Fields of service

Are you planning to become pregnant? We will be happy to advise you in advance on how to best prepare for a pregnancy and offer recommendations concerning nutrition and necessary immunisation.

If you have not been able to become pregnant or if you have had several miscarriages or premature births, we will lead you through diagnostics, helping to reveal causes. We will then counsel you on your individual options to enhance your chances of being able to expand your family. 

Special examinations or procedures may be useful for this, such as

• Cycle monitoring including transvaginal ultrasound and blood test
• Special blood tests for hormone changes
• Anaesthesia-free fallopian tube patency test (Hysterosalpingo Contrast-Sonography)

Your gynaecologist will be provided with a detailed report.
If necessary, referral to other specialists, e.g. Coagulation specialist ovarian stimulation treatment

Prenatal diagnostics

Most children are born healthy and without malformations or serious genetic diseases. Nevertheless, every pregnancy carries a small risk of physical and/or mental impairment in the child at a later stage. 

Our scientific expertise and high-end technical equipment allow us to perform our ultrasound scans to the highest standards. We will take time to listen to your concerns in your personal consultation and offer informative and sensitive counselling. For any questions that you have we will be on your side, supporting you as an individual, with unbiased advice both during the decision-making process and afterwards.

We offer the following full range of prenatal diagnostics:

First trimester screening:

What are the aims of first trimester screening?

1. To diagnose major fetal abnormalities:
Some serious fetal malformations can already be ruled out or recognized during the 1st trimester (approx. in between 12th and 14th week of pregnancy). This makes it possible to coordinate any further course of actions during pregnancy at an early stage. 

2. To calculate your individual risk for preeclampsia or intra uterine growth restriction:

Preeclampsia is a complication of pregnancy due to placental malfunctioning that can lead to serious complications for both mother and baby and might make it necessary to deliver the baby preterm. Intrauterine growth restriction might appear as a part of preeclampsia or as a separate condition. The risks for both preeclampsia and intra-uterine-growth restriction are calculated from maternal medical history and a combination of biomarkers, such as mean arterial pressure, blood flow in your uterine artery and the concentration of a certain placental protein in your blood (serum PAPP-A).
In a case of high risk, it is possible to reduce the risk up to half by the intake of low dose Aspirin (ASS). during pregnancy starting before 16 weeks of pregnancy.

3. To assess the chance of certain chromosomal disorders (e.g. Down's syndrome) 

Your individual chance for chromosomal abnormalities will be calculated from your age and pregnancy age, a combination of ultrasound markers (nuchal translucency, nasal bone and others) and checking the concentration of certain hormones that are produced by the placenta in maternal blood. (first trimester screening).

First trimester screening will be covered by most private health insurances.

First trimester screening will not be covered by your statutory health insurance although most statutory health insurance companies offer extra budgets for pregnancy. You can spend these on medical services of your choice, (e.g. first trimester screening). In this case you will pay the service in advance and then be reimbursed by your individual health insurance. Please contact your health insurance for this option. 

Non-Invasive Prenatal testing “NIPT”

What is the NIPT?
NIPT analyses cell free DNA of the fetal placenta in maternal blood and gives a strong indication of whether the baby is at high or low chance of having trisomy 21 (Down syndrome), trisomy 18 (Edwards syndrome) or trisomy 13 (Patau syndrome).

How to interpret NIPT-result?
If the NIPT shows that there is a high chance that the baby has trisomy 21 or 18 or 13 it does not mean that the baby definitely has one of these conditions. If you want to be certain whether or not the baby has one of these conditions you will need to have an invasive test (CVS or amniocenteses).
If the NIPT shows that there is a low chance (less than 1 in 10,000) that the baby has trisomy 21 or 18 or 13 it is very unlikely that the baby has one of these conditions.

What conditions does the NIPT not reveal?
The NIPT does not provide information on other rare chromosomal abnormalities. Signs for other rare chromosomal abnormalities can be found in first trimester screening and may then be confirmed by invasive procedure (CVS or amniocenteses)
The NIPT does not provide information on your risk for preeclampsia or fetal growth retardation. 
The NIPT does not provide information on physical defects, such as heart or brain abnormalities and spina bifida, or fetal growth.

If you want to rule out fetal anomalies and/or a risk for preeclampsia and fetal growth restriction it is therefore advisable that you should have ultrasound scans 11-13 weeks (first trimester screening and at 20-24 weeks (fetal anomaly scan) to examine the fetal anatomy.

Our priority will be to offer you detailed counselling on the informative value, limitations, advantages and disadvantages of the various methods so that you can make an informed decision about their implementation and what meets your needs.

Fetal abnormality scan (second trimester, 20-24 weeks of pregnancy)

During fetal anomaly scan we examine and assess the baby's organs, the amount of amniotic fluid and analyze the baby's growth and movement patterns. Special attention is paid to the brain, face, spine, heart, stomach, bowel, kidneys, and limbs. 
Our examination includes a fetal echocardiography (special examination of the baby's heart) and fetal neurosonography (special examination of the fetal brain and spine). In addition to conventional 2B-ultrasound diagnostics, doppler sonography and 3D and 4D techniques are used in this scan. If you wish, you will also be told the gender of your baby at this scan. 

At GynEast, a combination of specialist training and professional experience allow us to carry out differentiated exclusion of malformations and prenatal invasive procedures with our state-of-the-art ultrasound equipment.

The fetal anomaly scan is covered by most private insurances. The fetal anomaly scan is also paid by statutory health insurance if you have received a referral from your primary gynecologist with an indication for the abnormality scan.
If none of the above applies to you, the fetal anomaly scan will be performed by us as a self-pay service (IGEL).

Fetal echocardiography

The detection of congenital heart defects during pregnancy enables the optimum level of care for the newborn and greatly improves the chances of successful treatment. 
Fetal echocardiography is a very detailed scan of the fetal heart to enable the detection of possible congenital heart defects. Therefore, we use high-resolution ultrasound equipment and doppler technologies.
Fetal echocardiography is included in the fetal anomaly scan. The following structures are assessed:

• Position, size and structure of the heart and the great arteries as well as venous vessels
• heart function and blood flow across the heart valves and along the great arteries 
• the child's heart rhythm 

Doppler sonography

Doppler sonography describes a special ultrasound procedure for both the visualization of blood vessels (colour doppler) and the assessment of flow velocity in the blood vessels (pulsed/continuous-wave-doppler). This examination is mainly used to assess the supply to the fetus or to assess the blood flow within the fetal heart during fetal echocardiography. We also use Doppler sonography as part of the differentiated exclusion of malformations and during first trimester screening.

Invasive prenatal diagnostics

In very rare cases, genetic testing of fetal cells may be indicated. If this occurs, you will of course receive comprehensive and competent information about the possible outcomes and risks. We are offering the following invasive prenatal tests:

Chorion villus sampling (placental tissue sampling)

Beginning at 11 weeks of pregnancy, it is possible to obtain cells from the placenta. The placenta is punctured with a needle (usually through the abdominal wall) under constant ultrasound monitoring. 

Amniocentesis (amniotic fluid sampling)

An amniocentesis is possible from around 16 weeks of pregnancy. A very thin needle is inserted through the abdominal wall and around 15-20 ml of amniotic fluid is removed under constant ultrasound monitoring.

Studies have shown a significant improvement in cervical maturation as well as favourable effects on the coordination of contractions during labour from administering Prenatal acupuncture:
 
(Literature: https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-2000-8028
The Mannheim Scheme Prenatal Acupuncture: Effects on Cervical Maturation and Duration of Labour A. Römer, M. Weigel, W. Zieger, F. Melchert Geburtshilfe Frauenheilkd 2000; 60(10):513-518 DOI: 10.1055/s-2000-8028)

Other typical pregnancy complaints can also be positively influenced. 
We offer this procedure on request starting at 35 weeks of pregnancy. 

Acupuncture has a positive effect on many other gynecological and obstetric areas.

Talk to us about costs and appointments.
If you are interested, we will be happy to advise you whether this is a suitable measure in order to help improve your symptoms. 

We offer Acupuncture as a self-pay-service (IGEL). You may ask your individual health insurance for reimbursement. Some health insurances offer payment.

We are happy to offer comprehensive care as your medical companion throughout pregnancy. Thanks to our special expertise, we are also able to take care during your high-risk pregnancy to the full extent. If requested by your gynaecologist, we will also provide co-care for your pregnancy alongside your gynaecologist. 

When you have discovered that you are pregnant, please contact our practice as soon as possible. Your first appointment should ideally take place at around 7 weeks of pregnancy. In individual risk situations, it might be advisable to schedule an earlier appointment.

All your questions concerning pregnancy, birth and the postnatal period will be discussed and we will be able to help you select the appropriate maternity clinic or birthing center in the Rhine-Main region for your delivery.

Further information:

German mandatory guidelines for maternal care (Mutterschaftsrichtlinie) 
Information on drug safety during pregnancy and breastfeeding at Embryotox.de

The following services are not always covered by statutory health insurance, but may be useful for you as additional individual health services (IGEL)/self-pay-service:

• Detection of infections that could potentially jeopardise your pregnancy (CMV, toxoplasmosis,Parvovirus, B streptococcus)
• Extended screening for gestational diabetes (OGTT 75g)
• First trimester screening (ETS)
• Pre-eclampsia screening
• Fetal abnormality scan in 2nd trimester in low-risk-pregnancies

We will be happy to discuss the options during your appointment with us.

We will be happy to advise you individually on contraceptive issues. For questions in advance:

https://www.profamilia.de/themen/verhuetung

https://www.profamilia.de/fileadmin/publikationen/Fachpublikationen/Verhuetung/Factsheet_Wechselwirkungen-deutsch.pdf

https://www.profamilia.de/fuer-jugendliche/verhuetung/pille-vergessen

The first visits to the gynaecologist can be exciting and we appreciate that you might feel anxious. We take extra time for you in a teenage girls' consultation and you will only be examined when you are really ready. We will be happy to discuss any questions you may have about your body, growing up, intimate hygiene, periods, vaccinations, love, sex and pregnancy.

You may be assured that our practice observes the highest level of medical confidentiality.

Would you like someone to accompany you for your visit to the gynaecologist? You are welcome to bring your girlfriend, your boyfriend, a relative or whoever you like.

Please bring your vaccination record to every routine examination. This will enable us to assess your immunization status correctly and counsel you on your vaccinations or certain booster shots requirements.

Based on the guidelines of the German Standing Committee on Immunisation (STIKO), we will be happy to discuss with you which vaccinations you are missing or should be boosted.

- All immunizations needed before planning a pregnancy can be carried out at our clinic.

- All Immunizations in accordance to the STIKO can be carried out in our clinic/practice. This includes vaccinations against HPV/Cervical Cancer.

We carry out vaccinations against HPV in girls as well as boys starting at the age of 9. Before the age of 15 two vaccinations at a 6-month interval are sufficient. Starting at the age of 15 3 vaccinations are needed. Statutory Health insurances cover HPV-vaccinations up to your 18th birthday. After this the costs will not be covered by all health insurance companies. However, they are still advisable. You can discuss the assumption of costs with your health insurance company. Otherwise, the service can be carried out at your own expense. Talk to us about your options.

- We also carry out vaccinations against influenza, measles/mumps/rubella, tetanus/diphtheria and pertussis (whooping cough).

https://www.menopause-gesellschaft.de/

https://www.menopause-gesellschaft.de/wp-content/uploads/2018/01/Anwendungsempfehlung-Patientin_2012.pdf

The fallopian tubes connect the ovaries to the uterus. In the fallopian tubes sperm and egg cell meet and form the embryo, which later migrates to the uterus and implants there. Any blockages may stop the sperm from meeting the egg. 

If both fallopian tubes are blocked, natural conception is not possible. It can therefore be important to check the permeability of the fallopian tubes if you are unable to conceive.

HyCoSy stands for Hysterosalpingo Contrast Sonography and is a short and very routine procedure to check the fallopian tubes for any blockages or abnormalities. 

As an alternative to the surgical method, this is a simple ultrasound examination in which a few milliliters of a harmless cellulose foam is flushed into the uterus and fallopian tubes via the cervix. This foam is clearly visible on ultrasound.

The foam procedure can be performed in an environment that you are familiar with such as your gynaecologist's practice.