Fertility Treatment - Methods

For unintentional childlessness, there are many potential causes as well as various treatment possibilities. The cause of the disruption of reproductive abilities may lie in the woman, the man, or equally in both partners.
In addition to potentially conservative or operative measures, psychological support is vitally important for the childless pair during and often after treatment. Harmful stress factors can be recognised and broken down, allowing successful treatment to be effected more expediently as circumstances permit.

Cycle optimising via pills or injections represents a relatively gentle form of treatment which can address minimal disturbances in the oogenetic process, thus achieving female fertility. If no satisfactory solution is obtained via this method, one can turn to stimulation therapy ("injection therapy"). In this more intensive method, hormones are injected under the skin or into the muscles over the course of several days.
Insemination therapy is applied when the previously described methods do not result in pregnancy or when the man's spermogram indicates mild to moderate limitations in sperm function. In the context of this treatment, sperm are taken from the man, treated, concentrated, and ultimately flushed via a thin catheter through the cervix into the uterus at a time when the woman is receptive. This treatment is generally performed in conjunction with hormonal stimulation.

Endometriosis treatment involves the surgical removal of tissue similar to the lining of the uterus which is found outside the cavity of the uterus and inhibits fertility. The therapy should be complemented by medical treatment via injections or pills.
In vitro fertilisation (IVF) finds application in cases of oviduct closures, substantial disturbances in oviduct function, endometriosis, semen cells with severely inhibited function, or unresolved sterility. Treatment begins with the administration of various hormones to harmonise the hormonal environment as well as medications that hinder premature ovulation. 32-36 hours later, the ova are removed, brought together with healthy, moving seed cells, and cultivated in an incubator. When one or more embryos have formed, the transfer of one or more of these can be performed after 2-4 days at which point support for the nidation process is provided through the administration of further hormones.
If IVF is unsuccessful or if the seed cells are not in a position to penetrate the ova, an intracytoplasmic sperm injection (ICSI) can be performed (also known as a "micro-injection").

The course of treatment is similar to IVF with additional special preparations made for the ova and sperm.
For a closure of the male spermatic duct, a urologist can remove sperm from the epididymis during an out-patient operative procedure known as Micro Epididymal Sperm Aspiration (MESA). Alternatively, one can turn to Testicular Sperm Extraction (TESE), in which sperm are removed using a testicular tissue probe and subsequently isolated.

Cryopreservation of gametes saves the woman from unnecessary, stressful procedures. In this procedure, the previously conserved gametes can be subjected to several attempts to transfer them into the cavity of the uterus using unique stimulation and penetration cycles.
The best results are usually achieved by using a combination of different therapeutic approaches.²

You fertility doctor will gladly clarify the treatment methods described above as well as further options in greater detail.