Having an unfulfilled desire to have children can be extremely stressful for both partners. If you have already tried all the possibilities of getting pregnant naturally, artificial insemination (IVF - In Vitro Fertilization) is often the last resort.
But what exactly happens there, what does the typical IVF path look like, for whom is IVF the right choice and what steps can you consider beforehand? We got to the bottom of these questions and therefore talked to our fertility expert Dr. med. univ. Michael Schenk.
At what point should you consult an IVF specialist?
Dr. Schenk: IVF institutes are usually also clarification specialists. This means that if you don’t get pregnant after twelve months if you are under 35, you should seek professional help. If you are over 35, you should take this step after six months. Suppose there are problems such as polycystic ovaries, endometriosis or inflammation of the fallopian tubes. In that case, it is best to contact an expert as soon as you wish to have a child.
What can be the reasons why a pregnancy does not work out?
Dr. Schenk: Often the wrong timing plays a role. If a woman doesn’t know exactly when she is ovulating and when her fertile days are, then it is naturally difficult to get pregnant. That’s why my first step is always to recommend the smart ovulation tracker femSense to my patients. The sensor patch reliably measures body temperature, detects the postovulatory temperature rise and thus provides information about when and whether ovulation has occurred. However, if ovulation has still not occurred after 3 months, you should check whether there are other causes.
What steps should be considered before IVF?
Dr. Schenk: When couples have an unfulfilled desire to have children, they usually take the first steps themselves, such as LH tests, temperature measurement methods, and the like. We have done a Big Data analysis within the clinic and have realized that couples come to us on average at the age of 37. However, before that they have known for an average of 5 (!) years that they want a child. They usually spend these 5 years googling, asking friends and visiting several gynecologists until they finally end up in my practice. The crux of the matter is that the most important asset that affected couples have is time. This means that we have to do everything we can to ensure that they come to a fertility specialist early on and don’t think about what else they should do beforehand.
What does the typical IVF path look like?
Dr. Schenk: The typical IVF path is easily explained. First, you need to clarify whether there are any physical factors, such as a vitamin D deficiency, a selenium deficiency, or hypothyroidism, for which you should take medication ahead of time. Then, around the 20th day of the cycle, an ultrasound is done to clarify what the further course of treatment will be.
On the first or second day of the following menstrual period, a blood sample is taken to see if the specific cycle is hormonally good. Then, FSH (follicle stimulating hormone) is started at the lowest possible dosage to reach nine to fourteen eggs. However, this can vary, sometimes only 2-6 eggs are reached. Only the eggs that can be made to grow are selected. Then an injection is added to prevent ovulation, so that everything can be planned. In the meantime, ultrasound examinations are performed.
On the fourteenth day of the cycle, the eggs are collected and fertilized in a Petri dish. Three to five days later, the embryo is transferred. After another fifteen days, blood is drawn to determine if there is a positive pregnancy test.
For whom is IVF suitable?
Dr. Schenk: Artificial insemination is suitable for all couples for whom it did not work out naturally. One of the advantages of IVF is that you have the “pleasure of choice”. That is, as already mentioned, you get all the recruited follicles to grow in the cycle and thus you can find among the eggs those that are particularly promising both in morphology and morphokinetics.
Do you have a take-home message for all couples with an unfulfilled desire to have children?
Dr. Schenk: My take-home message, even if it sounds unromantic, is to include the family plan in the career plan. The older you get, the fewer genetically fit eggs you have available as a woman, and that’s why you shouldn’t forget that the optimal window to get pregnant is actually in your 20s. But if that’s not compatible with your career or if your ideal partner isn’t there yet, you should just keep that in mind and then, if you’re planning a pregnancy in your mid-30s and it doesn’t work out in time, it’s better to consult a fertility expert too early than too late.
Thank you very much for the interview and the exciting insights on the topic of IVF!