The treatment starts with the fertility consultation with the doctor. As well as the history of the involuntary childlessness, all the important physical and psychological aspects are discussed. This initial consultation includes a gynaecological examination, a vaginal ultrasound and a blood test of both partners. Finally, the further steps to clarify the causes of the patients’ involuntary childlessness and to treat this will be determined.
If no prior treatments have taken place and the examinations performed so far have not revealed a clear reason for the couple’s childlessness, the following steps will be taken:
1. Monitoring of the menstrual cycle
Examination of the natural cycle, determination of the precise date of ovulation and thus the optimum time for conception. Examination of the sperm cells in the cervix mucous after intercourse (post-coital test) and examination of the luteal phase.
2. Spermiogram
Examination of the sperm quality of the partner.
3. Hormone stimulation
If there is evidence of disrupted ovulation or a disrupted second half of the menstrual cycle: support for ovulation or the luteal phase by hormones.
4. Insemination
If the sperm quality is poor or if the results of the post-coital test are suspicious: transfer of sperm cells into the uterus.
5. Examination of the fallopian tubes
Examination of the functioning of the fallopian tubes through a laparoscope under general anaesthetic or through a contrast-enhanced ultrasound examination (HYCOSY) without anaesthetic (may be sensible after three unsuccessful treatment cycles at the latest).
6. Artificial insemination
Egg cells and sperm cells are combined outside the body in an in vitro fertilisation (IVF) with or without a microinjection. This method of fertility treatment is necessary in many cases and very successful.
The different types of treatment of artificial insemination are collectively referred to as ART (assisted reproduction techniques).