fertisuisse Basel (Basel)

Want to have a child

Have you been trying to get pregnant for more than a year in vain? Are you older than 35 and worried because pregnancy has still not occurred? Are you already receiving treatment and want to get a second opinion ? Have you had complications during pregnancy or suffered repeated miscarriages?

About every tenth couple in Switzerland is unfortunately unintentionally childless. In about 20-30% the cause is found either in the woman or in the man and in about 40% it is a combination of both partners. The most common reasons are disorders of male sperm production or function (sperm),the age of the woman, polyps and fibroids in the uterine cavity, blocked fallopian tubes, failure to ovulate, endometriosis and sexual dysfunction. Obesity, smoking, and stress can also contribute to unintended childlessness. In about 20%, no cause for the unfulfilled desire to have children can be found despite careful clarification. This is called unexplained infertility (infertility). Involuntary childlessness can be very detrimental to the physical and mental health of a couple and is therefore recognized as a disease by the WHO (World Health Organization).

*Care concept

Your medical officer will conduct all consultations (initial consultation, second consultation, follow-up consultation) with you, and will accompany and care for you during all phases of treatment. Necessary examinations within the framework of the clarifications and the fertility treatments are carried out by all members of the medical team. This procedure is efficient and has proven to be very successful. Please let us know if you have any special requests.

*causes

In order to find the cause(s) of unwanted childlessness, examinations must be carried out on both men and women. Even if the cause is apparently clear (e.g. blocked fallopian tubes), examinations must still be carried out on both partners in order to select the optimal, tailor-made treatment method.

Possible causes of involuntary childlessness:

• age of the woman
• Failure to ovulate (anovulation)
• Blocked fallopian tubes
• Endometriosis
• Polyps and fibroids
• Repeated miscarriages
• Unexplained infertility
• Disorders of sperm formation and function
• Disorders of sexual function

*Investigations

One of the most important basics of the clarification of an unwanted childlessness is the confidential discussion with your doctor. This involves your personal medical history, couple sexuality and the question of hereditary diseases. We attach great importance to finding the cause of the unfulfilled desire to have children and the right treatment. For this purpose, examinations are necessary.

In women, a cycle monitoring is usually performed. The examinations in men include a blood sample (e.g. to examine certain sex hormones), a sperm examination and a physical examination of the testicles with an ultrasound examination. In certain cases, it is necessary to perform a genetic examination. These examinations are all painless and help to find the causes of involuntary childlessness.

Our team is committed to perform the diagnostics efficiently and keep you informed about the results.

*treatments

We constantly try to perceive your needs and find the optimal treatment to give you the greatest chance of pregnancy. However, the exact clarification of the cause of the unfulfilled desire to have a child is the basis of the treatment. Since there can occasionally be a combination of causes, both partners must always be clarified. Sometimes a change in lifestyle (e.g. weight loss, abstaining from regular alcohol consumption and nicotine) is sufficient to achieve pregnancy naturally. In other cases, surgery is sufficient, such as in the case of stuck or fused fallopian tubes, endometriosis or polyps and fibroids in the uterine cavity. If ovulation does not occur, it can usually be induced by medication. Usually, insemination (injection of sperm into the uterine cavity) is performed at the time of ovulation. In the presence of serious or unexplained causes, in vitro fertilization (IVF) with and without microinjection (ICSI) may be necessary. Infertility treatments are always performed only with the written consent of the couple after explanation of possible side effects and complications and in strict compliance with legal guidelines.

**Women's Medicine

As the name suggests, our medical services are aimed at women of all ages. The need for medical advice and medical treatment changes throughout life. For very young women, the focus is on safe prevention of unwanted pregnancies and clarification of irregular or painful bleeding. At any time, women of reproductive age may experience menstrual cycle and bleeding disorders that can severely impact quality of life and must be taken seriously. Pre- and post-menopausal health care and maintenance play an important role. In addition, symptoms such as hot flashes and sleep disturbances can occur during menopause. We care for and treat women of all ages and try to help you in every way possible.

*contraception

Preventing unwanted pregnancies is an important area of women's medicine. Contraception should be efficient, safe, inexpensive, practical, and have few side effects and risks. Today, there is an abundance of different safe methods for all age groups. We will be happy to help you choose the best contraceptive method!

Contraception in risk situations There are many conditions for which a consultation with a specialist is advisable in order to avoid health risks when using contraception. Some examples are tendency to thrombosis, migraine, breast cancer, diabetes, high blood pressure, etc. There are many methods to avoid pregnancy efficiently without taking any health risk.

Cycle and bleeding disorders.

If menstruation is absent, too frequent or too infrequent (cycle disorders), very heavy or painful (bleeding disorders), investigations are indicated to rule out serious causes and to treat the symptoms properly and to your satisfaction. Bleeding that occurs after menopause should always be clarified.

*PCOS

Women with PCO syndrome (polycystic ovary syndrome) often have irregular cycles and tend to have increased hair and skin blemishes. Behind this is an excessive production of male sex hormones (androgens), which can be treated. Sometimes there is also obesity, as well as an increased risk of having or developing diabetes, elevated blood pressure and other so-called diseases of affluence. Women with PCO syndrome need good medical care and special attention to their health.

*Hirsutism and acne

Hirsutimus is the term used to describe excessive hair, similar to that of a man, due to excessive production of male sex hormones (androgens). Acne can also be caused or aggravated by increased production of androgens. This is disturbing and distressing for most sufferers and should therefore be treated.

*Overweight

The number of overweight people is steadily increasing worldwide, including in Switzerland. Obesity and lack of exercise can have serious health consequences and are important risk factors for the development of diabetes or cardiovascular disease. In young women, obesity can lead to unwanted childlessness, increased miscarriages and complications during pregnancy. Losing weight permanently is difficult and requires a profound change in lifestyle. Thanks to professional advice, friendly support and motivation from your doctors, we can help you reduce your weight.

*Youth Gynecology

Very young women sometimes shy away from visiting a gynecologist, although they have urgent questions or problems, fears and doubts. The efficient prevention of pregnancy is especially important for women who are still in training. In an uncomplicated and confidential conversation we will advise and help you.

*endometriosis

Endometriosis is a chronic inflammatory disease caused by the presence of endometrium outside the uterine cavity. Endometriosis may or may not be painful and symptoms usually occur during menstruation. Endometriosis can also be a possible cause of infertility. Usually a lot of time passes before endometriosis is recognized as such, which can be very frustrating for those affected. Endometriosis can be treated surgically and/or hormonally. Particularly in women who still wish to have children, the greatest caution and restraint is required when surgically removing endometriosis. In particular, repeated operations of the ovaries, can severely impair their function and lead to premature menopause. The course of endometriosis can usually be favorably influenced by hormonal treatment.

*menopause

The last menstrual period (menopause) occurs on average at about 51 years of age and most women do not regret this. However, the hormonal changes that occur before and after menopause can lead to a disturbing reduction in quality of life. There are several treatments that can alleviate the symptoms. Due to many and sometimes contradictory media reports, many women are confused and have questions, which we are happy to answer. We will try to find the best solution together with you.

*Prior menopause

When menopause occurs before the age of 40, it is called premature. Affected women are often overwhelmed by this diagnosis and have many concerns and questions. The cause of premature menopause can rarely be determined. Young women should receive hormone treatment for premature menopause to prevent osteoporosis (bone loss) and cardiovascular disease and to restore quality of life. We will be happy to advise you regarding your questions and wishes.

*Osteoporosis

Bone formation and structure in men and women are to a certain extent dependent on sex hormones. Underweight, lifestyle, osteoporosis in close relatives or premature menopause can promote the occurrence of osteoporosis (bone loss). In collaboration with specialists in bone diseases, we will be happy to advise you.

**Laboratory

Our laboratories comply with all regulations and are equipped with the highest quality equipment. Our staff is highly trained and motivated. In the andrology laboratory, among other things, ejaculate analyses are prepared and sperm are processed for treatments. IVF and ICSI treatments take place in our clean room laboratory. Here the oocytes are prepared for fertilization and injected. Embryos to be transferred to the uterine cavity are cultured in special incubators. Fertilized eggs that are not yet to be transferred are frozen using the vitrification method.

*Ejaculate analysis

The ejaculated semen (ejaculate) solidifies quickly after discharge and is therefore heated for half an hour at 37°C so that the ejaculate liquefies again and can be analyzed. On the one hand, the discharged volume, the pH value and the concentration of the sperm are measured. On the other hand, tests are made to check whether autoantibodies against the own sperm are present, whether the survival (vitality) of the sperm is limited and whether there is a bacterial infestation. For sperm preparation, one milliliter of liquefied ejaculate is placed in a tube and washed with culture medium to remove seminal plasma. By centrifugation (very rapid circling), the sperm collect in the lower part of the tube and must swim to the surface on their own. Only the sperm that manage to swim up are then collected and tested for various parameters such as concentration, speed and maturation ability (capacitation).

Testicular biopsy (TESE)

If no or very few sperm are detectable in the ejaculate, a testicular biopsy can be used to obtain sperm for artificial insemination. In this procedure, a small amount of tissue is removed from the testicles with a fine needle (TESE = testicular sperm extraction). These tiny pieces of tissue are searched for living sperm under a microscope in the laboratory. It is not always possible to actually find living sperm in the biopsies. In special cases, the testicular tissue can already be extracted under microscopic view (micro TESE).

*IVF Therapy

After the cumulus complexes (oocytes with the surrounding nutrient cells) have been aspirated from the follicles, they are placed in a drop of nutrient medium coated with oil. In IVF therapy, the prepared sperm are added to the untreated cumulus complexes and left there overnight to fertilize the eggs. This means that at this stage it is not known in what state of maturity the eggs are. However, fertilization can only take place if the eggs are in the right stage of maturation. The next day, the sperm are separated from the eggs. The oocytes are closely examined under a microscope. Successfully fertilized eggs remain in the so-called embryo culture until they can either be frozen or transferred to the uterine cavity.

*IVF Therapy

After the cumulus complexes (oocytes with surrounding nutrient cells) are aspirated from the follicles, they are placed in a drop of nutrient medium coated with oil. In IVF therapy, the prepared sperm are added to the untreated cumulus complexes and left there overnight to fertilize the eggs. This means that at this stage it is not known in what state of maturity the eggs are. However, fertilization can only take place if the eggs are in the right stage of maturation. The next day, the sperm are separated from the eggs. The oocytes are closely examined under a microscope. Successfully fertilized eggs remain in the so-called embryo culture until they can either be frozen or transferred to the uterine cavity.

*Cryopreservation

Cryopreservation means "to preserve by cold." Oocytes, sperm and fertilized eggs can be frozen by modern methods such as vitrification (vitrification) and thawed at a later date. This makes it possible, for example before chemotherapy, to freeze eggs and sperm cells in order to fulfill the desire for a child after recovery. If several fertilized eggs have been produced after fertility therapy, some of them can be frozen and used later for another pregnancy.

**Male Medicine

Male-specific health problems are often emotionally distressing and can have a variety of causes. These include disorders of fertility, sexual function or androgen balance (androgens= male sex hormones). The field of andrology is an interdisciplinary specialty with content from urology, endocrinology, general medicine, sexual medicine and reproductive medicine. Our andrologist has been treating men with andrological problems since 2004 and is also available to you for clarification and possible therapy.

*Male sex hormones

Androgens and especially testosterone are not only responsible for the development of sexual characteristics, the desire for sex (libido) and erectile function in both young and older men, but can also play an important role in psycho-emotional factors (performance, fatigue, depression, etc). Male sex hormones are important for physical functions such as muscle building, bone health, red blood cell building or fat distribution. A deficiency of sex hormones can therefore lead to corresponding disorders.

*Sexual function

Sexual dysfunctions such as erectile dysfunction, problems with premature or delayed ejaculation, problems with internet sexuality etc. are an enormous burden for many men and their partnerships. The causes of sexual dysfunction can be purely physical or purely emotional. Very often there is a combination of causes behind it. Trustworthy and specialized care often leads to a solution of the problems or to a better handling of one's own sexuality. A wide range of therapy options is available for this purpose.

*Unfulfilled desire to have children

The clarification of both partners is very important, since in about half of the couples with an unfulfilled desire to have children, relevant causes are also found on the male side. In addition to a confidential discussion with the doctor and a physical examination, a good male evaluation also includes optimally performed laboratory tests of ejaculation and certain blood values.

**Our doctors

• Dr. Rebecca Moffat

• Dr. Anna Raggi

• PD Dr. Gideon Sartorius

• Dr. Giuseppina De Napoli

• Dr. Oliver Sterthaus (Embryologist / Biologist)