Blastocyst culture

Regardless of whether after IVF or IVF/ICSI, as well as in what is known as the “cryo cycle”, embryos can be cultivated for 2 to 3 days, or up to day 5. This is possible even in Germany, with its strict Embryonic Protection Act. It is performed with great success by a few centres. However, the problem in Germany is that the cells to be transferred have to be chosen on day 1 of the culture, i.e. generally 2 – 3 embryos per cycle (see the IVF Register www.deutsches-ivf-register.de). But not even every “top-quality embryo” reaches this stage as the conditions in an incubator are not as ideal as those in the uterus. It must be assumed that only 25 – 50 % of the “day 2 embryos” will become blastocysts.

The main advantage of the 5 day culture can only be used to the patient’s benefit if the selection can be made from all (i.e. more than 2 – 3) of the embryos. Therefore, with few exceptions, it makes little sense in Germany to perform the blastocyst culture, given that a potential pregnancy could even not occur at all as a result.

Given the requirements of the German Embryonic Protection Act, it is better for the pregnancy rate to perform the embryo transfer on day 2 or 3.

Monitoring / VZO (intercourse to the optimum)

Depending on the desire of the couple, the available findings and other basic conditions, it may be indicated to first follow the course of the natural cycle through more intensive examinations; in order to be able to inform you of the conception optimum (best time to achieve a pregnancy).

Hormone treatment

If the hormone examinations carried out have revealed a noteworthy hormone disorder, this can be treated specifically.

Anaesthesia

General anesthesia puts you in a sleep-like state, i.e. it switches off your consciousness and, above all, your sense of pain.

IUI

Insemination is one of the comparatively simple procedures and is performed in cases of rather mild limitations of male fertility or disorders in the cervical canal, e.g. disorders of mucus formation or condition after conization (conical section of the external cervix).

IVF

IVF (In Vitro Fertilization = test tube fertilization) is typically used when the woman has a bilateral tubal occlusion.

ICSI

If the semen quality is severely impaired or if sperm can only be obtained by means of testicular biopsy, ICSI will be necessary in addition.

Cryoconservation

It has been technically possible for many years to freeze cells of various kinds in order to subsequently thaw them out again after months to years without them having suffered any significant damage.

ADI

If no sperm at all is available, the use of sperm from a donor can also be considered. There may also be other reasons for why this appears to be indicated.

Blastocyst culture

Blastocyst culture involves cultivating the embryos up to day 5.