Will freeze 2 cycles of oil

Treatment methods for involuntary childlessness

The causes of unwanted childlessness are very individual, and so there are of course several forms of therapy.

 

In our center we offer all possibilities of therapy taking into account the latest scientific findings. In any case, a form of therapy tailored to you will be selected together with you.

 

Here, not only the medical recommendations, but also your wishes and ideas are incorporated. The individual options are presented below.

Cycle optimization

Here, if necessary with the addition of hormones, the natural cycle is monitored by means of ultrasound and hormone determination in the blood. Ovulation can then be triggered at the right time and time-optimized sexual intercourse can then be recommended to the couple.

Hormone therapy

A follicle usually develops in a woman's natural cycle. Since not every egg cell is fertilized and on average only every tenth fertilized egg cell leads to an intact pregnancy, the probability of successful artificial insemination in the untreated natural menstrual cycle, i.e. without prior stimulation of the ovaries, is rather low (about 5%). In order to increase this low chance of pregnancy, IVF and ICSI, but often also insemination, are usually carried out after the ovaries have been stimulated beforehand.

 

Here you can see different stimulation protocols:

 

(Larger image)

 

(Larger image)

 

(Larger image)

 

The aim of this approach is to increase the number of maturing follicles, to improve the quality and ability of the egg cells to develop, and to control the timing of follicle maturation and ovulation. The most important advantage of this ovarian stimulation treatment is the higher pregnancy rate per treatment attempt, depending on the type of treatment (IVF, insemination) and natural conditions (age, sperm quality). Intrauterine insemination treatment is also not very effective as an isolated measure. Pregnancy rates after insemination in the spontaneous cycle of only 3% are described. After hormonal stimulation of the ovaries, the pregnancy rate of intrauterine insemination is around 10% to 15% per attempt.

Insemination (heterologous and homologous)

If the semen quality is limited, a special processing of the sperm with filtering out the best sperm can be useful. These can then be introduced into the uterine cavity at the time of ovulation using a small plastic tube. The aim of this measure is to increase the number of fertilizable sperm in the woman's fallopian tube so that successful fertilization is more likely. This process is completely painless and can significantly increase the likelihood of pregnancy. Intrauterine insemination is used, for example, when the quality of the sperm is slightly impaired.

 

(Larger image)

InVitroFertilization

For example, if there is bilateral fallopian tube obstruction, the egg cell must be fertilized outside the body. These methods are called InVitroFertilization (IVF), as the egg cell is fertilized in a culture dish. First of all, the egg cells are obtained.

 

(Larger image)

The follicle aspiration (follicle puncture) takes place under ultrasound control in a brief general anesthetic in our fertility center. The egg cells are sucked out of the follicles by means of a fine needle inserted through the vaginal wall into the follicle and then brought together with the sperm threads in a test tube.

 

(Larger image)

ICSI (IntraCytoplasmic Sperm Injection)

With the ICSI method, one sperm thread is placed in each egg cell using a micropipette under a high-tech microscope. This procedure is used, among other things, for extremely limited sperm quality.

 

(Larger image)

Here you can see the embryo transfer: It is usually problem-free and completely painless:

(Larger image)

 

IMSI (Intracytoplasmic Morphologically Selected Sperm Injection)

What is IMSI?

IMSI (I.ntracytoplasmic M.orphologically S.elected sperm I.injection) is a special method of ICSI therapy, in which the sperm cells are selected under the microscope under 6600x magnification. A few years ago, advances in the field of microscopy led to the development of a new method with which it is possible to display sperm heads in high resolution and to use them for selection in ICSI therapy. A differential interference contrast (DIC) makes it possible to increase the magnification 6,600 times. This makes it possible to display so-called vacuoles (small vesicles filled with fluid) in the sperm heads that cannot be seen with a normal ICSI microscope. It is assumed that the cause of the formation of vacuoles lies in damage to the DNA, at least one has proven correlations between DNA strand breaks and the occurrence of vacuoles in the heads. The proportion of sperm without vacuoles in humans is usually very low (< 5%).="" spermien="" mit="" großen="" vakuolen="" führen="" zu="" einschränkungen="" der="" befruchtungsrate,="" zu="" nachteilen="" in="" der="" entwicklung="" des="" embryos,="" zu="" häufigerem="" einnistungsversagen="" und="" aborten.="" es="" ist="" daher="" vorteilhaft,="" spermien="" ohne="" vakuolen="" zu="" identifizieren="" und="" für="" die="" injektion="" der="" eizelle="" zu="" verwenden.="" imsi="" ist="" eine="" sehr="" komplexe="" und="" zeitintensive="" methode,="" die="" ein="" high-end-mikroskop="" der="" neusten="" generation="" voraussetzt.="" das="" kinderwunschzentrum="" berlin="" wurde="" nach="" intensivem="" training="" des="" laborpersonals="" für="" die="" imsi="" zertifiziert.="" 2008="" publizierte="" die="" italienische="" arbeitsgruppe="" um="" den="" international="" renommierten="" reproduktionsmediziner="" antinori="" eine="" überzeugende="" randomisierte,="" kontrollierte="" und="" doppelt="" verblindete="" studie,="" in="" der="" 446="" paare="" untersucht="" wurden,="" deren="" zeugungsunfähigkeit="" durch="" den="" mann="" verursacht="" war="" (antinori="" m,="" licata="" e,="" dani="" g,="" cerusico="" f,="" versaci="" c,="" d'angelo="" d,="" antinori="" s.="" intracytoplasmic="" morphologically="" selected="" sperm="" injection:="" a="" prospective="" randomized="" trial.="" rbmonline="" 16(6):835-41,="" 2008).="" bei="" 219="" paaren="" erfolgte="" eine="" klassische="" icsi,="" bei="" 227="" paaren="" die="" imsi.="" die="" schwangerschaftsrate="" in="" der="" icsi–gruppe="" betrug="" 26,5="" %,="" die="" in="" der="" imsi–gruppe="" hingegen="" 39="" %.="" der="" effekt="" war="" besonders="" deutlich="" bei="" denjenigen="" paaren,="" die="" bereits="" mehr="" als="" 2="" vergebliche="" versuche="" absolviert="" hatten.="" deutlich="" geringer="" fiel="" auch="" die="" zahl="" der="" aborte="" in="" der="" imsi–gruppe="" aus="" (17="" %="" im="" vergleich="" zu="" 37="" %="" in="" der="" icsi="" –="" gruppe).="">

 

Which couples particularly benefit from the IMSI?
In principle, the method can be used with any ICSI. We recommend the implementation of an IMSI especially for couples with more than two unsuccessful embryo transfers of well-developed embryos (implantation failures), patients with frequent miscarriages and couples in whom the embryos did not develop in accordance with the standards and on time in preliminary tests for no apparent reason. We also recommend the IMSI for couples who are over 37 years old.
Pre-sperm examination with the IMSI microscope
Before starting fertility treatment, there is the possibility of examining sperm as part of a spermiogram with the 6600-fold magnification of the IMSI microscope. With this preliminary examination, a considerable proportion of vacuolated sperm can often be found even if the sperm analysis is apparently normal. Insemination therapy would normally be recommended to this couple in ignorance of the vacuolation of the sperm heads. After examining the sperm with the IMSI microscope, knowing the numerous vacuoles of the sperm head, the couple can now forego unnecessary fertility treatments - such as inseminations in this case - and go straight to the correct, promising therapy (ICSI) with sperm selection. In this procedure, a selected vacuole-free sperm is injected into each egg cell with a microfine needle. (IMSI / ICSI).

 

Additional methods that can increase the likelihood of pregnancy

Since fertility treatment is unfortunately no guarantee that a pregnancy will occur safely, doctors and biologists have been working for a long time on procedures that increase the likelihood of pregnancy. If the full spectrum is exhausted, pregnancy rates that are up to a third higher can ideally be achieved. At the fertility center in Berlin, we offer you all the options that are approved in Germany and that have shown their positive influence on the likelihood of pregnancy. Among other things, we carry out:

Support of implantation ("assisted hatching")

Various studies have found that creating a small opening in the outer egg shell (zona pellucida) immediately before the embryo transfer can improve "hatching" and thus implantation. The higher implantation and pregnancy rate has been shown particularly in older women and in women in whom the egg is surrounded by a particularly thick egg shell.

 

(Larger image)

 

Our treatment center has a device with which this small opening in the zona pellucida can be created with a fine laser beam within seconds and without the risk of damaging the embryo.

Polar body examination

By removing a polar body of the egg cell, a statement can be made about the chromosome set of the egg cell (polar body examination). Since not every egg cell is genetically correct, healthy egg cells can be selected this way and later transferred as embryos.

Spindle view

The spindle plays a central role in the maturation of the human egg cell; it is responsible for the careful alignment and distribution of chromosomes during cell division. As the woman ages, spindle abnormalities appear in the oocytes. The absence of the spindle is correlated with a significantly reduced fertilization rate and poor or no embryonic development. The orientation of the spindle during ICSI also influences the further development of the embryos. The embryo only has the best chance of a successful pregnancy if it is correctly distributed.

Polar Aide ©

The success of an ICSI therapy is crucially dependent on the identification and selection of the optimal egg cell.
Each egg cell is surrounded by a protective covering, the zona pellucida. Several studies have shown that when a special polarization filter is used in ICSI therapy, there is a direct connection between the type of light refraction and the quality and development potential of the egg cell. Special software (Polar Aide ©) analyzes the type of light refraction of the zona pellucida in a few seconds and displays it optically. A high light refraction indicates a particularly potent egg cell, while a low light refraction indicates that the egg cell has a poorer chance of development. The informative value of this analysis is superior to previous assessment methods and improves the detection of optimal egg cells for further culture and embryo transfer. In a recent study (2008), the use of this method led to significantly increased pregnancy and birth rates. Many scientific publications have shown that polarization microscopy is completely harmless to egg cells. Side effects have not yet been proven.

 

(Larger image)

Extended egg culture (blastocyst culture)

In the blastocyst culture, the embryos are not transferred on the third day, but only on the fifth day. A blastocyst is a more developed embryo. Only 40% of all embryos even reach the blastocyst stage. The extended egg culture improves the synchronization between the uterus, the uterine lining and the embryo. With the statement about the development potential of the embryos, the probability of becoming pregnant can be made.

 

Furthermore, higher implantation rates of the embryo in the uterine lining are known. We offer the blastocyst culture especially for couples who have already completed 2-3 unsuccessful IVF cycles in order to gain information about whether the embryonic genome may not be activated and the embryos remain at the 4-8 cell stage.

Sperm selection using PICSI

With the selection of a suitable seminal thread by the biologist, PICSI is now available as a supporting medical product. The principle that the sperm naturally binds to the hyaluronic acid of the egg complex is used here.

 

Based on a study by the renowned American Yale University, ejaculate samples from men were examined for their attachment behavior. As a result of this work it can be concluded that the safety of taking in a chromosomally intact sperm can be increased by a factor of 4 using a PICSI dish.

Freezing of egg cells in the pronuclear stage

If more than two egg cells can be fertilized during artificial insemination and if they are in the pronucleus stage (pronucleus stage), they can be stored in liquid nitrogen at -196 ° C. The process of freezing and keeping frozen is called cryopreservation.

 

At a later point in time, these egg cells can be thawed again and transferred back to your uterus (embryo transfer). This method enables the fertility team to transfer fewer embryos per cycle, thereby reducing the risk of multiple pregnancies. At the same time, if a pregnancy does not occur or if you want to have children again without renewed stimulation of the ovaries, pregnancies can be achieved through the transfer of thawed egg cells (cryocycle). Treatment with hormone injections is usually not necessary for the transfer of the cryopreserved and thawed egg cells in the pronuclear stage. The mucous membrane is prepared for the embryo transfer by administering hormones in tablet form. The likelihood of a successful pregnancy is slightly lower than in the stimulated treatment cycle.

Freezing of egg cells, sperm, testicular tissue (TESE) or ovarian tissue

In the case of cancer, the first priority is the patient's survival. Thanks to modern treatment methods such as surgery, chemotherapy and radiation, more and more patients are conquering cancer. We offer the possibility to store the sperm cells, the egg cells or the testicular tissue (TESE) or the ovarian tissue in our freezer before a planned chemotherapy or radiation treatment to preserve fertility. This cryopreservation of these gaments requires extensive preparation. It is therefore advisable to contact us immediately after the cancer diagnosis is made known by the attending physician and the patient. Appointments for such a consultation are assigned immediately.

 

(Larger image)

 

The "implantation syringe"

In order to promote the implantation of the embryos in the uterine lining, there are indications that this can be favorably influenced by a special drug. We refer to this syringe as a "implantation syringe".

Embryoglue, "glue" for improved embryo implantation

A medium has been available since 2002 which was specially developed for embryo transfer after artificial insemination and is intended to improve nidation (implantation). Its physical properties are very similar to those of the secretions in the uterus and can help the embryo to implant in the uterine lining.

 

Treatment methods