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Risiken einer Kinderwunschbehandlung durch künstliche Befruchtung

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0-|-paragraph paragraph text“]Behandlung[/ffb_param][ffb_param route=“o gen repeated-lines 2-|-h1 h1 text“]Risiken einer Kinderwunschbehandlung durch künstliche Befruchtung[/ffb_param][/ffb_section-heading_4][/ffb_column_3][ffb_column_3 unique_id=“8ccv9q71″ 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data=“%7B%22o%22%3A%7B%22gen%22%3A%7B%22ffsys-disabled%22%3A%220%22%2C%22ffsys-info%22%3A%22%7B%7D%22%2C%22text-is-richtext%22%3A%220%22%2C%22tag%22%3A%22h2%22%2C%22align%22%3A%22text-center%22%2C%22align-sm%22%3A%22%22%2C%22align-md%22%3A%22%22%2C%22align-lg%22%3A%22%22%7D%2C%22clrs%22%3A%7B%22text-align%22%3A%22left%22%7D%7D%7D“][ffb_param route=“o gen text“]Risiken der Behandlung[/ffb_param][/ffb_heading_4][ffb_paragraph_4 unique_id=“8cd05t34″ data=“%7B%22o%22%3A%7B%22gen%22%3A%7B%22ffsys-disabled%22%3A%220%22%2C%22ffsys-info%22%3A%22%7B%7D%22%2C%22text-is-richtext%22%3A%220%22%2C%22align%22%3A%22text-left%22%2C%22align-sm%22%3A%22%22%2C%22align-md%22%3A%22%22%2C%22align-lg%22%3A%22%22%7D%7D%7D“][ffb_param route=“o gen text“]Eine Kinderwunschbehandlung durch eine künstliche Befruchtung ist ein langbewährtes und sicheres medizinisches Verfahren. Risiken durch die Kinderwunschhandlung werden durch individuelle Voraussetzungen mit beeinflusst.[/ffb_param][/ffb_paragraph_4][ffb_embeddedCode_4 unique_id=“8ckfnqeu“ data=“%7B%22o%22%3A%7B%22gen%22%3A%7B%22ffsys-disabled%22%3A%220%22%2C%22ffsys-info%22%3A%22%7B%7D%22%2C%22iframe%22%3A%22%3Ciframe src%3D%5C%22https%3A%2F%2Fplayer.vimeo.com%2Fvideo%2F691388364%3Fh%3Dae95fd770e%5C%22 %5Cnwidth%3D%5C%22640%5C%22 height%3D%5C%22360%5C%22 frameborder%3D%5C%220%5C%22 allow%3D%5C%22autoplay%3B fullscreen%3B %5Cnpicture-in-picture%5C%22 allowfullscreen%3E%3C%2Fiframe%3E %22%2C%22width%22%3A%2216%22%2C%22height%22%3A%229%22%7D%7D%7D“][/ffb_embeddedCode_4][ffb_heading_4 unique_id=“8cd09joi“ data=“%7B%22o%22%3A%7B%22gen%22%3A%7B%22ffsys-disabled%22%3A%220%22%2C%22ffsys-info%22%3A%22%7B%7D%22%2C%22text-is-richtext%22%3A%220%22%2C%22tag%22%3A%22h3%22%2C%22align%22%3A%22text-left%22%2C%22align-sm%22%3A%22%22%2C%22align-md%22%3A%22%22%2C%22align-lg%22%3A%22%22%7D%2C%22b-m%22%3A%7B%22pd-xs%22%3A%7B%22t%22%3A%2230px%22%7D%2C%22mg-xs%22%3A%7B%22b%22%3A%2230px%22%7D%7D%7D%7D“][ffb_param route=“o gen text“]Mehrlingsschwangerschaften[/ffb_param][/ffb_heading_4][ffb_paragraph_4 unique_id=“8cd0a8os“ data=“%7B%22o%22%3A%7B%22gen%22%3A%7B%22ffsys-disabled%22%3A%220%22%2C%22ffsys-info%22%3A%22%7B%7D%22%2C%22text-is-richtext%22%3A%220%22%2C%22align%22%3A%22text-left%22%2C%22align-sm%22%3A%22%22%2C%22align-md%22%3A%22%22%2C%22align-lg%22%3A%22%22%7D%7D%7D“][ffb_param route=“o gen text“]Die Übertragung von zwei Embryonen erhöht die Erfolgsaussicht im Vergleich zum Transfer von einem Embryo. Andererseits kommt es dadurch je nach Entwicklungsfähigkeit und Alter der Patientin zu Mehrlings-schwangerschaften. Bei Transfer von 2 Embryonen besteht ein Zwillingsrisiko von ca. 20-25%. Die Teilung eines Embryos nach dem Transfer ist zudem möglich. Dadurch können höhergradige Mehrlingsschwangerschaften z. B mit Drillingen eintreten. Oberstes Ziel einer IVF- oder ICSI-Behandlung sollte das Erreichen einer Einlingsschwangerschaft sein, denn Mehrlingsschwangerschaften sind als Risikoschwangerschaften anzusehen und mit Abstand die häufigste Ursache von Schwangerschaftskomplikationen wie Frühgeburten, Präeklampsien, Fehlbildungen und anderen ungünstigen Verläufen. Wir beraten Sie aufgrund der individuellen Gegebenheiten zur Anzahl der Embryonen für den Transfer.[/ffb_param][/ffb_paragraph_4][ffb_heading_4 unique_id=“8cd0b3ua“ data=“%7B%22o%22%3A%7B%22gen%22%3A%7B%22ffsys-disabled%22%3A%220%22%2C%22ffsys-info%22%3A%22%7B%7D%22%2C%22text-is-richtext%22%3A%220%22%2C%22tag%22%3A%22h3%22%2C%22align%22%3A%22text-left%22%2C%22align-sm%22%3A%22%22%2C%22align-md%22%3A%22%22%2C%22align-lg%22%3A%22%22%7D%2C%22b-m%22%3A%7B%22pd-xs%22%3A%7B%22t%22%3A%2230px%22%7D%7D%7D%7D“][ffb_param route=“o gen text“]Fehlbildungen bei den Kindern[/ffb_param][/ffb_heading_4][ffb_paragraph_4 unique_id=“8cd0bnu6″ data=“%7B%22o%22%3A%7B%22gen%22%3A%7B%22ffsys-disabled%22%3A%220%22%2C%22ffsys-info%22%3A%22%7B%7D%22%2C%22text-is-richtext%22%3A%221%22%2C%22align%22%3A%22text-left%22%2C%22align-sm%22%3A%22%22%2C%22align-md%22%3A%22%22%2C%22align-lg%22%3A%22%22%7D%7D%7D“][ffb_param route=“o gen text“]

Eine Einschränkung der Fruchtbarkeit mit einer Wartezeit von mehr als 12 Monaten bis zum Eintreten einer Schwangerschaft ist ein eigenständiger Risikofaktor für mögliche Schwangerschaftsprobleme wie eine verkürzte Schwangerschaftsdauer oder ein niedrigeres Geburtsgewicht der Kinder (Romundstad et al. 2008).

Auch beim Fehlbildungsrisiko im Rahmen von künstlichen Befruchtungen scheint ein Zusammenhang mit der „Subfertilität“ zu bestehen. Dabei gibt es keinen Unterschied zwischen der Häufigkeit von Fehlbildungen nach IVF oder ICSI. Bei Jungen, die nach einer ICSI-Behandlung geboren werden, werden jedoch häufiger urogenitale Fehlbildungen nachgewiesen (Bonduelle et al. 2004, Ludwig et al. 2009). Dies ist insofern nachvollziehbar, da Einschränkungen der Spermienqualität, die eine ICSI-Behandlung notwendig machen, bei den Vätern oft in einem ursächlichem Zusammenhang mit Fehlbildungen (z.B. Hodenhochstand) stehen. Gegenstand weiterer wissenschaftlicher Untersuchungen ist die mögliche epigenetische Prägung durch künstliche Befruchtungen.

[/ffb_param][/ffb_paragraph_4][ffb_heading_4 unique_id=“8cd0cj8r“ data=“%7B%22o%22%3A%7B%22gen%22%3A%7B%22ffsys-disabled%22%3A%220%22%2C%22ffsys-info%22%3A%22%7B%7D%22%2C%22text-is-richtext%22%3A%220%22%2C%22tag%22%3A%22h3%22%2C%22align%22%3A%22text-left%22%2C%22align-sm%22%3A%22%22%2C%22align-md%22%3A%22%22%2C%22align-lg%22%3A%22%22%7D%2C%22b-m%22%3A%7B%22pd-xs%22%3A%7B%22t%22%3A%2230px%22%7D%7D%7D%7D“][ffb_param route=“o gen text“]Punktionsrisiken[/ffb_param][/ffb_heading_4][ffb_paragraph_4 unique_id=“8cd0eg66″ data=“%7B%22o%22%3A%7B%22gen%22%3A%7B%22ffsys-disabled%22%3A%220%22%2C%22ffsys-info%22%3A%22%7B%7D%22%2C%22text-is-richtext%22%3A%221%22%2C%22align%22%3A%22text-left%22%2C%22align-sm%22%3A%22%22%2C%22align-md%22%3A%22%22%2C%22align-lg%22%3A%22%22%7D%7D%7D“][ffb_param route=“o gen text“]

Auch eine seit Langem etablierte Technik wie die ultraschallgesteuerte Follikelpunktion ist mit operativen Risiken verbunden. In seltenen Fällen kommt es zu Blutungen oder Verletzungen von Nachbarorganen der Gebärmutter. Nach Angaben des Deutschen IVF-Registers beträgt die Wahrscheinlichkeit für eine komplikationsbedingte Folgeoperation etwa 1 auf 5000 Punktionen.

[/ffb_param][/ffb_paragraph_4][ffb_heading_4 unique_id=“8ckb51qc“ data=“%7B%22o%22%3A%7B%22gen%22%3A%7B%22ffsys-disabled%22%3A%220%22%2C%22ffsys-info%22%3A%22%7B%7D%22%2C%22text-is-richtext%22%3A%220%22%2C%22tag%22%3A%22h3%22%2C%22align%22%3A%22text-left%22%2C%22align-sm%22%3A%22%22%2C%22align-md%22%3A%22%22%2C%22align-lg%22%3A%22%22%7D%2C%22b-m%22%3A%7B%22pd-xs%22%3A%7B%22t%22%3A%2230px%22%7D%7D%7D%7D“][ffb_param route=“o gen text“]Überstimulationssyndrom[/ffb_param][/ffb_heading_4][ffb_paragraph_4 unique_id=“8ckb5fgl“ data=“%7B%22o%22%3A%7B%22gen%22%3A%7B%22ffsys-disabled%22%3A%220%22%2C%22ffsys-info%22%3A%22%7B%7D%22%2C%22text-is-richtext%22%3A%221%22%2C%22align%22%3A%22text-left%22%2C%22align-sm%22%3A%22%22%2C%22align-md%22%3A%22%22%2C%22align-lg%22%3A%22%22%7D%7D%7D“][ffb_param route=“o gen text“]

Beim sog. ovariellen Überstimulationssyndrom, das mit geschätzten 0,5%-5% früher eine häufige Komplikation von künstlichen Befruchtungen war, kommt es zu einer Flüssigkeitsverschiebung aus kleinen Blutgefäßen in den Bauchraum oder den Lungenverschiebespalt. Das Blut verdickt sich und es kann ein erhöhtes Thromboserisiko resultieren. Die heute in Risikosituationen eingesetzten Stimulationsprotokolle und Auslösemedikamente reduzieren die Wahrscheinlichkeit für ein Überstimulationssyndrom auf ein Minimum, insbesondere wenn zunächst die befruchteten Eizellen eingefroren werden (sog. freeze-all-Zyklus) und ein Embryotransfer erst nach Rückbildung der Eierstöcke im Folgezyklus durchgeführt wird.

[/ffb_param][/ffb_paragraph_4][ffb_heading_4 unique_id=“8ckbpq4t“ data=“%7B%22o%22%3A%7B%22gen%22%3A%7B%22ffsys-disabled%22%3A%220%22%2C%22ffsys-info%22%3A%22%7B%7D%22%2C%22text-is-richtext%22%3A%220%22%2C%22tag%22%3A%22h3%22%2C%22align%22%3A%22text-left%22%2C%22align-sm%22%3A%22%22%2C%22align-md%22%3A%22%22%2C%22align-lg%22%3A%22%22%7D%2C%22b-m%22%3A%7B%22pd-xs%22%3A%7B%22t%22%3A%2230px%22%7D%7D%7D%7D“][ffb_param route=“o gen text“]Vorzeitige Wechseljahre[/ffb_param][/ffb_heading_4][ffb_paragraph_4 unique_id=“8ckbqft6″ data=“%7B%22o%22%3A%7B%22gen%22%3A%7B%22ffsys-disabled%22%3A%220%22%2C%22ffsys-info%22%3A%22%7B%7D%22%2C%22text-is-richtext%22%3A%221%22%2C%22align%22%3A%22text-left%22%2C%22align-sm%22%3A%22%22%2C%22align-md%22%3A%22%22%2C%22align-lg%22%3A%22%22%7D%7D%7D“][ffb_param route=“o gen text“]

Ein Zusammenhang zwischen der Durchführung von künstlichen Befruchtungen und einem vorzeitigen Eintreten in die Wechseljahre aufgrund einer stimulationsbedingten Erschöpfung der Eierstöcke ist nicht gegeben. Bei einer schwächeren Reaktion der Eierstöcke auf eine Stimulation (low response) ist allerdings ein frühzeitiges natürliches Eintreten in die Wechseljahre beobachtet worden.

[/ffb_param][/ffb_paragraph_4][ffb_heading_4 unique_id=“8cd0h226″ data=“%7B%22o%22%3A%7B%22gen%22%3A%7B%22ffsys-disabled%22%3A%220%22%2C%22ffsys-info%22%3A%22%7B%7D%22%2C%22text-is-richtext%22%3A%220%22%2C%22tag%22%3A%22h3%22%2C%22align%22%3A%22text-left%22%2C%22align-sm%22%3A%22%22%2C%22align-md%22%3A%22%22%2C%22align-lg%22%3A%22%22%7D%2C%22b-m%22%3A%7B%22pd-xs%22%3A%7B%22t%22%3A%2230px%22%7D%7D%7D%7D“][ffb_param route=“o gen text“]Hormonabhängige Krebserkrankungen[/ffb_param][/ffb_heading_4][ffb_paragraph_4 unique_id=“8cd0hrg5″ data=“%7B%22o%22%3A%7B%22gen%22%3A%7B%22ffsys-disabled%22%3A%220%22%2C%22ffsys-info%22%3A%22%7B%7D%22%2C%22text-is-richtext%22%3A%221%22%2C%22align%22%3A%22text-left%22%2C%22align-sm%22%3A%22%22%2C%22align-md%22%3A%22%22%2C%22align-lg%22%3A%22%22%7D%7D%7D“][ffb_param route=“o gen text“]

Kinderwunschbehandlungen werden in der Regel bei Paaren mit Fruchtbarkeitsproblemen angewendet. Dies erschwert die Beurteilung von Auswirkungen einer Kinderwunschbehandlung auf die Häufigkeit von Krebserkrankungen. Gerade für die gynäkologischen Tumore von Eierstock, Brust und Gebärmutterschleimhaut ist ein günstiger Effekt durch stattgefundene Geburten bekannt. Sie treten bei Frauen, die bereits geboren haben, seltener auf. Insgesamt konnte für keine dieser Tumorarten eine Risikoerhöhung durch ovarielle Stimulationsbehandlungen nachgewiesen werden. Insbesondere zeigten Metaanalysen (Kashyap et al. 2004 und Jensen et al. 2009) keine Auswirkung auf das Vorkommen von Eierstockkarzinomen.

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