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Time schedule

Fertility treatment

In the run-up to fertility treatment, a series of preliminary examinations are necessary. These are carried out by your gynaecologist, urologist or us and serve to identify the cause of your unfulfilled desire for a child.

Only then can a treatment planned with care and optimal timing begin, which will take several phases and steps, so approach the treatment with a broad time frame and do not put yourself under pressure.

Time schedule in the run-up to fertility treatment

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Fertility treatment usually begins in the 2nd half of the menstrual cycle preceding the actual treatment cycle. Certain drugs, so-called GnRH analogues, greatly restrict or "downregulate" the body's own production of hormones necessary for ovarian maturation. In this way, it is possible to influence the following actual treatment cycle, making it possible to determine the optimal time for ovulation. An alternative to down-regulation is treatment with GnRH antagonists during the stimulation phase, usually from the 5th-6th stimulation day. This prevents premature ovulation.

Ovarian stimulation with special hormones (FSH) usually begins on the 2nd or 3rd day of the cycle. The aim of stimulation is to allow as many follicles as possible to grow in the ovaries. This produces several mature eggs, which increases the chances of success of the treatment. The stimulation phase usually lasts 10 - 14 days. During this time, a certain amount of hormone is injected under your skin every day. You should have this done by us. Later, you or your partner can inject yourself, which will save you the daily trip to the doctor. In order to be able to follow the maturation of the follicles and thus the eggs, several blood samples will be taken during the stimulation phase and ultrasound examinations of the ovaries will be carried out. The findings obtained from these tests can be used to determine the optimal state of maturity of the eggs.

If the blood and ultrasound values during the stimulation phase show that the time of optimal egg cell maturity has been reached, treatment with stimulation hormones is discontinued and ovulation is triggered by the administration of human chorionic gonadotropin (hCG). The hCG usually has to be injected under the skin in the evening and can therefore easily be administered by yourself or your partner.

About 36 hours after the ovulation-triggering hCG injection, insemination is performed or, in the case of IVF/ICSI treatment, the eggs are retrieved from the mature follicles of the ovaries. This is done using a special puncture needle which is inserted through the vagina under ultrasound guidance. You will be lightly anaesthetised to facilitate the procedure. You should therefore come to the puncture on an empty stomach. After the egg collection, we will keep you with us for observation for about two hours. After that, you can go home.

At about the same time as the follicle puncture, we will ask the partner to collect a sperm sample by masturbation. If this causes you problems, talk to us openly about it in advance of the treatment. We will also find a feasible way for you. Semen samples for inseminations can also be collected at home.

After preparation of the sperm sample, it can now be used for insemination or extracorporeal fertilisation of the retrieved eggs. By means of conventional IVF or ICSI, a union of egg and sperm cells is brought about. The following day, the eggs are examined for pronuclei, which indicate that fertilisation has taken place. A maximum of three of these fertilised eggs are then selected and stored in the incubator until the following day. Surplus fertilised eggs can be frozen and used for later transfers. If you do not wish this to happen, we will have to destroy them. After a further day, if the process is optimal, the fertilised eggs will have developed into embryos, which usually consist of 2 - 4 cells and can now be returned to the uterine cavity (embryo transfer).

Embryos created during IVF/ICSI treatment are transferred to the uterus on the second or third day after egg collection (embryo transfer). A thin flexible plastic catheter is used, which is inserted through the vagina into the uterine cavity, where the embryos are rinsed out. Embryo transfer is usually painless. After the transfer, you will stay in bed for 10-15 minutes and then you can go home.

The luteal or corpus luteum phase is the most uncomfortable phase of fertility treatment for you, because only after two weeks can it be assessed whether the treatment was successful, i.e. whether pregnancy has occurred or not. During these long two weeks of waiting you will normally receive supporting hormones such as progesterone and, if necessary, hCG . A control ultrasound examination of the ovaries is also routinely performed. If the pregnancy test is positive, an ultrasound scan will be performed in the next two weeks if the period is still not regular. If the pregnancy is intact, please contact your gynaecologist for further treatment.