IVF – In vitro fertilization

Stimulation concludes with ovarian puncture and egg retrieval – usually on day 12 to 14 of the menstrual cycle. Eggs are retrieved under short-term general anesthesia through the vagina, using a special puncture needle under ultrasound guidance. This entire procedure usually takes up to 15 minutes.

After egg retrieval, the woman rests in bed for approximately 2 to 3 hours. On the same day, the partner provides a semen sample, which is then processed, and the sperm are used for fertilizing the retrieved mature eggs. Before leaving the clinic, we inform the couple about the quality and number of retrieved eggs, the parameters of the current spermiogram, and agree on the fertilization method and the use of supplementary laboratory methods to increase treatment success.

Egg Fertilization can proceed either by the standard “classical” IVF method or by the ICSI method, with sperm potentially being processed beforehand using one of the separation methods. In the classical IVF method, a sperm sample is added to the eggs, and the sperm then penetrate their outer layer on their own, similar to natural conception. This method is suitable if the partner has good sperm analysis results. In cases of impaired results, the intracytoplasmic sperm injection (ICSI) method is recommended. ICSI is one of the so-called micromanipulation methods, where a sperm is introduced directly into an egg using a thin needle under microscopic control with the aid of a special device. Its success rate ranges up to 80-85% compared to 50-70% when using the standard fertilization method.

The resulting embryos are placed in an incubator for culture, where their development is continuously monitored. On the first day after OPU, the embryologist checks the fertilization outcome, and subsequently, the embryos are monitored at regular intervals throughout the entire culture period. We inform patients about the fertilization results and agree on the date and time of embryo transfer. Standard embryo culture, covered by insurance, lasts 48 hours. However, the time required for an embryo to reach the blastocyst stage is 5 to 6 days. At this stage, it leaves its outer layer and is ready to implant in the uterine lining. The development of some embryos stops during this period due to various, mainly genetic, reasons. In natural conception, implantation would not occur in such a case. Therefore, for embryos that reach the blastocyst stage, there is a significantly higher probability of successful pregnancy. For this reason, we also offer the option of extended culture. This is also essential if the couple is interested in preimplantation genetic testing, as a sample can only be taken at the blastocyst stage. A special incubator with a built-in camera – the time-lapse system (EmbryoScope+) – can also help us in selecting a suitable embryo during cultivation.

Embryo transfer is performed on day 14 to 21 of the menstrual cycle. The preferred standard procedure is to transfer one, the most promising embryo, while the remaining embryos are frozen (vitrified) and used for subsequent transfers if needed later (cryoembryo transfer). We only freeze embryos that have the potential to develop after thawing, ideally at the blastocyst stage. Transferring multiple embryos does not significantly impact success rates but significantly increases the probability of multiple pregnancies.

The embryo transfer itself is performed using a thin catheter through the cervix directly into the uterine cavity under ultrasound guidance. This procedure takes less than 5 minutes and is painless. After the procedure, the patient rests in bed for some time and can then go home.

10 – 14 days after embryo transfer, a pregnancy test is performed by determining the level of the pregnancy hormone (hCG) in the blood. Earlier results might still be skewed by hormonal preparation. During this time, supportive treatment is administered to increase the probability of a successful pregnancy. In some cases, spotting may occur, but this does not mean the cycle was unsuccessful. The pregnancy test can still come back positive, and therefore it is important not to arbitrarily discontinue medication and, in case of any doubts, to contact your coordinator or our emergency line.

Waiting for the results of infertility treatment can be stressful for many. Therefore, it is advisable to fill this time with various physically undemanding activities. Bed rest or sick leave is not necessary if the IVF cycle proceeded without complications.