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In vitro fertilisation (IVF)
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IVF (in vitro fertilisation) is a method of assisted fertilisation. In this method, the egg is not fertilised with the sperm cell in the woman's body, but rather in the laboratory. About 100,000 sperm cells are added to each egg in a small dish. Fertilisation then takes place 'naturally' by only one sperm cell being released into the egg. The method is called "in vitro", which simply means "in a glass jar".
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When is in vitro fertilisation appropriate?
For example, IVF is an option
in case of blocked or missing fallopian tubes in the woman (tubal sterility)
when the man's sperm quality is reduced
endometriosis,
unexplained infertility
after a number of inseminations without pregnancy
What happens during in vitro fertilisation?
1. The woman receives hormone treatment
The chances of a successful IVF result are significantly increased if several eggs mature at the same time (usually with the help of hormone therapy). If this is no longer possible or desired (older age, limited egg reserve, hypersensitivity to hormones), IVF cycles can also be performed with one or a few eggs ('mild stimulation IVF').
2. The woman comes for egg retrieval
When the eggs are mature, the doctor extracts them, guided by ultrasound, through a fine needle inserted into the ovary. During this egg retrieval, fluid is sucked out of the follicles. The procedure usually takes 15-20 minutes. The woman may be given painkillers and a mild sedative before the procedure. The retrieved eggs are then prepared for fertilisation in the laboratory.
3. The man gives a sperm sample
The sperm from the sample is purified in the laboratory. This process separates the motile sperm from the non-motile sperm. If no sperm are found in the man's ejaculate, material from a testicular biopsy (TESA) can be used. If the partner does not have sperm that can be fertilised, donor sperm from a sperm bank is used.
4. After egg collection and semen testing
The day after egg collection, the fertilisation of the eggs is checked. The fertilised eggs develop into embryos, which are stored in an incubator for up to five days. After five days, the fertilised egg consists of 100-150 cells and is called a blastocyst.
5. Inserting the fertilised egg
When the blastocysts are ready, the doctor places the embryo in the uterus.
Blastocyst placement is painless and takes only a few minutes. The blastocyst can now attach to the lining of the uterus and develop further.
A pregnancy test is carried out two weeks after the procedure to check whether the woman has become pregnant.
What are the chances of a successful outcome of in vitro fertilisation?
The chances of achieving pregnancy using in vitro fertilisation depend mainly on the age of the woman. The pregnancy rate is around 40% per embryo transfer in women aged 30, while it is just under 30% in women aged 40.
If the fertilised eggs cannot be implanted, they can be frozen for use at a later date. This means that the woman avoids hormone treatment and egg retrieval for the next attempt.
Are there risks and side effects of in vitro fertilisation?
As with any medical procedure, there are risks associated with IVF. All complications are rare - but in individual cases can be very serious.
The most common side effects are bleeding and infection. The risk is small - only about 1 in 400. Another risk is that you can hit your other organs with the egg retrieval needle - this is rare. Overstimulation occurs in just under 2%. Overstimulation is caused by a strong reaction to hormone treatment and can result in abdominal pain, nausea and breathlessness. Symptoms usually disappear within 1-2 weeks, but in severe cases hospitalisation and blood-thinning treatment may be needed.
The main risk of IVF treatment is multiple births.
Being pregnant with more than one foetus can increase the risk of:
Premature birth, pre-eclampsia, foetal death, diabetes during pregnancy etc.
Therefore, as a general rule, we only retrieve one egg at a time to take care of you and your baby.
Your contact doctor will explain in detail the risks of the treatment and the course of treatment during the initial consultation.
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