artificial insemination (IVF) - ISCI, PSCI

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 (Physiologische ICSI)
• Differences among IVF / ICSI / P-ICSI
• Sensitive and prudent

In Vitro Fertilization (IVF)

In Vitro Fertilization has been used since 1978 in the fertility treatment. It's been a tried and tested method for decades, and the best known method of helping a childless couple to have a child.

It is suitable for various medical indications:

• For closed fallopian tubes.
• In the absence of seed or inadequate seed quality.
• For various hormonal disorders.

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

Wann wird eine IVF durchgeführt? 

Eine IVF ist immer dann das Mittel der Wahl, wenn Fruchtbarkeitsstörungen bei Mann oder Frau vorliegen bzw., wenn andere medizinische Behandlungen keinen Erfolg gezeigt haben. Häufig ist die IVF für ungewollt kinderlose Paare die letzte Möglichkeit, ein Kind zu zeugen.

Eine IVF empfiehlt sich, wenn:

• Sie am PCO-Syndrom (Polycystisches Ovarsyndrom) leiden
• Sie Endometriose haben
• Die Eileiter verschlossen, zu eng oder verwachsen sind (z. B. durch eine Entzündung ausgelöst)
• Die Geschlechtsorgane des Mannes oder der Frau Fehlbildungen aufweisen 
• Die verringerte Samenqualität des Mannes eine natürliche Befruchtung unmöglich macht
• Unfruchtbarkeit des Mannes vorliegt, z. B. durch Vorerkrankungen wie Mumps
• Lesbische Paare mit Kinderwunsch eine Samenspende nutzen wollen

How does an IVF work in detail?

First meeting

If a pair of children with an unfulfilled desire to have a baby contact us, we always start the path of fertility treatment with a detailed initial consultation. This serves to get to know each other and you get 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, your questions and wishes play a central role in this appointment.

Detailed diagnostics

Every treatment requires careful investigation. 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 investigations on women:

• ultrasound
• cycle observations
• Hormone examinations
• If necessary, we do a uterine or abdominal reflection.

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

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

If we discover that IVF is the most promising method for you, we will work with you to determine the treatment plan and coordinate all steps exactly. 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 doubts at any time.
We are there for you and your concerns.

In vitro fertilization usually proceeds according to this scheme:

1. Hormone Treatment
   At the beginning of treatment, 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 vesicle is about 18 millimeters, we consider the egg to be mature and fertile. This is the right time to start ovulation.
3. Taking the egg
   About 36 hours after we have caused ovulation, we take you egg cells from the mature follicle. This procedure is called follicle puncture. It is performed through the vagina and painless in almost all cases. For this 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. Then we ask you to stay in our rest room 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 taken. In a discreet room with us in the Fertility Clinic, the man can provide (through masturbation) fresh sperm. Previously frozen semenwe thaw in the laboratory in good time. Before we put the sperm cells in the Petri dish to the egg cells, they are processed. So we can improve their fertilization ability. United in a nutrient solution, we then put eggs and sperm in an incubator. Now it is time to wait until the fertilization has happened. It is ours always that at least 80% of all oocytes taken are fertilized.
5. Transfer of embryos to the uterus
   The fertilized egg cells produce embryos that can develop in the incubator for three to five days. Then they can be inserted into the uterus. We carry out the transmission on the second to a maximum of six days after egg collection. Usually we put one to two embryos in the uterus. For women under the age of 38, it is recommended that only one embryo be transferred during the first two IVF treatments. Thus, the number of multiple pregnancies can be limited. This procedure is performed by the vagina and produces little or no pain. Afterwards, we will work with you to see if the embryo is successfully implanting and developing in the uterus. Our stated goal for all our patients is to achieve pregnancy in as few as one treatment cycle.
6. Track progress
   After two weeks we will do a blood test. Using the pregnancy hormone HCG we can determine if you are pregnant. Four weeks after the embryo transfer, we can detect by ultrasound whether the embryo lives. If several embryos have been used, there is the possibility of multiple births.

ICSI (Intracytoplasmic Sperm Injection)

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

In these situations, ICSI is the method of choice:

• The vas deferens are missing.
• The vas deferens is closed.
• The spermatic ducts are closed, preventing sperm from entering the semen (obstructive azoospermia).
• The formation of spermatozoa in the testicles is disturbed. As a result, the semen contains no or very few fertile sperm (non-obstructive azoospermia).
• Semen contains sperm antibodies. Natural fertilization is difficult.
• Only frozen sperm cells are available. This is the case for example after cancer. Lesbian couples also use cryopreserved sperm from a sperm bank.

How does an ICSI work?

The course of an ICSI corresponds for the most part to that of in vitro fertilization. However, in an ICSI, a single spermatozoa is injected directly into one of the ova with a needle. This increases the probability of fertilization. If the fertilization is successful, the resulting embryo is transferred to the woman's uterus on the second to sixth day after taking the egg. The further procedure corresponds to that with an 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 by a hyaluronic acid pre-test. In mature sperm hyaluron is a fixed component of their shell. Immature sperm do not have this component. Using this procedure we select a mature sperm cell under the microscope for ICSI treatment..

Sensitive and prudent

Artificial insemination is a challenge for most couples. It is a sensitive, very personal topic.

Therefore, we attach great importance not only to make the best possible physical treatment. We accompany and support you every step of the way. We take your fears and concerns seriously and consider your wishes. If a pregnancy succeeds, then it is a common success. A success that we are particularly pleased about.

Visit one of our info evenings or make an appointment for a first meeting.
We are happy to assist you with the methods of artificial insemination pregnant.