Question 1

Marital status?

Accepted Answer

In Switzerland, a couple doesn't need to be married to start an active fertility therapy. For Swiss law, the child's well-being comes first. Therefore, a sustaining and long-lasting relationship is required. Couples in which one of the partners is not yet divorced cannot be considered for a therapy.

Question 2

Age?

Accepted Answer

With restricted ovarian function: therapies up to the age of 42, otherwise up to the age of 44.

Question 3

Time investment?

Accepted Answer

For time-consuming fertility therapies we try to propose appointments outside the regular office hours. We try to optimize the numbers of check-up appointments (no too many, but enough). For an insemination, 3 consultations are normally fixed per month. For an in-vitro fertilisation, one must allow ca. 5 consultations for the whole therapy until the embryo is being transferred. The day when the oocytes are being removed and after the embryo transfer (generally 2 days later), we advise you not to go to work. Yet, we will be able to give you the respective dates in advance. There are no restriction to go to work after an insemination and the day following the embryo transfer though.

Question 4

Waiting period?

Accepted Answer

Nowadays, for a fertilization outside the body, one must allow at least two months (generally three) between the first meeting and the oocytes removal.

Question 5

Psychological stress?

Accepted Answer

Experience has shown that the greatest stress doesn't result from the therapy itself, but from the two weeks following the active therapy (until the outcome of a possible pregnancy). We therefore recommend you to remain active (cinema, restaurant..) and also to consider an alternative supportive therapy (shiatsu, foot massage, acupuncture, etc.).

Question 6

Medication?

Accepted Answer

For the ovary stimulation, we generally recommend the FSH (follicle-stimulating hormones) which are normally released in the body during a «natural» cycle (Merional, Fostimon, Gonal, Puregon, Menopure). The follicle-stimulating hormone is injected under the skin by the patient herself on a daily basis and over a period of approx. 2 weeks. Generally, one uses an «self-injector», which means that the patient doesn't need to activate the piston of the syringe herself. Since the injected doses are higher than the ones in a normal cycle, the cycle fluctuations are being more strongly experienced than during a «normal» cycle. The medication is well tolerated; it is nevertheless important to avoid any overstimulation of the ovaries. Besides, one can sometimes notice a slight irritation where the shot is made. We have never observed any other side effects. Moreover, a LHRH antagonist is being used. This is a medication which avoids that the follicles pop off before the oocytes are ripe. This medication induces a ca. 4 week reversible menopause (Decapeptyl, Lucrin, Suprefact). The medication can be administered in one go (injection in the muscle) or by means of a daily injection over generally 4 weeks. The side effects can be comparable to the ones of the menopause (hot flushes, agitation).

Question 7

Blastocysts?

Accepted Answer

The scientifically accepted Cochrane Library has recently disclosed that the blastocyst transfer during an in-vitro fertilisation (the transfer taking place 5-6 days after the oocyte taking) is not an advantage as to the pregnancy success. With very young couples, it is possible that this procedure increases the chances of pregnancy, but the overall likelihood to conceive a healthy child after a therapeutic cycle is not increased.

Question 8

Children's health?

Accepted Answer

With children conceived in the «classical» way there is a 2.5% chance of malformation. During a fertilisation outside of the body, the malformation risk can reach 3.5%. One has to point out though that patients who undergo such a therapy are generally older.

Question 9

Can malformations result from malformed sperms?

Accepted Answer

Malformed sperms are not able to fertilize an oocyte. Therefore, a greater amount of malformed sperms do not increase the malformation risk.

Question 10

Is it true that in Switzerland one has to insert the embryos into the womb within 2 days at the latest? And does one have a greater chance of success while undergoing a blastocyst transfer abroad?

Accepted Answer

5-6 days after fertilization, the embryonic cells start organizing themselves. One part forms the placenta and the other one the embryo. In Switzerland, it is allowed to develop fertilized oocytes up to the blastocyst stage. According to Swis law, it is only allowed to develop the amount of embryos which will finally be inserted into the womb. Generally, chances are equal whether blastocysts or 2-3 days old embryos are being inserted into the womb (greater international Cochrane study). In special cases, we develop embryos until they reach the bastocyst stage. For the couples, the geographic proximity of the therapy center and the well-being during the whole aftercare are often more important than false promises found on the internet.

Question 11

Is it possible that frozen fertilized oocytes could be mixed up?

Accepted Answer

We would be happy to show you the different security measures which are taken in order to prevent any mistake to almost 100%.

Question 12

When do I have to inform my child that he/she has been conceived outside my body?

Accepted Answer

A child doesn't need to know where, when and how he/she has been conceived. From the moment the pregnancy test turns out to be positive, the pregnancy is then being treated like a «normal pregnancy». After a fertilization outside the body, as soon as the test is positive, all following tests are then covered by the health insurance.

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