THEn Italy, one in five couple has difficulty conceiving naturally and more and more often chooses to rely to the PMA, medically assisted procreation. According to the most recent data of the Istituto Superiore di Sanità, only in 2022, over 87,000 couples took this path, contributing to the birth of more than 16,000 children. It is, however, a complex path, not only from a medical point of view, but also emotional and organizational. OftenIndeed, An attempt is not enough, you have to try and try again. But, the passing time, the unnerving expectations, the continuous visits, the uncertain outcomes and the failures, contribute to an increasing meaning of exhaustion that slowly wears the initial determination. Studieshowever, that continue incessantly, offer great hopes.
PMA, because not giving yourself for won after the first failure
There are, in fact, good news: science brings new perspectives that can make the difference. Two studies, presented at the European congress of the human reproduction society and embryology (EShre 2025), offer concrete and encouraging responses. The first, shows that the second cycle of treatmentoften underestimated, It can even be more effective than the first. The second proposes a less medical and more natural technique, suitable for over 40 patients.
The second cycle has more successful chance
The study conducted by the group generates on a sample of over 1,200 couples in seven Italian centers analyzed the effectiveness of the second PMA cycle compared to the first. The data show that almost half of women responded better to the second attempt: More oocytes produced, greater oocity quality, More embryos arrived at the blastocyst stadiumor to the stadium in which they are ready to be transferred to the uterus or frozen for future uses. Even those who had not obtained vital oocytes in the first cycle recorded positive results in the second stimulation. Not only that. The rate of live births in the second cycle was 24%regardless of the outcome of the first.
From multicyclic strategy to the most natural PMA: how assisted fertility is changing (Getty)
The second cycle? Immediately after the first
The study, in essence, has shown that fail a first time does not mean having to give up. In fact, the data seem to demonstrate that follicular cohorts are independent of each other: That is, every menstrual cycle starts from scratch and the results of a cycle do not preach the subsequent ones. It should be added, however, that, Next to biological factors, Time also plays a key role.
Every month of waiting between the first and second treatment slightly reduces the chances of obtaining pregnancy. A detail that may seem negligible, but that acquires weight in women with compromised ovarian reserve or advanced reproductive age. Therefore, The message that emerges is clear: not to postpone too much. Continue the path without long breaks can make a difference.
Over 40, the way of the modified natural cycle
For women who arrive at the PMA with an age that exceeds 40 years of age comes a concrete alternative to heavy and stressful hormonal cycles: The modified natural cycle. This was present to another study, this time of the group there, one of the major references in reproductive medicine, in collaboration with an international team of experts in the centers in Italy and Spain. The protocol aims to respect the natural rhythm of the body, intervening only in a targeted way: a monitoring of ovulation, a small dose of HCG hormone to synchronize the release of the egg, and a minimum administration of progesterone.
The results speak clearly
The results are clear: The technique is effective as much as classic hormonal protocols in terms of pregnancy rate, but with less spontaneous abortions (11.8% against 17.4%). The treatment is also perceived by patients as lighter and more familiar, with less obstetric complications. A relevant aspect, especially for those who face this path with an already significant psychological load.
A new vision of the PMA: more personalized, more human
The two studies, in synergy, indicate a clear direction: The PMA can no longer be designed as a standard protocolbut it must be considered as a path sewn on the needs of the couple. Success depends on clinical variables, of course, but also from times, mental approach and respect for biological rhythms. Science does not promise miracles, But today more than ever is able to offer answers and alternatives. And, every cycle, it must be seen not as an isolated attempt, but as a stage of a family story under construction.
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