The desire to have a child is a central life goal for many people. However, when the hoped-for pregnancy does not occur, it can be distressing—especially if all conventional options have been exhausted. In such cases, in-vitro fertilisation (IVF) offers an effective alternative.
Costs and Organisation of In-Vitro Fertilisation
Before deciding on a treatment, you should receive thorough advice from your gynaecologist. In many cases, the National Health Service (NHS) covers the costs of initial examinations, while the actual therapy usually needs to be funded privately. These expenses typically range from £6,000 to £8,000 and include hormone therapy, egg retrieval, fertilisation, cultivation, and embryo transfer. Additionally, freezing and storing surplus embryos incurs approximately £700 for cryopreservation and around £450 annually for storage fees. The costs for hormone medications can vary depending on the product and dosage, amounting to between £1,200 and £2,400.
Step-by-Step: How Fertilisation Works in the Lab
In-vitro fertilisation follows a clear process, executed in several precisely coordinated steps:
- Ovarian Stimulation: Initially, an ultrasound is performed to check if all conditions for egg maturation are met. Over the next two to three weeks, hormonal preparation takes place. Subsequently, daily hormone injections stimulate the growth of multiple ovarian follicles. The dosage is based on the measured hormone levels in the blood (e.g., estrogen levels). Once the egg growth reaches an optimal stage, an additional injection triggers final maturation.
- Egg Retrieval: About two days after the trigger injection, the follicles are retrieved via aspiration. The procedure typically lasts 10 to 15 minutes and can be performed under general anaesthesia or with the assistance of painkillers. One to two hours later, patients are allowed to leave the clinic but should not drive on the same day.
- Insemination of the Eggs: After retrieval, the eggs are assessed for their ability to be fertilised. The semen sample is processed to isolate viable sperm. Subsequently, approximately 100,000 motile sperm are added per egg. If sperm quality is significantly compromised, intracytoplasmic sperm injection (ICSI) may be performed additionally.
- Embryo Cultivation: The fertilised eggs mature in an incubator for two to five days. After 16 to 18 hours, it becomes evident whether fertilisation has occurred. After an additional 40 to 64 hours, the embryos ideally show several cell divisions. If necessary, they are cultured further until the blastocyst stage.
- Embryo Transfer: Depending on the developmental stage, one or two embryos are transferred into the uterus. In the case of a blastocyst transfer, usually only one blastocyst is implanted. The transfer is performed using a soft catheter and is typically painless. To optimally prepare the uterine lining for implantation, progesterone is administered from the day of egg retrieval.
- Cryopreservation of Embryos and Blastocysts: Unused embryos can be frozen and stored for up to ten years. Thanks to modern cryopreservation techniques, they often remain viable after thawing and offer similar success rates in subsequent transfers.
Pregnancy Test: When and How?
Approximately 12 to 14 days after the embryo transfer, a blood test is conducted to determine if a pregnancy has occurred. If the result is positive, the first ultrasound examination takes place around ten days later.
Luteal Phase: Progesterone Support
From the day of egg retrieval, patients receive progesterone to prepare the uterine lining for potential implantation. If the pregnancy test is positive, this support continues until approximately the 10th week of pregnancy.
Natural Fertilisation in the Lab: Fewer Hormones, Fewer Eggs
A natural variant of the treatment largely avoids intensive hormone therapies, allowing only one or two eggs to mature. While this reduces potential side effects and costs, it also decreases the likelihood of successful fertilisation, as fewer eggs are available.
ICSI: When Sperm Quality is Compromised
Intracytoplasmic sperm injection (ICSI) is primarily used in cases of male infertility, such as oligo-, astheno-, and teratozoospermia (OAT syndrome). In this procedure, a single sperm is directly injected into the egg to increase fertilisation chances when sperm quality is severely impaired.
Latest Advances and Trends
- Personalised Treatment Plans: Individually tailored protocols based on genetic data for higher success rates.
- Artificial Intelligence & Predictive Analytics: Algorithms assist in the optimal selection of embryos and planning the treatment course.
- 3D Imaging & Monitoring: New technologies like EmbryoScope+ allow continuous observation of embryo development.
- Mitochondrial Replacement Therapy (MRT): Replacement of defective mitochondria to prevent related genetic disorders.
- Preimplantation Genetic Testing (PGT): Identification of chromosomal abnormalities to select healthy embryos.
- Laser-Assisted Hatching: Facilitates implantation by making a small incision in the embryo's outer layer.
- Artificial Wombs: A research field aiming to allow embryos to develop outside the body.
- Stem Cell Therapies & Genome Editing: Correction of genetic defects using CRISPR and stem cell techniques.
- In-Vitro Gametogenesis (IVG): Generation of eggs and sperm from body cells for specific cases of infertility.
Potential Downsides and Risks
Artificial fertilisation offers many couples and individuals new opportunities but is not without challenges:
- Physical Strain: Hormone stimulation can lead to side effects such as headaches or mood swings. Egg retrieval carries risks like infections or bleeding.
- Emotional Stress: Doctor visits, waiting periods, and uncertain treatment outcomes can cause significant emotional pressure. Psychological support or a stable support network can be invaluable here.
- Multiple Pregnancies: Transferring multiple embryos increases the risk of twins or triplets. Such pregnancies are often associated with higher health risks.
- High Costs: The treatment is expensive and is often only partially covered by insurance. Additional expenses can arise from medications or freezing and storage fees.
Legal Aspects in the United Kingdom
In the United Kingdom, artificial fertilisation is subject to specific legal frameworks:
- Anonymity of Sperm Donors: Donors can choose to remain anonymous, although there is ongoing discussion about the right of children to obtain identifying information about their donors.
- Legal Parenthood: Typically, the social partner is recognised as the legal father when using donor sperm.
- Embryo Protection: Only a certain number of embryos may be transferred, and the sale or trade of embryos is prohibited.
- Contract Law: Agreements between donors and recipients must be legally sound to avoid conflicts.
Alternative RattleStork
In addition to traditional methods of artificial fertilisation, our platform RattleStork offers a private and flexible way to realise your desire to have children. Here, couples and individuals can directly communicate with sperm donors to find personalised solutions.
Conclusion
In-vitro fertilisation provides couples and individuals with an effective means to realise their desire for children, even under challenging circumstances. Thanks to rapid developments in reproductive medicine, success rates are continuously improving. Additionally, platforms like RattleStork open up further avenues for uniquely fulfilling the dream of starting a family.