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INFERTILITY DIAGNOSTICS

"Why can’t we manage it?“


Professional diagnostics provides clarity
about the causes and allows
suitable therapy to be identified that will help you to have a child.

fertisuisse - State-of-the-art fertility treatment
in Olten and Basel

More and more couples are discovering that wanting a child is not always easy to achieve. If pregnancy does not occur naturally, reproductive medicine offers promising options to fulfil the previously unfulfilled desire of having a child. In Switzerland, approximately one in every ten couples is unwantedly childless. The causes of not being able to have a child are found in men just as often as they are in women. Research shows that nearly 40% of cases indicate a combination of causes stemming from both partners. In our fertility treatment centres, state-of-the-art diagnostic procedures are used to determine the exact reason for diminished fertility - sensitively and with minimal side effects. We consult with heterosexual couples, same-sex couples and single women. During the treatment process, our physicians comply with the highest scientific standards and solely use cutting-edge technologies in diagnostics and therapy.

 

 

Previously unsuccessful therapy

You simply cannot conceive and you ask yourself „“What are we doing wrong?”“ The reason for not conceiving can be found in women in approximately 30% of the cases and just as often in men. In our fertility centres, state of the art diagnostic procedures are used to determine the exact reason for diminished fertility - gently and with minimal side effects.
The most common reasons are dysfunctions in the production or functioning of male sperm cells (sperm), the age of the woman, polyps and myomas in the uterine cavity, blocked fallopian tubes, the absence of ovulation, endometriosis and sexual dysfunctions. Obesity, smoking and stress can also contribute to being involuntarily childless. In approximately 20% of cases, the cause of infertility cannot be determined despite diligent examination. These cases are referred to as unexplained infertility . Being involuntarily childless can severely affect the physical and mental health of a couple and therefore, is recognised as an illness by the WHO (World Health Organisation).
Professional associations recommend consulting a fertility specialist after six to eight months of unsuccessfully trying to conceive at the latest. For couples over the age of 35, we recommend contacting a specialist after three to four months.

 

 

The first appointment

To be able to compile an individually adapted course of therapy for you, the possible causes for your previous childlessness are discussed during your first appointment. It is important for our team of physicians to know how long you have already wanted a child and if there have been previous pregnancies - including miscarriages –. We review findings from other physicians/labs. We discuss previous surgeries, infections or chronic illnesses with you. The frequency and time of sexual intercourse is also addressed. We know that it is not always easy to discuss topics such as these.


Trust in our experience and empathy. We want you to feel comfortable and that you are in safe hands.

 

 

Female causes

Approximately 30% of the factors in cases of infertility relate to the woman. Even if the cause is apparently obvious (e.g. blocked fallopian tubes), additional exams must be conducted in order to select a tailor-made treatment method.

Possible causes of infertility:
The woman’s age
The social development in recent decades contributed to many couples not starting a family until much later in life. Between 80 and 85% of women younger than 35 spontaneously conceive within 12 months. As a woman passes the age of 35, her natural fertility decreases significantly. At the same time, the risk of a miscarriage increases. The success of fertility treatment is also significantly influenced by the woman’s age. Pre-implantation genetic diagnosis (examining the embryo’s genetic material) can, particularly for women over the age of 37, help in having a child more quickly. If a pregnancy has not occurred after 6 months at the latest, despite having routine sexual intercourse, women, who are older than 35, should contact a fertility specialist. We are more than happy to consult with you on this in a personal meeting. Arrange an appointment now.
Absent ovulation (anovulation)
Even before a girl is born, her immature eggs make their way to both ovaries, where they lie dormant, protected in small ovarian follicles, until puberty begins. During puberty, the ovaries start doing their actual job, which is developing mature egg cells and the woman’s two most important sex hormones, oestrogen and progesterone. A woman’s cycle is controlled by the small pituitary gland. Under the influence of the follicle stimulating hormone (FSH), a dominant follicle matures in the first phase, the so-called follicle phase, in which there is an egg. Provoked by complex hormonal signals, ovulation occurs and the egg reaches the fallopian tube, where it is inseminated by a sperm cell. Occasionally, this complex hormonal cycle is disrupted and ovulation rarely occurs or not at all. Typically, monthly menstruation does not occur or only occurs irregularly.
Blocked fallopian tubes
The fallopian tubes are the connection between the ovaries and the uterus. During ovulation, the finger-like appendages at the end of the fallopian tube encase the dominant follicle of the ovary and absorb the mature egg, which is inseminated in the fallopian tube by a sperm cell. Incredibly fine hairs transport sperm to the fallopian tube and the embryo away from the ovary to the uterine cavity. After successful insemination, the embryo takes roughly five days to pass through the fallopian tube and in doing so, ultimately reaches the uterine cavity, where it embeds itself. Infections, adhesions and scar tissue or endometriosis can compromise the functioning and mobility of the fallopian tubes or completely block off the fallopian tube.
Endometriosis (painful menstruation)
Endometriosis is a chronic inflammatory disease, which is caused by the uterine lining being located outside of the uterine cavity. Endometriosis can but does not have to be painful and the discomfort usually arises during menstruation. Endometriosis can also be a cause of infertility. In case of severe symptoms, endometriosis can be treated with medication or surgical removal of the foci. In-vitro fertilisation (IVF) has proven to be a successful therapy which can fulfil the desire to have a child in cases of endometriosis. We are more than happy to consult with you on this in a personal meeting. Arrange an appointment now.
Polyps and myomas
These foreign words refer to benign tumours that form in the uterine cavity. Polyps are found quite frequently. They almost always turn out to be harmless tumours in the uterine lining. However, they can impede the implantation of an embryo. That is why they are removed as part of a hysteroscopy. Occasionally, myomas (benign tumours on the uterine wall) are found. If these extend into the cervix or are located directly under the lining, surgical removal is usually recommended (as part of a hysteroscopy). Adhesions in the uterine cavity can also hinder the implantation of the embryo or lead to miscarriages. These adhesions are removed during a hysteroscopy.
Repeated miscarriages
Miscarriages are a common occurrence in humans. Approximately 20% of all pregnancies end prematurely (before the 12th week of gestation) with a miscarriage. 2 or more consecutive miscarriages before the 12th week of gestation is considered repeated. Miscarriages, particularly when they occur repeatedly, are very straining and frustrating. The woman’s age plays an important role in the case of repeated miscarriages because with increasing age, the probability of a chromosome-linked disorder in the embryo, and therefore a miscarriage, increases. Abnormal genetic material in the embryo is by far the most frequent cause. However, this does not mean that the parents’ genetic material is abnormal. Rare causes of repeated miscarriages are deformities or adhesions of the uterine cavity, blood clotting dysfunctions, thyroid dysfunctions, sugar metabolism disorders or modifications in the number or combination of chromosomes in one of the partners. Examinations should be conducted after three consecutive miscarriages at the latest. We recommend an ultrasound and hormone exam as early as after two miscarriages. We are happy to inform you and consult with you personally in this regard. Arrange an appointment now.
Unexplained infertility
Despite all efforts and diligent examinations, 10-20% of the couples with fertility problems do not succeed in finding the cause for not being able to conceive. Fertility treatment can still be successfully performed.
Sexual dysfunctions
Sexual dysfunctions are not uncommon. Sexual intercourse can be painful for women and men or be made extremely difficult due to a severe contraction of the female pelvic muscles. A lack of desire, reduced sexual arousal, no or weak erection and no or premature ejaculation are among the most common sexual dysfunctions. By mutual agreement, some couples do not have any sex or only very rarely. If the couple or one of the partners are/is suffering from a sexual dysfunction, treatment options are available.

Male causes

Disorders in sperm production or limitations in sperm quality belong to the most frequent causes of involuntary childlessness in men. Appropriate analyses (spermiogram) can provide further insight.

Possible causes:
The man’s age
Men produce sperm throughout their entire lives. Over time, the percentage of fast moving sperm decreases and there can be changes in the functioning of the sperm. This can result in a reduction of sperm fertility. Furthermore, older age in men is associated with a higher percentage of chromosomal abnormalities in the sperm. Infertility, miscarriages, illnesses or birth defects in the children can be the result. We are more than happy to consult with you on this in a personal meeting. Make an appointment now.
Semen analysis (examination of the sperm cells)
Ideally, the semen (ejaculate) is obtained by masturbation in our centre. There is a discreet room available that is specifically intended for this purpose. If preferred, the ejaculate can also be obtained at home. In this case, we will inform you of the necessary transport measures. The obtained semen is then analysed in a complex procedure in the andrological lab. During this procedure, primarily the number of sperm, the percentage of normally shaped sperm and the mobility and speed of the sperm are measured. The results are assessed in compliance with the World Health Organisation (WHO) standards. Too few, too slow or too many abnormally shaped sperm cells can lead to a pregnancy not occurring. Sometimes all three parameters are limited. In this case, it is called an OAT syndrome (Oligo: low number, Astheno: poor movement, Terato: abnormal shape). However, sometimes pregnancy results naturally despite abnormal results (i.e. without treatment). It is important to know that abnormally shaped sperm cannot lead to deformities in a child. The production and functioning of sperm can be subject to strong fluctuations, as a result of which we occasionally recommend repeating the semen analysis.
Disorders in sperm production and function
Disorders in sperm (sperm cells) production and function are a frequent cause of involuntary childlessness. In most cases, there is a disorder in sperm production in the testicular tissue. Occasionally however, there is a hormonal imbalance or the delivery of the sperm is disabled, e.g. due to a sexual dysfunction or after an infection/surgery. Sperm cells are produced in the seminiferous tubules of the testicle. It takes two and a half months for sperm cells to mature and become functional. This process of maturing is complex and a substantial part of it is regulated by the pituitary gland. Disorders can arise in the process, for instance as a result of taking hormones (doping). After that, the sperm travels from the testicle to the epididymides, where the „the final production“ of the sperm takes place, in particular the ability to move. The sperm reaches the woman’s vagina through the spermatic ducts and through the urethra during ejaculation. The ejaculate consists of sperm and the fluids from the epididymides, seminal vesicles and prostate. Normally, there are several million sperm cells in an ejaculation, of which only a few reach the woman’s fallopian tubes, where the fertilisation of the egg takes place. In the process, usually only one single sperm cell can penetrate the egg, which in the event of successful insemination, will contribute the paternal part of the genetic information.
Hormone problems
Men can also experience hormonal problems and these can lead to infertility. Two hormones in particular are important for male fertility: FSH and LH (). Both hormones are released by the pituitary gland. LH provides for the production of testosterone in the testicles, FSH has a direct effect on the production of sperm in the testicle. We are more than happy to consult with you on this in a personal meeting. Make an appointment now.
Undescended testicle (cryptorchidism)
In the case of an undescended testicle, the testicles are not or not consistently in the scrotum as required for the uninterrupted production of sperm. This results in the temperature level in the body being too high for the testicles in the long run. The production of sperm and hormones only takes place to a limited extent or not at all. As a result, limited fertility or infertility occurs.
Genetic disorders
A quickly done blood test can detect hereditary genetic causes in cases of distinctly diminished sperm quality. In some cases, using a pre-implantation genetic diagnosis (examination of the embryo’s genetic material) can help. We are more than happy to consult with you on this in a personal meeting. Make an appointment now.
Sexual dysfunctions
Sexual dysfunctions are not uncommon. Sexual intercourse can be painful for both partners. A lack of desire, reduced sexual arousal, no or weak erection and no or premature ejaculation are among the most common sexual dysfunctions. By mutual agreement, some couples do not have any sex or only very rarely. If the couple or one of the partners are/is suffering from a sexual dysfunction, treatment options are available.

Restricted ovarian reserve

According to today’s state of knowledge, fallopian tubes do not endlessly produce eggs in the women’s body; – in other words, the egg reserve (ovarian reserve) is finite. The current reserve of eggs in the ovaries can be determined in an ultrasound scan by counting the follicles and assessing the amount of Anti-Müllerian hormone (AMH) in the blood. Both values in combination with the age indicate whether the patient has an ovarian reserve that corresponds to her age.
In fertility diagnostics, the determination of the ovarian reserve is of crucial significance before a planned therapy. Based on the findings, the physicians can determine the functional condition and the egg quality with a view to estimating the chances of success of a planned treatment.

 

 

At fertisuisse, quality is our top priority

Our mission is to achieve patient satisfaction by ensuring a highly competent treatment in close collaboration with the conducted diagnostics. The fundaments of highly efficient treatment methods are continuous advanced training of our employees, the application of state of the art technology in diagnostics and in the labs and routine quality inspections. Our labs are accredited, comply with all regulations and are equipped with cutting-edge technology.
Our dedicated and trained team of employees makes precise diagnoses based on complex findings and compiles a specific treatment plan. In the andrology lab, semen analyses, among other things, are conducted and sperm is preprocessed for treatments. IVF and ICSI treatments take place in our cleanroom . Here, the eggs are prepared for fertilisation and then injected. The embryos that are to be transferred to the uterine cavity are cultivated in specific incubators until they reach the blastocyst stage. Fertilised eggs, which are not to be transferred yet, are frozen using the vitrification process. Everything under one roof.

With the help of the time-lapse incubators, our embryologists can evaluate the dynamic of embryo growth. Every single embryo is photographed every five minutes until reaching the blastocyst stage (five to six days). This results in a time-lapse film, which provides us with valuable information about the development of the embryo. A development that progresses ideally can increase the likelihood of a pregnancy. The time-lapse incubation is also an important requirement for making a pre-implantation genetic diagnosis. When the embryo begins to hatch, our experienced embryologists remove some of the cells from the embryo sac. Later on, the sac becomes the placenta. These cells undergo genetic testing. For women over the age of 37, this can improve the likelihood of pregnancy per embryo transfer and reduce the time until a child is born. A preimplantation genetic diagnosis is also used for couples whose children are at risk of suffering from life-threatening genetic disorders (monogenic diseases).
Our goal is to fulfil your desire for a child by using state-of-the-art technology.

 

 

Your trust is important to us

A trusting atmosphere and individual support are important factors on the path to having the child you want. We want our service to make you feel well looked after and in safe hands at our facilities at all times. In line with fertility treatment, we offer you hormonal stimulations, insemination, artificial insemination (ICSI/IVF), pre/implantation genetic diagnosis (PGD), time lapse embryo culture, blastocyst culture, assisted hatching and social freezing (creation of a fertility reserve). Your medical examiner will discuss the best strategies with you and support and accompany you through all phases of treatment. Necessary examinations in line with making determinations and fertility treatments are conducted by our team of doctors. This course of action is efficient and has proven itself.
Alternative medical treatments
Our range of services is complemented by gentle methods derived from Traditional Chinese Medicine (TCM). Alternative medical methods can increase fertility for men and women and are suitable for supporting the preparation of insemination or in-vitro fertilisation. The use of acupuncture can have a positive effect on hormonal balance and therefore increase the chances of conception. You have the option of receiving acupuncture treatment from our experienced therapists before and/or after embryo transfer. Relaxation, holistic care and a feeling of security will support you on the journey to the child you want.

We take time for your needs.

Please let us know if there is anything you need.

fertipedia

 

Technical terms explained quickly

From Amenorrhea to Zygote: Here you will find an overview of medical terms and their explanations.

 

Mediacenter

 

 

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