IMIM - Institut Hospital del Mar d'Investigacions Mèdiques

Barcelona research infertility group Miguel Angel Checa

The Barcelona Infertility Research Group has two distinct areas of interest: epidemiological research and clinical research.

Epidemiological research projects 

Assisted human reproduction and atmospheric pollution (FIVATMOS)

The aim of this study is to analyse the impact on reproductive success of acute exposure to air pollutants in the preconception phase, in terms of clinical pregnancy, in vitro fertilisation (IVF) and embryo transfer (ET). To do this we have designed a prospective cohort study that will include the first 700 women who undertake an IVF cycle in the Infertility and Human Reproduction Centre (CIRH- Centred'Infertilitat i Reproducció Humana) and Hospital del Mar in Barcelona (Parc de Salut Mar), who live in the Barcelona area. The levels of nitrogen dioxide (NO2) and particulate matter (PM2.5) exposure will be determined, according to the model developed by the ESCAPE (European Study of Cohorts for Air Pollution Effects) project, 7 days and on the day of embryo transfer, and the 3rd and 15th days prior to the transfer, in both prospective parents, and the reproductive success of the IVF treatment will be analysed. This project is funded by a FIS and is the subject of the doctoral thesis of Dr. Mireia González.

Semen quality and atmospheric pollution (SEMAP)

Our goal is to study the effect of exposure to air pollution on the quality of semen. To acheive this we have developed a two-faceted project. On the one hand, we will retrospectively assess the association between air pollution and semen quality in sperm donors at the Infertility and Human Reproduction Centre (CIRH). On the other, we will prospectively analyse the association between air pollution and semen quality in the first 500 patients who come for infertility consultations, meet the inclusion criteria, and agree to participate in the study. They must live in Barcelona and will be recruited from two infertility clinics: Hospital del Mar (public) and CIRH (private) who assess 1300 couples a year between them. On two occasions the participants will have to provide semen, blood and urine samples and answer a detailed questionnaire.

Classic semen quality parameters will be analysed, together with DNA fragmentation, apoptosis %, vitality %, oxidative stress, and aneuploidy. For both analyses the exposure to air pollution will be estimated on an individual basis for the participant’s, in various periods prior to obtaining the sample. Exposure models developed in the European project ESCAPE (European Study of Cohorts for Air Pollution Effects) will be employed. This project focuses on the thesis of a collaborator, Rafael Lafuente (CIRH).

Assisted reproduction techniques and quality of life

Infertility is a disease that causes couples to suffer psychosocially, motivating many changes in their relationship with their partner and social surroundings. This generates emotional and affective stress that influences their quality of life. Our aim is to exploit synergies within the EPiSAP programme, to assess the impact that assisted reproduction techniques have on the quality of life of infertile patients.

Clinical research projects

Prognostic value of sperm DNA fragmentation in intrauterine insemination

 Various current studies indicate that sperm DNA fragmentation is an important factor in sperm quality, being a limiting factor in the success of a pregnancy brought about either through natural means or assisted reproduction treatments. However, its clinical application is still controversial, partly due to the low sensitivity of the methods used. To this end, recent studies comparing different techniques point to the Comet method, in its two variants, alkaline and neutral, as having the best sensitivity and specificity for predicting infertility and abortions, respectively.

This scenario involves determining the prognostic value of sperm DNA fragmentation in relation to the success of intrauterine insemination. Therefore, this more sensitive Comet method will be used in its two forms, alkaline and neutral, to detect breaks in single- and double-stranded DNA, respectively. Demonstrating this association between sperm DNA fragmentation and the success of intrauterine insemination will allow us to direct the infertile patient to the most appropriate reproduction treatment, with subsequent savings in insemination cycles with a low probability of success, and optimising the couple's waiting time. The aim of this future study is therefore to demonstrate the existence of an association between sperm DNA fragmentation, using the Comet method, and the success or failure of intrauterine insemination treatments.

"Endometrial priming for embryo transfer"

The aim of this study is to see which of the two patterns of endometrial preparation for the transfer of frozen embryos is most effective at increasing pregnancy rates (oral or transdermal), and determine which is associated with a higher treatment compliance. For this reason, this study includes 134 consecutive embryo transfers that will be randomised into the two treatment regimes. This study is registered at ClinicalTrials.gov Identifier NCT01430650. This work is the PhD thesis of Dr. Paula Ferrer.

“Step up vs step down in controlled ovarian stimulation”

The aim of this study is to see which of the two ovarian stimulation protocols increases ovulation rates in infertile couples. It will include 178 consecutive couples diagnosed with infertility, who will be randomised between the two gonadotropin treatments, and who will

Contact

Coordinator:
Miguel Angel Checa

Tel:
93 2483129

Pg. Marítim 25-29
08003 Barcelona

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