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Medical clarification and treatment of the possible causes


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Couples wishing to conceive a child but who are not able to achieve pregnancy despite having frequent, unprotected sex for at least one year should consider medical investigation (fallopian tubes, sperm). In most cases, the reasons for infertility involve a variety of factors such as diseases, genetic disorders, increasing age, unhealthy lifestyle patterns and harmful environmental impacts.

Precise diagnosis provides information as to how individual therapy may look for the couple concerned. The appropriate treatment is determined individually on the basis of the medical results of both partners, since the cause of infertility may involve either the female or the male or both.
This clearly shows the importance of professional advice and medical examination by an experienced specialist doctor in order to be able to answer the couple’s following question:

“What treatment is appropriate for our situation?”



IVF Centers Prof. Zech – Bregenz
Tel.: +43 5574 44836

Practitioner of Reproductive Medicine and Certified Geneticist Univ. Doz. Dr. Nicolas Zech informs about therapy options for:

    Endometriosis [→ What is Endometriosis?]
    Therapy: Individual approach for optimizing the chances of conception. Depending on the nature and localization of the endometriosis, it is recommended to undergo IVF-Treatment (ICSI/IMSI).

    Fallopian tube obstruction [→ What is fallopian tube obstruction?]
    Therapy: Bypassing the “blocked transport route” by a surgical procedure called oocyte retrieval. The oocytes obtained are then fertilized with semen in a test tube – “Artificial Insemination” (IVF/ICSI/IMSI).

    PCO-Syndrome [→ What is PCO Syndrome?]
    Therapy: If, after low-dose hormone administration including cycle monitoring for about 3-6 months, no success has been achieved despite open ovarian tubes and adequate good semen quality, it is recommended to undergo IVF treatment (ICSI/IMSI). The targeted administration of hormones is aimed at inducing the development of the entire pool of follicles (containing the egg cells). The mature oocytes are then retrieved and fertilized with the sperm outside the female body, i.e. in a test tube.
    On the fifth day of embryonic development (blastocyst stage), the embryo is transferred into the uterine cavity.

    Corpus luteum insufficiency [→ What is meant by corpus luteum insufficiency?]
    Therapy: In the context of fertility treatment, the primary attempt is to complement the function of the corpus luteum by progesterone supplementation. The hormone is administered at the time when the hormone would normally be produced by the corpus luteum. The treatment is individually tailored to the patient.

    Uterus: Malformations, myomas, polyps [→ What are myomas, polyps?]
    Therapy: Depending on the medical findings, the situation may be remedied by surgical intervention. However, sometimes scars will remain, lowering the chances of getting pregnant. In these and other situations there is the possibility to consider surrogacy. Couples concerned should make sure to obtain comprehensive information, since surrogate parenting is prohibited in many countries.

    Therapy: A very individual approach is taken after extensive consultation and evaluation of possible causes. The use of pre-implantation genetic diagnosis could provide a solution. Optimizing the hormonal situation is a suitable remedy in many cases. Available therapeutic options include the exclusion of male factor infertility using techniques such as the IMSI procedure. Egg donation may be an option, too.

    Consequences of cancer treatment [→ What is cancer treatment?]
    Therapy: Prior to chemotherapy or ovary removal surgery, there is the possibility of egg freezing (cryopreservation), offering the individuals concerned the opportunity to make use of assisted reproductive techniques (ICSI/IMSI) to get pregnant later in life. In situations where this precautionary measure has not been taken, egg donation treatment could be considered as an option for infertile couples.

    Semen findings: Insufficient number of motile sperm
    Therapy: The diagnosis requires special examinations. With the help of micronutrients and vitamins (e.g. „Fertilovit® M plus“) or by administering hormones it may be attempted to increase the quantity of sperm and/or to improve its quality.

    Obstruction of the vas deferens [→ What are obstructed vas deferens?]
    Therapy: Surgical sperm extraction from the testes by the TESE method (Testicular Sperm Extraction). Subsequently, the spermatozoa can be used for ICSI in a fertility treatment cycle.

    Azoospermia [→ What is azoospermia?]
    Therapy: It may occur, due to specific causes (e.g. genetic diseases), that no sperm is produced in the testes (spermatogenesis). In most cases, only sperm donation treatment will help overcome this situation. In some cases, testicular biopsy (TESE) can be performed in order to retrieve sperm cells.

    Consequences of cancer treatment [→ What is cancer treatment?]
    Therapy: In order to maintain the ability to reproduce, there is the possibility of freezing testicular tissue or ejaculated sperm. The spermatozoa may be used to fertilize the female partner’s oocytes by IVF/ICSI/IMSI, thus providing the couple with the chance of achieving a pregnancy in the future.

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Medical clarification and treatment of the possible causes