ARTIFICIAL INSEMINATION (IVF) - ICSI, PICSI
You want nothing more than a baby? It does not work the natural way? With the methods of artificial insemination (assisted reproduction) we have already helped many couples. We use our wealth of experience and support you in your desire for children. In order to fulfill your wish for a child, we use all the necessary possibilities of modern medicine. With the methods of artificial insemination we help heterosexual as well as lesbian couples to a pregnancy. In all methods of assisted reproduction, fertilization does not take place in the woman's body, but is carried out in the laboratory of the fertility center.
Dr. Brunbauer, your IVF expert in Vienna
In vitro fertilization has been used since 1978 in fertility treatment. It has been a tried and tested method for decades, and the best known method of helping a childless couple to have a baby.
It is suitable for various medical indications:
- For closed Fallopian tubes.
- In the absence of sperm cells or inadequate sperm quality.
- For various hormonal disorders.
WHAT HAPPENS IN AN IVF?
In vitro fertilization involves removing the egg from the ovary and then placing it in the test tube, together with the man's sperm. Fertilization in the test tube takes place naturally, without medical intervention. If the fertilization works, we transfer the resulting embryo into the uterus two to five days later.
IVF is always the method of choice when there are fertility problems in the man or woman or when other medical treatments have not been successful. Often, IVF is the last option for unintentionally childless couples to conceive a child.
IVF is recommended if:
- You have PCO syndrome (polycystic ovary syndrome).
- You have endometriosis
- The fallopian tubes are blocked, too narrow or fused (e.g. caused by an inflammation)
- The male or female reproductive organs have malformations
- The man's reduced semen quality makes natural fertilization impossible
- Infertility of the man, e.g. due to previous illnesses such as mumps.
- Lesbian couples who wish to have children want to use sperm donation
Dr. Mathias Brunbauer
Medical director | SPC for gynecology and obstetrics | IVF-specialist
"The chances of getting pregnant through IVF treatment are 50% per cycle. We would be happy to open up this path fpr you as well."
IN VITRO FERTILIZATION USUALLY PROCEEDS ACCORDING TO THIS SCHEME:
An IVF treatment cycle takes place in successive steps and runs for several weeks. Each treatment is preceded by an initial consultation and comprehensive examinations of both partners. Only when we have recommended IVF treatment based on the results of your diagnosis and you decide to go ahead with it after careful consideration, do we start the procedure. It is also possible to receive support for IVF treatment through the IVF funds.
FIRST MEETING
If you wish for a baby and therefore contact us, we always start your treatment with a detailed initial consultation. This serves to get to know each other and to give you first information. We discuss your medical history and make a first clarification of your situation. With the first interview, we lay the informative and emotional foundation for further treatment and care. It should give you a first orientation.
Therefore, we focus on your questions and wishes during this appointment.
DETAILED DIAGNOSTICS
Every treatment requires careful examination. In doing so, we get an accurate picture of why your desire for a child has remained unfulfilled so far.
As a rule, we perform these medical examinations on women:
- Ultrasound
- Cycle monitoring
- Hormone examinations
- If necessary, we will refer you for hysteroscopy or laparoscopy.
In the case of men, these diagnostics are carried out:
- Semen analysis
- Ultrasound of the testicle
- Hormone examinations
- If necessary, a tissue sample is taken directly from the testicles.
If we discover that IVF treatment is the most promising method in your case, together we will determine the treatment plan and precisely coordinate all steps. We will inform you in detail about the treatment. It is also important for us to give you enough time to deal with the topic. Feel free to ask questions or express doubts at any time.
We are at your service and take your concerns seriously.
Hormone treatment
At the beginning of an IVF cycle, most women undergo hormone treatment. With special hormone preparations, we suppress the natural hormone secretion and thus prevent ovulation. About two weeks later we start ovarian stimulation.
You will receive hormone injections over ten days, which you or your partner can give you. The drug contained in it stimulates the ovaries. Subsequently, several follicles mature at the same time. This increases the chance that we can win several fertilizable oocytes. We monitor the hormone treatment with you very carefully and are at your disposal, if you are uncertain or have questions.
Initiation of ovulation
If the hormone stimulation has been running for a week already, we check the size and maturation of your eggs by means of an ultrasound examination. As soon as the diameter of the individual follicle is about 18 millimeters, we consider the egg to be mature and fertile. This is the right time to "trigger" ovulation.
Taking the egg
About 36 hours later, we aspire the mature eggs from each follicle. This procedure is called follicle puncture. It is performed through the vagina and is painless in almost all cases. For the procedure you will receive a sleep aid that has an analgesic, anxiolytic and calming effect (sedoanalgesia). The procedure takes about 10 minutes and is also monitored by an anesthesiologist. Afterwards you will stay in our recovery rooms for a while, until the effect of the sleeping aid has completely subsided.
PREPARATION OF THE SPERMS
Fertilization in the laborator
We use fresh or frozen (cryopreserved) semen for the fertilization of the oocytes. The partner should obtain fresh sperm directly in the clinic. For this there is a private and comfortable room available. If your partner's sperm have been cryopreserved before, we will thaw them in time. In order to improve the fertilization ability of the sperm cells, we prepare the seminal fluid in the laboratory before combining sperm and oocytes in the Petri dish. Then, in our incubator, with a little luck, fertilization happens naturally. Eggs that have not been fertilized can be frozen, so they are available for another treatment attempt and we do not have to repeat hormonal stimulation.
EMBRYO MATURATION
THE EMBRYO TRANSFER
Embryos develop in the incubator for three to five days until they can be inserted into the uterus. We carry out the embryo transfer between 2-6 days after egg collection. Usually we put one or two embryos into the uterus. For women under the age of 38, who undergo their first or second treatment, the transfer of only 1 embryo is recommended, in order to avoid multiple pregnancies. The procedure is performed with a catheter, a thin tube, through the vagina. It takes only a few minutes and is usually painless. Surplus embryos can be frozen and used in a later treatment cycle.
EVIDENCE OF PREGNANCY
Two weeks after the embryo transfer we will do a blood test for HCG, in order to determine if you are pregnant. Another 3 weeks later we check during an ultrasound if the embryo(s) are developing well.
There are two criteria to be considered in the success of artificial insemination or IVF:
The cumulative pregnancy rate (i.e.: the pregnancies achieved in fertility treatments after several, consecutive embryo transfers) is 65%.
The success of artificial insemination at our institute in Vienna depends not only on the treatment itself being free of complications. The probability of pregnancy is also influenced by the age of the couple wishing to have a child, the hormonal situation and lifestyle. Obesity, stress, nicotine and excessive alcohol consumption can reduce the chances of success.
ICSI (intracytoplasmic sperm injection)
ICSI is the most common fertility treatment. It especially helps couples, in which the fertility of the man is severely limited.
In these situations, ICSI is the method of choice:
- The spermatic ducts are missing.
- The spermatic ducts areoccluded.
- The spermatic ducts are blocked, preventing sperm from entering the ejaculate (obstructive azoospermia).
- The formation of spermatozoa in the testicles is disturbed. As a result, the semen contains zero or only a few fertile sperm (non-obstructive azoospermia).
- Sperm antibodies are found in the ejaculate, which makes natural fertilization difficult.
- Fetilization is done with frozen spermcells, e.g. after cancer treatment. Lesbian couples also use cryopreserved sperm from a sperm bank.
HOW DOES AN ICSI WORK?
The course of an ICSI is the same as for in vitro fertilization. However, performing an ICSI, one single sperm cell is injected directly into one of the ooocytes with a needle. This increases the probability of fertilization. If the fertilization is successful, the resulting embryo is transferred to the woman's uterus between day 2 and 6 after taking the egg cells. The further procedure corresponds to that of a classic IVF treatment.
CHANCES OF SUCCESS OF AN ICSI?
The prospects of ICSI are similar to those of IVF. The pregnancy rate is 50% per cycle. The birth rate is 35% per treatment course.
P-ICSI (physiological ICSI)
In a P-ICSI, sperm are selected for ICSI. Mature sperm are separated from immature ones by a hyaluronic acid pre-test. In mature sperm hyaluron is a fixed component of their shell, while immature sperm do not have it. Using this procedure we select mature sperm cells under the microscope for ICSI treatment..
THE DIFFERENCE BETWEEN IVF / ICSI / P-ICSI
IVF
Fertilization of the egg takes place in the test tube without medical intervention.
ICSI
A single sperm cell is injected directly into an egg cell with a needle.
P-ICSI
Before injecting a sperm cell into an egg, hyaluronic acid is used to select a mature sperm cell.
Sensitive and prudent
Having to face IVF treatment is a challenge for most couples. It is a sensitive, very intimate topic.
We accompany and support you during every step of the way. We take your fears and concerns seriously and consider your wishes. If a pregnancy succeeds, then it is a success for all of us.
Visit one of our info evenings or make an appointment for a first meeting.
We are happy to assist you getting pregnant - thanks to the latest methods of artifical insemination.
FREQUENTLY ASKED QUESTIONS
Just ask us.
We have compiled the most common questions for you. For further information, please visit our comprehensive FAQ section. If you have additional questions or need personalised advice, feel free to contact us by phone at +43 (0)1 402 53 41. Our team is always happy to assist you.
We offer you these types of artificial insemination:
- In Vitro Fertilization (IVF)
- Intracytoplasmic Sperm Injection (ICSI)
- P-ICSI (Physiological ICSI)
In vitro fertilization involves removing the egg from the ovary and then placing it in the test tube with the man's sperm. Fertilization in the test tube takes place naturally, without medical intervention. If the fertilization works, we put the resulting embryo into the uterus two to five days later.
In detail, an IVF usually runs according to this scheme:
- Hormone treatment
- Initiation of ovulation
- Taking the egg
- Fertilization in the laboratory
- Transfer of embryos to the uterus
- Success control
The chance of getting pregnant through IVF treatment is 50% per cycle. The birth rate is 35% per treatment course.
The success depends not only on the fact that the treatment itself is uncomplicated. The probability of pregnancy is also influenced by the age of the couple, the hormonal situation and the lifestyle. Obesity, stress, nicotine and excessive consumption of alcohol can reduce the chance of success.
ICSI (Intracytoplasmic Sperm Injection) is the most common fertility treatment. It helps especially couples, in which the fertility of the man is severely limited.
The course of an ICSI corresponds for the most part to that of in vitro fertilization. However, in an ICSI, a single spermatozoa is injected directly into one of the ova with a needle. This increases the probability of fertilization. If the fertilization is successful, the resulting embryo is transferred to the woman's uterus on the second to sixth day after taking the egg. The further procedure corresponds to that with an IVF treatment.
The prospects of ICSI are similar to those of IVF. The pregnancy rate is 50% per cycle. The birth rate is 35% per treatment course.
In a P-ICSI (Physiological ICSI) the spermatozoa are selected for the ICSI.
Mature sperm are separated from immature by a hyaluronic acid pre-test. In mature sperm hyaluron is a fixed component of their shell. Immature sperm do not have this component. Using this procedure we select a mature sperm cell under the microscope for ICSI treatment.
Apart from the selection of sperm used, a P-ICSI works the same way as an ICSI.
Fertility decreases with age. The biologically best age for the first child would be the period of 25 to 35 years. At this age, the body is the most resilient.
With age, the prospect of a successful fertility treatment decreases. Therefore, couples who want to start a family should not wait too long. The younger, the higher the chance of success.
If excess oocytes fall in the first treatment cycle, they can be cryopreserved.
In another attempt, the woman can thus be spared the hormonal stimulation.
In one treatment cycle, several eggs are usually fertilized, but the woman uses a maximum of two embryos. The surplus embryosare cryopreserved and thus available for another treatment cycle.
If you are unwanted childless, it is essential to clarify the causes. We carry out detailed examinations and recommend the appropriate treatment based on your diagnostic results. This may include IVF. In some cases, however, simpler therapies are sufficient to achieve pregnancy.
Health insurance companies in Austria do not cover the costs of fertility treatments. Therefore, the IVF Fund assists with financing. It covers 70% of the costs if you meet the necessary requirements.
The IVF Fund covers the pro rata costs of four attempts per couple. If you finance the treatment yourself, there is basically no limit to the number of cycles.
Ja. Voraussetzung ist, dass Sie in einer eingetragenen Partnerschaft leben oder durch einen Notariatsakt bestätigen, dass Sie sich über die rechtlichen Folgen dieser Art der medizinisch unterstützten Fortpflanzung im Klaren sind und sich damit einverstanden erklären.
Yes. The prerequisite is that you live in a registered partnership or confirm by notarial deed that you are aware of the legal consequences of this type of medically assisted reproduction and agree to it.
Usually the treatment lasts several weeks. IVF is coordinated with the woman's cycle and is planned and carried out in such a way that you have the greatest possible chance of pregnancy.