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When pregnancy fails to arise, this can have many causes. Not infrequently, it is an interaction of various factors that is responsible for the fact that the desire for a child has so far remained unfulfilled. That's why patient consultation plays such a big role in our fertility clinic: sometimes just optimised cycle monitoring and sexual intercourse at the right point in time helps lead to success.
If an actual fertility disorder is evident in the woman, the man or both partners, modern reproductive medicine offers various therapeutic options. Our experienced team will recommend the best treatment for your individual situation and support you empathetically during the treatment process.
If it is proving impossible to get pregnant in the conventional way, the doctor can perform so-called insemination (semen transfer). The male sperm is introduced into the uterus of the woman with the help of a simple medical procedure. These may be the sperm of one's partner (homologous) or of a sperm donor (heterologous/donor). To do this, the processed sperm are transferred directly into the woman's uterus using a catheter following ovulation, which is triggered by hormonal stimulation. Insemination is often used in the case of mild fertility disorders in the man, for example.
In IVF, mature eggs are retrieved from the woman following hormonal stimulation and brought together with about 50,000 processed sperm from the partner. Fertilisation of the eggs takes place outside the body, but of its own accord. If fertilisation is successful, then usually two embryos are transferred to the uterus after 2–5 days. In-vitro fertilisation (IVF) is a form of so-called assisted fertilisation.
If the chances of success of IVF are low, because the number of suitable sperm is too low, the eggs obtained following hormonal stimulation can be fertilised in the laboratory by means of microinjection using one sperm cell each. The resulting embryos are transferred to the uterus, just like in IVF.
Intracytoplasmic sperm injection (ICSI) is primarily used when the male sperm quality is so severely impaired that the egg cannot be fertilised by the semen independently. In this process, individual sperm are drawn up into a hollow needle and injected directly into the eggs (obtained by performing a follicular puncture on the woman).
With the IMSI method, our specialist staff works with a high-performance microscope. As a result, magnification of the sperm is about 15 times greater. Only optimal sperm are selected. The probability of getting pregnant is higher with this method.
In addition to IMSI, the P-ICSI method can also be considered. Here, sperm are selected according to their degree of maturity, which can be tested in a hyaluronan binding assay.
If there are no fertile sperm in the man's ejaculate, sperm may be able to be harvested from the testicular tissue (TESE) or the epididymides (MESA) by means of a biopsy and used for artificial insemination by ICSI.
Sometimes there are no, or hardly any, healthy sperm in the man's ejaculate. Pregnancy is then usually impossible by natural means. Frequently in such cases, however, sperm capable of fertilisation are still found in the man's epididymides or testes. The doctor can extract these by means of a surgical procedure. Microsurgical epididymal sperm aspiration (MESA) or testicular sperm aspiration (TESE), for example, are possible options here.
Hormonal treatment is used to stimulate egg maturation before artificial insemination. At the same time, ovulation can be precisely controlled. Couples whose desire to have a child has so far been unfilled therefore have the opportunity of increasing their chances of getting pregnant through targeted hormonal treatment. Because often, it is the hormonal balance that is responsible when getting pregnant hasn't yet worked. Hormonal disorders can occur in both men and women, but hormone therapy is usually offered to women. The goal is to promote egg maturation and induce ovulation. This hormonal treatment can increase the likelihood of successful fertilisation and is performed in our clinics
Medications There are a number of medications available to support/enable artificial insemination, such as those that promote follicular production and maturation of the follicle, to trigger ovulation, in order, for example, to create the best possible conditions for insemination. For example, a hormone commonly used in the first stage of fertility treatment is clomiphene. Clomiphene is usually taken in the form of tablets. However, follicle-stimulating hormone (FSH) or human menopausal gonadotropin (hMG) can also be taken to promote maturation of the egg.
Medical issues or fertility problems are not always the reason for treatment in our fertility clinics. Our range of treatments also includes further aspects of planned parenthood.