Nearly six years ago functions in Cuba the Care Program to Infertile Couple. Its coordinator, Doctor Rogelio González Sánchez, talked with CubaSí on the particularities of the service.
Perhaps, the first calling of human beings even long before wanting to be doctors, teachers or carpenters, it’s to become a parent. Some achieve it in their first attempt, some even unintentionally, as a welcoming surprise, but for many it becomes more difficult. However, every passing day science opens new doors to achieve that dream.
The Cuban Health System assists from several programs this need. Nearly six years ago functions in Cuba the Care Program to Infertile Couple. Its coordinator, Doctor Rogelio González Sánchez, talked with CubaSí on the particularities of the service.
How is the program organized?
"In each municipality there is an OB-GYN doctor consulting, that’s where the real assistance begins. We have established that it can be done in the municipalities, what must be done at the hospitals, how long it’s necessary to attempt in the municipalities; if things don’t work out, send them to the hospital. For example, a 34-year-old woman in the municipality doesn’t receive any treatment, just the regular preliminary tests, but no treatment, because there’s no time to study her in the municipality, we must send her to the hospital."
Which are then the responsibilities of the appointments in the municipalities?
"Their main task for municipal commissions is to identify risk factors for infertility of each region, as to work, a bit to avoid it, a bit to offer health education, so that youngsters with the same factor don’t appear again. There are some factors that are very frequent like sepses in both men and women; vices like alcohol drinking, smoking, among others… "
Contrary to what most people think, it’s not an appointment solely for women. Why?
"The name is Program to Infertile COUPLE, which includes them both, because it affects both; the male factor is between ages 40-50 % present in all infertilities in Cuba; it’s not just the woman, it’s also the man”.
What can cause to approach the assisted reproduction programs in Cuba?
"All over the world, and we also meet the regulations established for the care to infertile couple, that simplifies the problems you might encounter. If the Fallopian tubes of a young woman are non-existent, that is the main cause, and the utero-tubal peritoneal factor is around 25-30% in all infertility causes. If the tube is blocked or non-existent because she had an ectopic pregnancy and had to be operated on or because she was born with congenital malformation. The solution is the embryo transfer procedure for in vitro fertilization. Of course that happens when all regulations are met, and the couple gets what they wanted, to have a baby. Hence, the State, understanding that has financed and has dedicated a group of professionals who will carry out all procedures…
"In the Cuban Program it is necessary to have very certain what it causes he/she makes you not to conceive, if it doesn't use that technique. Besides that the Ministry finances everything, the ethical part of us is also in that if it doesn't take that technique, it is not necessary to subject to an organism to aggressions that you/they don't play" him.
Starting from what age is it advisable to attend consultation?
It is wanted that the whole couple that wants to conceive and it takes one year without achieving it and looking for pregnancy, because you begins to study, because some of the causes can be a little slow to find them and to solve them. And the other thing, the woman has a thing that she calls himself reproductive window: after the 35 years the pregnancy possibilities begin to diminish very quick, therefore, in the woman, since it is fertile that should be a year of having had the menarquía - there are some that take a long time a little more in maturing and we never wanted them to be embarrassed with less than 20 years, because the adolescence arrives until that age and they are more complicated the pregnancies - up to the 35 he/she has a reproductive window that is very good to be embarrassed; of there in the it advances they begin to diminish the pregnancy possibilities, they begin to increase the risks of malformations, the anovulación risks, the risks of low respondedoras, then it is more complicated."
Is it certain that who undergo to this procedure they have more possibilities to miscarry?
"In women that spend of the 36 years the abortion risk it is bigger, because they begin ova that don't have enough genetic information to reproduce, to appear then they increase the abortions. He/she doesn't have to do with the procedure, but with own causes as this."
How would you value the level of development of these procedures in Cuba?
"This Program that has relatively few years like such, he/she has gone advancing quickly. The techniques in the whole world change in three years. Of the fertilization in vitro to the injection intracitoplasmática the time was very quick, because they realized that some masculine factors impacted so much, and it was necessary to look for another technique; and of the freezing, críopreservación to vitrificación ten years have not passed, he/she has gone quicker, and already this last it is what is giving more results.
"We are still introducing this technique. We already have four centers in the country, the Ameijeiras was the first one that began, although in Cuba fertilization had been made in vitro from 1989; there are born children of that time. He/she came the special period and it stopped, but that you began in the Institute of Endocrinology and they had some results. The economic situation took to stop it, but it was restarted between 2006 and 2007 in the Hospital Siblings Ameijeiras. We have gone introducing new techniques little by little, we are maybe a little slower in the introduction of those that are dedicated to solve the masculine factor that is a little more complicated. The blockade also affects vastly the Program: it is necessary go to look for the medications, the cultivation means, the expendable, much more far, and that enlentece also the Program, but the total intention is to maintain it and to give solution to a group of couples that you/they need" it.