Desire to have Children
Natural fertility
In young and healthy couples who have unprotected sex once or twice a week, or once or twice during the fertile window, pregnancy should result in 20-251 TP3T per cycle and 80-901 TP3T after one year. If pregnancy has not occurred after one year, it is clinically referred to as infertility, and the vast majority of these cases have underlying organic causes. Since many causes of infertility are now very treatable, it is advisable to investigate possible causes at this point – ideally following a stepwise approach: first, simple examinations should be performed (such as semen analysis, hormone tests, cycle and ovulation monitoring), followed, if necessary, by further examinations, such as of the fallopian tubes (using contrast ultrasound or laparoscopy).
If you have an unfulfilled desire to have children and general questions about further diagnostics, you will certainly find numerous details here. in the following interview (about the fertility congress) Answered. In addition, you will find below a number of possible detailed topics that may be of interest to you:
All tests are okay – but you're not getting pregnant? │ Idiopathic infertility
How long should you continue trying? What are the chances that it will still work? Are there any sensible alternatives to artificial insemination? What can increase the chances of natural pregnancy?
By asking you a few questions about yourself, your partner, and any existing medical information, I can help you assess your chances of conceiving spontaneously within the next few months. I offer a highly personalized and independent consultation on all possible optimization options: What is the point of having sex during your "fertile days"? What exactly are the truly fertile days? And how reliably can they be determined? What is the benefit of vitamins, supplements, and special diets for couples trying to conceive?
If you would like to arrange a detailed, individual, and independent consultation/assessment with me on these topics, I am happy to assist you personally. (See menu items below.) „Appointments“ and „"Contact"“ You can find all the details on how to arrange a personal online appointment with me here.
Problems with fertility treatment (IVF / ICSI / PICSI / TESE)
Not enough eggs are retrieved (Diminished Ovarian Response DOR): In preparation for in-vitro fertilization (IVF), the goal is usually to mature the optimal number of egg follicles: on the one hand, as many as possible – thus increasing the chances of pregnancy – but on the other hand, not too many – because this increases side effects and the burden of the treatment. An optimal number of mature follicles is generally in the range of 7 to 14, as this usually results in high pregnancy rates with overall low side effects. If the number of maturing eggs is significantly reduced, this is referred to as a diminished ovarian response (DOR). The most common cause of a low egg count (DOR) is a reduced ovarian reserve, usually in connection with – possibly premature – reproductive aging (if interested, you can find more details in the section [section name missing in original text]). Hormones – Ovarian aging (See further information). Occasionally, other specific hormonal constellations (e.g., extended-cycle birth control pills, high-dose progestins, use of GnRH superagonists) can also explain a reduced ovarian response. In general, optimized stimulation methods (type of protocol, type and dosage of stimulation medications) or appropriate pretreatment (cyclic hormone therapy, possibly also specific vitamins and trace elements) can often help optimize the ovarian response and thus the number and perhaps also the quality of the eggs.
The egg cells cannot be fertilized, or only with great difficulty – fertilization failure: Follicle stimulation and egg retrieval went well – but the eggs were either not fertilized or only partially fertilized. What could be the reasons?
Under normal circumstances, approximately 4 out of 5 mature eggs should be fertilized during an ICSI/IVF cycle. If the fertilization rate is significantly lower, this is referred to as partial or complete fertilization failure, and in this situation, the chances of pregnancy are considerably reduced, possibly even nonexistent. To optimize this situation, it is crucial to identify and address the potential causes of fertilization failure: Can the stimulation treatment, medication dosage, or timing of ovulation induction be optimized? Can the partner be better prepared? Are there possible technical issues? Rarely, there may also be individual causes of fertilization failure in the woman or man that are potentially untreatable. These should also be identified so they can be considered in further treatment planning.
If you have experienced fertility failure once or even several times, a thorough and independent assessment of possible influencing factors and causes is often worthwhile. I offer to review your previous treatment cycles in detail, with the aim of accurately assessing and optimizing your chances for future attempts. Feel free to schedule a personal online appointment with me.
Recurrent Implantation Failure (RIF)
Multiple embryo transfers have been performed, yet no pregnancy has occurred. What are the possible causes? Are they embryonic, maternal, or paternal? What additional tests have been conducted? In this stressful situation, numerous and often complex additional tests or interventions are frequently recommended—sometimes with unclear benefits. You should consider seeking independent advice on this matter. I would be happy to offer you an independent consultation and assessment to evaluate your individual situation. Does it make sense in your case to explore additional diagnostic and/or therapeutic options?
First, please listen to the following podcast, which I recorded for the Federal Ministry for Family Affairs:
Podcast of the Federal Ministry for Family Affairs:
„"Frequent implantation failure"“Prof. Dr. Thaler
I am happy to offer you a detailed online consultation regarding your individual situation! You can find more information under the menu items. „Appointments“ and „"Contact"“ Here you will find all the details on how to arrange a personal online appointment with me.
Yes to children – but later: Egg freezing / Social freezing
Fertility protection for medical reasons - Fertility preservation
Given the potential for premature aging of the ovaries, as well as before treatment with fertility-damaging drugs or radiation therapy, it is fortunately possible today to protect fertility through fertility preservation. The treatment of cancer, as well as some chronic autoimmune and rheumatological diseases, can sometimes significantly impair the number and function of female and male germ cells (eggs and sperm). Consequently, after chemotherapy or radiation therapy, there is often a risk of significantly premature or even immediate menopause with varying degrees of infertility. With modern methods (hormone therapy/freezing of germ cells, and possibly also freezing of ovarian or testicular tissue), it is now possible to reduce or largely avoid the negative effects of chemotherapy and radiation therapy. Crucially, early consultation and planning are essential.
Through our university-based LMU fertility center, I have advised and cared for many patients before, during and after cancer treatment. I have summarized some important aspects in the attached lecture as part of the patient academy of the LMU University Hospital.
Furthermore, I offer you a personalized and comprehensive online consultation. Here, I can gladly share my extensive experience in fertility preservation to answer any questions you may have about the procedure, chances of success, and potential side effects of all fertility-preserving measures, individually and independently. (See the menu items below.) „Appointments“ and „"Contact"“ You can find all the details on how to arrange a personal online appointment with me here.
From a purely biological perspective, the best years for getting pregnant and having children are the early twenties. During this phase of life, eggs are at their healthiest, and the number of maturing follicles each month is highest. Additionally, the risk of miscarriage or chromosomal abnormalities (such as Down syndrome) is lowest during this period. However, in today's world, having children during this time is often quite difficult for a variety of reasons: vocational training, financial considerations, the lack of suitable housing, and, not infrequently, the absence of a suitable partner – to name just a few common issues. As a result, the "optimal" years for having children often pass by, and "later" can, in some cases, be "too late." Modern reproductive medicine now allows for the retrieval of "young" eggs and their freezing for later use (a process known as "social egg freezing"). These processes are now so optimized and safe that many of the advantages of early pregnancy can be utilized later in life. Of course, this raises many questions:
Given my years of experience with egg freezing – for medical reasons (e.g., fertility preservation) or for personal life planning ("social freezing") – I have the Brochure: „Children yes, but later“ I have written this document, which I am happy to offer you here as a free download. If you have any further questions, please feel free to ask. If you would like to discuss this with me in a personal and independent online consultation, I am of course happy to do so.