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“A lot helps a lot?”

The dangers of self-medication in fertility treatment


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Even the area of reproductive medicine is touched by the commonly held misconception “a lot helps a lot” when it comes to taking medicines. We often encounter situations in which patients undergoing hormonal stimulation (ovarian stimulation) want to increase the prescribed dosage of their own accord, saying they had read something about it and believed that this would be beneficial to a successful outcome, i.e. contribute to improving oocyte maturation.

To start with, I should like to point out that the selection of an optimal stimulation protocol shall be based on the following factors:

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Quality in IVF Centers

Application and Relevance of a Quality Management System


Certificate: ISO 9001:2008 | IVF Centers Prof. Zech

“If there’s a way to do it better: find it.”
Thomas A. Edison (1847-1931)

If we interpret this quote by Thomas Edison, the continual pursuit of improvements may (as, for example, in the case of Edison) lead to new inventions or to the improvement of already existing technologies.

It is a matter of finding ways, enabling us to achieve a certain quality standard that is subject to constant review and improvement. This requires an established structure, for example with respect to the workflows in a company.

Here, experts are referring to quality management systems aiming, among other things, at implementing appropriate measures and building up a trusting relationship with customers.

What exactly is meant by this when dealing with the working procedures of an IVF center?

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“Sometimes there’s more in the basket and sometimes less “

The number of oocytes in an IVF treatment


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The stage of hormonal stimulation (ovarian stimulation) is an exciting time. Daily injections are required and each ultrasound scan is anticipated with great excitement. What our patients want to know is:

“How many follicles can be identified?
Do all the follicles continue to grow?
How many large and probably mature follicles were produced?”

Hormone doses and therapy protocols are determined on an individual basis in order to achieve the best possible outcome.
It is a much earlier point in time that decides how many follicles will develop during the month of therapy in question. Already three months earlier, a group of 30-300 smaller follicles (a so-called cohort) starts to develop.

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Terms for Genetic Diagnostic Methods in Fertility Treatment


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When it comes to genetic analysis in reproductive medicine, there exist a number of commonly heard terms, such as Pre-Implantation Diagnosis (PID), Pre-Implantation Genetic Testing (PGT), Pre-Implantation Genetic Diagnosis (PGD), Pre-Implantation Genetic Screening (PGS).

But how can they be distinguished from one another? Are there any differences between them?

I had been asked these questions during one of our regular fertility-information evenings (→ Locations, dates and contents). In the following text I would like to go into more detail on my answers.
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The Precautionary Freezing of Egg Cells

Different Motives – Different Regulations


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Cutting-edge medical procedures provide women with the opportunity to have some of their oocytes frozen and “stored” as a precautionary measure. This is intended to preserve the positive status quo of their fertility at the time of cryopreservation, which in turn represents an option for achieving a pregnancy using their own “younger” oocytes in a future IVF cycle.

The underlying motives can be of both of a sociological nature, as well as of a medical nature. Statutory provisions do not exist to the same extent for both aforementioned aspects.

Thus, for example, there are countries where this procedure can be carried out only if medically indicated, for example in patients undergoing chemotherapy which may have a major damaging impact on their oocytes.

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When the path to parenthood is “blocked”

Therapy options in connection with the treatment of blocked/damaged fallopian tubes


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Blocked or damaged fallopian tubes are among the main causes of unwanted childlessness and are seen as classical indications for IVF treatment (“In vitro fertilization”).
Tubal damage is frequently associated with the accumulation of serous, inflammatory or post-inflammatory fluids. We are referring here to a condition called hydro- or sactosalpinx.

What are the possible implications of this concomitant phenomenon and what therapy options are available?

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Genetics in reproductive medicine

Background and Significance

by | Published on 14. April 2016, in Treatment.

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Genetic disorders may cause severe diseases in humans and are known to have adverse effects on fertility, which may even lead to miscarriages. A closer look into these genetic disorders suggests that there are two main reasons for this:
Chromosomal disorders and gene mutations.

In chromosomal disorders, a distinction is made between numerical anomalies (changes in chromosome number – aneuploidy) and structural anomalies (changes in chromosome structure – e.g. translocations). According to experts, these chromosomal alterations are responsible for around half of all spontaneous miscarriages.

Gene mutations involve changes to the genetic makeup of a single gene, gene segment or several genes, resulting in so-called monogenetic or polygenetic diseases. One of the best-known examples of such a disease is cystic fibrosis – also known as mucoviscidosis – which is the most common inherited monogenic disease in Western Europe.

The linking of reproductive medicine and genetics is thus becoming more and more important. In this respect, it is worth mentioning the well-known term Pre-Implantation Genetic Diagnosis (PGD).

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Myths vs. facts of male sexuality


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My previous blog post (→ “From Venus to Casanova all the way to Marilyn Monroe…”) has dealt with sexual myths from their beginnings right up to the present day. Against this background, I would like to pursue the following questions on the basis of two examples:

What are the myths on male sexuality that still persist today?

Can current scientific research help us confirm or deny these myths?

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Towards happiness of fatherhood

TESE – sperm retrieval procedure for “in vitro fertilization”

by | Published on 15. March 2016, in Treatment.

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IVF treatment (IVF/ICSI/IMSI) involves the fertilization of the egg cell by a sperm outside the female body in the laboratory. In some cases, however, sperms have to be collected directly from the man’s testes during a minor surgical intervention called TESE – “Testicular Sperm Extraction”.

The TESE procedure is used in men with a very low sperm count (cryptozoospermia, OAT-syndrome) or no sperm at all in the ejaculate (e.g. due to blocked seminal ducts).

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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?” Read more…