Start of therapy
This might also be of interest to you: If infertility is present: due to a disruption in the number, motility and morphology of the sperm, testosterone or anti-oestrogens are used to treat it. If the sperms only show a disturbed motility, they are treated with Kallikrein for several months.
- Ovarian = ovulation-related therapy of infertility Ovulation triggers such as clomiphene or cyclofenil stimulate the body’s own production of gonadotropins such as FSH and LH (luteinizing hormone).
They are taken in low doses at the beginning of the cycle. They should be taken in combination with estrogens because ovulation inhibitors have an antiestrogenic effect and thus reduce the permeability of the cervical mucus.The side effects of taking ovulation triggers are an excessive stimulation of the ovaries, so that cysts can develop there. There is also the risk of multiple pregnancies when there are potentially more eggs to be fertilized.
If the female organism is not able to secrete enough gonadotropins on its own, they must be administered in the form of human menopausal gonadotropin (HMG) and human chorionic gonadotropin (beta HCG). The HMG is obtained from the urine of menopausal women and contains FSH and LH in equal proportions. This serves for follicle maturation.
The HCG then triggers ovulation. When gonadotropins are administered, it should be noted that they must be given together with GnRH (gonadotropin-releasing hormone) analogs. The GnRH comes from the hypothalamus and ensures the release of FSH and LH from the pituitary gland.
Even if gonadotropin production is insufficient, this small amount still has an effect on the maturation of follicles. This must be prevented during therapy, otherwise the follicles cannot mature uniformly and premature formation of corpus luteum occurs. One starts with the administration of gonadotropins on the third day of the cycle and administers them subcutaneously in small doses.
If the release of GnRH from the hypothalamus is disturbed, it can be replaced by cyclamate, which is released pulsatilely every 90 minutes by a portable mini pump.
- The ice release syringe
- How can I promote ovulation?
a) Homologous insemination (artificial insemination of the woman) This indication of infertility for this is the reduced quality of the male sperm. There is too little ejaculate and a too low sperm concentration. The woman is suffering from cervical infertility.
By preparing the sperm using Kallikrein and transferring them to a fertile stage, a positive selection of vital and motile sperm can be made. b) Heterogeneous insemination The only difference to the above method of determining infertility is that the sperm comes from a donor. Heterologous insemination can be considered if male infertility is established.
However, the further psychosomatic consequences for the father, who is constantly reminded of his infertility by the child, are questionable. Legal difficulties arise when the child later wants to clarify the identity of its biological father. c) In vitro fertilization In this infertility test, a transvaginal puncture of a mature follicle is performed to obtain mature oocytes.
The egg is then later exposed to 100,000 sperm to increase the probability of fertilization. In vitro fertilization can be described in three phases: intracytoplasmic sperm injection If fertilization of the egg is not successful in the third phase of in vitro fertilization, intracytoplasmic sperm injection guarantees the union of the two gametes. This method requires only one spermatozoon from the male patient, which is then injected directly into the plasma of the egg by means of a cannula.
Even male patients without sperm in the ejaculate can benefit from this method, as the spermatozoa can be obtained directly from the testicles or epididymis.
- In the first phase of stimulation, the objective is the maturation of a dominant follicle: This is pre-treated with GnRH so that the body’s own GnRH production is suppressed and the doctor has control over the uniform and even development of follicles. They grow under the administration of HMG and release the egg under beta-HCG administration.
- In the second phase, the follicle is punctured, which is done with ultrasound.
The contents of the follicle are aspirated and the mature egg is retrieved. This is placed in the incubator. ()
- In the third phase, this mature egg cell must be cultivated.
Only after 3 to 6 hours are the eggs prepared so that they can be brought together with the sperm. After 20 hours, the egg is examined for pronuclei, which is proof of successful fertilization. Only when the sperm have penetrated the egg, can the egg complete its second division, which is reflected in the formation of the pronucleus. After 40 hours, 3 fertilized eggs are transferred to the uterus.
Further interesting information from the field of gynecology: An overview of all topics in gynecology can be found at Gynecology A-Z
- Causes of infertility
- Male infertility
- Unfulfilled desire to have children
- Contraception
- Sterilization
- Pill
- Conception
- Venereal diseases
- Pregnancy
- Birth
- Premature Birth
