Dr. Maximilian Schuff
A recently published study (see link) conducted by a Swiss working group on the increased risk of high blood pressure in children conceived by assisted reproductive technologies (ART) is currently making big waves, not least through nonstop media coverage. Additionally, this was fueled by some statements made by the senior author of this publication. He insists that IVF should be considered as a cardiovascular risk factor, similar to the risk from smoking (NZZ of 7 September 2018).
Thus, the study suggests a direct correlation between IVF treatments and specific health risks. This, of course, leads to much uncertainty among couples who either have already started treatment or who are still considering the use of assisted reproductive technologies. Against this background, it is even more important for us at the IVF Zentren Prof. Zech to provide a scientifically well-founded analysis of this study in order to enable our patients to make informed, fact-based decisions. To this end, we have published a response letter (more to follow) in the specialist magazine Journal of the American College of Cardiology where the study was published. In that respect, we would like to give a few words of explanation. Artikel lesen
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A new study has created a great deal of uncertainty among patients
Egg and sperm cell are of equal importance for the development of the embryo. A closer look at the sperm factor suggests that the assessment of sperm quality followed by the selection of appropriate spermatozoa for the fertilization of the oocyte are important steps on the path towards the much longed-for child.
During fertilization, signaling cascades are triggered inside the oocyte by the fertilizing sperm. During the fusion of the sperm and oocyte plasma, the release of a factor carried within the sperm head changes the calcium concentration in the oocyte cytoplasm. This again induces a series of subsequent reactions, finally enabling the fertilization of the oocyte.
It will therefore become all the more important to perform a comprehensive analysis of sperm morphology (shape, structure). An existing impairment (e.g. identification of vacuoles = crater-like structures in the sperm head) may have negative impacts. Already at the end of the 1990s, electron microscopic investigations revealed a correlation between the presence of vacuoles and the impairment of natural male fertility (Berkovitz et al., 1999). Artikel lesen
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Assessment and Significance in Fertility Treatments
If practitioners of reproductive medicine talk about the implantation rate, they mean the percentage of those embryos that implanted themselves into the uterine lining after having been transferred to the womb. Fetal heartbeat can be visualized via ultrasound in order to definitely confirm the implantation of the embryo.
If we assume, for example, that 100 couples undergo IVF treatment involving the transfer of two embryos, resulting in the successful implantation of 50 embryos, this would mean an implantation rate of 25%.
The implantation rate depends on the age of the woman and is directly related to the number and quality of the embryos transferred. What does this mean with regard to the prospects of becoming pregnant? Are the chances significantly higher following the transfer of two embryos? Artikel lesen
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Part 4 of the topic-series »Success Rate«
Among patients undergoing fertility treatment (IVF/ICSI/IMSI), the following question is repeatedly raised in the relevant forums:
“Could it be possible that my embryo may somehow ‘spill out’ of the uterus after embryo transfer?”
In this respect, it should be noted that the uterine cavity is not a true cavity in the classical sense of the term. The cavity is completely covered by the endometrium (lining of the womb), i.e. there is no empty space (see graphical representation of the uterus).
This means that the opposite sides of the endometrium are in contact with each other. Between them, there is a liquid film covering the mucosa where the embryo sticks to. As an example, imagine some moist leaves sticking to a glass pane, a phenomenon which is only due to the leaf’s “airtight sticking” to the pane. Although the endometrium is not completely level, the viscose liquid film is sufficient to make the embryo adhere to it.
This biological background takes us to two factors that are given by the laws of physics. Artikel lesen
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A biological-physical approach regarding embryo implantation in fertility treatment
Couples considering IVF treatment are accompanied by high hopes and expectations towards their treating specialists. During the initial consultation, most of them raise the key question regarding their chances of achieving pregnancy through reproductive technologies.
Predicting the outcome of fertility treatment is always a medical challenge, as there are numerous factors which may influence the individual chances of getting pregnant and giving birth.
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Part 2 of the topic-series »Success Rate«
Illnesses, environmental pollutants, ageing are, inter alia, factors which may impair fertility. Unwanted childlessness is often due to a combination of several causes. To date, we know far too little, for example, about the role played by psychological strain. Couples wishing to conceive are usually under great pressure and are often exposed to high stress.
A number of questions arise at this point:
If this stress is caused by the unfulfilled desire to have children, then what about couples who have not been diagnosed with fertility disorders?
Is it possible that in both cases stress can reduce the chances to conceive a child? Artikel lesen
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What do we know about the links existing between them?
Involuntary childlessness today is no longer an inevitable fate, thanks to a wide range of treatment methods. This variety includes different approaches in terms of their efficiency which, from the perspective of the respective physicians, biologists and experts, undoubtedly also play a role here. However, from a scientific point of view, it is important to take a very critical look at them. This also applies to one of the most essential points with respect to IVF treatment, namely assessing the development potential of growing embryos.
Due to our competence that is based on over three decades of experience in successfully performing assisted reproductive techniques, we are able to identify efficient methods and, more than anything, to safely use these methods. Since 1996, we have established at our IVF Center in Bregenz an IVF technique known as blastocyst culture (extended culture up to the 5th day of embryonic development) as the method of choice in order to improve pregnancy rates (first systematic blastocyst culture worldwide). Artikel lesen
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How treatment methods may help to make the dream of having a child come true
“After my wife’s oocytes had been fertilized by my sperm and some of the impregnated ova have developed into embryos, we now want to know which embryo is the one most suitable for being transferred to the uterus and what our chances are to achieve a pregnancy and the birth of a healthy child.“
What matters most to these intended parents – and what they share in common with many others – is that they want to know more about the development of their embryos. Embryo formation is probably one of the most important steps in the course of an IVF treatment. In order to evaluate the developmental potential of embryos prior to performing embryo transfer, the professional knowledge of experienced biologists is needed. Such assessment can be supported by using an assistive tool – the so-called “Time-Lapse Analysis”, which allows for monitoring embryonic development by means of time-lapse imaging using a special camera system (e.g. EmbryoScope). Subsequently, the embryo with the highest implantation potential (Single-Embryo-Transfer) is to be determined on the basis of pre-established criteria. This approach, of course, raises some questions:
Could it happen that embryos whose early development has to be regarded as suboptimal are nevertheless able to result in pregnancy and the birth of a healthy baby?
Moreover, can it be justified that instead of transferring these embryos, the focus is put on the success of a subsequent future IVF cycle – an attempt with an uncertain outcome?
To answer these questions, a study was carried out. The results have been published in the renowned scientific journal RBM Online. The study shows how important it is to do research in this field of reproductive medicine. Artikel lesen
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How to correctly assess embryonic development
Due to modern reproductive medicine which is aimed at identifying in detail the reasons for involuntary childlessness, the so-called “paternal effect” increasingly becomes the focus of research attention.
This also holds true for the IVF Centers Prof. Zech, where the focus is placed on the medical evaluation of clinical findings of both partners in a couple as well as on a treatment tailored to their individual needs so as to provide them with the best chances to conceive a healthy child – if possible as early as the first treatment cycle.
From today’s perspective, we can assume that men can significantly contribute to a successful pregnancy outcome by a healthy diet, in which the optimal balance of vitamins, in particular with regard to folic acid is of the uttermost importance. Artikel lesen
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Today, women are more highly educated and skilled than in the past. The proportion of women who graduated from high-school has greatly increased and there are more women on the executive floors than 10 years ago. However, there is a downside to this professional commitment: These days, women are postponing motherhood and family planning to a later age – and may suffer the consequences, because it might already be too late by then…
Birth Rate: Declining
There are fewer births in Switzerland, Germany, Italy and many other European countries. The state makes its best efforts to reverse the trend – however, child allowance, expansion of daycare centers for children, paternity leave, child care subsidy, and any other supporting action by the public authorities seem to be totally ineffective.
The declining birth rates have become (once again) a source of media attention, producing sobering headlines with monotonous regularity: “Germany – bottom of the league when it comes to birth rates in Europa“, “Not keen on KIDS“, “Having children is as unattractive as it has ever been“. Various studies attempt to provide explanations for this “trend” and blame it on the lack of child-friendliness, the concerns of women to depend again on outdated role models and, last but not least, on the most challenging problem of all: finding a way to balance career and family. Artikel lesen
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Infertility Possible causes in women
Possible causes in men
Why is age a reason for?
Fertility treatment Spermiogram
Testicular Sperm Extraction
IVF / ICSI / IMSI
Pre-Implantation Genetic Diagnosis (PGD)
"Social Freezing" / "Medical Freezing"
Fertility treatment processPart 1 | Initial Consultation
Part 2 | Ovarian Stimulation
Part 3 | Ultrasound Scan
Part 4 | Egg retrieval
Part 5 | Embryo Transfer
Success rate - What to look forPart 1 | "What does this mean for us?"
Part 2 | Assessing the chances
Part 3 | Pregnancy rate
Part 4 | Implantation rate
Part 5 | Cumulative pregnancy rate