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Why an embryo does not “spill out”?

A biological-physical approach regarding embryo implantation in fertility treatment

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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. Read more…

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Pregnancy rate

Part 3 of the topic-series »Success Rate«

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Of course, patients often ask me about pregnancy rates achieved by our IVF centers. Quite often this question is linked with the notion that the pregnancy rate can provide precise forecasts on the successful outcome of fertility treatment. Actually, a uniform definition does not exist. It is therefore necessary to make a clear differentiation. In order to assess a couple’s chances for a successful treatment outcome, it is always crucial to consider their personal situation.

What exactly does this mean? Read more…

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Love in Times of Egg Donation

Study on the relationship between mother and child after IVF treatment using donated eggs

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Some couples with an unfulfilled desire to have a child have a long way to go until they have achieved their goal of starting a family – inseminations, hormonal treatments used for ‘artificial insemination’, IVF therapies, cryo cycles, etc. Some couples, however, need a “Plan B”: An egg donation.

With donated oocytes, these couples are able to realize their dream of having a child. The donated oocyte is inseminated by the husband’s sperm. Subsequently, the embryo is transferred to his partner’s womb which has been prepared accordingly. If everything works, she will give birth to a baby nine months later.

The woman delivering the baby is the child’s mother, from a “biological” and social point of view. However she is not the child’s genetic mother. I know from conversations I have had with patients that many egg-recipients are concerned with the following question:

“I am worried that I might not love the child just as much as if it was conceived with my own eggs?”
Read more…

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“What does this mean for us?”

Part 1 of the topic-series »Success Rate«

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[← article overview of the topic-series »Success Rate«]


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When it comes to choosing an IVF center, among other things, couples seeking fertility support want to learn more about the clinic’s performance figures (e.g. pregnancy rate, live birth rate). In some countries, IVF centers are required by law to publish their results and make them freely available. In countries where this is not the case, the disclosure of such data occurs on a voluntary basis. In both cases, for most couples the following question arises when taking a closer look at the outcomes presented:

“But what does this actually mean for us?” Read more…

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Assessing the chances

Part 2 of the topic-series »Success Rate«

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[← article overview of the topic-series “Success Rate”]


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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.

Read more…

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“A lot helps a lot?”

The dangers of self-medication in fertility treatment

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Even the area of reproductive medicine is touched by the commonly held misconception “a lot helps a lot” when it comes to taking medicines. We often encounter situations in which patients undergoing hormonal stimulation (ovarian stimulation) want to increase the prescribed dosage of their own accord, saying they had read something about it and believed that this would be beneficial to a successful outcome, i.e. contribute to improving oocyte maturation.

To start with, I should like to point out that the selection of an optimal stimulation protocol shall be based on the following factors:

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Quality in IVF centers

Application and Relevance of a Quality Management System

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IVF Centers Prof. Zech

“If there’s a way to do it better: find it.”
Thomas A. Edison (1847-1931)

If we interpret this quote by Thomas Edison, the continual pursuit of improvements may (as, for example, in the case of Edison) lead to new inventions or to the improvement of already existing technologies.

It is a matter of finding ways, enabling us to achieve a certain quality standard that is subject to constant review and improvement. This requires an established structure, for example with respect to the workflows in a company.

Here, experts are referring to quality management systems aiming, among other things, at implementing appropriate measures and building up a trusting relationship with customers.

What exactly is meant by this when dealing with the working procedures of an IVF center?

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“Sometimes there’s more in the basket and sometimes less “

The number of oocytes in an IVF treatment

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The stage of hormonal stimulation (ovarian stimulation) is an exciting time. Daily injections are required and each ultrasound scan is anticipated with great excitement. What our patients want to know is:

“How many follicles can be identified?
Do all the follicles continue to grow?
How many large and probably mature follicles were produced?”

Hormone doses and therapy protocols are determined on an individual basis in order to achieve the best possible outcome.
It is a much earlier point in time that decides how many follicles will develop during the month of therapy in question. Already three months earlier, a group of 30-300 smaller follicles (a so-called cohort) starts to develop.

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PGD, PGS, PID, PGT …

Terms for Genetic Diagnostic Methods in Fertility Treatment

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When it comes to genetic analysis in reproductive medicine, there exist a number of commonly heard terms, such as Pre-Implantation Diagnosis (PID), Pre-Implantation Genetic Testing (PGT), Pre-Implantation Genetic Diagnosis (PGD), Pre-Implantation Genetic Screening (PGS).

But how can they be distinguished from one another? Are there any differences between them?

I had been asked these questions during one of our regular fertility-information evenings (→ Locations, dates and contents). In the following text I would like to go into more detail on my answers.
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The precautionary freezing of egg cells

Different motives – Different regulations

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Cutting-edge medical procedures provide women with the opportunity to have some of their oocytes frozen and “stored” as a precautionary measure. This is intended to preserve the positive status quo of their fertility at the time of cryopreservation, which in turn represents an option for achieving a pregnancy using their own “younger” oocytes in a future IVF cycle.

The underlying motives can be of both of a sociological nature, as well as of a medical nature. Statutory provisions do not exist to the same extent for both aforementioned aspects.

Thus, for example, there are countries where this procedure can be carried out only if medically indicated, for example in patients undergoing chemotherapy which may have a major damaging impact on their oocytes.

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