Since fertility treatment is not, unfortunately, a guarantee of a successful pregnancy, doctors and biologists have been working for years to develop procedures that further increase the likelihood of pregnancy.
In ideal cases, once we have exhausted the complete spectrum of options, patients will benefit from a pregnancy rate increased by up to a third.
At the Kinderwunschzentrum Berlin, we offer you all treatment options approved for use in Germany that have been demonstrated to have a positive effect on the likelihood of pregnancy.
Laser Assisted Hatching
Various studies have determined that creating a small opening in the exterior embryonic membrane (zona pellucida) directly before transferring the embryo can help in the “hatching” process and therefore improve implantation.
A small opening is made in the zone pellucida using a fine laser beam. This poses no risk of damaging or harming the embryo.
The spindle plays a central role in the maturation of the human egg cell; it is responsible for the meticulous process of arranging and distributing chromosomes during cell division. As a woman grows older, spindle abnormalities can occur in her egg cells. The absence of the spindle is correlated with a significantly reduced fertility rate and poor or no embryonic development. The orientation of the spindle during ICSI also influences continued embryo development. Only when spindles distribute chromosomes correctly does the embryo have the best chances for a successful pregnancy.
The success of ICSI treatment is also decisively influenced by the identification and selection of optimal egg cells.
Each egg cell, or ovum, is surrounded by a protective covering called the zona pellucida. Multiple studies have proven that if a specialized polarization filter is used during ICSI therapy, there is a direct correlation between the way light is refracted and the quality and developmental capability of the egg cell. A specialized software program (Polar Aide©) analyzes the type of light refraction in the zona pellucida in seconds, then represents this refraction visually.
A high level of light refraction indicates an especially potent egg cell, while a low level of light refraction suggests the egg cell has a lower chance of developing. The significance of this analysis is superior to previous evaluation processes, and improves the recognition of optimal egg cells for culturing and embryo transfer. In one current study (2008), using this method led to significantly increased rates of pregnancy and birth. Many scientific publications have shown that polarization microscopy is completely harmless to egg cells.
Blastocyst Culture (extended ovum culture)
In a blastocyst culture, the embryos are not transferred on the third day, but rather on the fifth.
A blastocyst is an embryo that has continued to develop.
The extended ovum culture improves synchronization between the uterus, endometrium, and embryo.
Furthermore, higher embryo implantation rates into the endometrium have been measured with this procedure.
Blastocyst culture is, however, only possible with some fertilized egg cells. In all other embryos, transfer on day two or three after removal is recommended.
The “Implantation Injection”
There are indications that a special medication can positively influence and encourage implantation of embryos in the endometrium. We call this injection the “implantation injection.”
Since 2002, there has been a medium available specifically developed for embryo transfer following artificial insemination which is intended to improve implantation. Its physical characteristics are highly similar to the secretions of the uterus.
Polar Body Analysis
By extracting a polar body from the egg cell, we can make a determination on the set of chromosomes in the egg cell (polar body analysis). Since not every egg cell is genetically healthy, this is a method of selecting healthy egg cells and later transferring these as embryos.
Surplus fertilized egg cells created during artificial insemination can be stored at –196°C in liquid nitrogen. The process of freezing eggs and then storing them in their frozen state is called cryopreservation.
At a later time, these egg cells can be thawed again and transferred back into your uterus (embryo transfer).
Additionally, if pregnancy does not occur, or if you desire to conceive another child without further stimulating your ovaries, you can become pregnant by transferring thawed egg cells (cryo-cycle).
Unfertilized egg cells, sperm cells, and, for instance, testicular or ovary tissues can also be frozen
TESE / MESA Operation
If no sperm cells are found in a man’s ejaculate, or if he has undergone a sterilization procedure in the past, sperm cells can normally be harvested directly in the testicles (TESE operation) or in the epididymis (MESA operation).
The number of sperm cells obtained in this way is, however, so low that it is only sufficient for artificial insemination.
This procedure is only performed by an experienced urologist and on site at the Kinderwunschzentrum Berlin. The testicular / epididymis tissue is immediately analyzed by a laboratory team.
The sperm cells extracted in this manner are then frozen (cryopreserved) and are available for other therapy options.