Female Infertility: Therapy

The following recommendations – in the spirit of holistic reproductive medicine – should be implemented before starting reproductive medical therapy.

General measures

  • Regular sex (every 2 days) during fertile days increases the likelihood of pregnancy. After ovulation, an egg is fertile for about 12-18 hours. Sperm can survive in the uterus for up to 5 days. An ovulation calendar can help to determine the fertile days. For this purpose, there are, for example, practical cycle apps for the smartphone.
  • Notes on the optimal time of conception (conception):
    • Sexual intercourse on the day of ovulation (ovulation): pregnancy rate 33%.
    • Sexual intercourse six days before ovulation: pregnancy rate 5-10%.
    • Fertilization ability of sperm (sperm cells) in the woman’s body: – 2 days.
  • Note: With a waiting period of:
    • < 2-3 days: sperm concentration and sperm motility (mobility) decrease and sperm have less DNA damage (DNA fragmentation).
    • > 5-6 days: decrease in sperm motility and increased DNA damage.

    According to the results of one study, daily sex did not negatively affect sperm quality, whereas long intervals affected important quality parameters (esp. DNA fragmentation).

  • Nicotine restriction (abstaining from tobacco use).
  • Limited alcohol consumption (women: max. 12 g alcohol per day; men: max. 25 g alcohol per day).
  • Limited caffeine consumption (max 240 mg of caffeine per day; equivalent to 2 to 3 cups of coffee or 4 to 6 cups of green/black tea).
  • Aim for normal weight!Determination of BMI (body mass index, body mass index) or body composition using electrical impedance analysis.
    • BMI ≥ 25 → participation in a medically supervised weight loss program.
    • Falling below the BMI lower limit (from the age of 19: 19; from the age of 25: 20; from the age of 35: 21; from the age of 45: 22) → Participation in a medically supervised program for the underweight.
  • Review of permanent medication due topossible effect on the existing disease.
  • Sufficient and restful sleep – At reproductive age (20-40 years), sleep duration should be between 7 and 9 hours.
  • Avoidance of psychosocial stress:
    • Stress reduces fertility – Physical and mental stress increase prolactin levels. Prolactin is a hormone that acts on the mammary gland and controls milk production in women after pregnancy. Elevated prolactin levels often lead to irregular periods or even no periods at all. Also, ovulation may be suppressed.
  • Avoidance of excessive exercise – adversely affects fertility.
  • Avoidance of environmental pollution:
    • Pesticide-laden foods such as teas, fresh herbs, peppers, spinach, grapes, currants, cherries, apricots, pears, raspberries, tangerines, peaches lead to an increase in clinical miscarriages, while plant-based diets with low pesticide loads reduce clinical miscarriage rates. Conclusion: reach for the organic variety.
    • Occupational exposure to anesthetic gases may affect fertility in women

Conventional non-surgical therapy methods

  • Drug therapy:
    • Endometriosis
    • Hyperprolactinemia
    • PCO syndrome
  • Follicle stimulation therapy

Vaccinations

The patient’s vaccination status should be checked and, if necessary, vaccinations should be made up or completed:

  • Hepatitis B
  • Rubella
  • Varicella

Vaccinations that a woman should have received in full before becoming pregnant include:

  • Diphtheria-tetanus
  • Yellow fever vaccination when traveling to endemic areas.
  • Hepatitis B
  • Influenza vaccination during the influenza season.
  • Measles-mumps-rubella vaccinations
  • Pertussis
  • Poliomyelitis
  • Varicella (complete at least three months before planned conception in seronegative women).

Nutritional medicine

  • Nutritional counseling based on nutritional analysis
  • Nutritional recommendations according to a mixed diet taking into account the disease at hand. This means, among other things:
    • Daily total of 5 servings of fresh vegetables and fruits (≥ 400 g; 3 servings of vegetables and 2 servings of fruits).
    • High-fiber diet (whole grains, vegetables).
  • Observance of the following special dietary recommendations:
    • Diet rich in:
  • Selection of appropriate food based on the nutritional analysis
  • See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
  • Detailed information on nutritional medicine you will receive from us.

* Folic acid should be taken at least 4 weeks before conception until the completion of the first trimester (third of pregnancy). The recommended daily dose is 400 µg.

Sports Medicine

Psychotherapy