In-Vitro Fertilisation – also known as test tube fertilisation – has proven to be particularly effective in cases of slightly reduced sperm quality in men and impaired fallopian tube function in women.
During In-Vitro Fertilisation, female egg cells and male sperm cells are combined outside the body in the laboratory and fertilised. Intracytoplasmic Sperm Injection (ICSI) is an advanced method of IVF in which a selected sperm cell is injected directly into the retrieved egg under a microscope. Both fertility treatments consist of the following treatment steps:
1. Start of cycle monitoring
3rd to 5th day of your cycle At your first appointment, we examine your uterus and ovaries using a 3D ultrasound. In so doing, we count the small (“antral follicles”) that are maturing there. We will also take a blood sample to analyse your hormone levels. We pay particular attention to oestrogen and LH levels, which are important for egg cell maturation.
2. Ovulation monitoring
10th to 14th day of your cycle At the second appointment, we check egg maturation by examining your hormone levels again and performing another ultrasound scan to count and measure the maturing follicles. We assess whether your ovulation is about to take place and whether cervical mucus has accumulated. We also take smears (bacteriology and cytology).
3. Ovulation detection
21st to 24th day of your cycle We test your blood again at the third appointment to determine your luteal phase hormones (e.g. progesterone and oestrogen). Based on the progesterone value, we can determine whether ovulation has taken place. One of this hormone’s important roles is in the fertilization of an egg and its subsequent implantation into the uterine lining.
4. Stimulation of egg cell maturation
Between the 21st and 23rd day of the pre-cycle, we inhibit the body’s own hormone production using GnRH analogues – before the actual stimulation begins. This prevents premature ovulation and allows us to better control the stimulation cycle. You can easily inject yourself with the medication for this at home. Ten to 14 days later, you will be brought back in for an ultrasound and blood test. Once down-regulation has been achieved, the stimulation cycle is
5. Triggering of ovulation
Around the 10th day of your cycle, we will check the size and maturity of the follicles using ultrasound and take a blood sample to measure your hormone levels. If the follicles have grown well, you will self-inject the ovulation-triggering hormone hCG (Human Chorionic Gonadotropin) after consulting with us.
6. Egg retrieval
Approximately 36 hours after ovulation is triggered, you will be brought in to the clinic and egg retrieval will be carried out via the vagina before ovulation takes place. You will be given a short anaesthetic for this minor outpatient procedure. After the egg retrieval, patients usually feel comfortable and can leave the recovery room after one to two hours.
7. Release of the ejaculate
In subsequent IVF, the woman’s egg cells are combined with the man’s sperm cells in our reproductive biology laboratory – the aim being fertilisation of the egg cells. In the case of intracytoplasmic sperm injection, the reproductive biologist injects a selected sperm cell directly into one of the retrieved mature egg cells using a fine needle.
8. Fusion of egg cells and sperm
On the day of egg cell retrieval and the planned IVF or ICSI treatment, we also need the man’s freshly retrieved sperm (we use frozen germ material in selected cases). Before the egg and sperm are combined, we prepare the sperm in a special process which significantly improves the sperm’s viability.
9. Embryo implantation
The embryos are transferred into the uterus via the vagina using a thin, flexible catheter. This takes place two to five days after fertilisation. The embryo transfer takes no longer than 20 minutes, can be carried out without anaesthetic and is virtually painless for you. Your body then takes over again and the embryo or embryos – if successful – will implant naturally in the uterus
10. Success monitoring
We check the pregnancy hormone hCG in your blood and determine whether you are pregnant around 14 days after the embryo transfer. We can examine how the embryo is developing as early as the 6th to 7th week of pregnancy using 3D/4D ultrasound. This is done by means of very early pregnancy screening. We recommend further 3D/4D ultrasound exams in the 8th to 9th week of pregnancy. We will then hand you over to your gynaecological practice with a detailed report.