Frequently asked questions about consultations
When should we seek medical advice if we are trying to conceive?
As a general guideline: If you are under 35 and pregnancy has not occurred despite regular, unprotected intercourse after twelve months, a medical evaluation is recommended. From age 35, you should take this step after around six months, as fertility declines with age. For women over 40, an immediate evaluation—or a consultation right at the start of trying to conceive—may be advisable, because time is a decisive factor at this stage of life.
Regardless of age, an earlier appointment is worthwhile if your cycle is irregular or stops, you have severe period pain, endometriosis or PCOS is known, there are changes in the uterus or fallopian tubes, there are indications of reduced male fertility, or there have been repeated miscarriages. In principle, both partners should be examined.
How does the initial consultation with us work?
At the first appointment, we want to understand where you are medically and personally. Our fertility specialists take plenty of time to review your medical history, your cycle, your previous experiences and your questions, and to interpret any existing findings. This is followed by an ultrasound examination, and together we plan the next diagnostics—such as hormone tests, cycle monitoring, tubal diagnostics or a semen analysis.
We also explain openly what we recommend and why. This helps to narrow down possible causes quickly and define the next steps individually.
What do I need for the initial consultation, and do I have to decide on a treatment beforehand?
No decision is required in advance. Especially if you are still unsure, the consultation provides orientation: we clarify your questions and give you a well-founded medical assessment, on the basis of which you can plan your next steps at your own pace.
After you book your appointment, you will receive a detailed medical history questionnaire so that we can prepare in a targeted way. No prior diagnostics are required. You are welcome to send us any existing findings, lab results or documents from previous treatments in advance, or bring them with you to the appointment.
Can the initial consultation also take place by video?
Yes. In addition to in-person consultations at our private center in Munich, we offer video consultations. They are confidential and encrypted via a certified system and take about an hour. You will receive the necessary documents in advance by email, complete them online and send them back to us.
The video consultation covers all aspects of fertility counseling—for couples, single women, lesbian couples and patients who would like information about social freezing.
Which examinations are part of fertility diagnostics?
Commonly, this includes a hormone analysis—especially the AMH value to assess ovarian reserve—an ultrasound of the ovaries and uterus, cycle diagnostics to evaluate follicle development, and an assessment of tubal patency. For the partner, this includes a semen analysis, supplemented as needed by expanded semen diagnostics.
Depending on the situation, specialized tests may be added, such as analyses of the endometrium or immunological examinations after repeated miscarriages.
What could be the reason if pregnancy does not occur?
The reasons may lie with the woman, the man, or both—and not uncommonly, several factors interact. In women, the main issues include disorders of egg maturation or ovulation, endometriosis, changes in the fallopian tubes or uterus, age-related decline in egg quality, and hormonal conditions such as PCOS, thyroid dysfunction or elevated prolactin levels.
In men, it is primarily about sperm production and quality, as well as varicoceles, testicular conditions, genetic changes, infections, disorders of sperm transport or certain medications. In some couples, no clear cause is found initially despite thorough evaluation (idiopathic infertility)—which does not mean there is none.
Should my partner also be examined?
Yes. Male factors play an equally important role: in about half of affected couples, a male cause or contributing cause is found. Reduced fertility in men often goes unnoticed for a long time and can only be identified through a semen analysis.
That is why, ideally, both partners should be examined together from the outset. Many men also have their fertility checked even before or at the beginning of trying to conceive—the semen analysis is a straightforward test and provides an early initial assessment.
Do you also treat single women and lesbian couples?
Yes. In addition to heterosexual couples, we support many single women and female couples on their path to having a child—using donor sperm. We often start with insemination; depending on age and medical prerequisites, however, IVF or ICSI may be the more sensible approach from the outset.
In the initial consultation, we discuss the medical, legal and organizational steps—from selecting a sperm bank to planning the treatment.
Can I come to you for a second opinion?
Yes. Many patients and couples ask us to interpret existing findings, previous treatments or a proposed treatment plan—for example, if questions remain open, several treatments have already taken place, or an important decision is pending. We review your documents, assess the course to date, and discuss whether the current approach still makes sense or what alternatives are available.
It is helpful to provide as many lab findings, medical letters, stimulation plans and—after IVF/ICSI—embryology reports as possible, ideally before the appointment. Changing clinics is not mandatory: whether you continue your current path or proceed with treatment with us is a decision you can make at your own pace.
It is not working for a second child—should we have an evaluation?
If no further pregnancy occurs for at least twelve months after a pregnancy has already occurred (from age 35: six months), this is referred to as secondary infertility. Estimates suggest this affects about one in ten couples trying to conceive.
Since the first pregnancy, ovarian reserve, cycle pattern, hormone balance, the uterus or fallopian tubes may have changed; more rarely, adhesions after a cesarean section or a niche defect in the scar can make implantation more difficult. The partner’s sperm quality can also change unnoticed. Targeted diagnostics can therefore show whether treatment is necessary—often it is sufficient to treat the underlying cause.
When is further evaluation advisable after a miscarriage?
A miscarriage is a major burden. The good news is that after a single miscarriage, the chances of the next pregnancy are still very good; the most common cause of early miscarriages is random chromosomal changes in the embryo. Further diagnostics are primarily advisable after repeated miscarriages or if additional risk factors or pre-existing conditions are present.
Possible causes then include, for example, changes in the uterus, hormonal or metabolic conditions, clotting and autoimmune disorders such as antiphospholipid syndrome, more rarely genetic factors in the parents, or increased sperm DNA fragmentation. We clarify which examinations are necessary in a personal consultation.
Frequently asked questions about diagnostic procedures & treatments
Which treatment makes sense for unmet desire to have children?
We always decide this based on your findings. Not every woman or couple needs assisted reproduction: often it is sufficient to treat the underlying cause in a targeted way or to optimize the cycle. Depending on the findings, the following options are particularly considered:
- Cycle monitoring or timed intercourse (VZO, “intercourse at the optimum time”): Using ultrasound and hormone levels, we determine your fertile days as precisely as possible.
- Hormonal stimulation: It supports egg maturation and ovulation, for example in the case of hormonal abnormalities.
- Insemination (IUI): It is advisable if the fallopian tubes are open and semen quality is at most mildly reduced.
- IVF or ICSI: These may be considered in the case of blocked fallopian tubes, significantly reduced sperm quality, or if previous treatments were not successful.
We will discuss together with you which approach is best suited to you after the diagnostics.
What does the fertility test show, and can it predict whether I will become pregnant?
No single blood value and no examination can reliably predict whether or when you will become pregnant. However, the fertility test provides important information: how your ovarian reserve should be assessed in relation to your age, whether there are indications of an unusually low reserve or hormonal abnormalities (for example with PCOS or thyroid disorders), and whether further examinations make sense.
The AMH value shows the size of the egg supply, not the quality of the eggs—age is the decisive factor for that. A low value does not automatically rule out a natural pregnancy. Abnormal results are reviewed by one of our physicians before you receive your report; if there are significant deviations, we will contact you personally.
How does the fertility test work?
You have a choice: with the at-home test, you collect the blood sample with a small finger prick and send it in; alternatively, we take the blood at our center. In both cases, we analyze seven hormone values in our laboratory—AMH as well as FSH, LH, estradiol, prolactin, testosterone and TSH—and a fertility specialist evaluates them individually.
Because FSH, LH and estradiol depend on the cycle, the blood draw should take place between cycle day 1 and 5. The AMH baseline check alone is possible on any cycle day. Unlike ovulation tests from drugstores, which only measure the LH surge, the test provides an overview of ovarian reserve and hormone balance.
How should the man prepare for a semen analysis?
Please follow the guidance on the period of abstinence that you receive in advance—the WHO currently recommends two to seven days; depending on the question, a shorter abstinence period may also be advantageous. Alcohol, drugs, intense physical exertion and fever can temporarily worsen the values. Please let us know about any regular medications or recent illnesses.
If you live nearby, you can collect the sample at home by arrangement; it must then reach us within 40 minutes, transported close to the body. Because sperm quality fluctuates, a repeat test after a few weeks is often advisable if values are abnormal—and an abnormal semen analysis does not automatically rule out a natural pregnancy.
What is insemination and how does it work?
With insemination (IUI), motile sperm prepared in the laboratory are placed directly into the uterus at the optimal time using a thin catheter. It is suitable, for example, in cases of unexplained infertility, mildly reduced sperm quality, mild endometriosis, or when using donor sperm. At least one patent fallopian tube is required.
We determine the timing via cycle monitoring, if necessary with ovulation triggering—in a natural or mildly stimulated cycle. Preparing the sample takes about 1.5 to 2 hours; the procedure itself takes only a few minutes and is usually painless. A pregnancy test is possible about 14 days later. Depending on age, three to six cycles are common before considering IVF.
What is the difference between IVF and ICSI?
With IVF (in vitro fertilization), eggs and sperm are brought together in the laboratory and fertilization occurs on its own. With ICSI (intracytoplasmic sperm injection), a single sperm is injected directly into the egg. This is mainly considered when sperm quality is significantly reduced or when few eggs were fertilized in a previous IVF cycle.
Which method makes sense depends on the cause of infertility—one is not inherently more successful than the other. If there is no male factor fertility disorder, IVF and ICSI achieve comparable pregnancy and live birth rates in many cases. Even in women over 40, ICSI alone has no proven advantage solely due to age, because it cannot compensate for age-related changes in egg quality.
What are the risks of IVF?
The most important risk is ovarian hyperstimulation syndrome (OHSS). In this case, the ovaries react very strongly to the hormones and enlarge; fluid can also accumulate in the abdomen. Individually dosed medication, modern protocols and close monitoring significantly reduce the risk; if the risk is increased, embryos can be frozen and transferred later. Complications during retrieval, such as bleeding or infection, are rare.
The risk of multiples depends primarily on the number of embryos transferred—when a single embryo is transferred, it is very low and comparable to a natural pregnancy.
At what age does social freezing make sense, and how many eggs should be frozen?
Biologically, the rule is: the younger you are when freezing, the better the later chances, because the number and quality of eggs decline—usually noticeably from the mid-30s. The years between the late 20s and mid-30s are therefore a good time to address the topic. Social freezing is still possible at 40, but the chances of success are then significantly lower.
As a guide, depending on age and the desired number of children, around 20–30 mature eggs may be sensible. Even a high number of eggs does not guarantee a child, because not every egg survives thawing. In the consultation, we calculate your individual chances and a sensible target number.
How does social freezing work, and does it use up my ovarian reserve?
A cycle takes about two weeks: after around ten to twelve days of hormonal stimulation with ultrasound and blood checks, final maturation is triggered; about 36 hours later, egg retrieval follows under short anesthesia. The mature eggs are vitrified the same day and stored at around −196°C, where they do not continue to age biologically.
This does not use up ovarian reserve faster, and menopause does not start earlier: stimulation uses follicles that would mature in each cycle anyway and would otherwise be lost. Temporary symptoms such as a feeling of tightness, bloating or fatigue are possible; according to current knowledge, long-term health risks are not known.
Can sperm also be frozen?
Yes—for personal reasons, for example if having children is planned much later, before a vasectomy, or before treatment such as chemotherapy that can impair fertility. There is no general age limit.
After semen analysis and infection screening, the sample is prepared, mixed with a cryoprotectant medium and cryopreserved in liquid nitrogen. How many samples are sensible depends on sperm quality and your family planning—more sperm are usually needed for later insemination than for ICSI.
Where does donor sperm come from, and is sperm donation anonymous?
We work with licensed sperm banks in Germany and abroad, including in Germany and Denmark. Donors are comprehensively screened, for example for infections as well as genetic and chronic conditions. You choose the donor yourself based on verified profiles; a known donor may also be an option. If you later wish to have a sibling from the same donor, additional samples can be reserved depending on the sperm bank.
The donation is not anonymous: donor data are recorded in the sperm donor register so that the child can learn their genetic origin—up to the 16th birthday via the parents, and thereafter independently. The donor has no legal parental role and is not liable for child support.
Frequently asked questions from patients
Which online services are available for patients in treatment?
In our patient portal, you can conveniently complete important steps online:
- Report cycle day: submit the first day of your period so that we can plan the next treatment steps.
- Request a repeat prescription: send prescription requests for your ongoing treatment online.
- Book a monitoring appointment: for example, schedule ultrasound and blood draw appointments online.
- Calculate due date: determine your estimated due date and other important pregnancy dates.
Why is the first cycle day important for my treatment?
Planning your next treatment steps begins with the first day of your period—for example for insemination, IVF, ICSI, social freezing or a frozen cycle. So that we can coordinate your appointments in good time, please let us know briefly. You can do this easily online via our patient portal.
Cycle day 1 is the first day of true menstrual bleeding with fresh, red blood; light spotting beforehand does not count. If bleeding starts after 6 PM, the following day is considered cycle day 1.
How often do I need to come in for monitoring during hormonal stimulation?
Regular ultrasound checks are important to assess follicle maturation and number and to adjust medication; depending on the course, we also measure hormone levels. The intervals depend on how your ovaries respond—during cycle monitoring, it is usually two to three appointments per cycle, spaced two to three days apart.
If no follicle matures, we adjust the dose or medication. You can book your monitoring appointments online.
Can I work or exercise during treatment?
Yes, treatment can usually be combined well with work and everyday life. You only need to plan a little time for monitoring appointments. Exercise is also generally possible. If the ovaries become more enlarged due to stimulation or symptoms increase, we recommend temporarily reducing intensive activity.
You should take the day off for egg retrieval. After sedation or anesthesia, you must not drive yourself for at least 24 hours. We will be happy to discuss what makes sense in your situation individually.
Do I need to take it easy after insemination or embryo transfer?
No, bed rest is not necessary and does not improve the chances. After insemination, you can resume your normal routine, including work and exercise, after a short rest. After embryo transfer, normal activities such as walking are usually possible; whether and when light exercise is advisable depends on how you feel and how your ovaries respond, and is discussed individually.
When can I take a pregnancy test?
After IVF or ICSI with a fresh transfer, we measure the pregnancy hormone hCG in the blood, usually about 14 days after egg retrieval—i.e., depending on the transfer day, nine to eleven days after the transfer. We will tell you the exact date. After insemination, a urine or blood test is possible after about 14 days.
Please do not test too early at home: detectable hCG from the trigger injection can distort the result.
Which symptoms mean I should contact you immediately?
After egg retrieval, mild lower abdominal pain or a feeling of tightness is normal for a few days. Please contact us if pain is severe or increasing. If you have severe or increasing abdominal pain, persistent vomiting or shortness of breath, immediate medical evaluation is important, as this may indicate ovarian hyperstimulation syndrome (OHSS).
Bleeding in an existing pregnancy should also always be medically evaluated.
What happens to embryos that are not transferred?
Suitable fertilized eggs or embryos can be frozen with your consent and stored in our in-house cryobank. This allows another attempt as a frozen embryo transfer, without renewed stimulation and egg retrieval.
We will keep you informed about fertilization and the further development of your embryos during treatment.
How can I calculate my due date?
In the patient portal, you will find a due date calculator. It determines your estimated due date and other important dates during pregnancy—after natural conception (based on the first day of the last period or the day of ovulation and cycle length) as well as after insemination, IVF/ICSI or a frozen cycle (based on the date of egg retrieval, insemination or embryo transfer on day 3 or day 5).
I live abroad—how does treatment work?
Many steps take place before you travel: in a secure video consultation, you meet your treating physician and discuss your medical history and findings. Many preliminary examinations—such as hormone analyses, ultrasound or semen analysis—can be carried out in your home country. Before treatment begins, however, an in-person visit in Munich is required, during which we assess your findings and expand the diagnostics.
We then create your individual treatment and timeline plan. For steps such as egg retrieval or embryo transfer, you come to Munich; after you return home, we can continue to support you as needed, for example via video consultation.
How often and for how long do I need to travel to Munich?
This depends on your therapy and your treatment plan—for IVF, ICSI or social freezing, for example, the length of stay differs. We coordinate appointments as early as possible and, as far as medically feasible, bundle them so that your stay is easy to plan and efficient.
Our center is centrally located in Munich and is easily accessible from the main train station and the airport.
In which languages is consultation possible?
Our physicians speak German, English, Italian and French. This means you can discuss all questions about diagnostics and treatment directly and calmly with us in your preferred language.
Frequently asked questions about costs & financing
How much does a consultation appointment cost?
There are various consultation formats for getting started—in person at our center or by video. The following guideline amounts apply, each plus any VAT that may apply:
- In-person initial consultation on site (approx. 30 minutes): €120
- Video consultation (approx. 1 hour): €120
- Consultation on fertility, social freezing or sperm donation including ultrasound and basic hormone testing (approx. 1 hour): €470–€550
- Consultation for hormonal disorders including ultrasound and basic hormone testing (approx. 30 minutes): €120
- Second opinion with review of prior findings and an in-depth consultation: approx. €250–€320
Additional examinations as part of a second opinion, such as laboratory analyses, are billed separately based on effort.
What costs should I expect for examinations?
We bill our services in accordance with the German Medical Fee Schedule (GOÄ). The following amounts therefore serve as guidance, each plus any VAT that may apply:
- On-site fertility test (AMH and six additional hormones, evaluation within five days): €207
- At-home fertility test, including test kit, shipping, laboratory analysis and medical evaluation: €199
- AMH baseline check: approx. €87
- Hormone analysis: €220–€380
- Cycle monitoring with ultrasound and hormone measurement: approx. €150–€170 per appointment
- Tubal diagnostics (HyCoSy/HyFoSy): €295 plus approx. €90 for the contrast foam
- Semen analysis: €165
- DNA fragmentation test: €410 including semen analysis; approx. €265 if a current semen analysis is already available
- Endometrial biopsy: €200 plus the costs of external laboratories
You can conveniently pay for the fertility test online, for example by credit card. Before any further examinations take place, we will inform you transparently about the expected costs.
What costs are incurred for IVF or ICSI?
An IVF cycle costs around €3,200 to €3,600, and an ICSI around €6,200 to €6,900; the final ICSI costs depend, among other things, on the number of eggs retrieved. In addition, there are anesthesia, external laboratory tests and medications, which amount to around €400 to €1,500 depending on age and ovarian reserve.
Optional add-on procedures such as blastocyst culture, EmbryoGlue or the ZyMōt chamber may be useful; your physician will discuss these with you individually on request.
What costs arise when freezing eggs or sperm?
A social freezing cycle costs around €3,000 to €3,500, plus anesthesia, external laboratory and medications. Storage of the eggs costs €380 per year (storage with FERTILA GmbH).
When freezing sperm, the costs consist of diagnostics, cryopreservation and long-term storage. If multiple samples are advisable, you will receive an individual cost overview in advance.
Can I come to you if I have statutory health insurance, and will my insurer pay?
Yes, patients with statutory health insurance are very welcome and use our services as self-paying patients. However, as a purely private center, we cannot bill statutory health insurers, and they do not reimburse our services.
In general, statutory health insurance (GKV) contributes 50% toward fertility treatment under certain conditions. There is no cost sharing, among other things, if the couple is not married, the woman is over 40 or the man is over 50, from the 9th insemination cycle without stimulation, from the 4th IVF or ICSI cycle, after a sterilization that is not medically indicated, or if donor sperm is required.
Will my private health insurance cover the costs?
Each private health insurer has its own rules—depending on the plan, treatment without co-payment may even be possible. A prerequisite is usually an organic cause of infertility in the insured person and a probability of success of at least 15%. Fixed age limits or an upper limit on the number of cycles usually do not exist, and marriage is generally not required. According to data from the German IVF Registry, the chances for women up to and including 42 years of age are often still above 15%.
If the partner has statutory health insurance and is also infertile, private health insurance (PKV) will also cover their treatment costs if statutory insurance does not pay. We support you with the application process by providing a medical report, a cost plan and the necessary documents.
Are preventive and add-on services such as social freezing, fertility testing or PRP reimbursed?
In most cases, these are self-pay services. Social freezing for personal reasons is generally not covered; if there is a medical indication—for example before chemotherapy or radiotherapy, or in individual cases of endometriosis—coverage may be possible. A preventive fertility test without indication is generally not paid for by statutory health insurance. For PRP, endometrial diagnostics or HyCoSy, reimbursement by private health insurance depends on the plan and the medical indication.
It is best to clarify possible reimbursement with your insurer in advance—we will provide you with the required medical documents.
Does my employer contribute to the costs?
More and more companies offer employees so-called fertility benefits and cover part of the costs for fertility diagnostics, for treatments such as insemination or IVF, and for freezing eggs or sperm. It is best to ask your HR department whether your employer offers such a program.
Our center cooperates with Carrot Fertility, an internationally active provider of such employer benefits. If your employer is a Carrot partner, you can receive treatment with us as part of your Carrot program.
We will be happy to help you compile the required documents for reimbursement and discuss with you which services may be considered.
