Unfulfilled desire to have children - Three-stage concept
Which therapy is finally recommended depends on the cause. Together with you, we will create a holistic treatment concept in the sense of a step-by-step plan, taking into account your individual wishes and needs.
Stage 1 - Observation of Ovulation
First of all, so-called "cycle monitoring" is carried out. One observes the natural cycle, whereby the time of ovulation is decisive for fertilization. The easiest and best method for this is ultrasound. By using the ultrasound method, the follicles are measured. If these have reached a size of 18-20 mm, ovulation can be induced with a disposable syringe (Ovitrelle). This should happen within the following 24 - 36 hours. During this period of time, sexual intercourse is necessary in order for the ruptured egg to be fertilized. We do not recommend ovulation strips to be used, since the result is often not clear to interpret and the method of ultrasound is more precise.
Stage 2- Follicular Stimulation
The chance of pregnancy is increased if the follicles are stimulated to mature by means of hormone injections (e.g. Gonal F). This treatment alone can be an advantage for women who ovulate regularly.
The stimulation starts on the 4th day of the cycle. It Is performed by self-injection of a dose that is determined for you, into the subcutaneous tissue on the abdomen. Stimulation may only be started in consultation with us, since regular ultrasound examinations are necessary to prevent multifollicular stimulation, which could lead to a multiple pregnancy.
Around on 11th day of the cycle, an ultrasound examination is performed. This examination aims to observe the maturation of the egg. The further procedures are determined based thereon. Either, the egg maturation is supported by further Gonal F injections, or you can determine when ovulation should be triggered.
Maturation speed differs greatly from cycle to cycle and from woman to woman, therefore it is not possible to predict the time of ovulation at the beginning of the cycle.
Ovulation is triggered by administering Ovitrelle. You can do this at home or in our clinic. After administering Ovitrelle, ovulation takes place within the next 24-36 hours. Depending on the therapy route, within this timeframe, either sexual intercourse must occur at home or insemination must be performed at our clinic.
Stage 3 - Intrauterine Insemination
This procedure is painless and aims to reduce the distance between the egg and the sperm. A combination of ovulation induction and insemination can almost double the chance of pregnancy per cycle.
It is important to understand in advance that you cannot predict at what point in the cycle an insemination will take place. Depending on the follicle and the dose of Gonal F, a different duration of stimulation is needed. For you, this means that you should not travel during the ultrasound period and you and your partner should have some flexibility for the dates.
We can inform you at least 2 days before the IUI when it will take place.
The collection of the semen can take place either at home or in our practice. Please note that the semen sample should reach us 30 minutes after collection. During transport, the cup should be kept in a warm place (under the arm) so that the quality of the sperm is not affected by the transport. We will provide you with a suitable container for transporting the sperm. It is important that we have the material in our practice about 1.5 hours before the insemination appointment. The liquid is processed in our laboratory and assessed under the microscope.
The insemination itself is painless and takes about 10 minutes. The processed sperm are injected directly into the uterus through a fine tube. After a short rest period in our practice, you can continue your daily routine, do sports and go to work.
After the insemination, we will give you a drug (Utrogestan). Since it makes you tired, you should insert it vaginally in the evening.
If your period has not arrived after taking Utrogestan for 14 days, please take a pregnancy test. If the test is negative, stop using the Utrogestan. If the test is positive, please make an appointment with us and continue taking the Utrogestan.
Stage 4 – In Vitro Fertilization (IVF) / Intracytoplasmic Sperm Injection (ICSI)
In some couples, artificial insemination (IVF/ ICSI) is indicated due to female, male or mutual causes (e.g. blockage of the fallopian tubes, reduced sperm quality, failure of ovulation induction / inseminations or other factors). We do not perform this in our practice, but we will be happy to advise you about the procedure, chances and risks of the treatment and refer you to the fertility center of your choice.
IVF is an artificial insemination in the test tube. For this purpose, the woman is administered hormones which lead to an overproduction of follicles in the ovaries. Mostly under a short anesthetic, the mature egg cells are collected using an ultrasound vaginal probe and each egg cell is fertilized. The ICSI method (intracytoplasmic sperm injection) in which one sperm is injected into each egg, is suitable when the semen quality is reduced . The fertilized eggs are then transferred to the woman after 3-5 days. This is completely painless and does not require anesthesia.
Nowadays, especially in young women, the so-called single embryo transfer is recommended. This means that only one embryo is implanted, which minimizes the likelihood of twins and thereby also reduces the risk of pregnancy complications.
Fertility treatment abroad
If you should decide to undergo fertility treatment abroad, we can advise you on this and carry out the necessary preliminary examinations and accompanying ultrasound and laboratory tests. These are not covered by the health insurance. We charge a flat rate of CHF 150 per ultrasound examination.