In Vitro Fertilization

The most renowned European in vitro fertilization centers closely cooperate with the university clinics and scientific institutes. The direct access to the latest scientific investigations in reproductive medicine allows the European reproductive specialists to steadily increase the number of healthy IVF pregnancies and to sophisticate the existing techniques. Technologically advanced IVF laboratories, the latest reproductive tools as well as strict hygiene requirements contribute to higher pregnancy rate and attract an increasing number of patients from the USA, Canada, Great Britain and Saudi Arabia.

The “fertilization in a glass tube” is a comparatively old method, which has been around since the 1970s. About 200 000 US couples participated in the first wide-ranging IVF experiment in 1970-1973, but only the luckiest one succeeded to get an IVF child. The girl named Louise Brown was born 1974 with help of in vitro fertilization and is now a healthy mother of two children. The Australian fertilization specialist, who is responsible for this success, got a Nobel Prize for his contribution to reproductive medicine. The refinement of the fertilization technique took place in the 80s and 90s of the 20th century in Germany and other European countries to achieve the astonishing results at the beginning of the 21st century. The WHO reports that around two million of IVF children were born since 1980. Due to the technological breakthroughs this number is going to double in the next decade.

Usefull Information About In Vitro Fertilization

Nowadays the IVF (fertilization) method is advised in case of

  • sperm problems (30% of all infertility cases)
  • ovulation disorders (20%)
  • obstructed fallopian tubes (30%)
  • unexplained (idiopathic) infertility (10%).

The German specialists speak about indications for assisted reproductive techniques (fertilization) in those types of infertility, which cannot be managed with hormone medication, minimally invasive (laparoscopic/ endoscopic) therapies or surgical interventions.

The following tests are usually performed before IVF:

  • testing ovarian reserve (a key test for a female patient)
  • semen analysis in a man
  • estimated level of FSН and AMН as well as their correlation (this test is performed on the first days of the cycle)
  • fallopian tubes screening
  • blood hormones test
IVF procedure

Before performing in-vitro fertilization, you get a face-to-face consultation with the fertility expert, who determines the indications for a certain reproductive method. In many cases phone or Skype consultation with a reproductive specialist is enough to decide, if you are an IVF candidate.

On coming to Germany for IVF tests and treatment you should plan your stay in advance. Many patients take a two-week vacation and combine tests, stimulation and embryo transfer with sightseeing and shopping, which helps to reduce stress and improve the inner balance. It would be reasonable to bring along your medical documentation, records and tests (in English or in German) in order to skip the unnecessary diagnosing steps and to accelerate the treatment process. Nevertheless in some cases it is really recommended to repeat the medical investigations in order to obtain more precise results.

In vitro fertilization (IVF), colloquially called "artificial insemination", comprises many different individual steps. In addition to hormonal stimulation, this also includes small surgical interventions.

With in vitro fertilization (IVF), fertilization does not take place in the woman's body, but "artificially" in the laboratory. The treatment often lasts for several weeks.

With IVF, hormone treatment for women is almost always necessary. The doctor then takes egg cells from the ovary and combines them with the partner's sperm cells in a laboratory glass. If fertilization is successful and the fertilized egg cells continue to develop, one to a maximum of three embryos are transferred to the uterus.

Hormone treatment

In-vitro fertilization or ICSI usually starts with downregulation. Hormone preparations (GnRH agonists or GnRH antagonists) suppress the woman's own hormone release and thus prevent uncontrolled ovulation.

Depending on the treatment regimen, targeted hormonal stimulation of the ovaries begins up to 14 days later. It is supposed to stimulate the ovaries to let several egg cells mature at the same time. This increases the chances of obtaining several fertilizable egg cells.

Different hormone preparations can be used individually or in different combinations for hormone stimulation. They are injected or taken as a tablet. In most cases, a preparation containing the hormone FSH (follicle-stimulating hormone) is injected prior to in vitro fertilization or ICSI. The woman can do this herself or leave it to the partner. Since the ovaries can be overstimulated in rare cases, treatment must be monitored by a doctor.

In some cases, hormonal stimulation of the ovaries is not required. In vitro fertilization then takes place in the woman's natural menstrual cycle (Natural Cycle IVF).

Natural cycle IVF is an artificial insemination that is carried out without prior hormonal stimulation of the female ovaries. For this purpose, an egg cell matured in the natural cycle of the woman is obtained by puncture and then fertilized in the laboratory with the sperm cells of the man. With this method, it is important to remove the mature egg at the exact time just before ovulation. A Natural Cycle IVF can only be used by women who have a reasonably regular cycle with ovulation.

Ovulation is started

Around a week after the start of hormone stimulation, the doctor checks the size and maturity of the developing egg cells several times. To do this, he or she carries out ultrasound examinations and determines the hormone levels in the blood. When the eggs have matured and appear to be capable of fertilization, the woman stops taking hormones. With an injection of the hormone HCG (human chorionic gonadotropin) or a GnRH agonist, ovulation is started - about nine to eleven days after the start of the stimulation.

Removal of the egg cell

About 36 hours after initiation of the injection, the doctor uses a fine needle to remove eggs from the matured egg vesicles (follicle puncture). The procedure is usually carried out via the vagina and followed by ultrasound on the screen. In rare cases, the eggs are obtained by abdominal mirroring. The woman receives sedatives or pain relievers and a short general anesthetic if necessary. After the puncture, slight bleeding and a feeling of sore may occur.

Fertilization in the laboratory

On the day of the egg retrieval, fresh or frozen (cryopreserved) sperm from the partner is required. The man masturbates in a special room of the reproductive medicine center. Some men have difficulties with “on order” ejaculation. You can discuss the problem with your doctor to find another solution. For example, the man can get his semen at home and bring it to the center in a special container, provided the way is not too far.

In the case of a severe male fertility disorder, a testicular biopsy and then frozen (cryopreserved) sperm can be thawed in time.

Before the semen and egg can be brought together, the semen is processed in the laboratory. The aim is to improve the fertilization capacity of the sperm cells and to prevent possible allergic reactions in women. Then you bring together egg cells and sperm cells in a nutrient liquid and put them in an incubator. This is where the egg cells are fertilized - for in vitro fertilization.

The fact that a sperm has penetrated the egg can be recognized under the microscope by the two “pre-nuclei” that contain the genetic material of the sperm and the egg. At this pre-nucleus stage, the eggs are selected that are later to be transferred to the uterus. The other eggs are either destroyed or frozen. This means that they can be used for a possible further treatment attempt without having to remove egg cells again.

The transfer of embryos to the uterus

When one or more egg cells have been successfully fertilized, they are placed in an incubator, where they continue to develop. Between the second to a maximum of six days after egg retrieval, the doctor then transfers one to a maximum of three of the embryos that have formed into the uterus. This is done using a thin, flexible tube (catheter) through the vagina. Most women find the procedure to be little or not painful.

"Hatching aid": Assisted hatching

In special cases, for example after three unsuccessful embryo transfers or when frozen (cryopreserved) egg cells are defrosted at the pre-nucleus stage, one could try to improve the conditions for the nesting of the transferred embryos. For this purpose, the outer shell of the embryo is scratched with a laser device (assisted hatching). However, a clear improvement in the chances of success using this method has not been demonstrated.

Checkups

About 14 days after the embryo or embryos have been transferred to the uterus, the pregnancy hormone HCG in the blood can be used to determine whether pregnancy has started. To make sure, the doctor will do several check-ups. About a month after the transfer, an ultrasound examination can then be used to determine whether the embryo is alive and whether it is a single or multiple.

The German reproductive medicine in the forefront of global reproductive technology!

Within the IVF protocol a woman’s egg is fertilized in a glass tube and then introduced into the uterus with the aim of pregnancy. The traditional IVF includes the following basic steps:

  1. The stimulation of multiple follicles (induction of superovulation)
  2. Follicle puncture and extracting the egg cells (oocytes)
  3. Fertilization in a glass tube
  4. Embryo selection and cultivation
  5. Genetic screening (to avoid genetic diseases in a future child)
  6. Transfer of the multicellular formation (embryo)
  7. Support of luteal phase after transfer

With the development of at least 3 follicles and endometrial thickness of 8.2 – 11.2 mm, the hormonal stimulation is carried out in order to trigger hCG level. Within 36-38 hours after the administration of hCG the transvaginal follicle puncture under intravenous sedation is done. The extracted eggs are further fertilized with the sperm of a partner at the IVF laboratory.

The embryo development is visualized with a special camcorder, placed into the incubators. After two days the most vital embryos are selected under microscopic control. They are cultivated up to the blastocyst stage, i.e. 4-5 days. The expert teams work closely together and treat each embryo individually as a small patient, as your future child.

Embryo transfer procedure is performed under the computer navigation control on the 5th or 6th day. The transfer of the embryo is almost painless. In some cases light sedation is needed in order to avoid stress and achieve the necessary relaxation. The remaining high-quality embryos after transfer can be frozen (vitrified), which means that you can avoid the hormonal stimulation, if you come up with the idea to have the next child at this clinic.

As an international patient you are especially privileged. You are consulted and examined by the chief physician and get individualized medical care.

Many couples worry about the consequences of fertility treatment for a future baby. Could IVF invoke deformities or mental diseases? According to the current state of scientific knowledge, the children born from IVF or ICSI are as healthy as those, conceived in a natural cycle.

A certain risk is associated with hormone stimulation of ovaries. The main reason for overstimulation occurrence is the introduction of excessive amount of medication. Due to high level of expertise, scientific advance and soft medication the risk of ovarian overstimulation is minimized at German fertility clinics.

German fertility centers promote holistic approaches and make use of the complementary and alternative methods of the Eastern medicine (methods of Ayurveda, herbal medicine, acupuncture, relaxation techniques etc.) to support the body and soul of a patient. The latest studies have shown that synergetic combination of different medical traditions contributes to higher IVF pregnancy rates and helps to give birth to healthier children.

The price is formed with the view to a variety of factors, such as the diagnosis, age, personal indications etc. The cost of a total IVF cycle incl. the medications is approximately € 6,200-7 000€ (medications and anesthesia/sedation amounts to 3,800 €). In some cases the public health insurance overtakes 50% of IVF expenditures for the first of three cycles. It refers to the EU citizens. To get an estimated cost for further IVF treatment, please call us or fill in the contact form on our website.

After the protocol you should plan at least two days stay at the hotel not far from the clinic, so that the specialist could monitor your condition. Try to relax, avoid any stress and think positive, since your mental condition may affect the health of your future child. It is a myth that no plane trips should be performed after the IVF. Nevertheless you shouldn’t carry heavy luggage and stay seated for a long time. The so called pregnancy marker (human chorionic gonadotropin) could be tested two weeks after the embryo transfer. The clinical pregnancy is determined with ultrasonography control on the 30-35th day after the IVF.

How much IVF cost?

According to the GMG survey, about 85% of all international couples, applying for IVF help at German, Austrian or Swiss fertility centers, fulfill their dream about a baby.

German Medical Group is motivated to make your medical trip to Germany as simple, successful and stress-free as possible. Our aim is to achieve the best possible outcome for every couple with infertility diagnosis. Being a health services provider with more than 10 years of experience, we will

  • answer every question you have
  • consult you in finding the best specialist and clinic in Europe
  • provide information on treatment costs (you always get estimate cost from the clinic)
  • assist you in getting a medical visa (if you need one)
  • arrange your stay at the hotel
  • meet you at the airport
  • accompany you to the clinic
  • take care of your leisure time
  • act as a helpful go-between, facilitating your efficient IVF treatment.

We want you to focus on treatment and not on organizational problems! For more information, please, call us and get a free expert consultation in English: + 49 (7221) 39-65-785.

On average 50% success after three attempts!

In the case of IVF treatment, the probability of pregnancy per cycle is around 25-30% on average.

In Austria, however, this success rate varies greatly from couple to couple and depends on individual circumstances, such as:

  • Age (especially the mother),
  • Semen quality, and
  • Number and nature of the embryos.

Furthermore, not all pregnancies lead to a child born alive. A quarter of the initial pregnancies end prematurely, either in a miscarriage (20%) or in a pregnancy outside the uterine cavity (ectopic pregnancy, in 5% of all pregnancies). Since there are new prospects of a successful pregnancy with each new cycle, half of the couples leave the clinic with one or more children on average after three attempts. In Austria, the data of all treatments reported to the IVF fund are published annually in the IVF fund report.

Request for further information about In Vitro Fertilization in Germany using our Whatsapp and Viber number.
+49 176 738 762 53
Our goal is to contact you within a business day to review your medical and financial information.
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