Introduction

When presenting the treatment options to a patient, it is important to emphasize that in most cases, pregnancy is achieved with simple treatments. These include the induction or stimulation of ovulation with hormones in cases of ovulation disorders, antibiotic treatments for some infections (either in the woman or in the man); surgical correction through laparoscopy if there are cysts, adhesions, endometriosis, etc. In the case of men, surgical treatment in the case of varicocele, or medical treatment if the andrologist prescribes it. It might also be advisable to refer the couple to a sexual therapist or a psychological counselor if considered necessary.

In about 30% of the cases, it is necessary to turn to assisted reproduction, which means that the medical team assists in the union of egg (oocyte) and spermatozoon. These treatments can be low-tech, such as ovulation stimulation and insemination, or high-tech, such as in vitro fertilization and ICSI (sperm injection into an egg) for very severe male factors, for instance, when there are very few spermatozoa in the ejaculate. Even in the event of absence of spermatozoa in the ejaculate it is highly probable to find them when performing a testicular puncture or biopsy.

Thanks to the dramatic advances in the field of human reproduction in the last 15 years, most couples can achieve pregnancy. However, sometimes it is necessary to go through several treatment cycles. When a couple is faced with difficulties for procreation in the first place they must try to preserve their integrity and privacy so as to prevent stress, which is clearly counter-productive. Considering the criticism showered on reproductive technology in these days, it is the couple themselves that must make the decision to choose between a childless life, adoption or the trying to have a baby with the assistance of a medical team. In turn, it is the medical team’s duty to offer all the information available on tests, treatments, duration (as you may sometimes take months or even years), chances of success (which varies depending on each couple) and possible complications, but all the same it is always the couple that must make the decision to start tests and treatments in the search for the baby they want so much.