Pregnancy at an advanced age increases the risk of complications in pregnancy and childbirth.

-the full success of assisted reproduction treatment is the birth of a child healthy, unique and term after a pregnancy and a normal delivery. Multiple gestation cannot be deemed a failure, but not a full treatment success

-increasing the age of reproduction also increases the risk of genetic, gestational and perinatal

-the economic crisis affects the demand for treatments both in the public sphere and the private

-more than 180 experts in reproductive medicine of all Espana discussed these days in Cordoba in the VI Symposium fertility Ferring, endorsed by the Spanish society of fertility (SEF)

Córdoba, February 2013.- the age of the woman is the greatest determinant of human fertility and complications in pregnancy and childbirth. The increase in the age of the first pregnancy and the successive, and the decrease in the number of pregnancies per woman, is a clear trend in the past 30 years in developed countries.

Specialists have epidemiological data that is associated with the delay in the age of the first pregnancy fertility disorders increase and the need for recourse to assisted reproduction treatments.

With the increase in the age of reproduction also increase the genetic, gestational and perinatal risk. Complications such as gestational diabetes, hypertensive pregnancy-associated States and disorders of fetal growth, are determined by the age of the mother.

The immediate consequence is the increase in multiple pregnancies – two or more fetuses-by the use of assisted reproduction techniques, which according to international recommendations, should not exceed 10% of pregnancies, and that can have, among other consequences, prematurity.

It’s aspects of paramount importance with health, social and economic implications, which more than 180 experts in reproductive medicine of all Spain discussed these days in Cordoba in the VI Symposium fertility Ferring, endorsed by the Spanish society of fertility (SEF).

Dr. Federico Pérez Milán, Chairman of the SEF, and one of the speakers the full success of assisted reproduction treatment is the birth of a child healthy, unique and term after a pregnancy and a birth of normal course. Multiple gestation cannot be considered a failure, as is achieved a pregnancy, but not a full treatment success ”, therefore, continues professionals in reproductive medicine are developing preventive strategies of multiple gestation and proof of this is the progressive increase that is appreciating for years in the transfer elective of a single embryo. This conduct must have as a consequence a gradual reduction in the percentage of multiple gestations ”.

According to experts the three areas of assisted reproduction in which recent advances have a greater impact, and who are being treated at the Symposium are: the identification of prognostic factors of good response to ovarian stimulation; the therapeutic approach to improve the effectiveness in patients undergoing in vitro fertilization; and the application of emergent technologies for the diagnosis and prognostic assessment of gametes, embryo, endometrium and the interactions of these. All is a sunset date on reproductive dysfunction and a vision of the future on technological innovations applied to this field.

Spain is a true international reference in the field of reproductive medicine, the legislative framework – one of the first in Europe – gives legal protection to a wide range of techniques.

Increased scientific production of Spanish researchers in human fertility and its disorders, both in the field of basic science and clinical research, has contributed to the increase in the volume of assistance and care centres in our country, turning Spain into the second or third country of the European Union on volume of treatments, and the first in the case of egg donation treatments.

According to data from the last record SEF published referred to the year 2010, the global percentage of gestation per started cycle was 29.2% for IVF/ICSI with own oocytes and 27.9% for the cryotransfer of embryos from own oocytes (for defrost cycle). The rate of success for cycles with egg donation was 50.9% and 35.1% for the cryotransfer of embryos from donor oocytes.

According to these data, the cumulative probability of clinical pregnancy through transfer fresh more cryotransfer has been estimated at 37.4% for women less than 35 years, 28.9% for aged between 35 and 39 years old, and at 17.5% for patients of 40 or more years.

Meanwhile, the artificial insemination with sperm from the couple provided globally 12.9% pregnancy per cycle started, and the insemination by donor a 21.8%.

The economic crisis affects the demand for treatments both in the public and private fields: in the public because of the difficulty of patients to combine treatment, pregnancy and childbirth with the job duties, and private because the decrease of the income level implies less capacity to cope with the cost of treatments.

One of the latest trends is the Cryopreservation of oocytes, which allows its reserve for a later use in late pregnancies; This reduces the genetic risk associated with germinal aging, but must be present that Cryopreservation of oocytes does not guarantee subsequent gestation.

The change of circumstances that determine the voluntary delayed age of gestation is the approach most suitable to this problem, although it is out of the possibilities of action of professionals and they must be women, aware of the risks of that delay, looking for her first pregnancy at younger ages.