Prenatal Counseling: Information & Specialists

In most cases, a chronic illness is not an obstacle to pregnancy. In the past, women with, for example,

• diabetes,
• epilepsy, or
• multiple sclerosis

were advised against getting pregnant. Today, these conditions are no longer a reason to avoid pregnancy.

In fact, one in five pregnant women has a chronic condition. These women also have a lower risk of complications during pregnancy than pregnant women without a chronic condition.

However, for pregnant women with a chronic condition, both

• the likelihood that the child will be born by cesarean section,
• as well as the risk of preterm birth (10% versus 7.5%)

is slightly higher.

Nevertheless, there are conditions (such as certain cardiovascular diseases) in which pregnancy is not advisable. Therefore, women with serious or chronic conditions should seek comprehensive prenatal counseling before becoming pregnant.

Some medications can also be harmful to the unborn child. For this reason, medication regimens often need to be adjusted. Be sure to learn about potential risks to both mother and child!

These conditions are reasons for women planning to become pregnant to seek prenatal counseling:

• Thyroid disorders,
• epilepsy,
• rheumatic diseases, and
• severe organ dysfunction.

In addition, endometriosis is a widespread condition. In this condition, uterine lining tissue grows outside the uterus. Depending on its severity, endometriosis can affect a woman’s fertility. The treatment options available in this case can be discussed during a preconception counseling session.

Oncological diseases (cancer) can also cause lasting damage to fertility. This is caused not only by the tumor itself but also by chemotherapy and radiation therapy during treatment. This affects not only women but also men.

As a precaution, eggs and sperm can therefore be collected and stored (cryopreservation) before cancer treatment begins. If necessary, those affected can later use these for artificial insemination.

In addition, there are medications that protect the ovaries to a certain extent from the damage caused by cancer treatment. For this reason alone, young women and men who have been diagnosed with cancer should also seek pregnancy counseling.

The cases mentioned are examples of what are known as high-risk pregnancies. These require

• pre-pregnancy counseling and
• special care during pregnancy. 

This allows pregnant women to reduce the risk of complications during pregnancy. However, not every pregnant woman with a chronic illness has a high-risk pregnancy.

Each year, approximately 800,000 couples in Germany wait for the baby they desire, but their wish to have a child remains unfulfilled. Fertility clinics advise couples struggling to conceive on the options available for fertility treatment and reproductive medicine.

Before the actual reproductive therapy begins, specialized women’s clinics and fertility centers offer fertility counseling sessions. Here, experts answer initial questions and explain the upcoming preliminary examinations and treatment methods.

Diagnostics in Fertility Treatment

The foundation of fertility treatment is a thorough investigation into the causes of infertility. To this end, fertility specialists use what is known as infertility diagnostics. For women, this includes

• cycle monitoring (observation of menstrual cycle events and basal body temperature over several cycles),
• hormone testing, and
• a detailed examination of the fallopian tubes, ovaries, and uterus using ultrasound and laparoscopy.

Men are examined, among other things, for

• changes in the testicles,
• inflammation of the genital and pelvic organs, as well as
• general medical conditions

. During the physical examination, special attention is given to the

• testicles,
• epididymis,
• vas deferens,
• prostate, and
• the urinary tract

special attention. Ultrasound may also be used if necessary.

• The semen analysis provides information about sperm count and motility. Questions regarding
• drug, alcohol, and tobacco use,
• medication use,
• exposure to environmental toxins, and
• sexual activity

are part of infertility diagnosis.

Causes of Unintended Infertility

One of the most common reasons for the inability to conceive is stress, with all its effects on the body. Hormonal or organic disorders also play a role. These include, for example,

• PCOS (polycystic ovary syndrome) and blocked fallopian tubes in women, or
• impaired sperm production and blocked sperm ducts in men.

But also

• advanced age in both men and women,
• hyperthyroidism or hypothyroidism,
• celiac disease,
• epilepsy,
• rheumatic disease,
• endometriosis, and
• vitamin B12 deficiency

can all be causes of reduced fertility.

Depending on exactly which factors are preventing pregnancy,

• measures to stabilize the menstrual cycle,
• lifestyle adjustments, or
• targeted medical treatments

may help facilitate conception.

Possible Fertility Treatments

Among the most common fertility treatments are hormone therapies and methods of artificial insemination. These include, for example,

• insemination,
• in vitro fertilization,
• ICSI (intracytoplasmic sperm injection), and
• the methods developed from these—IMSI (intracytoplasmic morphologically selected sperm injection) and
• PICSI (physiological intracytoplasmic sperm injection).

As part of hormone therapy, eggs are brought to maturity and ovulation is induced with medication. This increases the likelihood of fertilization.

In artificial insemination methods, sperm and eggs are brought together in various ways. For example, through sperm transfer into the uterus or in a laboratory dish, or through direct injection of sperm into a previously retrieved egg. The fertilized eggs are then transferred back into the woman’s uterus.

Once the causes of infertility have been identified, various treatment options can be considered. Would you like to learn more about fertility treatment? Then read on here: Information on fertility treatment.