The A-Z of fertility treatment

In some people, a blood sample shows a conspicuous value in the determination of the so-called "APC resistance" or there is a "Factor V Leiden mutation". These are factors that are important for blood clotting.

Blood clotting is an extremely complicated system of different factors that are supposed to interact in such a way that the blood neither clots without cause nor remains fluid for too long if, for example, there is an injury. If the blood coagulates in the vessels for no reason, it is called a "thrombosis". In this case, a clot forms that can easily block vessels.

Patients who have a conspicuous APC resistance test or who have a factor V Leiden mutation tend to develop thrombosis more easily. The risk is particularly high when other factors that promote thrombosis come into play, such as the use of hormone preparations, e.g. birth control pills, operations, bedriddenness, nicotine abuse, pregnancy, childbirth and breastfeeding.

This is why it is important to determine these two factors before starting hormone treatment, such as treatment with in vitro fertilisation. If there are any abnormal findings here, a concomitant treatment with anticoagulant medication, such as heparin, must be considered.

The left and right fallopian tubes connect the respective ovaries to the uterus. At ovulation, the follicle containing the egg cell empties and it is the task of the fallopian tube to receive the egg. Fertilization of the egg then takes place in the outer third of the fallopian tube if sufficient sperm cells capable of fertilization reach the egg there immediately after ovulation. The fertilized egg develops rapidly over the next few days and goes through the first steps of embryonic development. During this process, numerous cell divisions occur and the embryo passes through different stages: multicellular, morula and blastocyst stage. During these five crucial days, the embryo is transported through the fallopian tube and ideally delivered safely into the uterine cavity. Here, implantation into the lining of the uterus can take place. During these five days, the fallopian tube exchanges numerous messenger substances with the embryo, so the fallopian tube is the first babysitter in a person's life.

If the fallopian tubes are blocked or have delayed passage, a previous inflammation is usually responsible. If the fallopian tube has a delayed opening, there is an increased risk of ectopic pregnancy, also called tubal pregnancy, because the embryo is still in the fallopian tube after 5 days and implants there.

From all these things you can see how significant an open and well-functioning fallopian tube is for the occurrence of a pregnancy.

Fallopian tube & insemination
For insemination, the injection of sperm into the uterus, open fallopian tubes are required, as the sperm must reach the egg unhindered and the embryo in turn must reach the uterus unhindered.

There are now three possibilities for testing the permeability of the fallopian tubes:

• X-ray examination, the so-called hysterosalpingography (HSG)
• Ultrasound examination (ExemFoam or Hysterocontractsonography - HyCoSy)
• Laparoscopy (examination of the abdomen)

Please seek advice on all three methods so that you can make a good decision about which one to choose.

Fallopian tubes & in-vitro fertilization (IVF)
A tubal examination is not necessary to carry out in vitro fertilization (IVF) treatment.

The possibility of pregnancy depends strongly on the age of the woman. From the age of 33, the female fertility begins to decline imperceptibly with advancing age - from 38+ there is already a significant decline.

We want to create an awareness of the natural processes in the woman's body and offer individual counselling and clarification. It is important for us to inform patients about the consequences of postponing a pregnancy to a later age. In order not to lose any time, we offer patients in this age group a particularly rapid and targeted assessment and consultation, including a determination of the so-called "ovarian reserve" (Anti Müllerian hormone). This enables us to find out how sensible treatment is.

During the initial consultation with us you will receive the following information:

• a realistic explanation of the chances of success
• an assessment of the risks associated with pregnancy
• an explanation of treatment alternatives such as "IVF in the natural cycle", pre-implantation diagnostics, egg donation or embryo donation

Experience the digital journey from the first contact with out center until pregnancy and then start your individual fertility journey. We accompany you professionally, safely and empathically and are fully there for you.