artificial insemination (IVF) - ICSI, PICSI

On this page you will find information about:

• In Vitro Fertilization (IVF)
• Course of treatments
• How does an IVF work in detail?
• Chances of success of an in vitro fertilization
• ICSI (Intracytoplasmic Sperm Injection)
• P-ICSI (Physiological ICSI)
• Differences among IVF / ICSI / P-ICSI
• Sensitive and prudent

In Vitro Fertilization (IVF)

In vitro fertilization has been used since 1978 in fertility treatment. It has been a tried and tested method for decades, and the best known method of helping a childless couple to have a baby.

It is suitable for various medical indications:

• For closed Fallopian tubes.
• In the absence of sperm cells or inadequate sperm quality.
• For various hormonal disorders.

In vitro fertilization involves removing the egg from the ovary and then placing it in the test tube, together with the man's sperm. Fertilization in the test tube takes place naturally, without medical intervention. If the fertilization works, we transfer the resulting embryo into the uterus two to five days later.

How does an IVF work in detail?

First meeting

If you wish for a baby and therefore contact us, we always start your treatment with a detailed initial consultation. This serves to get to know each other and to give you first information. We discuss your medical history and make a first clarification of your situation. With the first interview, we lay the informative and emotional foundation for further treatment and care. It should give you a first orientation.

Therefore, we focus on your questions and wishes during this appointment.

Detailed diagnostics

Every treatment requires careful examination. In doing so, we get an accurate picture of why your desire for a child has remained unfulfilled so far.

As a rule, we perform these medical examinations on women:

• Ultrasound
• Cycle monitoring
• Hormone examinations
• If necessary, we will refer you for hysteroscopy or laparoscopy.

In the case of men, these diagnostics are carried out:

• Semen analysis
• Ultrasound of the testicle
• Hormone examinations
• If necessary, a tissue sample is taken directly from the testicles.

If we discover that IVF treatment is the most promising method in your case, together we will determine the treatment plan and precisely coordinate all steps. We will inform you in detail about the treatment. It is also important for us to give you enough time to deal with the topic. Feel free to ask questions or express doubts at any time.
We are at your service and take your concerns seriously.

In vitro fertilization usually proceeds according to this scheme:

1. Hormone Treatment
   At the beginning of an IVF cycle, most women undergo hormone treatment. With special hormone preparations, we suppress the natural hormone secretion and thus prevent ovulation. About two weeks later we start ovarian stimulation.
   You will receive hormone injections over ten days, which you or your partner can give you. The drug contained in it stimulates the ovaries. Subsequently, several follicles mature at the same time. This increases the chance that we can win several fertilizable oocytes. We monitor the hormone treatment with you very carefully and are at your disposal, if you are uncertain or have questions.
2. Initiation of ovulation
   If the hormone stimulation has been running for a week already, we check the size and maturation of your eggs by means of an ultrasound examination. As soon as the diameter of the individual follicle is about 18 millimeters, we consider the egg to be mature and fertile. This is the right time to "trigger" ovulation.
3. Taking the egg
   About 36 hours later, we aspire the mature eggs from each follicle. This procedure is called follicle puncture. It is performed through the vagina and is painless in almost all cases. For the procedure you will receive a sleep aid that has an analgesic, anxiolytic and calming effect (sedoanalgesia). The procedure takes about 10 minutes and is also monitored by an anesthesiologist. Afterwards you will stay in our recovery rooms for a while, until the effect of the sleeping aid has completely subsided.
4. Fertilization in the laboratory
   We use fresh or frozen (cryopreserved) semen for the fertilization of the oocytes. The partner should obtain fresh sperm directly in the clinic. For this there is a private and comfortable room available. If your partner's sperm have been cryopreserved before, we will thaw them in time. In order to improve the fertilization ability of the sperm cells, we prepare the seminal fluid in the laboratory before combining sperm and oocytes in the Petri dish. Then, in our incubator, with a little luck, fertilization happens naturally. Eggs that have not been fertilized can be frozen, so they are available for another treatment attempt and we do not have to repeat hormonal stimulation.
   Embryos develop in the incubator for three to five days until they can be inserted into the uterus. We carry out the embryo transfer between 2-6 days after egg collection. Usually we put one or two embryos into the uterus. For women under the age of 38, who undergo their first or second treatment, the transfer of only 1 embryo is recommended, in order to avoid multiple pregnancies. The procedure is performed with a catheter, a thin tube, through the vagina. It takes only a few minutes and is usually painless. Surplus embryos can be frozen and used in a later treatment cycle. 
5. Pregnancy test
   Two weeks after the embryo transfer we will do a blood test for HCG, in order to determine if you are pregnant. Another 3 weeks later we check during an ultrasound if the embryo(s) are developing well. 

ICSI (Intracytoplasmic Sperm Injection)

ICSI is the most common fertility treatment. It especially helps couples, in which the fertility of the man is severely limited.

In these situations, ICSI is the method of choice:

• The spermatic ducts are missing.
• The spermatic ducts are occluded.
• The spermatic ducts are blocked, preventing sperm from entering the ejaculate (obstructive azoospermia).
• The formation of spermatozoa in the testicles is disturbed. As a result, the semen contains zero or only a few fertile sperm (non-obstructive azoospermia).
• Sperm antibodies are found in the ejaculate, which makes natural fertilization difficult.
• Fetilization is done with frozen sperm cells, e.g. after cancer treatment. Lesbian couples also use cryopreserved sperm from a sperm bank.

How does an ICSI work?

The course of an ICSI is the same as for in vitro fertilization. However, performing an ICSI, one single sperm cell is injected directly into one of the ooocytes with a needle. This increases the probability of fertilization. If the fertilization is successful, the resulting embryo is transferred to the woman's uterus between day 2 and 6 after taking the egg cells. The further procedure corresponds to that of a classic IVF treatment.

Chances of success of an ICSI?

The prospects of ICSI are similar to those of IVF. The pregnancy rate is 50% per cycle. The birth rate is 35% per treatment course.

P-ICSI (Physiological ICSI)

In a P-ICSI, sperm are selected for ICSI. Mature sperm are separated from immature ones by a hyaluronic acid pre-test. In mature sperm hyaluron is a fixed component of their shell, while immature sperm do not have it. Using this procedure we select mature sperm cells under the microscope for ICSI treatment..

Sensitive and prudent

Having to face IVF treatment is a challenge for most couples. It is a sensitive, very intimate topic.

We accompany and support you during every step of the way. We take your fears and concerns seriously and consider your wishes. If a pregnancy succeeds, then it is a success for all of us.

Visit one of our info evenings or make an appointment for a first meeting.
We are happy to assist you getting pregnant - thanks to the latest methods of artifical insemination.