Fertility Europe United in Europe – helping the storks to fly

Treatment of Subfertility

Martin ImhofFertility Europe, ESHRE, Stockholm July 4, 2011

Regular Fertility

• conception = 25-30% per female month

healthy couples conceive

• 50% after 3 month • 75% after 6 month• 90% after 12 month

• medium 4 month to conceive

Definition of Subfertility

• reduction of male and female fertility

• no pregnancy after a period of 12 months of sexual intercourse

• every 5th couple has problems in reproduction

• every 10th couple needs medical treatment

Subfertility

http://www.celebspin.com/2009/06/sarah-jessica-parker-debuts-baby-twins-100323

Age first Delivery

Age and Fertility

-- % abortion-- % fertility

Time delay

Wish to start family

Causal treatment

up to 7 years

Fertility Check

day 1 day 30

First Consultation

Blood check Semen analysis

8-10 days

SonographyHysteroscopy

Fallopian TubesInfection screening

SummaryNext steps

1-3 days

Female Treatment

• Track ovulation • Hormonale therapy• Therapy of infections • Ovarian stimulation• Laparoscopy • .....• Less than 3-5% need IVF

Swan et. al. – National Institute of environmental health sciences

•Review of 101 published studies•Data collected 52 years (1938-1996)

Average annual decrease of

U.S. minus 1.5%/year

Europa minus 3.1%/year

Semen Quality

Male Subfertility

Guidelines on food fortifcation with micronutrientsby Lindsay Allen et al. World Health Organization andFood and Agriculture Organization of the United Nations2006

Male factor subfertility: possible causes and the Impact of nutritional factorsWong WY et al., Fertil Steril 2000 73:435-442

Profertil Study with 120 men, Ø 35,9 a (23-58) Intake 2x1 Capsule daily for 3 Month

L-Carnitin 440 mgL-Arginine 250mgVitamin E 120 mgSelenium 60 μgGlutathione 80 mgFolic-acid 800 μgCoenzyme Q10 15 mgZinc 40 mg

Improvement of Male Fertility

Concentration in Mio/ml

53,19 mio

29,46 mio

20 mio

10 mio

50 mio

60 mio

40 mio30 mio

+ 80,54%

Prog. Motility Ejaculate in ml

3,61 ml

2,91 ml

1ml

0 ml

4 ml

5 ml

3 ml

2ml

+ 24,05%

19,27%

8,95%

5 %

0 %

20 %

15 %

10 %

+115,3%

Sperm QualityImproves with Micronutritients

natural conception

insemination

In vitro fertilisation (IVF)

Intracytoplasmatic sperm injection (ICSI)

Better Sperm - Less Intervention

Martial Fertility

First line• Age• Lost time

Second line • Medical condition

Fertility Treatment

Question of supporting not replacing nature

IVF treatments:treatment of majar medical

conditionsnot a reaction to lost time

Thank You for Your Attention

Reasons of Infertility

unknown

male

hormones

endometriosis

abortion

fallopian tubes

myoma

cervix

others

The Road to Conception