IVF – In Vitro Fertilisation
IVF (in vitro fertilisation) refers to the classical procedure of fertilisation in a test tube. In certain cases of fertility dysfunction the steps to fertilisation are performed outside of the body in the laboratory, rather than taking place in the fallopian tubes or in utero. In the following we will explain each step of the treatment.
Female hormone therapy is aimed at achieving the maturation of several egg cells within a single treatment cycle. The hormone therapy is administered via daily injections, which our patients give themselves after we provide careful instructions as to how this is done. The therapy’s success is monitored by means of ultrasonic scanning. Depending on the number and size of the antral follices the hormone dose is adjusted to your personal needs. At this point a decision is also made as to when the egg cells should be extracted from the ovaries (follicle puncture, see below). During the first 10 to 14 days of the treatment, it will be necessary to perfom 2 to 3 ultrasonic scans.
The ultrasound-guided extraction of eggs (called follicle puncture) is performed vaginally, under a short anaesthesia. We require a fresh sperm sample from your partner on this occasion. After a short recovery period, the couple can leave the practise.
It is important that the couple has already decided how many embryos should be saved at this time. Of course we offer you a professional consultation in this matter. Our goal is to ensure a high pregnancy rate, while at the same time avoiding a multiple pregnancy.
To enable a successful embryo transfer 2 to 3 days later, the following steps are required in the laboratory:
The following day, approximately 16 to 18 hours after the egg cells and the sperm were incubated together, we evaluate whether the egg cells were successfully fertilised. In this process, the egg cells are gently removed from the “cumulus cells” (these are special granulosa cells surrounding and nourishing the oocytes). Whether fertilisation has been successful can be easily identified. Fertilisation has taken place if the oocytes have two so-called pronuclei. These are small grooves in the center of the egg cell that can be easily detected under the microscope. Pronuclei are only formed after a sperm cell has entered into the egg cell and both the sperm and the egg cell have begun to unpack their genetic material and have condensed in the centre of the egg cell. The male and female chromosomes have not begun to converge yet.
On the day of the fertilisation check the decision will be made as to which fertilized eggs are to be kept for the embryonic transfer, and also whether additional fertilised eggs should be saved for cryogenic conservation (see below).
The fertilised eggs which have been selected for the embryonic transfer are then further cultivated.
2 or 3 days later, the embryonic transfer takes place. With the help of a thin, flexible tube up to 3 embryos having reached the multi-cell stage are placed in the uterus. No anaesthesia is required for this procedure. This means that the couple can experience this special moment together.
Most couples find waiting to take a pregnancy test, which takes about 14 days, long and stressful. Nevertheless, aside from stimulating the production of corpus lutein hormones, all possible therapeutic measures have been completed and the nidation can no longer be influenced.
After blood sampling on the morning of the 14th day, you will know by noon whether your pregnancy has been successful.