – it is all for nothing. DHEA supplements are good for nothing. Ubiquinol now is good for nothing. Don’t forget, it’s not a matter of nutrition, our latest diet is much more than we need, your grandparents had a lot of children, and their diet was far worse than yours. In Africa, they have a lot of children, in Bolivia, they have lots of children, and their diet is a disaster. Please, have a common diet, use a normal diet, be secure to have a healthy diet, but don’t think that there are products that you can add to get results. Melatonin is good for nothing or Curcuma, some articles are saying that it is good for semen, do you really think so? Please, don’t buy what people want to sell to you.
It’s not really important because your nutrition is the average of the last years, so you cannot really restore it if it comes to women. For men, the nutrition, that you are taking is essentials for the sperm. The diet from the last 3 months is good to get a healthier sperm, but a diet is not going to change the egg. Remember the egg was made before you were born, then your nutrition can affect just a bit your uterus, but never your egg.
If you read some articles first answer, and it is not going to be my final answer, but my answer is yes because there is some association between WiFi -fi and sperm. That’s right, but if you read some more articles on what is bad for sperm is living in a city, so smoke, petroleum, cosmetics, all the pesticides, and there is some association between WiFi and industrialization, then if you think of WiFi as a marker of industrialization the answer is yes. If you speak specifically about WiFi for example instead of Bluetooth, the answer is no. So, it’s a marker of industrialization, it’s an indirect marker, that’s why with WiFi it’s not used.
The answer is no, of course not. If you increase your intake of protein, you are not going to increase anything else than amino acids and those amino acids are going to be used for your general metabolism. If you increase some protein for the process, it’s because you think you’re going to get better results, but it won’t have any better results.
No, the answer is, of course, not. When you have to set a line, it’s far better to have a younger smoker than an old and healthy man. So being a smoker is not important for donors because they have been checked to be a donor. If you tell me that this donor smokes 2 packets a day, then I will say yes. For me for example, I would trust such donor because he’s honest, and how many of them say: I’m smoking, that happens rarely. How many of them could lie, the one that says I smoke from time to time, he’s a nice guy.
If it is 1 glass of wine after dinner, so 7 glasses a week, it’s not important. If you’re asking me about 3 beers a day, 2 glasses of wine a day, and 5 gin tonics on Fridays, I think you have a big problem because alcohol is going to burn some of your vitamins. Then this level of alcohol is not going to be good for you, your health, your baby and anything. Then, of course, alcohol over 40 if it’s just from time to time or some wine for example it’s not important, but be careful with heavy drinkers.
No, a PGD is a tool that we use in fertility, and it should be an agreement between patients and doctor. If you have a day-3 embryo and you transfer that embryo, you have the maximum possibilities of implantation. You also need to keep in mind that some of them can cause a miscarriage and some of them, maybe 2% might have Down syndrome. If you want to improve those figures and you want to put out those 2 embryos with Down syndrome and those 10 embryos with the risk of miscarriage, you’re going to take out other healthy embryos, just a few of them but you’re going to take some of them out. So it has some advantages and disadvantages, and I’m absolutely against putting a line here, let’s say you are over 40-42 whatever you should do a PGD, no, I don’t agree with that. In this life some people will have Down syndrome, and they will be happy in that family and others won’t, then as doctors we cannot say to people what they have to do, we need to offer them the possibilities, to explain well the possibilities, they have, or they don’t, but no I won’t accept a fixed-line.
You would need to give me more information so that I could answer properly. If this is a cyst that grows fast, there can be two things. First one, a simple one, which is the best thing you can do is to ignore it and wait. But some of them could have some specific characteristics, some specific data that makes them dangerous.
Let’s say this kind of cyst of 7 centimetres in 98% might be not important and in 2% maybe it is dangerous. You’re saying that it has grown, I would say, stay calm, I wouldn’t do surgery. I’ll do a puncture, transvaginal puncture to empty that cyst and avoid other things. If you do the surgery at the end, of course, there will be some tissue so I would be patient. Please, do what your doctor that did the ultrasound advises you, they can tell you why you should do it, it is hard to give you a certain answer without knowing you, seeing where it is and see other circumstances.
Yes, you can. You said you’ve been running, and you have been playing volleyball, don’t forget that humankind has been running away from lions for six million years, then the embryo you’re going to have in your uterus, it’s going to be in the same place. Setting and transfer are putting an embryo in the right place, and that’s why we advise you a common behaviour if you play volleyball, you can go ahead and continue.
As I’ve said, it’s not the same giving information to sell than telling the truth. If you ask me if there is any possibility that a massage will have any positive effect on fertility. I have to give you a radical answer – it’s good for nothing. Could you imagine that someone gives a massage for deafness, blindness, having bad semen, having arrhythmia then please don’t put your confidence on funny things? They are taking your money. Why don’t they give us results in scientific magazines, why they don’t write some papers showing us that it is working. Please, don’t pay attention to these low-level techniques. They are taking your money.