Time lapse

Time schedule in the run-up to fertility treatment

In the run-up to fertility treatment, a number of preliminary examinations are necessary which are carried out by your gynaecologist, urologist or us, and serve to determine the cause of your unfulfilled desire to have a child. Only then can a treatment planned with care and optimal time management begin, which runs through several phases and steps. So approach the treatment with a broad timeframe and do not put yourself under pressure.

Down regulation phase in fertility treatment

Usually, fertility treatment begins in the second half of the menstrual cycle preceding the actual treatment cycle. Certain drugs, so-called GnRH analogues, severely restrict or "down regulate" the body's own production of hormones necessary for ovarian maturation. In this way it is possible to influence the following treatment cycle, which makes it possible to determine the optimal time for ovulation. An alternative to down regulation is treatment with GnRH antagonists during the stimulation phase, usually from 5-6 days of stimulation. This prevents premature ovulation.

Stimulation of the ovaries with special hormones (FSH) usually begins on the second or third day of the cycle. The aim of stimulation is to allow as many follicles as possible to grow in the ovaries. This results in several mature eggs, which increases the chances of success of the treatment. The stimulation phase usually lasts 10 -14 days. During this time, a certain amount of hormone is injected under your skin every day. You should let us do this for you. Later, you or your partner can inject yourself, which saves you the daily trip to the doctor. In order to follow the maturation of the follicles and thus the oocytes, several blood samples are taken during the stimulation phase and ultrasound examinations of the ovaries are carried out. On the basis of the findings obtained in this way, the optimum state of maturity of the oocytes can be determined.

If the blood and ultrasound values during the stimulation phase show that the time of optimal egg cell maturity has been reached, treatment with stimulation hormones is discontinued and ovulation is triggered by the administration of human chorionic gonadotropin (hCG). The hCG must usually be injected under the skin in the evening and can therefore be administered easily by yourself or your partner.

Insemination is performed approximately 36 hours after the hCG injection that triggers ovulation or, in the case of IVF/ICSI treatment, the oocytes are removed from the mature follicles of the ovaries. This is done by means of a special puncture needle which is guided through the vagina under ultrasound control. To facilitate the procedure, you will be slightly anaesthetised. Therefore, you should appear sober for puncture. After egg collection, we will keep you with us for about two hours for observation. Then you can go home.

At about the same time as the follicle puncture, we will ask the partner to obtain a semen sample by masturbation. If this causes you problems, talk to us openly about it in advance of the treatment. We will also find a viable way for you. Semen samples for inseminations can also be collected at home.

After preparation of the semen sample, it can now be used for insemination or extracorporeal fertilisation of the collected eggs. Conventional IVF or ICSI is used to unite egg and sperm cells. On the following day, the oocytes are examined for pronuclei, which indicate that fertilisation has taken place. A maximum of three of these fertilised eggs are now selected and kept in the incubator until the next day. Surplus fertilised eggs can be frozen and used for later transfers. If you do not wish this, we must destroy them. After a further day, embryos have developed from the fertilised oocytes, which usually consist of 2 - 4 cells and can now be returned to the uterine cavity (embryo transfer).

The embryos created during IVF/ICSI treatment are transferred into the uterus on the second or third day after egg collection (embryo transfer). A thin, flexible plastic catheter is used, which is inserted through the vagina into the uterine cavity, where the embryos are then rinsed out. Embryo transfer is usually painless. After the transfer you stay 10 - 15 minutes and can then go home.

The luteal or corpus luteum phase is the most unpleasant phase of the fertility treatment for you, because only after two weeks can it be assessed whether the treatment was successful, i.e. whether a pregnancy has occurred or not. During these long two weeks of waiting you will normally receive supportive hormones such as progesterone and, if necessary, hCG. A control ultrasound examination of the ovaries is also carried out routinely. If the pregnancy test is positive, an ultrasound examination will be performed in the next two weeks if the menstrual period is still missing. If the pregnancy is intact, report again to your gynaecologist for further care.

Recommendations and assessments

in Mönchengladbach auf jameda

Very good doctor

We were in treatment from February 2018 to March 2019 with Dr. Döhmen and his team. We found ourselves in very good hands there. The whole team is super friendly. [...] If Dr. Döhmen wasn't there, his replacement Dr. Bender took over, this doctor is also great. So we can only recommend. Result: 35th SSW with twins.

Rating from 30.09.2019

Very good doctor and great practice team!

After several consultations in various fertility centres, we felt that we were in very good hands with Dr. Döhmen. At no time did you feel like you were one of many. This has always disturbed us in the other centres. We spent a total of 7 months with him in treatment and got to know Dr. Bender during this time - just as recommendable. Our wish came true - many thanks to the whole practice team. We will recommend you to others.

Rating from 03.09.2019

Very competent and sensitive doctor

We were treated by Dr. Döhmen for about a year. We felt very well taken care of during the whole time. The entire staff is always friendly and they are all super super sweet there! Unfortunately, the 3 ICSIs were not successful, but this definitely had nothing to do with the treatment method, but was due to my egg yield. It was a very emotional time and the whole team was very hard working and sensitive. Thanks for that!

Rating from 05.08.2019

Highly recommended

A good practice works best in a great team, where doctors and employees work hand in hand. We felt very well looked after and in good hands. Without your professional skills and your necessary empathy, our wish might have remained a wish. We would like to thank you and your entire team for supporting us in fulfilling our dream.

Rating from 10.06.2019

A very competent, nice and experienced doctor

We were super satisfied, both with Dr. Döhmen and with the entire practice team. Very nice staff, always answered our questions well and in detail. Dr. Döhmen is a very nice, experienced and trustful doctor. He knows what he's doing and is very friendly with patients.

Rating from 03.04.2019

Successful fertility treatment

We were treated by Dr. Döhmen from August 2017 to August 2018. He's very straightforward, matter-of-fact and doesn't revolve around anything. You know immediately where you are and what the possibilities are. We personally welcomed the honest and direct way all professional and medical information was understandable. Team also always very dear and endeavoured. [...] We are now in the 32nd SSW and thus in the final spurt and would go again and again to Dr. Döhmen in the practice.

Rating from 04.02.2019

Satisfied all round

On the recommendation of friends we turned to the practice and were treated by Dr. Döhmen. We had an ICSI and we had immediate success with the first attempt. Our healthy daughter was born in December 2018. We felt well taken care of during the treatment and were very satisfied all around.

Rating from 24.01.2019

I will always recommend the practice!

The appointment allocation is quick. Also the discussions, investigations and the further procedure are on the point. The care is very compassionate. My husband and I have always felt this way. The practice is very well organised. We felt very well taken care of there!

Valuation from 06.01.2019

Very friendly and professional service

Whether Dr. Döhmen or the employees, they were always very obliging and very nice. With all my fears and questions I have always felt very well taken care of.

Rating from 24.12.2018

Great time

We have been made aware of this practice by my gynaecologist. During the six months of treatment we felt comfortable and understood our problem. We never felt like we were alone. All doctors and assistants were very happy about our pregnancy. Thanks for a great time!

Rating from 11.10.2018

Successful fertility treatment

Very nice and competent team. Success with first treatment.

Rating from 19.07.2018

Very experienced nice doctor

Top treatment, good experience. After the first time, it was possible to have twins.

Rating from 02.07.2018

Very professional and empathic practice team and excellent physician

I am a doctor and have been recommended the practice by a colleague. It was our third ICSI attempt after unsuccessful attempts outside. The support by Dr. Döhmen was excellent from the very first day, very professional and all our questions were answered. The support by Dr. Döhmen in the treatment cycle but also by the entire team was great and very positive so that we were also very positive. The puncture and embryo transfer were very relaxed and professional. I was doing very well the whole time, all questions were answered. We actually got the wonderful news to be pregnant with twins and I am now in the 13th SSW. I can wholeheartedly recommend the Döhmen/Schalkalk practice and wish all couples who wish to have children every success.

Rating from 09.06.2018

Very competent and friendly

Very good practice throughout. Very experienced doctor. All staff very friendly. You're in good hands here.

Rating from 03.06.2018

Competent and friendly

Competent and friendly, knows what he's doing.

Rating from 26.05.2018

Sensitive and competent

All processes in practice are very well organised. The medical care is absolutely professional, all employees are highly competent and safe in what they do. The personal approach by both the doctors and the practice staff is characterised by goodwill and an emphatic basic attitude.

Rating from 22.02.2018

Competent and very friendly medical specialist

[...] Dr. Döhmen is a trustful doctor who takes care of questions and radiates calm and patience. It is very reassuring to know that you are in good hands, especially when a woman has a long, previously unfulfilled desire to have a child.

Rating from 12.12.2017

Very competent and friendly team

We were in treatment for almost a year. The second cryo seems to have worked. The team was at all times very busy and always nice and friendly. Competence cannot be questioned. The successes speak for themselves. I would recommend this clinic to everyone and would be happy to come back if I wish to have more children.

Rating from 27.10.2017

The best doctor ever

Successfully released from practice. Thanks to God, Dr. Döhmen and the great team, I have been a mother for a year now. After six years of unsuccessful desire to have children, this practice and this doctor were my very last hope. I can't say enough thank you, Dr. Döhmen, and see you next time.

Rating from 08.06.2017

Friendly and competent

A good treatment already takes place in the anteroom, where you are warmly welcomed and stay in the waiting room without long waiting times. Doctor is friendly and competent. I felt very well treated at all times.

Rating from 16.01.2017

Very nice and competent

Nowadays you rarely see doctors who are so friendly/human with you as Dr. Döhmen! Thanks a lot for that!

Rating from 11.01.2017
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