Heterologous treatments - AID and IVF - ET

Forefront treatments for medically assisted procreation

Heterologous treatments - AID and IVF - ET

AID (artificial insemination by donor/heterologous)

This involves slight pharmacological stimulation of follicular growth for the induction of ovulation. On the day of intrauterine insemination, the partner’s seminal fluid is thawed, prepared in the laboratory and transferred to the uterus by means of a fine catheter. Fertilization of the ovum therefore takes place ‘naturally’. The procedure is painless and does not require any pain relief. The success rate of the method varies according to the causes, the duration of sterility, the age of the patient, the seminal fluid counts (Sperm Bank) and the type of stimulation carried out.

Heterologous IVF-ET (fertilization in vitro and embryo transfer with donor sperm)

This consists of hormonal stimulation to induce multiple follicle growth followed by sampling of eggs, their in vitro fertilization (in a laboratory) using the donor sperm and subsequent transfer of the embryos to the uterus. Any supernumerary pre-embryos (zygotes or fertilized ova) are cryopreserved and kept available to the couple for subsequent embryo transfers. This technique is recommended in the following cases:

  1. blocked tubes
  2. severe seminal disease
  3. failure of techniques using homologous sperm (from the partner)

The success rate achieved is 32% per cycle on average but varies according to the causes, the duration of sterility, the age of the patient, the seminal fluid counts and the type of stimulation carried out.

The basic stages of heterologous IVF-ET are as follows: 

Ovarian preparation
This stage makes it possible to synchronize follicular growth with the aim of obtaining a higher number of mature eggs.

Ovarian stimulation 
The growth of follicles containing eggs is induced by subcutaneous injections. The ovarian response is monitored by means of trans-channel ultrasounds and hormonal blood sampling to evaluate follicle growth (number and quality).

Egg retrieval (Pick-up)
This involves drawing up the eggs using a fine needle under transvaginal ultrasound control.
The operation takes place in an operating theatre under sedation and is painless. The egg retrieval takes 10 to 15 minutes. The patient is discharged approximately 2 hours after the operation.

In vitro insemination 
The recovered eggs are placed in a culture dish together with the donor’s semen following appropriate preparation to achieve fertilization. After approximately 20 hours, the growth of the zygotes (eggs with two pronuclei, of maternal and paternal origin that have not yet fused together) is ascertained. According to Swiss law, all mature eggs that are recovered may be inseminated. The average fertilization rate is approximately 70%. Zygotes destined for transfer are left in the culture dish for a further 24-48 hours to become 2-8 celled embryos.

Embryo transfer
The embryos are transferred to the uterine cavity by means of a fine catheter. The transfer is fast and painless (without an anesthetic) and takes approximately 15-20 minutes. Because each embryo may be implanted independently of the others, we advise the transfer of two embryos to reduce the risk of multiple pregnancies. During the next 3-4 days it is advisable to avoid sport and excessive exercise.

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