IVF

Fertilisation outside the body is recommend in the following cases:

• Loss of tubal function
• Decreased sperm function
• Endometriosis
• No discernable cause of infertility

In-Vitro-Fertilisation (IVF)

With this method, egg cells are taken from the woman after a period of stimulation by vaginal puncture and fertilised with sperm cells in the laboratory environment (extracorporeal fertilisation). IVF is carried out when the loss of tubal function cannot be corrected and in the case of endometriosis, PCO and certain forms of male infertility. 2 – 5 days after the aspiration of eggs, the embryos are transferred into the womb or intact fallopian tube (embryo transfer). A maximum of two embryos are transfered, but we often suggest to transfer only one embryo (single embryo transfer) if we can transfer at the blastocyst stage, the quality of the embryos is good, and there are surplus embryos to freeze. The pregnancy rateas in our institute have always been around 50% per transfer. There is a 5-15% risk of having a multiple pregnancy, depending on the number of implanted embryos. The stimulation therapy can lead to a significant enlargement of the ovaries, which may cause discomfort. However, Hyperstimulation Syndrome, which requires hospital treatment, is a rare complication.

Intracyctoplasmic Sperm Injection (ICSI)

ICSI is used to complement IVF treatment when there is reduced sperm quality or when fertilisation in previous attempts was unsuccessful. The only requirement is the presence of at least a few motile sperm in the ejaculate, testis or epididymides. A single sperm cell is inserted directly into the egg cell with a thin needle under the microscope. This method results in a more than 90% chance of succesfully fertilized mature eggs. The success rate (pregnancy rate per treatment cycle) is comparable with normal IVF.

ICSI with sperm from the epididymides (MESA) or testes (TESA)

In some cases no sperm can be found in the ejaculate. However, it is still possible to collect sperm from the testes. MESA is short for microsurgical epididymal sperm aspiration and means the surgical extraction of sperm directly from the epididymis. This method can be successfully combined with ICSI in the absence or occlusion of the seminal duct. TESA is short for testicular sperm extraction. With this method, a small piece of testicular tissue is removed. If sperm can be found in the tissue, they are then available for ICSI. In MESA and TESA procedures, reproductive physicians work closely together with urologists.