VAD KAN BEHÖVA GÖRAS?
Medical history (anamnesis) assessment, gynecological examination, ultrasound, cycle protocol, measurement of temperature immediately after awakening (basal temperature), sexual intercourse at the optimal time, hormone analysis.
A spermiogram (evaluating the sperm’s quantity, number, motility and shape) performed by a urologist, cycle monitoring using ultrasound (uterine lining), hormone analyses, sexual intercourse at the optimal time.
If the spermiogram shows abnormal results, it is recommended that the man start taking PROFERTIL® at this stage, after consulting with a doctor. In many cases it is possible to avoid the third phase, i.e. artificial insemination.
In the case of abnormal sperm findings in phase two or if the woman has blocked fallopian tubes, the recommended approach is artificial insemination (IVF).
As a supplement to IVF treatment, PROFERTIL® increases the chances of success.
In particular, it can be possible to achieve a gradual improvement, i.e. ICSI treatment can ideally be avoided. ICSI therapy is recommended for very poor sperm quality (less than five to ten million per milliliter) or poor sperm morphology (appearance, shape of sperm).
|If the cause of infertility is a hormone disorder in the woman, one usually begins with hormone treatment. Various medications can regulate an irregular cycle and trigger ovulation. If the man cannot conceive a child, the doctor will also recommend medications in some cases. Such medications can be used to treat hormone disorders (e.g. testosterone deficiency).
|Insemination (semen transfer)
|Insemination involves the doctor injecting purified, concentrated seminal fluid into the uterus, vagina, cervix or fallopian tubes. This method is considered if the quality of the sperm is slightly impaired or if the cervix is so scarred (due to infection or inflammation) that the sperm have difficulty reaching the uterus. It is sometimes necessary for the ovaries to be stimulated with hormones before insemination.
|In-vitro fertilization (IVF)
|In this technique, the egg cell is fertilized outside of the body. IVF is considered if, for example, the egg cells do not reach the uterus because it is adhesive as a result of inflammation. IVF can also help with pregnancy if the woman has growths (myomas) in the uterus or antibodies against the sperm cells, if the quality of the man’s sperm is inadequate, or even if the doctor has found no cause for the infertility.
|Intracytoplasmic sperm injection (ICSI)
|With intracytoplasmic sperm injection (ICSI), the doctor injects the sperm directly into the egg cell. ICSI is considered when the sperm cell is unable to ‘independently’ fertilize the egg cell, either within the woman’s body or in a test tube. ICSI may also be considered in situations when the woman fails to become pregnant, despite IVF treatment.
|Operative sperm extraction
|Sperm collection from the epididymis (microsurgical epididymal sperm aspiration, MESA) may help if the vasa deferentia are closed up and cannot be opened with surgery or if the sperm in the semen sample are not moving. This is an option if the man cannot ejaculate, such as in cases where he is paraplegic or has had surgery for a tumor for example. If MESA cannot be carried out, some doctors recommend TESE (testicular sperm extraction), where the doctor extracts the sperm from the testicles. MESA and TESE are always combined with ICSI.
|An operation can help to achieve pregnancy if the fallopian tubes are closed or adhesions in the abdomen are preventing pregnancy. Surgeons can sometimes open up closed seminal ducts, for example after an inguinal hernia surgery.