The causes
of undesired childlessness are individual, therefore there are many
forms of therapy.
In our fertility centre we offer all types of therapy in accordance
with the most up-to-date scientific developments. Working together
with you, we always select a form of therapy which is tailored to
your personal needs.
We do not only rely upon medical recommendations here but also take
your wishes into consideration. The various methods will now be
presented individually:
Optimisation of Cycle
Here, the natural cycle is observed
through both ultrasound and the level of hormones
in the blood (in some cases hormones are administered). At the right
point in time, ovulation is set into motion and the couple is advised
to have intercourse at the optimum moment.
Hormone Therapy
During a natural cycle, the woman
normally develops one follicle. As not every egg cell is fertilised
and on average only every tenth fertilised egg cell develops into
an intact pregnancy, the probability of successful in-vitro fertilisation
during an untreated natural menstrual cycle (that means without
first stimulating the ovaries) is low (around 5%). In order to increases
the chances of pregnancy, IVF and
ICSI and, often, insemination are
generally carried out after having first stimulated the ovaries.
Here you can see various stimulation scenarios:
 (enlarge)
 (enlarge)
 (enlarge)
The aim of this procedure is to increase the number of mature follicles,
to improve the quality and potential for development of the egg
cells and to control the maturing of the follicle and ovulation.
The main advantage of this ovarian stimulation treatment is the
higher rate of pregnancy per attempted treatment, according to the
type of treatment (IVF, insemination)
and natural factors (age, sperm quality). An intro-uterine insemination
treatment is not very effective as an isolated method. In a spontaneous,
untreated cycle, pregnancy rates of just 3% are reported following
insemination. After a hormonal stimulation of the ovaries, the pregnancy
rate of an intro-uterine insemination lies at around 10% to 15%
per attempt.
Insemination (heterologic and homologic)
If the quality of the semen is insufficient, then a special treatment
which filters out the best sperm can make sense. This can then be
released into the uterus at the moment of ovulation with the aid
of a plastic tube. The aim of this method is to increase the number
of fertile sperm in the woman’s fallopian tube, in order to
increase the likelihood of successful fertilisation. This procedure
is completely painless and can greatly increase the probability
of becoming pregnant. Intra-uterine insemination is used when the
quality of the sperm is slightly lower than required.
 (enlarge)
In Vitro Fertilisation
If, for example, both fallopian tubes are blocked, then fertilisation
of the egg cell has to take place outside the body. These methods
are called In Vitro Fertilisation
(IVF) because the fertilisation of the egg cell takes place in a
petri dish. First, the egg cells are gathered.
 (enlarge)
The suction of the follicles takes place with the aid of ultrasound
during a short general anesthetic here at our fertility clinic.
The egg cells are extracted from the follicles using a fine needle
which is inserted through the vaginal wall and are then brought
together with the semen filaments in a test tube.
 (enlarge)
ICSI (Intro Cytoplasmatic Sperm Injection)
With the ICSI method, one individual sperm filament is inserted into
each individual egg cell respectively, under a microscope and using
a micro pipette. This method is often employed when sperm quality
is extremely low.
 (enlarge)
Here you can see the embryo transfer. Problems rarely occur and
it is completely painless:
 (enlarge)
Further methods that can increase the likelihood of becoming pregnant
As infertility treatment unfortunately does not guarantee certain
pregnancy, doctors and biologists have long been working on procedures
which increase the probability of becoming pregnant. If one exhausted
the complete spectrum, then, in an ideal case, the rate of pregnancy
could be increased by up to one third. In the Kinderwunschzentrum
(Fertility Centre) Berlin, we offer you all the possibilities that
are allowed in Germany and that have a proven positive influence
on the probability of becoming pregnant. Amongst other methods,
we offer:
Assisted Hatching
Various studies have shown that the creation of a small opening
in the embryonic membrane of the egg (zona pellucida) just before
the embryo transfer can improve
hatching and thus, the implantation itself. Higher implantation
and pregnancy rates have been recorded in older women and in women
whose egg cells are encased in a particularly thick embryonic membrane.
 (enlarge)
Our centre has equipment which can create this small opening in the
zona pellucida within seconds and without risk of damage to the
embryo, using a fine laser beam.
Polar body examination
An assessment of the chromosome complement can be made through
the removal of a polar body from the egg cell (polar
body examination). As not every egg cell is genetically sound,
healthy egg cells can hereby be selected and later transferred as
embryos.
Spindel View
The spindle plays a central role in the maturing of the human egg
cell; it is responsible for the careful alignment and distribution
of the chromosomes during cell
division. As women age, abnormalities in the spindle begin to occur.
The absence of the spindle correlates to a significantly reduced
fertilisation rate and a bad or non-existent development of the
embryo. In addition, the alignment of the spindle during ICSI
influences the further development of the embryo. The embryo only
has the best chance of a successful pregnancy if the chromosome
distribution is correct.
Extended Egg-cell Culture (Blasto-cyst Culture)
In blasto-cyst culture, the embryos are not transferred on the
third day but on the fifth day. A blasto-cyst
is an embryo which is further on in its development. Only 40% of
all embryos ever reach the blasto-cyst stage. The extended egg cell
culture improves the synchronization between the uterus, the endometrium
and the embryo. The knowledge of the development potential of the
embryo allows an assessment of
the probability of the start of a pregnancy to be made.
Furthermore, higher implantation rates of embryos in the womb have
been recorded. We offer blasto-cyst culture to couples who have
already completed 2-3 unsuccessful IVF cycles, in order to gain
information as to whether the embryonal genome is perhaps not activated
and if the embryos remain in the 4-8 cell stage.
Sperm Selection using PICSI
PICSI is a medical product available
to support the biologist in the selection of a suitable sperm. Here,
the principle that the sperm naturally attaches to the hyaluronic
acid of the egg cell complex is used.
On the basis of a study from the highly-regarded American Yale
University, the binding behaviour of ejaculation samples from men
were examined. The results of this work led to the conclusion that
the certainty of finding a chromosomally intact sperm through use
of a PICSI dish can be increased by a factor of 4.
Freezing of Egg Cells in the Pronucleus Stage
If more than two egg cells are fertilised during artificial insemination
and should these be in the pronucleus
stage, then they can be stored at –196°C in liquid
nitrogen. The process of freezing and storing in a frozen state
is called cryo- preservation.
At a later point in time, these egg cells can be thawed and transferred
back into their womb (embryo transfer).
This method allows the fertility team to transfer fewer embryos
per cycle and thus to reduce the risk of a multiple pregnancy. At
the same time, pregnancy can be achieved through the transfer of
thawed egg cells (cryo cycle) should a pregnancy not occur or should
the couple desire to have a further child. Treatment involving hormone
injections is usually not necessary for the transfer of cryo preserved,
thawed egg cells in the pronucleus stage. The endometrium is prepared
for the embryo transfer through the administration of hormones in
tablet form. The probability of a successful pregnancy is somewhat
lower than in a stimulated treatment cycle.
Freezing of Egg-cells, Sperm, Testicle Material
(TESE) or Ovarian Material
In the case of cancer, the survival of the patient is of utmost
importance. Thanks to modern treatment methods such as operations,
chemotherapy and radiotherapy, more and more patients are winning
the fight against cancer. We offer the possibility of freezing and
storing semen cells, egg cells, testicle tissue (TESE)
or ovarian tissue in order to retain fertility, before starting
chemotherapy or radiotherapy. The cryo preservation of these gametes
requires complicated preparation. Therefore it is advisable, that
the doctor in charge and the patient contact us as soon as the cancer
diagnosis has been made. In such cases, advisory appointments are
made immediately.
 (enlarge)
The „Implantation Injection“
There is proof that a special medicine can ease the implantation
of the embryo in the womb. We call this injection the “implantation
injection”.
Embryo „Glue“ to improve Embryo
Implantation
A medium has existed since 2002, which was specially developed for
the transfer of the embryo following artificial insemination and
which is thought to improve nidation (implantation). Its physical
properties are similar to the secretions in the womb and can help
the embryo to implant itself into the endometrium.
|
)
)
)
)
)
)
)
)
)
)
10787 Berlin / Mitte (Tiergarten) ){kind=link}
){kind=link}
){kind=link}
){kind=link}
){kind=link}
){kind=link}
){kind=link}