Assisted reproduction gives couples, single women, and LGBTQ+ families a real chance to have their own child when natural conception doesn’t occur. Whether it’s a minor cycle irregularity or more serious fertility issues, reproductive medicine offers tailored procedures with steadily increasing success rates. This article clearly explains which methods are available, when they’re appropriate, what costs are involved, and which risks to be aware of.
Fertilization Methods: Quick Comparison
- ICI / IVI – At-Home Insemination
Sperm is deposited near the cervix using a syringe or small cup. Ideal for mild fertility issues or donor sperm. Lowest cost, maximum privacy. - IUI – Intrauterine Insemination
Washed sperm are placed directly into the uterus via catheter. Suitable for moderate male-factor infertility, cervical issues, or unexplained infertility. - IVF – In Vitro Fertilization
Multiple stimulated eggs are combined with sperm in the lab. Standard for tubal factor infertility or failed IUI cycles. - ICSI – Intracytoplasmic Sperm Injection
A single sperm is microinjected directly into the egg. Best option for severe male infertility or TESE-derived sperm.
A full IVF or ICSI cycle currently costs approximately €4,000–€8,000 in Germany. German statutory health insurance covers up to 50% of the first three cycles for married heterosexual couples under strict conditions.
When Should You Seek Medical Help?
According to the WHO, infertility is defined as not conceiving after 12 months of unprotected intercourse (six months if over age 35) and should be evaluated by a specialist. Common causes include:
- Hormonal disorders such as PCOS or thyroid dysfunction
- Blocked or missing fallopian tubes (tubal factor)
- Poor sperm quality
- Endometriosis or adenomyosis
- Age-related decline in ovarian reserve
- Unexplained (idiopathic) infertility
- Family building without a male partner
Success Rates by Age
The German IVF Registry (D·I·R) reports the following average rates per embryo transfer in 2023:
- Age 25: ~46% clinical pregnancy, 38% live birth
- Age 30: ~41% clinical pregnancy, 33% live birth
- Age 35: ~32% clinical pregnancy, 24% live birth
- Age 40: ~17% clinical pregnancy, 12% live birth
After age 42, chances decline further. Many clinics then recommend egg donation—illegal in Germany but legal abroad.
Typical Risks and Side Effects
A Europe-wide ESHRE report (2023) shows the shift toward single embryo transfer significantly reduces risks. Nevertheless, possible side effects include:
- Ovarian Hyperstimulation Syndrome (OHSS): abdominal pain, nausea, fluid retention
- Mood swings: hormonal fluctuations
- Multiple pregnancy: especially if two embryos are transferred
- Minor bleeding or infection after egg retrieval
Personalized stimulation protocols and single embryo transfer minimize these risks.
Other Factors Affecting Fertility
- Endometriosis, fibroids, adhesions
- Infections like chlamydia or gonorrhea
- Chronic stress, sleep deprivation, depression
- Smoking, alcohol use, extreme under- or overweight
- Idiopathic infertility despite normal tests
Assisted Reproduction for Lesbian Couples
Lesbian couples typically use donor sperm via IUI or IVF. The non-gestational partner must adopt the child afterwards. Insurance coverage for these treatments is generally not available.
Sperm Donation with RattleStork – A Flexible Alternative
RattleStork connects intended parents with verified donors. Couples and individuals can plan at-home inseminations themselves—quickly, safely, and affordably.
Conclusion
Modern reproductive medicine offers a path to parenthood for almost every situation. Knowing causes, budgeting costs realistically, and understanding risks allows you and your medical team to choose the optimal method—from high-tech lab procedures to private sperm donation.