IVF / ICSI

Treatment options:

1) IVF (In Vitro Fertilization): Artificial insemination outside the body, in which sperm and eggs are joined together
Who is IVF offered to:

● Women who have had 3-6 unsuccessful inseminations
● Women with blocked fallopian tubes
● Women with a partner whose sperm quality is decreased
● Young women with low AMH, less than <10 pmol

2) ICSI (IntraCytoplasmic Sperm Injection, also called microinsemination): a single selected sperm cell is injected into a removed egg cell
Who is ICSI offered to:

● Women with previous IVF with low fertilization rate <50%
● Women with a partner with very poor semen quality
● Women with a partner who has been sterilized, here the sperm must be removed from the testicles by a small operation called TESA (TEsticular Sperm Aspiration).

IVF / ICSI protocol:

When you start fertility treatment with IVF or ICSI, you will be treated with hormones that stimulate the ovary. This way, multiple mature eggs will develop instead of one or rarely the two that normally develop in a cycle.
The clinic offers short, mild stimulation or long stimulation.
The doctor will choose the best protocol based on your treatment history, hormone levels, age, and other factors that play a role. Most women are assigned the short protocol.

The short protocol:

The treatment begins on 2-3. Day of the cycle (usually with injections), you usually stimulate for up to 14 days.

Light stimulation: Here you get a low stimulation dose, with which no additional eggs are expected to mature.
Who is the short protocol offered to:

● Women older than> 42 years
● Women with low AMH, less than <5 pmol, or AFC <4
● Women who have had 3-4 regular IVF treatments
● Women who want low levels of hormone stimulation

The long protocol:

The woman’s hormone production is downregulated by medication (either nasal spray or injections for 2 weeks before the start of stimulation), after which the stimulation of follicle formation is started for about 10 days with the hormone FSH (with injections).

Who is the long protocol offered to:

● Women who did not achieve a positive result with short / mild stimulation
● Women with endometriosis or another autoimmune disorder

Removal of egg cells (follicular puncture):

When the follicles are a certain size, it is time to plan your egg retrieval. With an ovulation-inducing injection, the final maturation of the egg cells is controlled. The collection will be done approximately 36 hours after the trigger is given, and we recommend that you arrive in Copenhagen the evening before.
The egg cells are removed under local anesthesia that is placed in the vagina. A type of morphine can be given that works quickly but also leaves the body quickly, so that you will be fully fit again when you leave the clinic.
The doctor takes the egg cells with a needle under an ultrasound view. The procedure only takes a few minutes and shouldn’t be painful, but it is a little uncomfortable.
You will then stay with us in the clinic for about an hour so that we can make sure that you are doing well. You can then go home or back to the hotel, but you are not allowed to drive yourself.
For the first 24 hours after the procedure, expect slight pain and light bleeding, but this should subside quickly. We provide you with painkillers before you leave the clinic.

Complications:

Complications can occur in the form of bleeding or infection, but the risk is very low and less than <0.5%

Semen sample:

On the day, the egg retrieval takes place, the man gives a semen sample to the clinic. In IVF, 100,000 sperm are added to each extracted egg; in ICSI, a single sperm cell is inserted directly into the egg.
On the day after the egg collection, we will inform you about the status of fertilization. The eggs are grown in an incubator, which is an advanced “hatching” system, and there are many different characteristics of the embryos that determine whether they will continue to be grown and when they will be transferred.
The doctor will agree with you when the transfer should take place, either on day 2, 3 or 5 after the egg collection, depending on your age, your egg reserve and the results from day 2.

Egg transfer:

The egg is inserted with a small, thin catheter. It takes a few minutes and is usually not painful.
The pregnancy test can be done 12-14 days after placement, and of course we hope that it is positive.

Your chances of getting pregnant are usually doubled compared to insemination and are 45 to 50% in women under 35. The chance decreases the older you get.