What is IVF?
IVF stands for in-vitro fertilization and means that fertilization takes place outside the body. Eggs and sperm meet in a culture dish, where the sperm penetrates the egg independently. Over the following days, an embryo develops, which is then placed into the uterine cavity.
What is ICSI?
In ICSI (intracytoplasmic sperm injection), a single selected sperm is injected directly into the egg using a fine micropipette. This method is used particularly when sperm quality is significantly limited or if no or only a few eggs were fertilized during a previous IVF attempt.
IVF and ICSI thus differ in the type of fertilization in the laboratory. The hormonal stimulation, egg retrieval, and further treatment are basically identical.
Different forms of IVF treatment
Various options for egg maturation and hormonal stimulation are available for IVF or ICSI treatment. Which form is best suited depends, among other things, on age and ovarian reserve, previous treatments, possible contraindications, and your personal preferences.
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IVF with hormonal stimulation
In mild IVF, egg maturation is supported with low-dose hormonal stimulation. This gentler stimulation approach can be particularly useful if there is a low ovarian reserve or if a lower hormonal burden is consciously desired. We tailor the treatment individually to the ovarian situation and personal preferences.
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Mild IVF
In mild IVF, egg maturation is supported with low-dose hormonal stimulation. This gentler stimulation approach can be particularly useful if there is a low ovarian reserve or if a lower hormonal burden is consciously desired. We tailor the treatment individually to the ovarian situation and personal preferences.
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IVF Naturelle
In IVF Naturelle, we use the natural follicle and egg maturation of your own cycle without hormonally stimulating the ovaries. Ovulation is triggered specifically so that the egg retrieval can be optimally planned. This particularly low-hormone form of IVF can be a sensible alternative, for example, in the case of a low ovarian reserve, certain medical contraindications to stimulation, or at the patient’s request.
More about IVF Naturelle
When IVF or ICSI is useful
- If the fallopian tubes are blocked or significantly impaired in their function
- In the case of limited sperm quality or a very low sperm count – ICSI can be particularly useful here
- In the case of endometriosis, if the disease and the individual fertility situation favor IVF treatment
- In the case of age-related declining fertility or limited ovarian reserve
- If other fertility treatments do not offer sufficient prospects of success or have already been unsuccessful
- In the case of long-standing unfulfilled desire for children without a clearly identifiable cause
IVF and ICSI in different life situations
Couples with a desire for children
For couples with limited egg or sperm quality, blocked fallopian tubes, or after unsuccessful insemination attempts, IVF or ICSI can significantly increase the chances of pregnancy.
Lesbian couples
In fertility treatment with donor sperm, IVF can be useful, for example, if insemination is not suitable or has already been unsuccessful, or if other medical factors must be considered.
Single Women
When wanting a child with donor sperm, we choose the treatment that fits your individual situation. Depending on age, ovarian reserve, and other requirements, insemination or IVF may be appropriate. Especially with increasing age, IVF can offer higher chances of success and save valuable time.
Women over 40
With increasing age, time becomes an important factor when wanting a child. IVF can then be useful earlier, as the chances of success are higher than with insemination and several eggs can be obtained and fertilized in one treatment cycle.
Our specialist assessment – The role of IVF in modern fertility medicine
Gold standard
IVF and ICSI are among the established and most effective procedures in modern fertility medicine. However, the key to success is not to treat as early or as intensively as possible, but to choose the treatment that fits the individual situation.
For some patients, IVF is the medically sensible path early on; for others, less invasive treatments may be sufficient at first. Age, ovarian reserve, fallopian tube function, sperm quality, and previous treatments play a role, as do personal wishes and priorities.
Together, we discuss which treatment offers the best medical conditions in your individual situation and develop a treatment path that is professionally sound and right for you.
IVF laboratory & complementary procedures
Depending on the initial situation, IVF or ICSI treatment can be supplemented and individually adapted by various procedures in the IVF laboratory. Whether and which of these are useful depends on your findings and the course of treatment to date.
After IVF or ICSI, some of the fertilized eggs can be further cultivated in the laboratory until the fifth or sixth day of development. This allows the embryonic development to be observed longer and the most suitable embryo to be selected for transfer.
Eggs and embryos can be frozen using vitrification and stored for later treatment. This allows further embryo transfers to take place without the need for renewed hormonal stimulation and egg retrieval.
If no sperm can be detected in the ejaculate, sperm can be surgically retrieved from the testicular tissue in suitable cases. The retrieved sperm can then be used for ICSI treatment and cryopreserved if necessary.
In microfluidic sperm selection, motile sperm are selected particularly gently and without centrifugation. The procedure can be used as a supplement, especially in the case of increased DNA fragmentation or limited sperm quality.
In PICSI, mature sperm that can bind to hyaluronic acid are selected for ICSI. The procedure can be considered as a supplementary method, especially in the case of abnormal sperm quality, increased DNA fragmentation, or after repeated miscarriages.
EmbryoGlue is a transfer medium containing hyaluronic acid in which the embryo is prepared immediately before the embryo transfer. There is evidence of improved pregnancy and live birth rates for hyaluronic acid-enriched transfer media, especially in fresh transfers.
After ICSI, calcium ionophore can support the activation of the egg and thus promote fertilization. The procedure is particularly suitable after a previous fertilization failure or a very low fertilization rate.
Procedure of IVF treatment
From treatment planning to embryo transfer, we accompany you step by step through your IVF or ICSI treatment at the private center Die Kinderwunschärztin in Munich. We tailor the exact process individually to your situation and the chosen treatment protocol.
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Planning & Preparation
Before starting IVF or ICSI treatment, we discuss the planned process with you in detail. We take your previous findings and treatments into account, perform the necessary blood tests and an ultrasound, and together determine the individual stimulation protocol. We also discuss the medication, the schedule, and any open questions.
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Check before starting treatment
Immediately before stimulation begins, we examine the ovaries via ultrasound and determine the relevant hormone levels.
We check whether the requirements for starting treatment are met – in particular, that there are no disruptive cysts and that the initial situation of the follicles is suitable for the planned start of stimulation.
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Hormonal stimulation & checks (8–12 days)
The individually tailored hormonal stimulation then begins. The goal is to bring several follicles to maturity at the same time.
With regular ultrasound and hormone checks, we track the development and can adjust the dosage if necessary. Additional medication prevents premature ovulation.
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Egg retrieval (puncture)
As soon as the follicles are sufficiently developed, the final egg maturation is specifically triggered. Egg retrieval takes place about 36 hours later.
The follicles are punctured with a fine needle under vaginal ultrasound control and the fluid they contain is aspirated. The retrieved eggs are then prepared for fertilization in our IVF laboratory.
The procedure usually takes only a few minutes and is generally performed under short anesthesia. After a short recovery time and a small breakfast, you can leave our center again.
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Fertilization & embryonic development in the IVF laboratory
After egg retrieval, the retrieved eggs are fertilized in our IVF laboratory.
In IVF, eggs and prepared sperm are brought together so that fertilization can occur independently. In ICSI, a single selected sperm is injected directly into the egg.
The following day, we see which eggs have been fertilized. Our embryologists then observe the further development of the embryos in culture. They are often cultivated until the blastocyst stage on the fifth or sixth day of development. -
Embryo transfer (day 3 or 5)
The timing of the embryo transfer depends on the individual situation and embryonic development.
The transfer often takes place on the fifth day of development at the blastocyst stage, as the development of the embryos can be assessed more precisely at this point. In certain situations, an earlier transfer may be useful.
For the transfer, the selected embryo is inserted through the cervix into the uterus using a very fine catheter. The procedure takes only a few minutes, requires no anesthesia, and is usually painless. -
Pregnancy test (~14 days later)
About two weeks after the retrieval, a pregnancy test is performed by determining the pregnancy hormone β‑hCG in the blood.
If the result is positive, we monitor the further progress and arrange the first ultrasound examination at the appropriate time.
If pregnancy has not occurred, we discuss the result with you. Together, we look at the course of treatment to date and the embryonic development and consider which next steps are sensible in your individual situation.
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Personal and continuous support
A dedicated specialist knows your history and accompanies you continuously through the treatment. This allows decisions to be made together and adjusted at short notice if necessary.
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Individual Treatment Planning
Every IVF or ICSI treatment is individually tailored to your personal situation. From the choice of stimulation protocol to the individual treatment steps, we take your medical requirements, previous experiences, and personal wishes into account.
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Modern IVF cleanroom laboratory
Our state-of-the-art IVF laboratory offers controlled conditions for fertilization, embryo culture, and cryopreservation. Doctors and embryology work closely together with short communication channels.
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An experienced, well-coordinated team
The doctors, embryologists, anesthesia, and the fertility team work closely together and accompany many IVF and ICSI treatments every day. This ensures that the individual steps from stimulation and retrieval to embryo transfer mesh directly with one another.
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Flexible checks – to fit your everyday life
Several appointments in a short time are necessary, especially during IVF treatment. That is why we offer checks early in the morning, in the afternoon, and on selected days in the evening, and try to integrate the treatment into your everyday life as well as possible.
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Simply organized & easy to reach
Appointments can be easily made online, and you receive important information quickly and directly. Digital processes and short communication channels facilitate the organization of your treatment – especially during the more intensive phases of IVF or ICSI.
What Our Patients Say
Costs of IVF or ICSI treatment
Below you will find typical guide values for IVF and ICSI treatments. The actual costs depend on your individual situation, the chosen treatment procedure, and possible additional services.
To the cost overviewThe costs of IVF treatment include medical care, egg retrieval, fertilization in the laboratory, and embryo transfer. Further costs are incurred for the required medication and anesthesia. Depending on the individual situation, additional services such as cryopreservation may be added.
Make an appointmentThe treatment process is identical to IVF treatment. In the laboratory, however, during intracytoplasmic sperm injection (ICSI), a single sperm is selected under the microscope and injected directly into the egg – especially in the case of limited sperm quality or unsuccessful IVF.
Make an appointmentIn addition to the treatment costs mentioned, the following costs are usually added. The amount depends, among other things, on the chosen treatment protocol and the individual situation.
- Medication for hormonal stimulation (approx. €400–1,500 depending on stimulation and ovarian reserve)
- Anesthesia during follicle puncture for painless egg retrieval (approx. €370)
- Statutory infection tests before treatment (approx. €90)
No fixed or flat-rate prices: We bill on the basis of the official scale of fees for doctors (GOÄ). According to the GOÄ, we are not allowed to quote fixed or flat-rate prices for medical services. The prices mentioned are intended to provide orientation and are typical for the treatments mentioned.
Possible VAT liability: Medical services may be subject to VAT (currently 19%). This applies if, after diagnostics have been carried out, no medical indication or confirmed diagnosis is present and it is therefore not a medical treatment in the strict sense. This can be the case in particular with social freezing treatments, but also with the treatment of single moms and same-sex couples.
We would be happy to provide you with detailed cost information for the planned treatment in advance. This allows you to clarify cost coverage with your private health insurance (PKV) as best as possible beforehand. Statutory health insurance (GKV) does not cover costs at our center.
Frequently asked questions about IVF / ICSI
IVF or ICSI treatment often raises many questions. Here you will find answers to topics that particularly concern patients.
What is the difference between IVF and ICSI?
Both procedures are part of artificial insemination. ICSI is a special fertilization method within the framework of IVF treatment. In IVF (in-vitro fertilization), eggs and sperm are brought together in the laboratory so that fertilization can occur independently. In ICSI (intracytoplasmic sperm injection), on the other hand, a single sperm is injected directly into the egg. ICSI is used particularly in the case of significantly limited sperm quality or if no or only a few eggs were fertilized during a previous IVF.
What is better – IVF or ICSI?
Neither IVF nor ICSI is fundamentally better. Which method is recommended depends on the cause of the unfulfilled desire for children. In the case of limited sperm quality, ICSI can improve the chances of fertilization. If there is no male fertility disorder, IVF and ICSI achieve comparable pregnancy and birth rates in many cases. We will discuss which treatment is right for you individually based on your findings and history.
Is ICSI more successful than IVF for women over 40?
Not fundamentally. Even for women over 40, ICSI offers no proven advantage over IVF based on age alone. The decisive factors are, in particular, sperm quality and the fertilization results of previous treatments. ICSI cannot compensate for age-related changes in egg quality. We will discuss which method is suitable for you based on your personal findings and situation.
How long does an IVF or ICSI treatment take in total?
From the start of hormone stimulation at the beginning of the cycle to the pregnancy test, treatment with a fresh embryo transfer usually takes about three to four weeks. The stimulation phase usually lasts eight to twelve days and is accompanied by ultrasound and hormone checks. This is followed by egg retrieval and, usually three to five days later, the embryo transfer. In the case of pre-treatment or a later cryotransfer, the timeline is extended.
Is IVF or ICSI treatment painful?
The injections can be briefly uncomfortable but are usually well tolerated. Egg retrieval is usually performed under short anesthesia or sedation, so that no pain occurs during the procedure. After egg retrieval, temporary lower abdominal discomfort may occur. If you experience severe or increasing symptoms, you should contact us. The embryo transfer is normally painless.
How many IVF or ICSI attempts are often necessary?
This varies greatly from person to person. Some couples achieve pregnancy in the first treatment cycle, while others require several attempts. The prospects of success depend, among other things, on the woman’s age, the cause of the unfulfilled desire for children, pre-existing conditions, and other factors. Not every further attempt requires a new egg retrieval: if suitable fertilized eggs or embryos are frozen, these can be used for a later cryotransfer.
What happens to fertilized oocytes that are not used?
Suitable fertilized eggs or embryos that are not transferred can be cryopreserved (frozen) with your consent and stored for a later treatment cycle. This allows further treatment attempts to be carried out without having to go through the entire IVF or ICSI treatment again.
Do I need to take it easy after the embryo transfer?
Bed rest is not required after embryo transfer and does not improve the chances of success. Normal everyday activities and, for example, walks are usually possible. Whether and when light sport is possible depends, among other things, on how you feel and the reaction of your ovaries to the stimulation. We will discuss with you individually which physical activities are possible and sensible during your treatment.
When can I take a pregnancy test after the embryo transfer?
We check whether pregnancy has occurred with a blood test for the pregnancy hormone hCG. In the case of a fresh transfer, this usually takes place about 14 days after the egg retrieval – depending on the transfer day, about nine to eleven days after the embryo transfer. We will inform you of the exact date. Testing at home too early can be misleading, for example due to still detectable hCG from the trigger shot.
Does the health insurance company cover the costs of IVF or ICSI treatment?
Cost coverage depends on your insurance, the agreed tariff, and the medical requirements. Private health insurance companies often cover the costs in full or in part if the insured person has an organically caused fertility disorder and the treatment is medically necessary. This also applies to unmarried couples. There is no uniform limit on treatment attempts in private health insurance; possible restrictions depend on the tariff.
Statutory health insurance funds generally contribute 50% to the approved treatment costs under certain conditions, sometimes with additional benefits. As a private center, we cannot bill statutory health insurance funds directly. We are happy to support you with a cost plan and the necessary medical documents to clarify possible reimbursement.
What are the risks of IVF or ICSI treatment?
Possible risks of IVF include, above all, ovarian hyperstimulation syndrome (OHSS), as well as rare complications during egg retrieval, such as bleeding or infection. If several embryos are transferred, the risk of a multiple pregnancy increases. Serious complications are rare.
The risk of hyperstimulation can be significantly reduced through individually tailored hormone treatment. Close monitoring helps to react early. In the case of severe or increasing abdominal pain, persistent vomiting, or shortness of breath, immediate medical clarification is important. The transfer of a single embryo significantly reduces the risk of multiples. We will discuss in detail before treatment which risks are personally relevant to you and how we prevent them.
What is Ovarian Hyperstimulation Syndrome (OHSS)?
Ovarian hyperstimulation syndrome (OHSS) can occur when the ovaries react particularly strongly to the hormone treatment. They enlarge, and fluid can accumulate in the abdominal cavity. Possible symptoms include a pronounced feeling of tension in the abdomen, abdominal pain, and nausea. Severe cases are rare nowadays.
The risk can be significantly reduced through individually dosed medication, modern treatment protocols, and close monitoring. If there is an increased risk, the embryos can first be frozen and only transferred in a later cycle, so that it now occurs only very rarely.
Does IVF increase the risk of multiple pregnancies?
The risk of multiples depends primarily on how many embryos are transferred. When a single embryo is transferred – Single Embryo Transfer – the risk is very low, comparable to a natural pregnancy. Rarely, identical twins can still occur if the embryo divides.
How can I improve the success of IVF or ICSI?
In addition to medical treatment, lifestyle factors can also play an important role. With a balanced, high-fiber diet, regular exercise, and avoiding nicotine and alcohol, you create good health conditions for fertility treatment and a later pregnancy. A healthy lifestyle is also important for the partner – especially quitting smoking, as smoking can impair sperm quality.
You should already be taking folic acid when wanting a child to support the early development of the child and prevent certain malformations. We will discuss with you individually whether and which other vitamins or dietary supplements are useful. Special “fertility diets” or preparations are not a prerequisite for successful treatment.
Sufficient sleep and a conscious approach to stress can also help to support the treatment physically and emotionally. We would be happy to advise you individually on supportive measures.
Can I work during IVF or ICSI treatment?
Treatment can often be reconciled with everyday professional life. During stimulation, you should plan time for regular check-up appointments. You will need a break for the day of the egg retrieval and the subsequent recovery. After sedation or anesthesia, you must not drive a car yourself for at least 24 hours. Whether further time off is sensible depends on how you feel and your professional activity.
