Day 0

We retrieve the eggs from the follicles – this procedure is called aspiration. The eggs are placed in a dish with a medium that mimics the environment of the uterus, kept at 37°C.

After a few hours, the eggs are ready for fertilization. The fertilization can be done either by the IVF or ICSI method.

IVF Method: The sperm is added to the eggs, allowing for spontaneous fertilization. A few hours later, the eggs are transferred to a culture dish, with each egg placed in its own small well.

ICSI Method: Here, a single sperm cell is manually injected into each mature egg. Before injection, the eggs are cleaned of the surrounding support cells. Under a microscope, a sperm cell is selected, activated by gently tapping on its tail, and then drawn into a pipette. A second pipette holds the egg in place while the sperm is injected. This process is repeated for all retrieved eggs.

Additional Calcium Treatment: If previous attempts using the ICSI method have shown a low fertili- zation rate, this might be improved by treating the injected eggs with calcium. The eggs are briefly placed in a calcium solution before being transferred to the culture dish.

After fertilization, the eggs are placed in their own well in a culture dish.

Day 1

We check if the eggs have been fertilized. We can tell by the presence of two pronuclei in the egg – one from the egg and one from the sperm.

It is not expected that all eggs will be fertilized. Normally, the fertilization rate is 50–60%, depending on the quality of the eggs and sperm.

Day 2

Today, we check if the fertilized eggs have divided. Typically, they have divided into 2–4 cells, sometimes even up to 6 cells.

Day 3

We check the cell division again. Typically, the embryos consist of 6–8 cells, sometimes up to 10.

Day 4

Cell division continues, and the cells begin to merge, so they can no longer be counted individually

Day 5

Each egg now consists of several hundred cells. The embryo has grown, and for the first time, we can distinguish which part will become the fetus and which part will become the placenta. This developmental stage is called the blastocyst stage.

We assess all the eggs and choose the best one for the embryo transfer into the uterus. If there are excess blasto- cysts, they will be frozen so they can be used later if desired.

On average, about 25-30% of the fertilized eggs develop into blastocysts that can lead to a pregnancy.

Day 6

We check one last time to see if more eggs have developed into blastocysts that could lead to a pregnancy. If so, these will also be frozen.

The development of the eggs often occurs in bursts, which makes it difficult to predict exactly how the embryos will develop during the 5–6 days in the incubator.

On Day 1, we will inform you about how many eggs were fertilized.

Blastocysts are frozen on Day 5 and Day 6. Once the culturing process is completed on Day 6, we will send you a confirmation of how many blastocysts we have frozen on Day 5 and Day 6.

Additionally, you will receive a thawing approval, which must be filled out and returned to us if you want to have a frozen blastocyst transferred. This approval must not be more than 1 month old at the time of thawing/transfer.

You have the option to add the following services:

Assisted Hatching (AHA):
In some cases, this method can improve pregnancy chances with IVF and ICSI. The egg is surrounded by a protective layer called the zona pellucida. The first cell divisions take place within this layer. Once the embryo reaches the blastocyst stage, it must “hatch” to implant in the uterine lining. It is thought that some embryos may have difficulty hatching from this shell. This can be assisted by Assisted Hatching, where we create small holes in the shell under a microscope.

Acupuncture:
We offer acupuncture to promote blood circulation in the uterus and enhance mental relaxation, as this process can often be stressful.

USB Stick with Video:
We offer a video of the embryonic development from Day 0 to Day 5/6 of the blastocyst that will be transferred.

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