State-of-the-art diagnostics, innovative techniques, service and safety - Kinderwunschzentrum Dresden fertility clinic.
Our aim is to inform you in an open and understandable way about diagnosis and treatment concepts and to use the individually most promising procedures without loss of time. State-of-the-art therapies include:
Cycle monitoring | Ovarian stimulation therapy | Intrauterine insemination | Heterologous treatments | In Vitro Fertilization - IVF | Intracytoplasmic sperm injection - ICSI | Physiological intracytoplasmic sperm injection | Embryo transfer | Time-lapse incubator - Information on egg culture | Assisted Hatching | Testicular biopsy - TESE | Cryopreservation - Freezing of sperm, testicular tissue, fertilized eggs | Social Freezing |ZyMot chamber
Menstrual cycles with irregular bleeding patterns are often an expression of absent or disturbed oocyte maturation. Monitoring oocyte maturation through ultrasound examinations and testing of blood hormone levels make it possible to determine the optimal time for sexual intercourse or insemination .
Ovarian stimulation therapy
To induce or improve oocyte maturation, hormone treatment / hormonal stimulation is often required (see also "Medication"). This is done with tablets or injections, which the woman can self-inject into the subcutaneous fatty tissue - according to instructions. The effect of this hormonal therapy is monitored with ultrasound examinations and testing of blood hormone levels.
At the time of ovulation, specially prepared, "washed" sperm from the partner (= so-called homologous insemination) are transferred directly into the uterine cavity with the help of a syringe and a thin catheter. Insemination is preferably used in cases of mild restriction of male fertility. …
Abnormalities in the area of the cervix, which interfere with the ascent of the sperm into the uterine cavity, can also be the reason to plan intrauterine insemination. Depending on the indication, the chance of success with this procedure is between 10 and 15 percent per cycle. Intrauterine insemination is a simple therapy with few side effects, but it should be performed no more than three to four times, as there is little chance of success after that.
Heterologous treatments with sperm donation
If no sperm can be obtained from the partner, hereditary diseases are present, or previous treatments have not been successful, fertility treatment by sperm donation with cryopreserved donor sperm is a possibility.
Sperm donation also offers homosexual female couples and single women the opportunity to fulfill their desire to have children.
If there is a desire for treatment with donor sperm, we will first inform you about the various treatment options (insemination versus IVF/ICSI therapy) during an initial consultation. The decision on the type of treatment depends on various factors, such as tubal patency, the female cycle and the age of the woman. We cooperate with various external sperm banks. Find out more directly from our cooperation partners: Cryos, Berliner Samenbank and European Sperm Bank.
Before signing a contract with the sperm bank and starting treatment with us, legal and psychosocial counseling are required by law. German health insurance companies do not cover the costs of these therapy procedures.
Since 2018, the Sperm Donor Registry Act has been in force and creates legal certainty in this area. A nationwide sperm donor register has been established at the German Institute for Medical Documentation and Information (DIMDI). Accordingly, persons who were born by means of a sperm donation have the right to know their own parentage at the age of 16.
In Vitro Fertilization - IVF
"IVF" stands for in vitro fertilization, the fertilization of eggs by sperm outside the body. Since the first "test-tube baby" in 1978, this method has been continuously developed and improved. …
In this procedure, the ovaries are hormonally stimulated by injections that can be self-administered at home, so that several eggs mature. Approximately 36 hours after ovulation is triggered with a hormone injection (e.g. hCG), the eggs are aspirated through the vagina under a short anesthesia. For this purpose, a vaginal ultrasound examination is performed. With the help of a guide rail attached to the ultrasound head, the puncture needle can be precisely guided through the upper end of the vagina directly into the ovary in order to aspirate the follicular fluid with the oocytes from the follicles. Due to the permanent ultrasound control this is done very gently, complications are very rare.
After the sperm has been delivered and the ejaculate has been prepared by washing and centrifugation, the oocytes and sperm are brought together in a special nutrient solution (photo). The sperm penetrate the eggs without further assistance. The fertilization rate can vary greatly with this method.
The fertilized eggs continue to develop into embryos through cell division:
- Day egg puncture + 1 = pronuclear stage.
- Day egg puncture + 2 = 2-4 cell stage
- Day egg puncture + 3 = 6-8 cell stage
- Day oocyte aspiration + 4 = berry stage (morula)
- Day oocyte aspiration + 5 = vesicle stage (blastocyst)
Intracytoplasmic sperm injection - ICSI
Intracytoplasmic sperm injection (ICSI) is an additional procedure in IVF that is used when the sperm quality is poor. Unlike IVF, fertilization in these cases cannot happen on its own, but a sperm is selected and injected directly into the egg. Fertilization rates of about 75% are achieved with this method, depending on the age of the woman.
Physiological Intracytoplasmic Sperm Injection.
In PICSI, sperm are selected for injection based on their binding to a substrate that also occurs on the human egg. Only mature sperm bind to this substance. Thus, in addition to motility and morphology, an additional criterion is applied to select the "best" sperm.
We recommend this treatment only under certain conditions. In the majority of cases, PICSI will not be necessary. We will advise you on this in our consultation. You can also obtain further information from the manufacturer's flyer, which we provide at the Kinderwunschzentrum Dresden fertility clinic.
After fertilization of the egg, the resulting embryos can continue to develop in the laboratory for up to five days. The timing of embryo transfer is decided individually, but is usually performed on the second or third day after puncture. The transfer is done with a soft plastic catheter and 1-3 embryos are transferred.
Time-lapse incubator - information about egg culture
In artificial insemination, the eggs are retrieved, fertilized outside the human body and cultured in a special incubator. The culture medium and conditions in the incubator replicate the environment in the human body in which the eggs would normally be at that time.
During development in the incubator, it is essential to inspect the oocytes at specific times. These microscopic examinations, which are kept as short as possible, can provide information about the correct course of development. Deviations from the normal course can be detected and support the selection of the optimal oocytes. Logically, during a conventional microscopic examination, the cells are not in their optimized environment in the incubator. Therefore, these examinations must occur as infrequently as possible, and the time spent outside the incubator must be kept to a minimum. Several years ago, incubators were developed that elegantly circumvent this problem. In these devices, the oocytes are observed via video microscopy in the incubator. Every single egg cell is photographed in the infrared range at intervals of a few minutes, so that continuous observation is possible without disturbing the cells. The result of this continuous monitoring is a time-lapse video recording of the development of each individual egg cell. This provides the embryologist with a whole new source of information for assessing development. These devices are now used in numerous centers. International research has led to completely new evaluation criteria that can be applied when using this technology. Such a device is also available in our center. In addition to the extensive information obtained by evaluating the time-lapse images, this device provides absolutely stable culture conditions. In 5-minute intervals, 7 photos are taken of each oocyte in different focal planes. The exposure time is only a few milliseconds each time. The "photo light" is in the infrared range, which prevents any influence on the cells.
The advantages of embryo culture in the Miri-TL incubator:
- optimal, completely undisturbed culture conditions from treatment to embryo transfer
- close monitoring of cell development by built-in video microscopy
- information about dynamic morphological events by time-lapse videos.
Studies have shown an increase in the implantation rate, a reduction in the early abortion rate and thus an increase in the continuous pregnancy rate.
The costs for this additional service are not covered by the German statutory health insurance. The additional costs are due to the material costs associated with this technique, as well as the additional daily cytological assessment of the recorded cell development.
The oocyte and thus also the embryo is surrounded and protected by a shell, the so-called zona pellucida. The early embryo develops in this envelope until the pressure of the growth causes the zona to burst. This moment is called the "hatching" of the embryo. The "hatching" is facilitated by enzymatic processes.
However, there are several factors that can prevent this "hatching", such as hardening or thickening of the zona pellucida. If the embryo does not manage to leave its envelope, implantation in the endometrium is naturally ruled out. This problem can be avoided by "thinning out" the zona pellucida in one place. This is done by means of a laser, which creates a kind of predetermined breaking point in the zona pellucida. This additional service is called "Assisted Hatching". This procedure definitely does not harm the embryo, this has been shown in various studies. Nevertheless, "Assisted Hatching" is not useful in every patient.
We recommend "Assisted Hatching" only for patients over 36 years of age, after multiple unsuccessful embryo transfers, or for cryo-transfers. The variant "Hatching on demand" is becoming more and more popular with our patients. Here, the laboratory decides whether the treatment is useful, e.g. because the zona pellucida is too "thick" or too "firm".
We will discuss which variant makes sense for you in a personal consultation.
Testicular biopsy - TESE
TESE stands for testicular sperm extraction and refers to the extraction of sperm from a piece of testicular tissue that must be removed prior to a planned ICSI therapy. This tissue extraction is performed by a specialized urologist.
The operation is usually performed in advance of the planned ICSI therapy. The tissue samples are examined for suitability by microscopy and then frozen (cryopreserved). Ideally, any piece of testicular tissue can be used to perform ICSI therapy. The combination of ICSI treatment with TESE can make it possible to conceive even in cases where no sperm are found in the ejaculate. Such a complex therapy is possible only through close cooperation with a urologist. In many cases, consultation with an experienced human geneticist prior to therapy is also useful. Further information on urological issues can be found, for example, at our cooperation partner "Urologische Gemeinschaftspraxis Dresden-Friedrichstadt".
Cryopreservation - freezing of sperm, testicular tissue, fertilized eggs
Sperm freezing can be useful if a testicular operation or chemotherapy or radiotherapy is planned due to a male disease, which is expected to reduce fertility.
In individual cases, sperm freezing may also be planned before longer absence of the male partner. The frozen sperm can then be used for ICSI therapy or insemination therapy, depending on the initial situation. Our partner for long-term storage is the Air Liquide Medical Cryo-Bank.
The testicular tissue obtained during a TESE (see also there) or the sperm obtained in this way can also be cryopreserved and used for a subsequent fertility therapy. If more oocytes are fertilized in the course of IVF or IVF/ICSI treatment than planned for embryo transfer, such "surplus" fertilized oocytes can also be cryopreserved. If necessary, they can be thawed, cultured and transferred into the uterine cavity as an embryo at a later stage - this allows pregnancy to occur without having to go through all the steps of IVF or IVF/ICSI therapy again. The procedure is proven to increase the pregnancy rate in relation to egg retrieval.
Social Freezing - Your Desired Child at the Right Time
Since 2021, the Kinderwunsch Zentrum fertility clinic has been offering, in addition to cryopreservation, the freezing of eggs for fertility preservation for non-medical indications, so-called "Social Freezing".
For women and couples who want to postpone parenthood to a later stage in life due to personal circumstances and professional challenges, social freezing offers the chance of pregnancy at a later stage.
As a woman ages, her egg reserve decreases and the quality of her eggs declines. In addition, age affects the likelihood of malformations and miscarriages, as well as the rate of pregnancy complications.
Social freezing can increase the chances of pregnancy at a later stage. In this treatment procedure, healthy unfertilized eggs are retrieved at the earliest possible time and gently "frozen" using a process called vitrification. This freezing at a young age protects the eggs from aging and preserves your fertility even at a later date.
Best results with social freezing are achieved in women who are younger than 30 years of age at the time of egg retrieval and for whom a total of at least 25 - 30 eggs can be frozen. As in a regular IVF or ICSI cycle, the ovaries must first be hormonally stimulated. This usually takes 10-12 days. After that, the eggs are collected under a short anesthesia, vitrified and stored in liquid nitrogen.
ZyMot chamber for sperm preparation - Natural selection of the best sperm cells
ZyMot chambers are an alternative to standard sperm preparation using centrifugation. The preparation mimics the natural path of sperm through the cervical canal and can be used for IUI, IVF and ICSI. The procedure provides a natural and gentle way to select the sperm that have the highest motility and best performance. The preparation is very effective and promises to enrich motile sperm with significantly lower levels of DNA fragmentation in the resulting sample (Source: Broussard et al., Fertility and Sterility, 2019).
DNA fragmentation in sperm is one of the causes of male infertility, leading to repeated miscarriages and associated with poor embryo quality. Fragmentation can complicate pregnancy even when the spermiogram appears normal.
The natural ejaculate is introduced into the ZyMot chamber without exposing it to external influences (washing media, centrifugation). In this chamber sperm must swim through a special membrane with micropores into an optimized medium. This is possible only for well-motile sperm with normal morphology. Thus, a concentrate of optimal sperm is obtained, which can be used for subsequent egg fertilization (IUI, IVF, ICSI). Routine use of these chambers is not necessary in most cases. However, there are findings where the use of these chambers can provide a significant advantage.
We are happy to discuss whether this is the case for you.
The advantages the ZyMot chamber at a glance:
- improved progressive motility,
- very high percentage of sperm with normal morphology, increased fertilization rates as well as higher euploidy and pregnancy rates, no need for centrifugation of sperm and thus avoidance of the formation of so-called oxygen radicals.
The cost of this additional procedure is not covered by health insurance.
Dresden Fertility Center
in the Wöhrl Plaza
Prager Str. 8a
Phone +49 351 501 400-0
Fax +49 351 501 400-28
Email: Downloads Aerial view for orientation
Kryobank Dr. Held
Prager Str. 8a
Phone +49 351 501 400-26
Email: NEW: Video consultation!
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14.30 – 19.00 Hrs
|Fri.||08.00 – 14.00 Hrs|
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