Therapieformen
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Je nach Lebenssituation kommen unterschiedliche Therapieformen zur Erfüllung des Kinderwunsches zum Einsatz.
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Etwa jedes siebte Paar in Deutschland ist ungewollt kinderlos. Ihr unerfüllter Kinderwunsch ist unsere oberste Priorität. Um Ihnen stets eine optimale Behandlungserfahrung zu gewährleisten, ist ein auf Sie persönlich abgestimmtes Konzept zur Kinderwunsch Therapie essentiell. Dies beginnt in unserem Centrum stets mit einem individuellen Beratungsgespräch und der umfassenden Abklärung der infrage kommenden Ursachen.
Oft sind einfache Behandlungsansätze möglich, um den Kinderwunsch zu erfüllen. Dabei können auch Änderungen im Lebensstil die Aussichten auf eine spontane Schwangerschaft verbessern.
Behandlungsmöglichkeiten
Unterstützung der natürlichen Konzeption
Hormonelle Zyklusoptimierung
Insemination-IUI
Künstliche Befruchtung -IVF/ ICSI
IVF natura
Individuelle Laborleistungen
Präimplantationsdiagnostik-PID/PKD
Fertiprotektion
TESE
Social Freezing
Samenspende
Operative Maßnahmen
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Möglichkeiten zur Kinderwunsch Therapie: Überblick
Unterstützung der natürlichen Konzeption
Um Sie bestmöglich bei Ihrem unerfüllten Kinderwunsch zu unterstützen, können zur Kinderwunsch Therapie in einem ersten Schritt die Voraussetzungen für eine natürliche Konzeption verbessert werden. Verbesserungsoptionen können dabei beispielsweise physischen Einflussfaktoren sein, wie z.B. Gewicht, zeitlichen Faktoren, wie z.B. dem Zeitpunkt des Eisprungs, aber auch psychologische Faktoren, die sich auf den Schwangerschaftseintritt auswirken. Mehr über die natürliche Unterstützung Ihres Kinderwunsches erfahren Sie auf unserer Seite Unterstützung der natürlichen Konzeption.
Hormonelle Zyklusoptimierung
Neben Formen der künstlichen Befruchtung kann die Erfüllung eines bestehenden Kinderwunsches häufig auch mit weniger invasiven Maßnahmen unterstützt werden. So können häufig eine Zyklusbeobachtung (“Monitoring”) sowie eine hormonelle Optimierung des Zykluses helfen, um den geeigneten Zeitpunkt für den Geschlechtsverkehr zu ermitteln und so einen Schwangerschaftseintritt begünstigen. Mehr über die Optimierung des Zykluses erfahren Sie auf unserer Seite Hormonelle Zyklusoptimierung.
Insemination-IUI
Mittels der Insemination (IUI) werden Samenzellen direkt in die Gebärmutter und/oder die Eileiter eingebracht. Dieses Verfahren ist vor allem dann hilfreich, wenn es eine Ursache unwahrscheinlich erscheinen lässt, dass ausreichend viele Samenzellen auf natürliche Weise über die Eileiter zur Gebärmutter gelangen. Mehr zu dieser Art der Befruchtung finden Sie auf unserer Seite Insemination.
Künstliche Befruchtung -IVF/ ICSI
Bleiben einfachere Therapieansätze erfolglos oder fallen die Erfolgsaussichten dieser, aufgrund der diagnostischen Befunde, eher schlecht aus, kann zur Kinderwunsch Therapie auf eine künstliche Befruchtung zurückgegriffen werden. Dabei können sowohl die klassichen In vitro-Fertilisation (IVF) als auch die intrazytoplasmatische Spermieninjektion (ICSI) infrage kommen. Mehr zur Behandlung mittels IVF sowie ICSI erfahren Sie auf unserer Seite Künstliche Befruchtung.
IVF natura
IVF natura ist eine IVF-Behandlung im Spontanzyklus ohne hormonelle Stimulation. Der natürliche Zyklus bringt eine Reihe von Vorteilen für Patientinnen bzw. Paare, weshalb wir diese stes als Alternative in bestimmten Situationen anbieten. Mehr dazu erfahren Sie auf unserer Seite zu IVF natura.
Individuelle Laborleistungen
Um die Chancen auf eine eintretende Schwangerschaft zusätzlich zu verbessern, können verschiedene individuelle Laborleistungen zur Unterstützung eingesetzt werden. Mehr zu den verschiedenen Möglichkeiten erfahren Sie auf unserer Seite Individuelle Laborleistungen.
Präimplantationsdiagnostik-PID/PKD
Liegen bei dem behandelten Paar oder der behandelten Person erhöhte Risiken für bestimmte Erkrankungen vor, können die Zellen eines Embryos vor der Implantation in die Gebärmutter dahingehend untersucht werden. Diese Untersuchung wird Präimplantationsdiagnostik genannt. Mehr zur PID und PKD erfahren Sie auf unserer Seite Präimplantationsdiagnostik.
Fertiprotektion
Vorangehend an die Durchführung von keimzellschädigenden medizinischen Behandlungen können zum Schutz der Fruchtbarkeit Maßnahmen zur Fertilitätsprotektion (kurz: Fertiprotektion) vorgenommen werden. Mehr zu den verschiedenen Möglichkeiten zum Schutz der Fruchtbarkeit erfahren Sie auf unserer Seite Fertilitätsprotektion.
TESE
Lassen sich im Ejakulat des Mannes keine oder nur sehr wenige Spermien nachweisen, können unter Umständen bewegliche Spermien für eine Kinderwunsch Therapie direkt aus dem Hodengewebe entnehmen. Diese Behandlung wird testikuläre Spermienextraktion (TESE) genannt. Im Kinderwunsch Centrum München entstand auf diese Weise die erste Schwangerschaft nach TESE-Behandlung in Kooperation mit dem Andrologen Prof. J. Ullrich Schwarzer. Mehr zu der Gewinnung von Spermien aus einzelnen Gewebestückchen des Hodens erfahren Sie auf unserer Seite TESE.
Social Freezing
Soll die Erfüllung des Kinderwunsches zu einem späteren Zeitpunkt erfolgen, kann Social Freezing, also die Möglichkeit Eizellen zu entnehmen und einzufrieren, eine hervorragende Möglichkeit darstellen. Mehr zur Kryokonservierung von Eizelle erfahren Sie auf unserer Seite Social Freezing.
Samenspende
Sind bei dem männlichen Partner keine Spermien vorhanden, kommt eine Kinderwunsch Therapie mittels Samenspende infrage. Ebenso kann diese Art der Behandlung bei gleichgeschlechtlichen Paaren eingesetzt werden. Mehr zur Behandlung mittels Spendersamen im Kinderwunsch Centrum München erfahren Sie auf unserer Seite Samenspende.
Operative Maßnahmen
Einige Ursachen für einen unerfüllten Kinderwunsch können lediglich mittels operativer Maßnahmen gelöst werden. Mehr zu den verschiedenen Maßnahmen erfahren Sie auf unserer Seite Operative Maßnahmen.
Wir begleiten Sie auf Ihrem Weg zur Gründung einer eigenen Familie
Gerne stehen wir Ihnen im Kinderwunsch Centrum München umfassend auf dem Weg zu Ihrer Wunschfamilie beiseite. Um Sie bestmöglich bei der Familienplanung zu unterstützen, finden wir auf den Einzelfall abgestimmt, in einem individuellen Beratungsgespräch die optimalen Therapieansätze. Da eine Schwangerschaft nicht nur von Hochleistungen der Medizin abhängt, ist es besonders wichtig, auf persönliche Wünsche und Anliegen einzugehen. Zudem können je nach Ursache mit Hilfe von hochentwickelten Labortechniken unterschiedliche Therapieformen durchgeführt werden, um Sie umfassend auf Ihrem Weg zu begleiten.
Ihr unerfüllter Kinderwunsch ist unsere höchste Priorität. Gemeinsam mit Ihnen wollen wir herausfinden, welche Ursache dem zugrunde liegt und einen optimalen Behandlungsplan für Ihren erfolgreichen Start in die Familienplanung erarbeiten.
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Da die Eizelle für weniger als 24 Stunden befruchtungsfähig ist, ist der optimale Zeitpunkt für Geschlechtsverkehr ein bis zwei Tage vor dem Eisprung.
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Erste Kontrolluntersuchung:
Entweder in den ersten Menstruationstagen, (nach erfolgter Down-Regulation durch Decapeptyl oder das Nasenspray) bzw. vor dem eigentlichen Stimulationsbeginn und ansonsten zwischen dem 6. und 8. Zyklustag. Zeitlich planen Sie hierfür bitte je nach Andrang ca. 1 Stunde in unserer Praxis ein.
Zweite Kontrolluntersuchung: Planen Sie hierfür ca. eine halbe Stunde in unserer Praxis ein.
Weitere Kontrolluntersuchungen können hinzukommen. Eine besonders schwierige Stimulation kann zum Beispiel hierfür verantwortlich sein, wenn nämlich Ihre Eierstöcke nur verzögert oder aber deutlich stärker im Sinne einer Überstimulation, als erwartet reagieren.
Eisprungspritze (meist in der Zeit von 21 Uhr bis 24 Uhr): Sie wird erst auf unsere ganz besondere Anordnung etwa 34 bis 36 Stunden vor der Eizellentnahme (Follikelpunktion) gegeben.
Für diese Spritze ist es besonders wichtig, dass Sie selber spritzen gelernt haben.
Sehr wichtig ist, dass es sich dabei auch wirklich um die Eisprungspritze (Brevactid/Ovitrelle) handelt. Eine Verwechslung darf hier auf keinen Fall vorkommen, da sonst am Punktions- bzw. Entnahmetag keine oder nur unreife, d. h. nicht befruchtungsfähige Eizellen vorliegen würden!
Für die jetzt folgenden Tage können Sie von der Punktion (= Eizellentnahme) bis zum Tag des Transfers (= Zurücksetzen der befruchteten Eizellen) eine Arbeitsunfähigkeitsbescheinigung (= AU) erhalten.
Punktionstag: An diesem Tag bitte nüchtern zu uns kommen. Die Aufnahme erfolgt im IVF-Liegeraum meist zwischen 7.30 Uhr und 10.00 Uhr, und ca. zwei Stunden vor dem Eingriff, damit unsere Narkoseärztinnen noch mit Ihnen sprechen und Sie sich in Ruhe vorbereiten können.
Diesen Tag planen Sie bitte komplett als Fehlzeit ein, auch weil wir Sie schon aus medizinischen und rechtlichen Gründen mindestens noch zwei Stunden nach der Punktion bei uns beobachten möchten. Dafür stehen Ihnen unsere Liegeräume, gegebenenfalls auch mit Ein- oder Zweibettsystem zur Verfügung. An diesem Tag gibt Ihr Mann eine Samenprobe ab.
Die Entlassung darf dann auch nur in Begleitung Ihres Ehemannes oder Partners oder einer anderen Begleitperson erfolgen.
Zusammenfassend heißt das also, dass Sie zur Eizellentnahme immer nüchtern kommen müssen, sich von einer Begleitperson abholen lassen müssen und an diesem Tag nicht selber Auto fahren dürfen.
Der nächste Tag ist Ihr so genannter Ruhetag. Sie können sich von den (hoffentlich nicht allzu großen) Strapazen der Behandlung etwas erholen. Zwischen 12 und 14 Uhr erfahren Sie telefonisch in unserem Labor, ob die Eizellen befruchtet sind und wann der Transfer in den nächsten Tagen stattfinden soll. Abweichungen hiervon sind gelegentlich möglich (z. B. sonn- und feiertags) und werden Ihnen dann speziell mitgeteilt.
Am Transfertag werden jetzt die befruchteten und geteilten Eizellen in die Gebärmutter zurückgesetzt (= transferiert). Dies geschieht meist zwei bis drei Tage nach der Eizellentnahme. Auch diesen Tag planen Sie bitte möglichst ebenfalls komplett als Fehlzeit ein.
Die Aufnahme erfolgt wiederum morgens im IVF-Liegeraum, meist allerdings nicht vor 10 Uhr.
Nach dem Embryotransfer sollten Sie noch Zeit für eine Ruhephase von etwa einer Stunde mitbringen. Am Mittag oder frühen Nachmittag können Sie dann – diesmal auch ohne Begleitung – nach Hause gehen. Selbstverständlich kann Ihr Ehemann oder Partner Sie zum und beim Transfer gerne begleiten.
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Weiterführende Links
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– Kryokonservierung von Embryonen
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ICSI Behandlung
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Diese Methode wird dann angewandt, wenn der Spermiogrammbefund deutlich eingeschränkt ist. Aufgrund zu weniger, eingeschränkt beweglicher oder vermehrt unregelmäßig geformter Samenzellen ist das selbstständige Eindringen eines Spermiums in die Eizelle oft nicht möglich, d. h. eine spontane Befruchtung der Eizelle sehr unwahrscheinlich oder gar ausgeschlossen.
Alle Schritte bis zur Eizellentnahme verlaufen genauso wie bei der konventionellen IVF Behanldung. Dann, nach der Entnahme (Punktion) der Eizellen, erfolgen im Labor unter dem Mikroskop die technisch sehr aufwendigen Schritte der ICSI.
Die entnommenen Eizellen müssen zunächst von den um sie herum gelegenen Zellen (Granulosa) gereinigt („geputzt“) werden. Erst wenn diese Granulosazellen von der Eizelle entfernt worden sind, kann die Eizelle (besonders bezüglich ihres Reifegrades) begutachtet werden und ist jetzt, wenn sie reif ist, für die Injektion des Spermiums vorbereitet.
Die Eizelle muss mit einer speziellen Haltepipette fixiert werden. Erst dann kann ein einzelnes Spermium, das in eine noch wesentlich dünnere Injektionspipette aufgezogen wurde, direkt in die Eizelle überführt (injiziert = eingespritzt) werden. ICSI wird auch Mikroinjektion genannt, weil es unter dem Mikroskop durchgeführt wird. Das natürliche Eindringen eines Spermiums in die Eizelle wird also hier mechanisch nachgeahmt. Abgesehen von der Auswahl des Spermiums und seiner Übertragung in die Eizelle bleibt alles weitere genauso der Natur überlassen wie sonst auch.
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Weiterführende Links
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text“]Dies könnte Sie auch interessieren:[/ffb_param][/ffb_section-heading_2][/ffb_column_1][ffb_column_1 unique_id=“3nui15fs“ 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So können Sie wichtige Unterlagen in Ruhe zuhause vorbereiten.[/ffb_param][ffb_param route=“o gen content 2-|-classic-button classic-button button-title“]weiter[/ffb_param][/ffb_services-7_2][/ffb_column_1][ffb_column_1 unique_id=“3nui15fv“ data=“%7B%22o%22%3A%7B%22gen%22%3A%7B%22ffsys-disabled%22%3A0%2C%22ffsys-info%22%3A%22%7B%7D%22%2C%22xs%22%3A%2212%22%2C%22sm%22%3A%22unset%22%2C%22md%22%3A4%2C%22lg%22%3A%22unset%22%2C%22is-centered%22%3A0%2C%22not-equalize%22%3A0%2C%22is-bg-clipped%22%3A0%2C%22xs-last%22%3A%22no%22%2C%22sm-last%22%3A%22unset%22%2C%22md-last%22%3A%22unset%22%2C%22lg-last%22%3A%22unset%22%2C%22xs-offset%22%3A%22unset%22%2C%22sm-offset%22%3A%22unset%22%2C%22md-offset%22%3A%22unset%22%2C%22lg-offset%22%3A%22unset%22%2C%22xs-pull%22%3A%22unset%22%2C%22sm-pull%22%3A%22unset%22%2C%22md-pull%22%3A%22unset%22%2C%22lg-pull%22%3A%22unset%22%2C%22xs-push%22%3A%22unset%22%2C%22sm-push%22%3A%22unset%22%2C%22md-push%22%3A%22unset%22%2C%22lg-push%22%3A%22unset%22%2C%22xs-overlap%22%3A%22no%22%2C%22sm-overlap%22%3A%22unset%22%2C%22md-overlap%22%3A%22unset%22%2C%22lg-overlap%22%3A%22unset%22%7D%7D%7D“][ffb_services-7_2 unique_id=“3nui15g1″ data=“%7B%22o%22%3A%7B%22gen%22%3A%7B%22ffsys-disabled%22%3A%220%22%2C%22ffsys-info%22%3A%22%7B%7D%22%2C%22content%22%3A%7B%220-%7C-one-title%22%3A%7B%22one-title%22%3A%7B%7D%7D%2C%221-%7C-one-description%22%3A%7B%22one-description%22%3A%7B%22description-is-richtext%22%3A%221%22%7D%7D%2C%222-%7C-classic-button%22%3A%7B%22classic-button%22%3A%7B%22clrs%22%3A%7B%22text-custom-color%22%3A%22%5B41%5D%22%2C%22text-hover-custom-color%22%3A%22%5B1%5D%22%2C%22text-links-hover-custom-color%22%3A%22%5B41%5D%22%2C%22link-custom-color%22%3A%22%5B41%5D%22%7D%2C%22link%22%3A%7B%22target%22%3A%22same%22%2C%22url%22%3A%22https%3A%2F%2Ftest.ivf-muenchen.de%2Fkuenstliche-befruchtung-ivf-icsi%2F%23erfolgsaussichten%22%7D%2C%22icon-color%22%3A%22%5B41%5D%22%2C%22icon-border-color%22%3A%22%5B43%5D%22%2C%22icon-hover-color%22%3A%22%5B41%5D%22%2C%22icon-bg-hover-color%22%3A%22%5B43%5D%22%7D%7D%7D%2C%22icon-box-height%22%3A%22%22%7D%2C%22b-m%22%3A%7B%22bg%22%3A%7B%22bg%22%3A%7B%220-%7C-image%22%3A%7B%22image%22%3A%7B%22image%22%3A%22%7B%5C%22id%5C%22%3A3696%2C%5C%22url%5C%22%3A%5C%22https%3A%2F%2Ftest.ivf-muenchen.de%2Fwp-content%2Fuploads%2F2020%2F07%2Ferfolgsaussichten-kinderwunsch-behandlung.jpg%5C%22%2C%5C%22width%5C%22%3A1048%2C%5C%22height%5C%22%3A698%7D%22%2C%22bgpos%22%3A%22center right%22%7D%7D%2C%221-%7C-color%22%3A%7B%22color%22%3A%7B%22bg-color%22%3A%22rgba(0%2C 0%2C 0%2C 0.7)%22%2C%22opacity%22%3A%220.4%22%7D%7D%2C%222-%7C-color%22%3A%7B%22color%22%3A%7B%22bg-color%22%3A%22rgba(0%2C 0%2C 0%2C 0.7)%22%2C%22opacity%22%3A%220.4%22%2C%22hover-only%22%3A%221%22%7D%7D%7D%7D%2C%22mg-xs%22%3A%7B%22b%22%3A%220%22%7D%7D%7D%7D“][ffb_param route=“o gen content 0-|-one-title one-title title“]Erfolgsaussichten[/ffb_param][ffb_param route=“o gen content 1-|-one-description one-description description“]
Die Erfolgsaussichten für eine Schwangerschaft werden von vielen verschiedenen Faktoren beeinflusst. Zu den wichtigsten gehören das Alter der Frau, die Dauer des Kinderwunsches und die Ursachen für den unerfüllten Kinderwunsch.
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Von Einnistungsversagen oder „repeated implantation failure“ (RIF) spricht man, wenn mehrere Embryotransfers im Rahmen von künstlichen Befruchtungen nicht zu einer klinischen Schwangerschaft geführt haben. Dies kann auch immunologische oder infektiologische Ursachen haben.
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