FAQs, Fertility Clinic Dr. Brunbauer, 1010 Vienna

Frequently asked questions - Faqs

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The reasons for unwanted childlessness are manifold.

In general, the desire to have children by many couples has been postponed because education and work have a higher interest. The best biological age for a pregnancy is often surpassed when the desire for a child becomes stronger. In the case of the majority of the couples, one or both of the partners has a physical impairment that prevents the couple from becoming pregnant. In women, these are mainly closed fallopian tubes, endometriosis and the PCO syndrome. In men, problems with sperm production and sperm transport cause fertility problems.

Mental stress, long-term stress, heavy overweight or underweight, excessive alcohol or nicotine consumption, drugs, excessive exercise, heavy work, low-vitamin diet and high radiation exposure have negative effects on fertility. Also, previously suffered  infections, such as mumps, can reduce the quality of semen.

Modern reproductive medicine offers, depending on the situation, several procedures to achieve a pregnancy. These include insemination and the various forms of artificial insemination (IVF, ICSI, P-ICSI).

Each fertility treatment starts with a detailed initial interview.

Afterwards, careful research will be carried out to identify the reasons why it is not natural for you. On the basis of the examination results, we determine an individual treatment plan for you and discuss it exactly with you. Depending on which treatment suits you, we will take care of the individual treatment steps and accompany you attentively and understandingly during this time.

A good fertility clinic must enjoy your trust.

Fertility treatment presents a big challenge for most couples. Therefore, it is important that the team treating you not only has the latest medical knowledge, extensive experience and the most up-to-date technical equipment. It is also of enormous importance that you feel well advised and supported in your desire for children.

Your fertility clinic should therefore offer you a familiar and personal ambience in which you and your partner feel completely comfortable. And not least, she should have a high pregnancy rate.

None, unfortunately. In most countries, unwanted childlessness is not considered a disease and therefore does not fall under the obligation of the health insurance companies. Since 2000, there has been the Austrian IVF Fund, which under certain circumstances covers around 70% of the costs of fertility treatment.

Since 2018-06-01 we have a contract with the IVF Funds in the Wunschkind Clinic.

In order for a pregnancy to develop, many complex physical processes have to run in concert. A healthy, balanced diet supports the body. In contrast, a low-vitamin diet can have a negative impact on fertility.

Yes, if he is not operated excessively. Exercise is healthy and promotes well-being. Over-training, however, is detrimental. If you practice extreme sports, a break or at least a reduction of your training time during the child wish period is recommended. Especially suitable are endurance sports such as jogging, walking or swimming, as well as yoga. Attention Doping: Testosterone preparations significantly reduce sperm production!

Desired couples opt for a couple for offspring and therefore should work together to fulfill this wish.

Accordingly, it is equally true for men that a healthy diet is helpful and nicotine consumption is a hindrance. Stay in conversation with your partner, show understanding and tolerant. Do not consider unwanted childlessness as a personal failure. Together with your partner, contact a fertility clinic of your choice and use the possibilities of modern reproductive medicine.

In der Regel erwarten 60% der Paare nach sechs Monaten ein Kind. Nach zwölf Monaten sind 80 % der Frauen schwanger. Aber nicht in jedem Fall gehen die Pläne so auf. Deshalb setzen wir auf zusätzliche unterstützende Maßnahmen wie z.B.: Akupunktur, Yoga und Behandlungen zur Entspannung gegen Ängste ein, die die Chancen schwanger zu werden weiter erhöhen. Wir helfen Frauen mit großer Leidenschaft dabei, endlich ein Baby zu bekommen.

Die WHO hat definiert, dass nach einem Jahr regelmäßigem Geschlechtsverkehr ohne Verhütung eine natürliche Schwangerschaft eingetreten sein sollte. Ab dann ist die natürliche Wartezeit überschritten. Kommt es trotz einer längeren Phase ungeschützten Geschlechtsverkehrs nicht zu einer Schwangerschaft, ist eine Abklärung der Ursachen ratsam.

Kinderwunschpaare, die älter als 38 Jahre sind, sollten uns bereits nach einer Wartezeit von sechs Monaten aufsuchen und den Ursachen auf den Grund gehen. Zögern Sie nicht unsere professionelle Hilfe in Anspruch zu nehmen.

Mit eigenen Eizellen schwanger zu werden ist bis zum 45. Lebensjahr möglich, besonders wenn man zuvor noch kein eigenes Kind bekommen hat. Hat man jedoch bereits ein oder mehrere Kinder, so ist eine Schwangerschaft auch nach 45 noch möglich. Dr. Brunbauer erlebte bereits Schwangerschaften mit bis zu 47 u. 48 Jahren. Ist auch dieses Alter überschritten, ist nur mehr eine Eizellspende möglich.

Unfulfilled desire for children

If after one year of regular intercourse without contraception pregnancy does not occur, you should seek medical advice. From then on the natural waiting time is exceeded.

If you are older than 38 years of age, you should seek medical help after just six months and get to the root of the problem.

The clarification is gradual. The first step is always a detailed initial conversation. Among other things, we talk about previous illnesses and therapies, current physical complaints and your sexual behavior. Then, depending on your individual situation, we will carry out various examinations. As an oviduct ultrasound (HYCOSY).

Many causes lead to infertility or fertility problems. In women, it is often hormonal problems that cause ovarian dysfunction or egg cell maturation. The most common causes of fertility disorders or infertility in women are occluded fallopian tubes, endometriosis and the PCO syndrome. But anatomical reasons or hormonal changes and metabolic problems can cause difficulties.

The most common fertility disorders in men are disorders of sperm cell formation, sperm transport, inadequate bladder obstruction, antibody production, and hormonal and genetic disorders. In addition, general disorders of the kidneys, liver or heart as well as metabolic disorders impair fertility. Also infections (eg mumps) can sustainably reduce the seed production.

A number of risk factors can negatively impact fertility: mental stress, long-term stress, heavy overweight or underweight, excessive alcohol or nicotine consumption, drug use, excessive exercise, heavy work, low-vitamin diet and high levels of radiation exposure.

Fertility may be affected by overheating or hypothermia of the testes. Tight pants push the scrotum close to the body, which can lead to overheating.

However, it is not scientifically proven that tight pants alone lead to infertility.

Mumps is a childhood disease that usually occurs between the ages of five and nine years. Men who get mumps after puberty and develop testicular inflammation can reduce their fertility. In rare cases, fertility is lost.

Body and mind are one unit. If one part of this unit is affected, this also affects the other.

In the majority of couples, the unfulfilled desire to have a child causes physical causes. However, the interactions between body and psyche influence the situation. Therefore, the emotional well-being in the context of a fertility treatment should not be ignored. On the contrary: pairs of children who actively work on their well-being can have a positive influence on their desire to have children.

A good fertility clinic is characterized by:

  • A highly motivated and experienced team that you can count on.
  • A respectful, personal and familial treatment.
  • Experts in the fertility treatment, who will respond to your specific situation and work out the optimal solution for you.
  • Latest medical knowledge combined with the latest technology and experience from daily practice.
  • Profound, complementary support through measures such as TCM, acupuncture or nutritional counseling.
  • Psychological accompaniment on your way to the desired child.
  • Transparent calculation of costs.

UAnd of course she should have a high pregnancy rate and enjoy your confidence.

Diagnostics

That depends on your individual situation.

Man and woman are included in the diagnosis. We discuss all necessary examinations in detail with you and inform you about the procedure. Possible investigations include an ultrasound examination of the woman, the determination of the hormone status of the woman, the examination of the tubal patency (HyCoSy) and a semen test (spermiogram) in men.

The initial interview serves to get to know each other, to clarify your medical history and to develop a strategy for your further treatment. Contribute to the success of your first conversation with us by bringing all existing findings. Use our "Initial interview checklist" for your preparation. This first appointment with us gives you the opportunity to address topics and questions that you are dealing with. You can formulate your expectations and express your wishes.

It is important to us that you consult us well, are treated well and feel well overall.

As a rule, we conduct an ultrasound examination on the woman during the initial interview in order to gain a first insight into your situation.

The so-called Hydro Contrast Sonography (HyCoSy) is an almost risk-free and gentle examination. It lasts around five to ten minutes. This may cause mild, menstrual pain that quickly fades away.

No, the examination is performed on an outpatient basis without anesthesia.

No, as a rule, the examinations remain complication free. In very rare cases, as a result of a HyCoSy, allergic reactions to the contrast agent or to uterine inflammation occur.

In principle, this would be possible, but we prefer if the semen sample is obtained from us in the Wunschkind-Klinik. We provide you with a discreet space in which your privacy is maintained. The main reason is that no more than 60 minutes should elapse between ejaculation and examination of the sperm. The temperature also plays an important role. In addition, only special containers may be used to prevent contamination of the semen sample.

In the clinic, the optimal conditions are met to enable a precise semen findings.

We examine the spermogram quickly. Usually you get the results after 30 minutes.

Egg freezing

Egg freezing and social egg freezing allow young women to freeze their eggs. As a result, they are available at a later date for artificial insemination. The desire to have children can be fulfilled by this method even in advanced age, as soon as the woman has come the right time for a pregnancy.

However, Social Egg Freezing is banned in Austria.

In Austria, oocytes may only be removed and stored if there is a risk that their reproductive capacity will be lost as a result of a physical illness or therapy (eg chemotherapy).

Ovarian cells should not be cryopreserved for reasons of simpler family planning.

In Austria, the medical Necessary condition. This is given among others in these cases:

  • For ovarian cysts or endometriosis: If surgery requires removal of parts of the ovary.
  • For treatments that affect the ovaries.
  • In autoimmune diseases, such. Or diabetes mellitus, Hashimoto's thyroiditis.
  • Cancer, in which the oocytes are destroyed by chemo or radiotherapy or in which the ovaries must be removed.

We will first have a first meeting with you. Afterwards, we will make all necessary investigations. As a rule, hormone stimulation then takes place, as a result of which several eggs grow. We take the oocytes at the optimal ripening time and freeze them in liquid nitrogen.

If possible, we store up to 30 oocytes, so that sufficient eggs are available for later artificial insemination. The majority of ova survive the freezing without prejudice. The quality of egg cells does not decrease, even if they are stored for years.

60 to 85 percent of all women who use frozen eggs for artificial insemination become pregnant. There is no guarantee, however. The success depends largely on the age of the woman in taking the ova and on how old she is in the performance of artificial insemination.

The best chances of success exist if the oocytes were removed and cryopreserved before the age of 35 years. Because with increasing age, the number of oocytes decreases. At the same time the danger of genetic defects increases.

Egg donation

With the donor, a hormone stimulation is carried out for about two weeks. The growing oocytes are then removed at the optimal time and the resulting after fertilization embryo is frozen. Egg donation takes about three weeks.

Yes, egg donation has been allowed since 2015.

In general, yes. Unless if couples have a donor.

No. Charitable donation of egg cells is prohibited.

No, the child has no maintenance or inheritance rights with the donor.

No, embryo donations are prohibited by law.

Yes, donated sperm can be used and used as part of IVF treatment. A consent of both partners must be proven through a notarial act.

In IVF treatment with donated oocytes, hormone stimulation occurs in the donor, which releases the oocytes. Otherwise, the treatment route is the same.

Genetics / Preimplantation genetic diagnosis

With the pre-implantation diagnosis, we clarify whether your eggs or embryos are healthy. It allows us to select specific unencumbered oocytes or embryos and to avoid genetic defects in your baby.

PID can be carried out on oocytes and embryos.

Precondition for the pre-implantation diagnosis is that an artificial insemination (IVF, ICSI) takes place. The examination takes place outside the body, even before we transfer the embryo into the uterus.

We differentiate in polar body diagnosis (PCD) and trophectodermbiopsy (TOBI). In polar body diagnosis, we clarify whether genetic disorders, genetic defects or structural chromosome disorders are present in women. The Trophektodermbiopsie is primarily used when a miscarriage or stillbirth or a specific hereditary disease should be avoided.

The choice of sex is decidedly excluded. Besides, the feared hereditary disease is related to the sex of the child.

The investigations serve to select the best genetically suitable embryos. This increases the likelihood that the embryo is healthy.

Yes, because the most genetically suitable and fittest embryos are selected.

Hormone treatment

The three most common hormone disorders that occur in the absence of pregnancy are the PCO syndrome, endometriosis and yellow body weakness.

Depending on your individual situation, we use hormone treatment to pursue one of these three goals:

  • Stabilize your menstrual cycle.
  • Stimulate the maturation of oocytes.
  • cause an ovulation.

The hormone treatment is done with tablets or with syringes that you or your partner can administer to you. During the entire treatment period, we observe attentively the maturing of the egg. So we can determine the exact time of ovulation.

About one in three women becomes pregnant naturally after receiving hormone treatment and knowing the best time. Sometimesseveral treatments are necessary until the wish for a child is fulfilled.

Hormone therapies can have unpleasant side effects. In some patients, the treatment leads to hot flashes, dizziness or blurred vision. In rare cases overstimulation occurs.

We make sure that hormone therapy is well-dosed. In doing so, we act according to the motto "as much as necessary, as little as possible", so that the burden on you is kept within limits as far as possible.

Even in men, the hormone balance can get out of whack. Especially the sex hormone testosterone plays an important role in sperm production.

 A hormone therapy can provide relief and contribute significantly to the success of having children.

Depending on the individual situation, we carry out the appropriate therapy:

  • Capsules taken daily
  • injections
  • Administration of other hormones that stimulate semen production

Insemination

In these situations, we advise you to semen transfer:

  • If your sperm quality is limited: If you have too few fertile sperm or if your sperm cells are too slow to move.
  • If you have erectile or ejaculation problems.
  • If the sperm in the woman can not reach the uterus.
  • If the cervical mucus is overexcitable for the sperm cells during ovulation.
  • If you can not have sexual intercourse, for example because of physical limitations.

Then it is time to wait and see if a fertilization has taken place.

After about three weeks, we determine by pregnancy test, if it worked and you are pregnant. Another three weeks later you can already detect the heartbeat of the child on ultrasound.

For most women, several attempts are necessary until pregnancy occurs. Per treatment cycle and depending on the age, the pregnancy rate is between 12 and 15%. From experience we know that after three or four unsuccessful inseminations, it is usually better to think about artificial insemination.

For lesbian couples, the chances of success in insemination are slightly higher, as sufferers suffer significantly less from endometriosis, PCOS and closed fallopian tubes

That depends on your personal situation. In most cases, several attempts are necessary until pregnancy occurs.

Fertilization naturally occurs after the spermatozoa have been introduced into the uterus.

The insemination, the seed transfer, is a long-standing established fertility treatment.

At the most fertile point in the woman's menstrual cycle, the male's sperm are introduced directly into the uterine cavity. This allows more spermatozoa to reach the egg faster than naturally.

It is important that the man is flexible in time.

The insemination is always at the best time in the monthly cycle of the woman. If possible, we use fresh sperm for insemination. This wins the partner directly with us in the Wunschkind clinic.

Seed transfers are in principle low in risk. Nevertheless, situations may arise that require further treatment or accompaniment:

  • Physical stress on women through hormonal stimulation.
  • infections.
  • mental stress. An unfulfilled desire to have a baby is already a big challenge for most couples. Hormone therapy can lead to depressive moods that increase the emotional burden.

 

In addition, couples who opt for an insemination, should deal in advance with the idea of multiple pregnancy. In some cases, hormonal stimulation and the introduction of fertile sperm cells fertilize several oocytes.

Cryopreservation

Sperm, oocytes and embryos can be cryopreserved.

Embryos can be stored in Austria for ten years.

Social egg freezing means that women freeze young ova as reproductive measures. Egg freezing is allowed in many countries.

In Austria, oocytes may only be removed and stored if there is a risk that their reproductive capacity will be lost as a result of a physical illness or therapy (eg chemotherapy).

Ovarian cells should not be cryopreserved for reasons of simpler family planning.

In sperm, about half survive freezing and later thawing. The remaining amount is usually sufficient to fertilize eggs in the course of an IVF or ICSI.

The cryopreservation of embryos works largely lossless. Up to 95% of the frozen embryos can be thawed vital again.

In 2016, Chinese scientists found that the "baby-take-home-rate" after artificial fertilization with frozen embryos is higher than with fresh ones.

For sperm, lifelong storage is allowed.

Unfertilized ova may be kept for life.

Artificial fertilization

We offer you these types of artificial insemination:

  • In Vitro Fertilization (IVF)
  • Intracytoplasmic Sperm Injection (ICSI)
  • P-ICSI (Physiological ICSI)

In vitro fertilization involves removing the egg from the ovary and then placing it in the test tube with the man's sperm. Fertilization in the test tube takes place naturally, without medical intervention. If the fertilization works, we put the resulting embryo into the uterus two to five days later.

In detail, an IVF usually runs according to this scheme:

  1. Hormone treatment
  2. Initiation of ovulation
  3. Taking the egg
  4. Fertilization in the laboratory
  5. Transfer of embryos to the uterus
  6. Success control

The chance of getting pregnant through IVF treatment is 50% per cycle. The birth rate is 35% per treatment course.

The success depends not only on the fact that the treatment itself is uncomplicated. The probability of pregnancy is also influenced by the age of the couple, the hormonal situation and the lifestyle. Obesity, stress, nicotine and excessive consumption of alcohol can reduce the chance of success.

ICSI (Intracytoplasmic Sperm Injection) is the most common fertility treatment. It helps especially couples, in which the fertility of the man is severely limited.

The course of an ICSI corresponds for the most part to that of in vitro fertilization. However, in an ICSI, a single spermatozoa is injected directly into one of the ova with a needle. This increases the probability of fertilization. If the fertilization is successful, the resulting embryo is transferred to the woman's uterus on the second to sixth day after taking the egg. The further procedure corresponds to that with an IVF treatment.

The prospects of ICSI are similar to those of IVF. The pregnancy rate is 50% per cycle. The birth rate is 35% per treatment course.

In a P-ICSI (Physiological ICSI) the spermatozoa are selected for the ICSI.

Mature sperm are separated from immature by a hyaluronic acid pre-test. In mature sperm hyaluron is a fixed component of their shell. Immature sperm do not have this component. Using this procedure we select a mature sperm cell under the microscope for ICSI treatment.

Apart from the selection of sperm used, a P-ICSI works the same way as an ICSI.

Fertility decreases with age. The biologically best age for the first child would be the period of 25 to 35 years. At this age, the body is the most resilient.

With age, the prospect of a successful fertility treatment decreases. Therefore, couples who want to start a family should not wait too long. The younger, the higher the chance of success.

If excess oocytes fall in the first treatment cycle, they can be cryopreserved.

In another attempt, the woman can thus be spared the hormonal stimulation.

In one treatment cycle, several eggs are usually fertilized, but the woman uses a maximum of two embryos. The surplus embryos are cryopreserved and thus available for another treatment cycle.

Psychological welfare

No, the psychological accompaniment is not a duty but an offer to you.

The desire for children is emotionally challenging. Psychological support helps reduce stress and improve quality of life. With a good emotional base also increases the chances of the long-awaited wish child.

We see it as a matter of course to accompany you on request also psychologically through the desire for children. Our therapists have a wealth of experience and can help you, among other things, to relieve tension and improve communication, explore one's own condition, clarify your emotional needs, set your limits and strengthen your emotional power, according to your personal needs.

If the desire to have children has been unfulfilled for a long time, most couples find it difficult to remain relaxed and relaxed. Relaxation is a personal topic. There is no patent remedy for it. While some refuel in sports, others might enjoy a cozy dinner or a few hours in the reading chair. It is helpful to listen mindfully and consciously to decide what relieves and provides an inner time-out.

Supportive measures

TCM is a millennia-old medicine from China. It is a holistic treatment method. After TCM, human fertility depends on a harmonious interaction of body substances, the organ system and emotional well-being. Only when a body is in harmony, a baby develops.

Therefore, the goal of TCM is to create harmony and balance in the body and between the body and the environment.

Every TCM therapy begins with a first consultation. In doing so, we record all sensitivities and analyze, among other things, your lifestyle, digestion and your stress level. We look at the woman's monthly cycle and her hormone levels. We also examine the spermiogram of the man in detail. Tongue and pulse diagnostics are an indispensable part of any TCM session.

We use all this information to develop an individual therapy for you. Depending on your needs, we use all or only selected elements of TCM specifically for your treatment. In principle, all treatment methods of TCM help you to strengthen your energetic balance.

Acupuncture belongs to Traditional Chinese Medicine. The TCM sees the body traversed by energy channels in which the life energy flows. When this energy is disturbed, bodily functions become unbalanced.

For the treatment of fertility disorders, acupuncture has proven itself many times. Numerous studies have confirmed their positive effect.

Diet plays an essential role in fertility. The body needs vital substances, such as vitamins and minerals, to function optimally.

Therefore, a balanced diet is especially important forwomen who want to have children. For the body is the first to stop the reproductive functions if it is not sufficiently supplied with nutrients. Healthy, vitamin-rich food positivelyinfluences the organism and supports fertility.

Weight also plays a fundamental role here. Both underweight and overweight have a negative effect on fertility. This applies to women and men.

Regular exercise has a positive effect on the body and well-being.

Sport is beneficial if there is a wish for a child. Basically, fitness supports fertility. Even during pregnancy, moderate physical activity is beneficial.

However, the disadvantage is over-training. If the body demands too much, it puts its power into regeneration and draws the necessary energy from other body processes. Exercise to exhaustion has definite negative effects on fertility.

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