Abdominal endoscopy (Laparoscopy)
Laparoscopy, also known as abdominal endoscopy, is a surgical procedure aimed at visually examining the internal reproductive organs and diagnosing potential issues. It allows for a detailed assessment of the ovaries, fallopian tubes, and uterus, helping to identify causes of infertility such as endometriosis, tubal obstructions, or fibroids.
The procedure is performed in a hospital under general anesthesia. A small incision below the navel is made, through which a video camera is inserted into the abdominal cavity to view the ovaries, fallopian tubes, and uterus. This method enables the diagnosis of possible adhesions, tubal blockages, or endometriosis.
Andrology
Andrology is the medical field concerned with male reproductive function and disorders. It addresses fertility issues, erectile dysfunction, and hormone disorders, playing a crucial role in reproductive medicine.
Anovulation (Absence of Ovulation)
Anovulation is a condition in which ovulation, i.e. the release of a mature egg from the ovary, does not occur. This can indicate various health problems and means that there is no egg capable of fertilization that could be fertilized by the sperm.
Ovulation is crucial for a successful pregnancy, as an egg is only available for fertilization during ovulation. Without ovulation, no egg can be fertilized, which significantly reduces the chances of pregnancy. Regular ovulation is therefore a fundamental prerequisite for conception.
If anovulation is detected when trying to conceive, there are various approaches to treating the problem. First, a doctor should diagnose the cause of anovulation, which can often include hormonal imbalances, stress or conditions such as polycystic ovary syndrome (PCOS). Possible treatment options include:
- Drug therapy: drugs such as clomiphene or letrozole can stimulate ovulation.
- Hormonal adjustments: Hormonal therapy can help correct hormonal imbalances.
- Lifestyle changes: Improving diet, regular exercise and reducing stress can stabilize hormone levels.
- Fertility treatments: In severe cases, assisted reproductive techniques such as in vitro fertilization (IVF) may be considered.
Anti-Müllerian Hormone (AMH)
Anti-Müllerian hormone (AMH) is a protein that is produced in the female ovaries. It serves as an indicator of the ovarian reserve, i.e. the number of eggs still present in the ovaries. The number of eggs is fixed from birth and decreases continuously over the years. A higher AMH level indicates a larger number of eggs. The AMH level is determined by a blood test and can be determined at any point in the cycle.
Antibodies in Cervical Mucus
Antibodies in cervical mucus play an important role in the immune system of the reproductive organs. These antibodies, often specific to certain pathogens, help to protect the vagina and cervix from infection. These antibodies are crucial for maintaining a healthy microbial balance, but they can also have an impact on sperm motility and survival.
The presence of antibodies can be determined using the Kremer test.
Antral Follicels
Antral follicles are small vesicles in the ovaries in which egg cells grow. Antral follicles mature from the beginning of a menstrual cycle and can be measured and counted using ultrasound. This examination is known as the antral follicle count (AFC). The number of antral follicles can serve as an indicator of ovarian reserve and fertility:
0 to 7 follicles: Indicator of severely reduced fertility
8 to 11 follicles: First signs of reduced ovarian reserve
12 to 14 follicles: Normal ovarian reserve
15 and more follicles: Excellent ovarian reserve
APC Resistance (Activated Protein C Resistance)
APC resistance is a genetic abnormality in which the blood coagulation factor V has a reduced sensitivity to active protein C. This resistance increases the risk of thrombosis and can affect the chances of a successful pregnancy. This resistance increases the risk of thrombosis and can affect the chances of a successful pregnancy. Women with APC resistance may experience complications during pregnancy or when using hormonal therapies such as ovarian stimulation.
It is therefore crucial to check for APC resistance before starting hormone treatment. In the event of conspicuous findings, concomitant therapy with anticoagulant medication such as heparin should be considered.
Aspermia
Absence of ejaculate despite orgasm and contraction of the male sexual organs. This condition is often caused by a disruption in nerve conduction within the urogenital system, such as can occur in cases of spinal cord injury.
Assisted Hatching
Assisted Hatching (AHA) aims to facilitate the implantation of an embryo into the uterus. The outer shell of the embryo, known as the zona pellucida, is gently thinned or breached using a laser. This process simulates the natural hatching that occurs during early embryonic development. By making it easier for the embryo to penetrate the uterine lining, AHA is intended to improve the chances of successful implantation, particularly for embryos that struggle to attach due to age-related changes in the zona pellucida or other factors.
Azoospermia
Azoospermia refers to the absence of sperm in the ejaculate and is a common cause of male infertility. This condition can result from various factors, including anatomical blockages, hormonal imbalances, genetic defects, or infections.
Treatment depends on the underlying cause and may involve medication, surgical interventions, or assisted reproductive techniques such as testicular sperm aspiration (TESE).
Basal Temperature
Basal temperature is the body temperature measured immediately after waking up. It can help determine ovulation and monitor fertility.
Bicornuate uterus
A bicornuate uterus is a congenital malformation in which the uterus is divided into two halves instead of having a normal, unified shape. This anomaly occurs when the two structures that form the uterus in the womb do not properly fuse.
Biochemical pregnancy
A biochemical pregnancy is a very early pregnancy loss. Although the pregnancy test shows a positive result due to the HCG hormone, the pregnancy does not develop any further. Biochemical pregnancy can be caused by genetic abnormalities, hormonal imbalances, implantation disorders or immunological factors. This loss often goes unnoticed, as it is often mistaken for a delayed or heavier period, while other women only notice the positive test.
Blastocyst
The blastocyst is an advanced stage of embryo development, reached about five to six days after fertilization. At this phase, the embryo has developed enough to be ready for implantation into the uterine wall.
Blood clotting disorder
In women who experience two or more consecutive miscarriages, an undiagnosed blood clotting disorder may be a possible cause.
If a clotting disorder is present, meaning an increased tendency for blood to clot (thrombosis), small clots are suspected to form in the blood vessels of the placenta. This can prevent the embryo from properly implanting or receiving adequate nourishment, leading to a miscarriage.
Not every clotting disorder results in miscarriage, and not every woman with a clotting disorder necessarily experiences pregnancy loss. Generally, around 20 to 25 percent of women with two or more miscarriages show abnormalities in blood clotting.
Celiac disease
Celiac disease can affect fertility and increase the risk of miscarriage or premature birth. If untreated, the body's reaction to gluten can lead to hormonal imbalances and irregular cycles. A gluten-free diet may improve fertility and reduce risks during pregnancy. Early diagnosis and strict dietary adherence are crucial for a healthy pregnancy.
Chemotherapy
Cancer and the associated chemotherapy can have significant effects on fertility and the desire to have children.
Effects on female fertility:
Chemotherapy can damage the ovaries, leading to a reduced number and quality of eggs, potentially resulting in premature menopause or permanent infertility. The menstrual cycle may also be disrupted.
Effects on male fertility:
Chemotherapy can impair sperm production and quality, which may cause temporary or permanent infertility.
Treatment options:
Cryopreservation of eggs, sperm, or embryos before therapy can improve the chances of future pregnancies.
chromosomal abnormalities or chromosome disorders
Chromosomal abnormalities or chromosome disorders: Chromosomal abnormalities in embryos occur when there are anomalies in the number or structure of chromosomes. These disorders can significantly affect embryo development and are a common cause of miscarriage or genetic diseases.
Chromosome disorders often arise due to errors during cell division, particularly during meiosis, when egg or sperm cells are formed. One of the most common chromosome disorders is Down syndrome (trisomy 21).
Preimplantation diagnosis can help detect chromosomal abnormalities.
Clomiphene
Clomiphene is an anti-estrogen that is pharmacologically used as an ovulation inducer. The drug is prescribed for anovulatory women and to improve fertility in cases of infertility. Clomiphene is administered over six ovulatory treatment cycles, or up to 12 cycles if the endometrial conditions are favorable (> 7 mm), with a dosage of 50 or 100 mg per day for five days, starting on the 2nd, 3rd, 4th, or 5th cycle day. Sonographic monitoring is an essential part of the therapy to assess responsiveness and prevent multiple pregnancies.
cordyceps
Cordyceps, a fungus traditionally used in Asian medicine, is often praised for its supposed benefits in boosting energy and immunity. Some believe it may also support fertility, as it is considered a potential aid for improving reproductive health and libido. However, there are currently no scientific studies or clinical research findings that confirm these assumptions. Without solid scientific evidence, Cordyceps should not be regarded as a reliable method for supporting fertility.
COVID-19
COVID-19 has not yet shown clear long-term effects on male or female fertility. However, severe cases in men can temporarily impact sperm quality, and women may experience cycle-related changes due to the illness or stress-related factors.
Cryopreservation
Cryopreservation is a technique used for the long-term storage of sperm, eggs, or embryos. These biological materials are cooled to extremely low temperatures, typically below -196°C. At these temperatures, cellular activity is almost entirely halted, preserving the integrity and functionality of the cells for extended periods.
There are two main cryopreservation methods:
1. Vitrification:
This method rapidly cools cells to extremely low temperatures, causing them to enter a glass-like state without forming ice crystals. This minimizes cellular damage and improves survival rates after thawing.
2. Slow freezing:
This technique gradually lowers the temperature, allowing ice crystals to form. To reduce potential damage, cryoprotectants are used to help prevent harmful ice crystal formation.
Both approaches are widely used in fertility treatments and other medical applications requiring long-term cell storage.
Diminished ovarian reserve
A diminished ovarian reserve means that the number of available eggs in the ovaries is lower—often earlier or more significantly than biologically typical. The ovarian reserve naturally declines with age, but it can also be affected by genetic factors, medical conditions, or procedures.
A key marker for assessing ovarian reserve is the AMH level (Anti-Müllerian Hormone). A low AMH level indicates fewer available eggs but does not provide information about their quality.
A reduced ovarian reserve can impact fertility, but it does not rule out the possibility of pregnancy.
DNA fragmentation (of sperm)
DNA fragmentation of sperm means that there are breaks or other damage in the genetic information (DNA) within the sperm. This damage can reduce the quality of the sperm and make the successful fertilization of an egg or the healthy development of an embryo more difficult.
Downregulation
Downregulation is used in artificial insemination (IVF) to temporarily stop a woman's natural cycle. Thanks to this hormonal intervention, the course of treatment can be precisely controlled and eggs can be retrieved at the best possible time.
Egg donation
Egg donation is a medical procedure in which a woman (the egg donor) provides her eggs for another woman (the recipient) in order to support her fertility. This may be particularly necessary if the recipient has no healthy eggs of her own due to health problems, premature menopause or genetic disorders.
Legal situation in Germany:
In Germany, egg donation is prohibited under the Embryo Protection Act (ESchG).
Legal situation in Austria:
In Austria, the Reproductive Medicine Act (FMedG) has permitted third-party egg donation and the use of third-party eggs for medically assisted reproduction under certain conditions since 2015. The legislation also stipulates that children conceived through egg or sperm donation have a right to access and obtain information about the donor's data from the age of 14.
Egg quality
Egg quality describes the health of a woman's eggs, which is crucial for successful fertilization and pregnancy. High egg quality increases the chances of natural conception or successful IVF. However, as age advances, egg quality declines, reducing fertility. Other factors such as smoking, poor nutrition, environmental toxins, and certain medical conditions can negatively impact egg quality. Maintaining a healthy diet, regular exercise, and avoiding harmful habits can help improve egg quality.
Ejaculate
Ejaculate plays a central role in fertility, as it contains the sperm necessary for egg fertilization. The quality and quantity of sperm in the ejaculate are crucial for reproductive ability. Factors such as sperm count, motility, and morphology influence the likelihood of successful fertilization. Health issues, lifestyle factors like smoking or excessive alcohol consumption, and environmental conditions can affect sperm quality.
Embryo
An embryo is the early developmental stage of an organism that begins after the fertilization of the egg and the fusion of genetic material from the egg and sperm cell. In human reproduction, embryonic development covers the first eight weeks after fertilization, during which the embryo rapidly divides and differentiates to form the fundamental structures and organ systems of the body.
During this critical phase, the main organs and tissues develop, and the embryo takes on a human-like form. After the first eight weeks, the embryo is referred to as a fetus. A well-developed embryo is essential for reproduction and the successful birth of a child.
Embryo grading (assessment of embryo quality)
Embryo grading (assessment of embryo quality): Embryo grading refers to the evaluation and classification of embryos during in vitro fertilization (IVF) or other assisted reproduction techniques. The assessment is based on specific criteria such as cell number, cell uniformity, and structural characteristics. This process helps determine the developmental capability and potential of an embryo for transfer.
Embryo transfer
Embryo transfer is a procedure within in vitro fertilization (IVF) in which one or more embryos are transferred into the uterus. The embryos are introduced into the uterine cavity using a catheter (a thin plastic tube).
It is important that the patient arrives with a full bladder, as this helps facilitate the catheter's insertion. Ultrasound guidance is used to optimally place the embryos in the uterine cavity. The embryo transfer is completely painless.
EmbryoGlue
EmbryoGlue is a specialized culture medium used during embryo transfer to increase the chances of successful implantation into the uterine lining. EmbryoGlue is a hyaluronan-containing fluid that is added to the embryo(s) shortly before transfer. Both the uterine wall and the embryo have binding sites for this hyaluronan. It is believed to act as a connection point between the embryo and the uterine wall.
EMMA Test
The EMMA test (Endometrial Microbiome Metagenomic Analysis) is a diagnostic procedure used to examine the microbiome of the uterine lining. This test analyzes the presence and composition of microorganisms in the uterus, helping to identify potential disturbances that could affect embryo transfer and pregnancy rates. The EMMA test is particularly recommended for women experiencing repeated implantation failure.
Endometriosis
Endometriosis is a chronic condition in which tissue similar to the endometrium (the lining of the uterus) grows outside the uterus. This tissue can appear in various areas of the pelvis, such as the ovaries, fallopian tubes, bladder, or intestines, and may cause pain, heavy menstrual bleeding, discomfort during intercourse, and difficulties with urination or bowel movements.
Endometriosis can affect fertility by blocking the fallopian tubes, disrupting egg maturation, or surrounding the uterus, making embryo implantation more difficult. The inflammatory tissue may also damage the ovaries and reduce egg quality.
Since symptoms are not always immediately recognized as endometriosis, diagnosis can take months or even years.
ERA Test
The ERA test (Endometrial Receptivity Analysis) is a diagnostic procedure used to evaluate the receptivity of the uterine lining for embryo implantation. The test analyzes endometrial tissue to determine the optimal timing for embryo transfer during in vitro fertilization (IVF), thereby increasing the chances of a successful pregnancy.
The test identifies the ideal duration of progesterone intake before embryo transfer.
Factor V Leiden
Factor V Leiden mutation is a genetic alteration in Factor V, a protein that plays a crucial role in blood clotting. In individuals with this mutation, the blood clotting system is characterized by faulty regulation of Factor V. This mutation prevents proper inactivation of Factor V, increasing the risk of blood clots (thrombosis).
The risk of blood clots is particularly high when additional factors that promote thrombosis are present, such as hormone therapy, surgeries, prolonged bed rest, smoking, pregnancy, childbirth, and breastfeeding. Therefore, these risk factors should be assessed before starting hormone treatment to determine if anticoagulant medications like heparin may be necessary.
Fallopian tube ultrasound (HyCoSy - Hysterosalpingo-contrast sonography)
HyCoSy is an ultrasound procedure used to assess the patency of the fallopian tubes. A contrast agent is injected into the uterine cavity and fallopian tubes, which is then visualized using ultrasound. This allows for a detailed examination of the inner structures of the uterus and fallopian tubes, helping to identify potential blockages or abnormalities that could affect fertility.
Preparation:
The examination is usually performed in the middle of the menstrual cycle to ensure that the uterine lining has not thickened.
Process:
A thin catheter is inserted through the vagina and cervix into the uterus, and the contrast agent is injected. Ultrasound is used to visualize the contrast medium within the fallopian tubes and check their patency.
Patients generally find it less painful compared to a hysterosalpingography (HSG).
Fallopian tubes
The fallopian tubes are the two ducts in the female reproductive system that connect the ovaries to the uterus. They play a crucial role in reproduction by transporting eggs from the ovaries to the uterus. Fertilization of the egg by sperm usually occurs within the fallopian tubes.
Fertility Diet
The Fertility Diet was developed by the Harvard School of Public Health to promote fertility. The diet is based on scientific findings that suggest certain eating habits can have a positive impact on reproductive health.
According to the Fertility Diet, the focus should be on:
- Healthy fats: Prioritize monounsaturated fats (e.g., olive oil, avocados) and omega-3 fatty acids (e.g., fish). Saturated fats and trans fats should be minimized.
- Whole grains: Consume complex carbohydrates to help maintain stable blood sugar levels.
- Protein-rich foods: Emphasize plant-based proteins (legumes, nuts, etc.), while moderating the intake of animal proteins.
- Increased antioxidants: Eat fruits and vegetables rich in antioxidants to reduce oxidative stress and support cellular health.
- Avoid sugary and processed foods: Limit sugar and processed foods, as they may negatively affect insulin levels.
This diet aims to improve hormonal balance and maintain a healthy body weight, both of which are crucial factors for fertility.
Fertilization
Each month, during ovulation, an egg is released from one of the two ovaries. The corresponding fallopian tube then captures the egg. The egg remains in the outer third of the fallopian tube, waiting to encounter sperm cells. Once a sperm penetrates the egg, fertilization occurs.
After fertilization, the egg—now called an embryo—is transported through the fallopian tube and reaches the uterus in time to implant itself.
Fibroids
Fibroids in the uterus are benign growths composed of smooth muscle and connective tissue.
Fibroids that extend into the uterine cavity or are embedded in the uterine wall can negatively impact embryo implantation. Therefore, an ultrasound examination of the uterus is recommended before any fertility treatment to assess their presence and potential effects.
Flu vaccination
A flu vaccination is recommended for those trying to conceive and before pregnancy begins. It provides protection against influenza, which can be more severe during pregnancy and may increase the risk of complications for the unborn child.
Follicle
A follicle is a small, fluid-filled structure in the ovary that contains an immature egg (oocyte). Follicles mature during the menstrual cycle and produce hormones that regulate ovulation and menstruation.
A woman is born with a certain number of follicles in her ovaries. At birth, she has approximately 1 to 2 million primordial follicles. This number declines to about 300,000 to 400,000 by puberty. During each menstrual cycle, several follicles begin to mature, but usually, only one reaches ovulation. In the reproductive years (approximately between ages 12 and 51), one dominant follicle matures each month, while others degenerate. By the end of the reproductive years, a woman typically has only about 1,000 to 2,000 remaining follicles, which are no longer suitable for successful fertilization.
Follicle puncture
Follicle puncture is a surgical procedure performed as part of fertility treatment to retrieve eggs. A reproductive specialist uses a thin hollow needle to extract fluid from individual follicles and flushes out the eggs. The puncture process takes approximately 3-5 minutes and is typically conducted under sedation or short anesthesia.
Follicle-stimulating hormone (FSH)
FSH, or follicle-stimulating hormone, is a key hormone for the maturation of ovarian follicles. It rises in the first half of the menstrual cycle, stimulating follicular growth and maturation in the ovaries.
FSH levels (in mIU/ml) on cycle days 1-4:
- <10 mIU/ml:
FSH is within the normal range. A positive response to hormone treatment is expected.
- 10-15 mIU/ml:
Reduced ovarian reserve. Response to hormone treatment may be limited, and the success rate of treatment may be lower.
- 15-20 mIU/ml:
Significantly reduced ovarian reserve. An even lower response to fertility treatment is expected, and pregnancy rates are significantly decreased.
- >20 mIU/ml:
Depleted ovarian reserve. No or only very poor response to hormone treatment is expected.
Gamete
A gamete is a sex cell. A female gamete is an egg cell, while a male gamete is a sperm cell. Gametes are haploid, meaning they contain only a single set of 23 chromosomes. During fertilization, a sperm and an egg fuse to form a diploid zygote, combining the genetic information of both parents and establishing the foundation for the development of a new organism.
Growth hormone - human growth hormone (HGH)
Growth hormone—medically known as human growth hormone (HGH)—is produced in the pituitary gland and plays a key role in various bodily functions, including cell growth, metabolism, and tissue regeneration.
In fertility treatment, HGH may offer supportive benefits in specific cases—such as for women with diminished ovarian reserve or reduced egg quality. Preliminary studies suggest that the hormone may help enhance egg maturation and improve IVF success rates. Its use is always individualized and must be carried out under medical supervision.
Habitual abortion
A habitual abortion refers to the repeated loss of pregnancy, defined as at least three consecutive miscarriages before the 12th week of gestation.
Possible causes of recurrent miscarriages:
- Coagulation disorders
- Uterine malformations
- Thyroid hormone disorders
- Luteal insufficiency
- Infections in the uterus caused by pathogens such as ureaplasma or toxoplasma
If no clear cause can be identified, preimplantation genetic diagnosis may provide insights into possible chromosomal abnormalities.
Hashimoto
Hashimoto's thyroiditis is an autoimmune disease in which the immune system attacks the thyroid gland. This can lead to chronic inflammation and often results in hypothyroidism (underactive thyroid). The condition is characterized by a range of symptoms, including fatigue, weight gain, sensitivity to cold, and depression. Diagnosis is typically conducted through blood tests measuring thyroid hormones and antibodies.
Women with untreated or poorly managed Hashimoto's have a higher risk of miscarriage, preterm birth, and pregnancy complications.
It is essential for women with Hashimoto's to regularly monitor their thyroid levels and consult a doctor to ensure optimal hormonal balance before and during pregnancy. A well-regulated thyroid function can significantly improve the chances of a successful pregnancy.
HyCoSy - Hysterosalpingo-contrast sonography
Hysterosalpingo-contrast sonography (HyCoSy) is a diagnostic procedure used to assess the patency of the fallopian tubes. A contrast agent is injected into the uterus via a catheter, allowing its distribution into the fallopian tubes to be observed. This process can be monitored using ultrasound.
HyCoSy typically takes around 5 minutes and is usually painless.
Hysteroscopy
A hysteroscopy is a minimally invasive procedure that allows for the detection of changes in the uterine wall and the collection of tissue samples.
During a hysteroscopy, a thin-walled instrument called a hysteroscope is inserted through the vagina and cervix to examine the inside of the uterus. There are two types of hysteroscopy:
- Diagnostic hysteroscopy: Used to diagnose changes in the uterine lining.
- Operative hysteroscopy: Used to remove polyps or perform other surgical procedures.
The outpatient procedure can be performed under light anesthesia and typically takes only a few minutes.
ICSI (intracytoplasmic sperm injection)
Intracytoplasmic sperm injection (ICSI) is a fertility treatment method in which a single sperm is directly injected into an egg. This procedure is commonly used in cases of reduced sperm motility or quality.
Idiopathic infertility
Idiopathic infertility refers to a type of infertility where, despite extensive medical examinations (such as hormone tests, fallopian tube patency assessments, and sperm analysis), no clear cause for the issue can be identified. This means that both female and male fertility are considered normal, yet pregnancy does not occur. Around 20% of couples trying to conceive are affected by this condition.
Immunology
Immunology is the science of the immune system. It explores how our body detects, combats, and protects itself against pathogens. This field covers topics such as innate and adaptive immunity, allergies, autoimmune diseases, vaccines, and immunotherapies.
Implantation
Implantation (nidation) is the process in which a fertilized egg embeds itself into the uterine lining. This occurs approximately 6 to 10 days after fertilization, when the embryo reaches the uterine wall and attaches. Implantation allows the embryo to absorb nutrients and oxygen from the mother’s blood, enabling further development. Disruptions during this process, such as an insufficient uterine lining, structural abnormalities, or blood clotting disorders, can lead to implantation issues, resulting in miscarriages or difficulties in achieving pregnancy.
Implantation bleeding
Implantation bleeding is a light bleeding that can occur when a fertilized egg embeds itself into the uterine lining. This usually happens about 6 to 12 days after fertilization, around the time of the expected period. The bleeding is typically very mild and can range in color from light to brown. It differs from a normal menstruation in its brevity and lightness.
Implantation curettage
An implantation curettage is a surgical procedure in which the uterine lining is cleaned following a failed implantation or miscarriage. It removes remaining tissue from the uterus to prevent complications.
Implantation flush
The Implantation flush or PBMC flush (Peripheral Blood Mononuclear Cell flush) is a procedure for isolating peripheral mononuclear blood cells, which play an important role in the immune system. The body's own blood cells are specially processed and cultured in combination with the pregnancy hormone HCG. This treatment activates the cells so that they develop protective properties for pregnancy. These prepared blood cells are then introduced into the uterine cavity before embryo transfer. This creates an environment that resembles a "healthy" pregnancy, increasing the uterus’s readiness for implantation.
Implantation pain
Implantation pain can be perceived as mild, cramp-like discomfort in the lower abdomen. This may occur when the fertilized egg embeds itself into the uterine lining. These pains typically arise about 6 to 12 days after fertilization. Around 20-30 percent of women experience these mild sensations.
In vitro fertilization (IVF)
In vitro fertilization (IVF) is a fertility treatment in which eggs are fertilized by sperm in a laboratory dish.
The process involves several steps:
1. Hormonal stimulation:
Medications are used to promote egg production in the ovaries.
2. Egg retrieval:
The eggs are collected through follicle puncture.
3. Fertilization:
In the lab, eggs are fertilized with sperm.
4. Embryo cultivation:
The resulting embryos are cultured for several days.
5. Embryo transfer:
One or more embryos are transferred into the uterine cavity to achieve pregnancy.
IVF offers an advanced solution for individuals facing fertility challenges and can be tailored to different medical conditions.
Intrauterine insemination (IUI)
Intrauterine insemination (IUI) is a fertility treatment in which processed sperm is directly introduced into a woman's uterus. This procedure is commonly used for couples with reduced sperm quality or motility, as well as in cases involving donor sperm.
IUI is typically performed during ovulation to maximize the chances of fertilization. It is less invasive than in vitro fertilization (IVF) and, compared to IVF, offers a more cost-effective option for couples trying to conceive.
Iodine
Iodine is essential for thyroid function, which in turn plays a central role in regulating metabolic processes and hormones. During pregnancy, the need for iodine increases as the unborn child's thyroid gland is dependent on the mother's supply. An iodine deficiency can lead to developmental disorders of the baby's brain and cognitive abilities.
In terms of fertility, iodine contributes to the normal function of the ovaries and is important for a stable cycle. An iodine deficiency can promote hormonal imbalances that make ovulation and conception more difficult. Studies show that an adequate iodine supply is associated with better reproductive health and pregnancy rates.
Pregnant women and women who wish to have children should therefore make sure they have an adequate iodine intake, for example through iodized table salt, sea fish or dietary supplements as recommended by a doctor. Women with thyroid disorders in particular should seek medical advice.
Jod
Jod ist essenziell für die Schilddrüsenfunktion, die wiederum eine zentrale Rolle bei der Regulierung von Stoffwechselprozessen und Hormonen spielt. Während der Schwangerschaft steigt der Bedarf an Jod, da die Schilddrüse des ungeborenen Kindes auf die mütterliche Versorgung angewiesen ist. Ein Jodmangel kann zu Entwicklungsstörungen des Gehirns und der kognitiven Fähigkeiten des Babys führen.
In Bezug auf die Fruchtbarkeit trägt Jod zur normalen Funktion der Eierstöcke bei und ist wichtig für einen stabilen Zyklus. Ein Jodmangel kann hormonelle Ungleichgewichte begünstigen, die den Eisprung und die Empfängnis erschweren. Studien zeigen, dass eine ausreichende Jodversorgung mit einer besseren Fortpflanzungsgesundheit und Schwangerschaftsrate verbunden ist.
Schwangere und Frauen mit Kinderwunsch sollten daher auf eine ausreichende Jodzufuhr achten, beispielsweise durch jodiertes Speisesalz, Seefisch oder Nahrungsergänzungsmittel nach ärztlicher Empfehlung. Besonders Frauen mit Schilddrüsenerkrankungen sollten sich ärztlichen Rat einholen.
KIR genes
KIR genes (Killer-cell Immunoglobulin-like Receptor Genes) are a group of genes present on the surface of natural killer (NK) cells.
KIR genes on NK cells can be crucial for embryo implantation. A balanced ratio of KIR receptors may promote successful implantation.
Analyzing KIR genes is particularly recommended when fertility treatments repeatedly fail or miscarriages occur frequently. The examination is conducted through a blood test in a laboratory. Results are categorized into three main groups based on the presence or absence of specific KIR genes: AA, AB, and BB. If the AA group is identified, it may partly explain an unexplained infertility condition.
Kremer test
The Kremer test evaluates whether sperm cells can penetrate a woman's cervical mucus and whether her immune system has developed antibodies against the sperm.
For this test, a small sample of cervical mucus is collected using a pipette from the cervix. In the laboratory, specialists assess whether sperm from the sample can move freely within the mucus or whether they become immobile. Immobile sperm indicate the presence of antibodies, which could affect fertility.
LH (Luteinizing hormone)
LH (luteinizing hormone) is an essential hormone for controlling the menstrual cycle and fertility. It triggers ovulation by causing a sudden release shortly before ovulation. After ovulation, LH supports the formation of the corpus luteum, which produces progesterone to prepare the uterine lining for a possible pregnancy. An LH deficiency can lead to cycle disorders and failure to ovulate, while an excessively high LH level is often associated with polycystic ovary syndrome (PCOS), which can affect fertility.
Luteal insufficiency
Luteal insufficiency is a hormonal disorder in which the corpus luteum does not produce enough progesterone. This hormone is crucial for maintaining the uterine lining during the early weeks of pregnancy. Luteal insufficiency can lead to difficulties in conception, recurrent miscarriages, irregular menstrual cycles, or premenstrual syndrome (PMS).
Diagnosis is conducted through a blood test to determine progesterone levels, usually measured in the second half of the cycle (about 7 to 10 days after ovulation). A low progesterone level may indicate luteal insufficiency.
Luteal phase
The luteal phase is the second half of the menstrual cycle, which begins directly after ovulation and lasts until the next period. It usually lasts 10 to 16 days and is crucial for a successful pregnancy, as progesterone is produced during this time to prepare the uterine lining for possible implantation of the fertilized egg. A shortened or disrupted luteal phase can make implantation more difficult and is often referred to as luteal insufficiency, which can affect fertility.
Medical freezing
Medical freezing refers to the targeted freezing of biological material for medical purposes. This includes eggs, sperm, embryos, or tissue, which are preserved at extremely low temperatures (usually below -196°C in liquid nitrogen).
This technique is commonly used in reproductive medicine to maintain fertility or in cancer treatment to preserve healthy cells for future use. Through medical freezing, the cellular structure remains intact, allowing the material to be used after thawing.
Meiosis
Meiosis is the process of cell division that leads to the formation of gametes (egg and sperm cells). It reduces the chromosome number from diploid (2n) to haploid (n), ensuring that offspring inherit the correct number of chromosomes.
In humans, meiosis occurs in the gonads (testes and ovaries). During fertilization, haploid sex cells combine their chromosomes, allowing the offspring to receive the proper chromosomal count. This process is essential for genetic diversity and reproductive success.
Microbiome
The microbiome in both the vagina (vaginal microbiome) and the uterus can significantly impact fertility.
In cases of repeated implantation failure, the EMMA test is recommended to analyze the microbiome in the uterus. This test evaluates the presence and balance of beneficial bacteria, particularly Lactobacillus species, which play a crucial role in maintaining a healthy uterine environment. Identifying microbial imbalances can help optimize fertility treatments and improve implantation success rates.
Miscarriage
Miscarriage is the medical term for the unintentional loss of a pregnancy before the 24th week of gestation.
MTHFR gene mutation
The MTHFR gene mutation affects the methylenetetrahydrofolate reductase (MTHFR) gene, which encodes an enzyme essential for folate metabolism and homocysteine regulation. Mutations in this gene can lead to elevated homocysteine levels in the blood, potentially increasing the risk of cardiovascular diseases.
This mutation may impair the body's ability to process folic acid efficiently. Individuals with this mutation cannot convert folic acid into its active form as effectively, which is why it is often recommended to take folate in its bioavailable form instead.
- Heterozygous variant: Inherited from one parent.
- Homozygous variant: Inherited from both parents.
The presence of this mutation may have implications for fertility, pregnancy outcomes, and general health, so testing and appropriate supplementation can be beneficial.
Natural killer cells
Natural killer (NK) cells are a type of immune cell that play a crucial role in the innate immune system. They have the ability to identify and destroy virus-infected and tumor-like cells. NK cells are also present in the uterus, where they can significantly influence fertility and pregnancy.
One of their key functions is supporting embryo implantation. NK cells help establish immune tolerance toward the embryo, which carries genetic material from the father. Maintaining a balanced proportion of NK cells is essential for successful implantation.
Women experiencing repeated implantation failure may benefit from testing their NK cell activity to assess potential immune-related challenges in their fertility journey.
Nicotine
Nicotine is a psychoactive substance primarily found in tobacco that stimulates the central nervous system. It increases dopamine release, leading to temporary heightened alertness and relaxation, but it is highly addictive.
Long-term effects of nicotine can be harmful, including damage to the cardiovascular system, narrowing of blood vessels, and impaired lung function. Continued exposure increases the risk of serious health issues such as heart disease and respiratory complications. Reducing or quitting nicotine consumption can significantly improve overall health and well-being.
Nidation (Implantation)
Nidation refers to the process of implantation of a fertilized egg (embryo) into the endometrium (uterine lining). This crucial step typically occurs 5 to 7 days after fertilization, when the embryo, now a blastocyst, embeds itself into the well-vascularized uterine lining.
Successful implantation is essential for the continuation of pregnancy, as it establishes the foundation for embryonic development and placenta formation. Proper hormonal balance and a receptive endometrial environment significantly influence the likelihood of a successful nidation.
NIPT test
The NIPT test (Non-Invasive Prenatal Test) is a method for early detection of chromosomal abnormalities in the fetus. A blood sample from the pregnant woman is analyzed to obtain information about possible genetic disorders such as trisomies, including trisomy 21. The NIPT test can typically be performed from the 10th week of pregnancy.
Nutrition
A balanced diet can have a positive effect on fertility. Unsaturated fatty acids support hormone production, while complex carbohydrates stabilize blood sugar. Antioxidants protect egg cells and sperm from oxidative stress. Omega-3 fatty acids promote the implantation of the egg and improve sperm quality. Foods with healthy fats such as avocados, nuts and olive oil contribute to hormonal balance. A good nutrient supply of vitamins and trace elements, including folic acid, is essential for cell division and egg maturation. Supplements such as NAC and alpha-lipoic acid can support fertility. Sugar, caffeine, alcohol and trans fats have a negative effect on reproduction. Zinc, selenium and iron-rich foods are beneficial for sperm quality and implantation. Overall, a varied diet with high-quality, natural foods is the best basis for a healthy desire to have children. All relevant nutrients are also contained in VILAVIT Female and VILAVIT Male to further increase the chances of a healthy pregnancy.
Obstruction or dysfunction of the fallopian tubes
The fallopian tubes connect the ovaries to the uterus, and fertilization typically takes place here.
If they are blocked or their mobility is impaired—due to conditions such as inflammation, endometriosis, or adhesions—the egg cannot reach the uterus. This can make natural conception difficult or impossible. In such cases, IVF (in vitro fertilization) may be a possible treatment option.
OHSS (Ovarian Hyperstimulation Syndrome)
OHSS (Ovarian Hyperstimulation Syndrome) is a medical condition that occurs as a result of excessive stimulation of the ovaries during hormonal treatment to induce ovulation, often in the context of in vitro fertilization (IVF). Overstimulation can lead to swelling and fluid accumulation in the abdominal cavity.
Symptoms range from mild discomfort, such as abdominal pain and nausea, to severe complications, including shortness of breath and significant fluid retention, which may require intensive medical treatment.
Omegaven® infusions
Intravenous infusion therapies with fat emulsions such as Intralipid® and Omegaven® are often used to suppress the abnormal activity of natural killer (NK) cells. Suppressing NK cells is intended to increase the receptivity of the uterus for implantation.
Oral health
Good oral health is important for fertility, as untreated gum disease can increase the risk of miscarriage and pregnancy complications. Inflammation in the mouth affects the entire body and may impair fertility. Regular dental check-ups and good oral hygiene are essential to address existing issues such as cavities or gum infections before pregnancy and to minimize risks.
Osteopathy
Osteopathy can play a supportive role in fertility. In women, osteopathic treatment can help improve blood circulation in the pelvic area, relieve tension, and promote hormonal balance, which may enhance fertility. In men, osteopathy may improve sperm quality by increasing blood flow and reducing stress.
However, it is important to view these treatments as part of a comprehensive medical approach to fertility support.
Outpatient hysteroscopy
An outpatient hysteroscopy is a minimally invasive procedure used to examine and treat the uterus. See hysteroscopy for more details.
Ovarian hyperstimulation syndrome (OHSS)
Ovarian hyperstimulation syndrome (OHSS) is a potential complication of in vitro fertilization (IVF) and other fertility treatments involving hormonal stimulation of the ovaries. It occurs when the ovaries respond excessively to stimulation and produce a large number of eggs.
Symptoms can range from mild to severe, including abdominal pain, bloating, fluid accumulation in the abdomen, nausea, vomiting, and diarrhea. In more severe cases, it can lead to breathing difficulties and fluid buildup in the legs and lungs.
Ovarian insufficiency
Ovarian insufficiency is a medical condition in which follicle maturation is impaired. This can lead to irregular or absent menstrual cycles, other hormonal disturbances, and even infertility. Ovarian insufficiency can be caused by various factors, including genetic disorders, autoimmune diseases, and certain medical treatments such as chemotherapy. Diagnosis is typically made through blood tests to determine hormone levels, particularly FSH (follicle-stimulating hormone) and estrogen.
Ovulation
Ovulation is the point in the menstrual cycle when an egg is released from the ovary and is ready to be fertilized.
Ozempic
The medication Ozempic is used to treat type 2 diabetes and supports weight reduction in overweight patients.
Due to its role as an insulin sensitizer, Ozempic can also influence fertility, particularly in women with obesity or insulin resistance. Improved blood sugar regulation may also help reduce pregnancy complications.
Women undergoing treatment with Ozempic who wish to become pregnant should consult their doctor, as there is insufficient long-term data on the medication's safety during pregnancy.
PBMC flush
The PBMC flush (Peripheral Blood Mononuclear Cell flush) is a procedure for isolating peripheral mononuclear blood cells, which play an important role in the immune system. The body's own blood cells are specially processed and cultured in combination with the pregnancy hormone HCG. This treatment activates the cells so that they develop protective properties for pregnancy. These prepared blood cells are then introduced into the uterine cavity before embryo transfer. This creates an environment that resembles a "healthy" pregnancy, increasing the uterus’s readiness for implantation.
PICSI
PICSI (Physiological Intracytoplasmic Sperm Injection) is a specialized in vitro fertilization technique in which sperm are selected based on their ability to bind to hyaluronic acid. These sperm considered more mature and of higher quality. This method is intended to increase the likelihood of successful fertilization and healthy embryo development.
Polar body diagnosis
Polar body diagnosis is a genetic examination of polar bodies that arise during egg maturation. It allows for the analysis of maternal chromosomes in the egg before artificial fertilization to detect genetic abnormalities early. This method is often used in women of advanced age or those with genetic risk factors to improve the chances of a successful pregnancy. Since only maternal genes are examined, paternal chromosomal abnormalities cannot be detected with this technique.
Polycystic ovary syndrome (PCOS)
PCOS, or polycystic ovary syndrome, is a hormonal disorder that can lead to menstrual irregularities, elevated male hormones, and often infertility in women. Common symptoms include irregular or absent menstrual cycles, acne, increased hair growth, and difficulties with weight management. The exact cause is not fully understood, but insulin resistance and genetic factors play a significant role. Treatment is tailored to the individual and usually involves lifestyle changes, hormonal therapies, or medications to regulate blood sugar metabolism.
Preimplantation genetic diagnosis (PGD)
Preimplantation genetic diagnosis (PGD) is a genetic examination of embryos that is carried out as part of artificial insemination (IVF or ICSI). It enables the identification of genetic diseases or chromosomal abnormalities before the embryo is transferred to the uterus. The method is often used for couples with pre-existing genetic conditions or repeated miscarriages in order to increase the chances of a healthy pregnancy.
Legal situation in Austria:
In Austria, pre-implantation genetic diagnosis has been permitted since 2015 if there have been at least three failed attempts at artificial insemination or three medically proven miscarriages or stillbirths (in the case of natural pregnancies) where it is assumed that this is due to genetic dispositions of the child or the cells capable of development. It is also permitted if one of the parents has a genetic disease that increases the risk of a miscarriage or stillbirth or a serious hereditary disease in the child. It is only possible in approved facilities and with comprehensive counseling.
Legal situation in Germany:
In Germany, PGD has been permitted since 2011 if a serious genetic disease of the child is to be expected or serious damage to the embryo leading to a stillbirth or miscarriage is to be detected. PGD may only be carried out with the written consent of the woman from whom the egg cell originates, in approved centers and subject to prior review by an interdisciplinary ethics committee.
Primosistan or Primosiston
Primosistan or Primosiston is a hormone consisting of estrogen and progesterone, used in fertility treatments to
- regulate irregular bleeding
- influence the timing of the menstrual cycle
- synchronize follicles before starting hormonal therapy.
Progesterone
Progesterone is a hormone commonly used in fertility treatments. Its intended effects include:
- Preparation of the uterine lining: Progesterone ensures that the endometrium is well-vascularized and sufficiently developed to support embryo implantation.
- Support of early pregnancy: After fertilization, progesterone helps maintain pregnancy by stabilizing the endometrium and regulating the immune system in the uterus to prevent embryo rejection.
Progesterone can be administered in various forms, including vaginal suppositories, injections, or oral tablets.
PRP flush (Platelet-Rich Plasma flush)
The PRP flush (Platelet-Rich Plasma flush) is an innovative procedure used in fertility treatment to enhance reproductive potential. A blood sample is taken to obtain platelet-rich plasma, which is rich in growth factors.
PRP can be injected into the uterine cavity to improve the quality of the endometrium. The growth factors in PRP promote tissue healing and regeneration, which can support embryo implantation.
This flush may help women experiencing repeated implantation failure by increasing the likelihood of successful implantation and positively influencing an inadequately developed endometrium.
Quality of egg and sperm
The quality of egg and sperm is crucial for fertility and successful conception, as healthy reproductive cells increase the chances of fertilization and proper embryo development. Poor egg quality is often linked to age-related decline, chromosomal abnormalities, and oxidative stress, while low sperm quality can result from lifestyle factors, hormonal imbalances, or environmental influences.
Improving egg and sperm quality involves maintaining a healthy diet rich in antioxidants, essential fatty acids, and vitamins like folic acid, which support cellular health. Regular exercise, reducing stress, avoiding smoking and excessive alcohol, and ensuring proper sleep also contribute to better reproductive health. All important nutrients to further improve fertility can also be found in VILAVIT Female and VILAVIT Male.
Reconstruction of the vas deferens
The reconstruction of the vas deferens is a surgical procedure that allows men to restore their fertility after a vasectomy. During the procedure, the severed or blocked vas deferens is surgically repaired to restore its continuity.
Repeated implantation failure (RIF)
Repeated implantation failure (RIF) refers to the repeated inability of embryos to implant in the uterus following an in vitro fertilization (IVF) cycle. This typically occurs after at least three unsuccessful IVF attempts, where high-quality embryos have been transferred but no pregnancy has been achieved.
Possible causes include:
- Significantly reduced egg or sperm quality
- Immunological factors
- Hormonal imbalances
- Smoking
- Severe overweight
A promising approach for repeated implantation failure may be PBMC flushing a few days before embryo transfer. A positive effect has been observed, particularly in patients who have undergone three or more unsuccessful embryo transfers.
repeated miscarriages
Repeated miscarriages refer to the loss of three or more pregnancies at an early stage, usually before the 12th week. They can be caused by various factors, including genetic abnormalities, hormonal imbalances, immune disorders, structural uterine abnormalities, or infections.
ROPA
The ROPA method (Reproductive Option for Partners) is an assisted reproduction technique that allows same-sex female couples to have a child together. In this method, one partner donates her eggs, which are then fertilized with donor sperm and transferred into the uterus of the other partner. This enables both partners to actively participate in the reproductive process—one as the genetic mother through egg donation and the other as the gestational mother.
Secondary Infertility
Secondary infertility occurs when a woman is unable to achieve another pregnancy after having had at least one previous pregnancy—regardless of whether the first pregnancy resulted in birth, miscarriage, or termination.
In contrast to primary infertility, where no pregnancy has ever occurred, women with secondary infertility have already given birth to at least one child.
Semen analysis
A semen analysis or spermiogram is an examination used to assess the quality and quantity of sperm in a semen sample (ejaculate). It is commonly conducted to evaluate male fertility, such as in cases of family planning or medical diagnostics.
Procedure:
The semen sample is typically collected through masturbation and must be analyzed in the laboratory within a short time frame. For accurate results, sexual abstinence for about 2–7 days before the sample collection is recommended.
Reference values:
The World Health Organization (WHO) provides reference values as a benchmark. Deviations from these values do not necessarily indicate infertility but often require further medical investigation.
Semen sample
A semen sample is important for assessing male fertility and for providing sperm for in vitro fertilization.
The sample is collected through masturbation, ideally in a clinical setting. It is crucial to maintain abstinence for 2-5 days before providing the sample (i.e., no ejaculation during this period). The sperm are analyzed in the laboratory or processed for fertility treatment to select the most motile and healthiest sperm.
The quality of the semen sample is essential for the success of a fertility treatment, as it influences the chances of successful fertilization and a healthy pregnancy.
Smoking
Smoking affects fertility in both women and men, reduces egg and sperm quality, and increases the risk of miscarriages and pregnancy complications. Quitting can improve fertility, especially in men, and increase the chances of a healthy pregnancy.
Social Freezing
Social freezing is the precautionary freezing of eggs for non-medical reasons. Women choose to freeze their eggs to keep the option of a later pregnancy open. Social freezing is permitted in Germany but not in Austria.
Sperm Quality
Sperm quality describes the health and functional characteristics of sperm that are important for successful fertilization. It includes factors such as the number, motility (motility), shape (morphology) and genetic integrity of the sperm. Good sperm quality increases the likelihood of natural conception, while poor quality can impair fertility.
The World Health Organization (WHO) has defined specific criteria for the assessment of semen quality in its latest edition of semen analysis reference values:
- Sperm concentration: at least 16 million sperm per milliliter
- Total sperm count: At least 39 million per ejaculate
- Motility (mobility): At least 42% of the sperm should be motile
- Morphology (shape): At least 4% of the sperm should have a normal shape
Sperm concentration has fallen by around 50% since the 1970s. It is assumed that the causes lie in lifestyle and environmental factors.
Various factors influence semen quality, including age, lifestyle (e.g. diet, smoking, alcohol consumption), environmental toxins and hormonal health. Medical tests such as a spermiogram can be used to assess semen quality, especially in cases of infertility.
More information at VILAVIT Male.
Spermatogenesis
Spermatogenesis is the process by which sperm cells—the male reproductive cells—are formed in the testes. It takes place in the seminiferous tubules of the testes and lasts about 64 to 72 days in humans.
At the beginning of spermatogenesis, precursor sperm cells multiply by frequent division, ensuring an adequate number of cells for further development. This is followed by maturation, during which the amount of genetic material in each cell is halved, allowing for the correct number of chromosomes upon fertilization.
In the final stage, the cells transform into their characteristic sperm shape—with a head containing genetic material and a tail for movement. The entire process is regulated by specific signaling substances in the body, primarily the hormones testosterone, FSH, and LH.
Spermiogram
A spermiogram is an examination used to assess the quality and quantity of sperm in a semen sample (ejaculate). It is commonly conducted to evaluate male fertility, such as in cases of family planning or medical diagnostics.
Procedure:
The semen sample is typically collected through masturbation and must be analyzed in the laboratory within a short time frame. For accurate results, sexual abstinence for about 2–7 days before the sample collection is recommended.
Reference values:
The World Health Organization (WHO) provides reference values as a benchmark. Deviations from these values do not necessarily indicate infertility but often require further medical investigation.
Stress
Chronic stress can negatively affect fertility in both women and men. Stress can disrupt hormonal processes, alter the menstrual cycle in women, and impair sperm quality in men.
Learning stress management techniques can be beneficial, such as relaxation exercises (yoga, meditation), engaging in conversations with trusted individuals, or seeking psychological support.
Surrogacy
Surrogacy is a method of assisted reproduction in which a woman carries a child for another person or couple. It can be an option for people who cannot become pregnant themselves for medical reasons, such as repeated implantation failure or lack of a uterus. In terms of fertility, it is an alternative to adoption or other reproductive techniques. There are two forms: traditional surrogacy, in which the surrogate mother is genetically related to the child, and gestational surrogacy, in which the egg of another woman is used. The legal regulations on surrogacy vary greatly around the world, which is why detailed legal advice is essential. In any case, it is prohibited in Austria and Germany.
Testicular biopsy (TESE)
Testicular biopsy, or testicular sperm extraction (TESE), is a medical procedure in which tissue is taken from the testes to retrieve viable and fertilizable sperm cells. The goal is to fertilize eggs using the ICSI method with the extracted sperm.
Testicular sperm extraction (TESE)
Testicular sperm extraction (TESE) is a surgical procedure in which sperm are directly retrieved from the testes. This technique is primarily used for men who have no detectable sperm in their ejaculate, such as in cases of azoospermia—a condition where the seminal fluid contains no sperm.
The extracted sperm can then be used in assisted reproductive techniques such as in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) to enable conception.
thyroid dysfunction
A thyroid dysfunction can significantly affect fertility, as both an underactive thyroid (hypothyroidism) and an overactive thyroid (hyperthyroidism) can lead to menstrual irregularities and fertility problems.
Hypothyroidism and fertility:
In hypothyroidism, the thyroid produces too few thyroid hormones (T3 and T4). These hormones play a central role in metabolism and the regulation of the reproductive system. A deficiency in thyroid hormones can lead to irregular cycles and problems with egg maturation, making conception more difficult. Iodine deficiency is a common cause of hypothyroidism, as iodine is an essential component of thyroid hormones. An adequate iodine level is therefore crucial for normal thyroid function.
Hyperthyroidism and fertility:
In hyperthyroidism, the thyroid produces too many hormones, which can also disrupt hormonal balance and lead to menstrual irregularities and reduced fertility. Excessive iodine intake can worsen hyperthyroidism. Women trying to conceive should ensure sufficient iodine intake to minimize the risk of hypothyroidism and support their fertility.
Thyroid dysfunction during pregnancy:
During pregnancy, the thyroid plays a particularly important role, as it affects not only the mother's health but also the development of the fetus.
Time-lapse
Time-lapse is an advanced method in assisted reproduction that allows real-time, uninterrupted observation of embryo development during in vitro fertilization (IVF). High-resolution images are taken at regular intervals and later compiled into a time-lapse sequence, providing a visual representation of the embryo’s development over several days.
Transvaginal Sclerotherapy
Transvaginal sclerotherapy is a minimally invasive procedure used to treat ovarian or pelvic vein insufficiency by closing abnormally dilated veins. A sclerosing agent is injected directly into the affected veins via a transvaginal approach, causing them to seal and redirect blood flow.
This procedure can help alleviate symptoms such as chronic pelvic pain and is often performed under ultrasound guidance. If pelvic vein insufficiency or ovarian varicosis contributes to infertility, the treatment may improve fertility outcomes.
TREPS (Trophoblast Retrieval and Embryo Preselection)
TREPS is a method used in assisted reproduction during in vitro fertilization (IVF) to optimize embryo quality and increase the likelihood of a successful pregnancy. Cells from the trophoblast—the outer cell layer of the embryo—are extracted to obtain genetic information. This analysis enables a more precise selection of the best embryo for transfer.
Trophectoderm biopsy (TEB)
Trophectoderm biopsy (TEB) is a method in assisted reproduction in which a small number of cells are extracted from the trophectoderm, the outer layer of the embryo. These cells are analyzed for genetic disorders and chromosomal abnormalities to select the most suitable embryo for transfer.
TEB is typically performed on embryos at the blastocyst stage, which occurs on the fifth day after fertilization.
Unexplained childlessness
Unexplained childlessness or idiopathic infertility refers to a type of infertility where, despite extensive medical examinations (such as hormone tests, fallopian tube patency assessments, and sperm analysis), no clear cause for the issue can be identified. This means that both female and male fertility are considered normal, yet pregnancy does not occur. Around 20% of couples trying to conceive are affected by this condition.
Uterine Malformations
Uterine malformations are anatomical abnormalities of the uterus that develop during embryonic formation. These malformations can vary in shape, size, or structure, ranging from mild variations to severe defects. They may increase the risk of first-trimester miscarriage, cesarean section, preterm birth, and premature rupture of membranes. However, the level of risk depends strongly on the specific type and severity of the malformation.
For individuals experiencing infertility or recurrent early pregnancy losses, it is especially important to rule out uterine malformations. This can be done through examinations such as ultrasound, hysteroscopy, laparoscopy, and hysterosalpingography.
Uterine Myomatosus
A uterine myomatosus refers to a uterus affected by fibroids. Fibroids are benign growths of muscle and connective tissue that develop in or on the uterine wall. They can vary in size and appear in different locations within the uterus.
Fibroids can impact fertility, particularly if they are near the uterine cavity or fallopian tubes. They may hinder embryo implantation or increase the risk of miscarriage. However, many women with fibroids can still conceive, and some experience no symptoms at all.
Vasectomy
A vasectomy is a surgical procedure in which the vas deferens are cut or blocked to prevent sperm from traveling from the testes to the urethra. This ensures that sperm do not enter the ejaculate.
Vitrification
Vitrification is a modern technique used to rapidly freeze eggs, embryos, or ovarian tissue. This quick cooling process prevents harmful ice crystal formation, effectively "flash-freezing" the cells into a glass-like state.
This method helps preserve delicate cells, ensuring they remain viable after thawing. Vitrification is commonly used in social freezing, reproductive medicine, and fertility preservation before cancer treatment.
WHO 2021
The WHO 2021 reference values for semen analysis are based on an updated international dataset and provide more precise guidelines for assessing male fertility. They serve as a foundation for clinical applications and scientific research in reproductive health.
X sperm
X sperm are sperm that carry the X chromosome and thus lead to the conception of a female baby; they are slightly larger and slower than Y sperm but have a slightly longer lifespan.
X-linked hereditary diseases
X-linked hereditary diseases are genetic diseases caused by mutations on the X chromosome. As men only have one X chromosome, they are often more severely affected, while women can have a milder variant of the disease due to their second X chromosome. Examples of X-linked diseases include fragile X syndrome, Duchenne muscular dystrophy and hemophilia. In terms of fertility, some of these diseases can affect reproductive health by causing hormonal imbalances, developmental disorders or reduced sperm and egg quality. Genetic counseling plays an important role in family planning to understand risks and consider possible preventive measures.
Y sperm
Y sperm are sperm that carry the Y chromosome and lead to the conception of a male baby. They are smaller, faster and have a shorter lifespan than X sperm.
Zygote
The zygote is the very first stage of embryonic development, formed when a sperm fertilizes an egg. It undergoes cell division and eventually develops into an embryo, marking the beginning of pregnancy. The quality and health of the zygote play a crucial role in successful implantation and early development.