Statistics indicate that one in ten births that occur in Spain are the result of assisted reproduction and the demand for this type of treatment continues to increase. This has a lot to do with the delay in the age at which women decide to become mothers and the increasing deterioration in semen quality, factors that hinder fertility and reduce the chances of conceiving for many couples. But there are cultural factors that are also contributing to promoting these treatments: from gender biases to the culture of immediacy in which we live immersed.
“Assisted reproduction techniques have cornered the market because they are more effective and profitable than any treatment to improve fertility or semen quality and because more and more couples want to control their reproduction, they want to choose the moment of pregnancy based on their schedules. professional or personal”, explains Lluís Bassas, andrologist and director of the Fundació Puigvert sperm bank.
“We are used to planning our entire lives and, in that agenda, we decide: now I study, now I look for work, now I want to buy a house… and at a certain moment it is decided ‘now reproduction fits’, and how probably that decision Having children has been delayed, it is more difficult to achieve it and the pressure to achieve quick results is increasing”, agrees Julio Herrero, head of the assisted reproduction area at the Vall d’Hebron hospital.
He emphasizes that the culture of “promptness” is added to this. “We are a society used to turning to medicine to find an immediate solution to everything that happens to us, and in the same way that you take a pill when you don’t want to have children, you have the idea that as soon as you stop that pill the person will become pregnant; But this is not the case because 22% of couples of reproductive age have difficulties (and the older they are, the higher the percentage), and since they know that medicine offers more effective reproductive methods than natural ones, they go to them,” he comments. Blacksmith.
This implies, says Bassas, that some people reject treatments that would perhaps allow them to achieve pregnancy naturally in one or two years and prefer to undergo the physical (for the woman) and economic cost of an assisted reproduction treatment “because they say that they need pregnancy now because it is now when they have a professional break to prepare for exams, for example.”
The andrologist at the Puigvert Foundation believes that this behavior is also due to a certain gender bias. “The increase in late maternities means that doctors do not focus on men, that male fertility is not looked at (many reproduction clinics do not even have andrologists on the team), and that women are directly subjected to more effective treatments and fast than waiting for slow sperm to triumph.”
Herrero assures that this pressure of immediacy reaches specialists in reproductive medicine “because patients want quick results, that they transfer the embryo now and achieve pregnancy with that first embryo, and nature is not like that.”
The Director of Innovation at IVI RMA Global and the IVI Foundation, Nicolás Garrido, agrees that when an infertile person seeks treatment to have children “they want the cure for today, not in six or ten months.” As an example, he comments that they have a research project that requires the patient to undergo treatment for four months before undergoing assisted reproduction to improve the results “and there are patients who refuse to wait those four months even though this would improve their chances.” of success”.
Josep Maria Pomerol, an andrologist at the Institute of Andrology and Sexual Medicine of Barcelona, ??assures that this also happens with varicocele surgeries. “A varicocele can affect reproduction and the quality of the spermatozoa and before we operated on them, just like the obstructions of the seminal duct; However, today, always in a hurry, waiting six months for at least two generations of sperm to develop after surgery is considered a long time and many of these patients go directly to assisted reproduction,” he says.
Garrido assures that it is necessary to distinguish between couples who undergo assisted reproduction because they do not wait and avoid the uncertainty of whether they will conceive by themselves in six months just because they want to have a child right away and those who do it for cost-benefit reasons, because They are already late for maternity and the chances of pregnancy that they can gain by waiting a few months are lost because the woman’s age continues to advance.
“We often see women at the limit of reproductive age with a partner with subfertile semen who perhaps with more time would achieve a pregnancy but, since they have left motherhood until very late, we do not have that waiting time,” agrees Pomerol.
Piotr Sokol, specialist in assisted reproduction at Dexeus Mujer, explains that the need for immediate treatment in the majority of cases he treats “is modulated by the age and gynecological circumstances of the woman in terms of ovarian reserve and quality”, so that When there is a male infertility factor that requires treatment or a change in lifestyle for several months (spermatogenesis lasts three), “the dilemma arises and the need to offer these couples an attractive proposal from a reproductive point of view,” and end up in assisted techniques.
Pomerol and Bassas admit that the use of assisted reproduction also has to do with the fact that andrology has not found valid and rapid treatments to improve the number or quality of sperm, while artificial fertilization techniques allow pregnancies to be achieved with a single sperm. per egg.
