In vitro fertilisation (IVF) is the oldest and most common form of artificial insemination. In the IVF method, a woman’s extracted egg is combined with a man’s sperm in vitro, whereby the sperm enters the egg independently. After insemination, the fertilised eggs are placed into the woman’s uterus.
Overview of IVF
In vitro fertilisation offers an opportunity for conception in cases where the desire to have children has not been fulfilled, especially if there are serious causes of infertility or other treatment methods have failed. In contrast to natural insemination, the fusion of egg and sperm cells in IVF takes place outside the woman’s body – under strictly controlled conditions in the laboratory.
In contrast to intracytoplasmic sperm injection (ICSI), in which a single sperm is injected directly into the egg, IVF insemination takes place through the independent penetration of the sperm into the egg. IVF treatment is usually divided into several phases, starting with hormone stimulation, egg removal and then insemination in the laboratory.
Treatment goal
The main goal of IVF treatment is to enable pregnancy by overcoming the natural barriers to insemination. The targeted ovary stimulation, egg extraction. insemination in the laboratory,and embryo insertion into the uterus increases the chances of successful implantation and development of a child.
IVF vs. ICSI
The choice between in vitro fertilisation and intracytoplasmic sperm injection depends on the particular causes of infertility. IVF is usually used when there are no severe sperm quality impairments, or when other causes, such as misplaced fallopian tubes or unexplained infertility, need to be treated. ICSI, on the other hand, is primarily used for severe male fertility disorders, such as a very low sperm count, severely restricted motility or abnormal sperm shape.
Requirements for IVF treatment
In order to be able to carry out artificial insemination, the following conditions must be met:
- Basic data is available (woman’s hormonal examination, ultrasound, sperm analysis)
- Maximum age of the woman between 43 and 44 years, maximum age of the man between 63 and 65 years
- Negative HIV, hepatitis B/C and syphilis status of both partners
- Proven immunity to rubella and chickenpox
- Stable partnership (the couple does not have to be married)
The IVF treatment process
Phase 1: Hormone treatment
In order to obtain as many eggs as possible at the same time, the ovaries are stimulated with hormones. The specialist monitors the size and maturity of the ovary follicles with two to three ultrasound examinations. As soon as the eggs appear mature, i.e. ready for fertilisation, ovulation is triggered by an injection of another hormone.
Phase 2: Egg removal and insemination in the laboratory
The eggs capable of fertilisation are removed 36 hours later using a long, fine needle in a single intervention, optionally under short general anaesthesia. On the same day, the partner’s sperm is prepared in the laboratory, placed in contact with the eggs and further cultivated in an incubator.
Phase 3: Implanting embryos into the uterine cavity
If the insemination of one or more eggs has been successful and these have developed into embryos over the next few days, the doctor will use a thin catheter to transfer the two-day-old embryo to the woman’s uterus.
Phase 4: Determining the results and pregnancy test
Two weeks after egg collection, a blood test will show whether the woman has become pregnant. Around one month after embryo transfer, an ultrasound can be used to check whether the embryo is viable and whether it is a single or multiple pregnancy.
Phase 5: Cryopreservation
As part of the treatment, fertilised eggs, embryos or blastocysts may be frozen (cryopreserved) and used at a later date. This allows for a new transfer without additional hormone stimulation treatment, if necessary. Thanks to modern technology, the chances of success after thawing are comparable to a fresh transfer.
Preparation and precautions
Successful IVF treatment requires careful preparation and preventive medical care. This includes comprehensive diagnostics to clarify the cause of infertility and to optimise the physical and hormonal conditions. Medical examinations such as hormone analyses, ultrasound and sperm analysis are essential to selecting the appropriate treatment method for the individual.
In addition, couples are advised to maintain a healthy lifestyle. Quitting smoking, eating a balanced diet, reducing stress and normalising body weight can increase the chances of success.
Aftercare and recovery
IVF therapy aftercare aims to provide the best possible support both physically and emotionally. Immediately after embryo transfer, it is recommended to refrain from physical exertion; light everyday activities are generally unproblematic. If the treatment is unsuccessful, a follow-up consultation offers the opportunity to analyse the causes and plan future steps – be it a new attempt with frozen embryos or adjusting the treatment method. Psychological support can also be valuable at this stage in order to better cope with the emotional strain and provide support for the couple desiring children.
Potential complications of IVF
As with any medical treatment, complications may occur during IVF treatment. This includes:
- Ovarian hyperstimulation syndrome (OHSS): a rare but possible consequence of hormone stimulation that can lead to symptoms such as abdominal pain, nausea, weight gain or fluid retention.
- Multiple pregnancy: the transfer of more than one embryo increases the risk of a multiple pregnancy.
- Ectopic pregnancy: as with natural pregnancies, in rare cases the embryo can implant outside the uterus, e.g. in the fallopian tube.
- Infections: infections may occur very rarely after egg collection.
- Emotional stress: the psychological pressure and emotional fluctuations associated with the therapy and the uncertain outcome can be challenging.
Prospects of success
The chance of success depends most crucially on the age of the woman and her individual egg cell reserve. From the age of 35, the chances of success are halved by the age of 40.
During the treatment planning phase, various tests are carried out, with the results providing a relatively precise assessment. Your attending doctor will inform you in advance about the chances of successful pregnancy.
Legal basis
In Switzerland, artificial insemination is subject to the Reproductive Medicine Act (RMA), which lays down clear ethical and legal frameworks. Treatment is reserved for couples who are either married or in a stable relationship. A maximum of three embryos may be created and transferred per treatment cycle. Under certain conditions, preimplantation genetic diagnosis (PID) is also permitted, for example if there is a risk of serious hereditary diseases or to avoid chromosomal abnormalities. However, selecting embryos according to sex or external characteristics is prohibited by law in Switzerland. Embryos can be cryopreserved and stored for up to ten years for use in later cycles. Practices such as egg donation and surrogacy are also prohibited by law.