If pregnancy has not occurred after six to twelve months of regular unprotected intercourse, a medical evaluation is advisable. Women over the age of 35 are advised to seek advice after six months, as fertility declines significantly with age.

The first consultation involves taking a detailed medical history. We discuss your fertility journey to date, any existing findings, previous pregnancies or miscarriages, your menstrual cycle, lifestyle and the frequency of sexual intercourse. Based on this discussion, we plan any further investigations or treatments individually.

Please bring any existing medical records (e.g. hormone results, surgical reports, previous diagnoses). It is helpful to note down your cycle data and any questions you would like to discuss in advance. If possible, attend as a couple so that we can assess your situation comprehensively.

At the outset, this usually includes a gynaecological examination, hormone tests, an ultrasound examination of the ovaries and uterus, and a semen analysis for the male partner. Depending on the findings, further specific investigations may be required.

In around 20 percent of cases, no clear cause for the failure to conceive can be identified despite comprehensive diagnostic investigations. In such cases, we speak of idiopathic or unexplained infertility. Various treatment strategies are also available in this situation.

Age, particularly the woman’s age, is a crucial factor. Egg quality and the number of available oocytes decline significantly from the mid-30s onwards. Lifestyle factors such as smoking, excess weight, alcohol, stress and lack of sleep can also negatively affect fertility in both partners.

When investigating infertility, it is important to assess the shape of the uterine cavity, the structure of the uterine lining (endometrium) and the patency of the fallopian tubes. With hydrosonography (also called hydrosono or saline infusion sonography), the main focus is on the shape of the uterine cavity and the structure of the endometrium. With HyCoSy (hysterosalpingo-contrast sonography), tubal patency is assessed in addition. In most cases, both examinations are combined as part of a diagnostic cycle.
Procedure: First, a transvaginal ultrasound examination is performed. A speculum is then inserted to visualise the cervix and, if necessary, take a swab - just as in a routine gynaecological examination. A fine catheter is inserted into the cervix. This is usually not felt at all. Saline solution is first instilled through the catheter into the uterine cavity (hydrosono). A foamy contrast fluid is then injected. The tiny air bubbles in the foamy fluid are clearly visible on ultrasound. If the fallopian tubes are open, it is possible to observe the tiny air bubbles passing through the tube and escaping into the abdominal cavity near the ovary.

POR stands for poor ovarian response, meaning a reduced response of the ovaries to hormonal stimulation. If fewer than five oocytes are retrieved, this is referred to as poor ovarian response. Your doctor can often identify during the preliminary investigations whether a reduced ovarian response to hormonal stimulation is to be expected. Occasionally, a reduced response of the ovaries to stimulation occurs unexpectedly.

Yes. Since the introduction of “marriage for all”, married lesbian couples in Switzerland are permitted to use donor sperm. We provide same-sex couples with comprehensive advice on the legal and medical aspects and support them throughout the entire treatment process.

Under current Swiss law, donor sperm may only be used by married couples. Single women therefore cannot currently be treated in Switzerland, but we are happy to advise on reputable options abroad and provide support with medical diagnostics.

We offer all established forms of assisted reproduction, including innovative hormonal stimulation treatments, insemination (IUI), insemination with donor sperm, in vitro fertilisation (IVF), intracytoplasmic sperm injection (ICSI) and preimplantation genetic testing. We also perform surgical procedures such as hysteroscopy and laparoscopy. The choice of treatment depends on the individual diagnosis and situation.

At our fertility centres in Olten and Basel, we place the highest priority on safety. Hormonal treatments and invasive procedures such as oocyte retrieval are carefully monitored. Nevertheless, in rare cases side effects such as ovarian hyperstimulation can occur - we provide comprehensive information before treatment begins.

The duration depends on the chosen procedure and the individual situation. IVF treatment usually takes several weeks, including hormonal stimulation, oocyte retrieval and embryo transfer. In some cases, several cycles are required before pregnancy occurs.

A negative test result can be emotionally very distressing. Psychological support is available to you at any time, and we discuss the next steps together - whether this means another treatment attempt, an alternative approach or, where appropriate, coming to terms with ending the fertility journey.

Surplus embryos may be used for further treatment cycles within the limits of the law or - after consultation with the couple - discarded. In Switzerland, their use for research or donation is not permitted.

Yes. You can work as usual after insemination or embryo transfer. Not working provides no medical benefit.

On the day of oocyte retrieval, the laboratory will inform you how many mature oocytes were retrieved. The following day, you will be informed how many oocytes were successfully fertilised. After 5 to 6 days, you will be informed of the number of embryos that could be cryopreserved.

If a fresh embryo transfer is planned, you will receive your transfer appointment directly after oocyte
retrieval. Please attend the appointment with a full bladder. The best way to achieve this is to empty
your bladder 1-2 hours before the transfer and then drink half a litre of water.

PGT (preimplantation genetic testing) is a laboratory technique that can detect genetic changes in an embryo before implantation. Assisted fertilisation (IVF/ICSI treatment) is a prerequisite for genetic testing of embryos. There are two types of preimplantation genetic testing. PGT-A examines the number and structure of an embryo’s chromosomes. PGT-M examines a specific change (mutation) in a gene within the embryo’s genetic material. PGT-M can be combined with PGT-A.

Moderate exercise is generally recommended. However, very intensive exercise - in the so-called anaerobic training range - should be limited to a maximum of 2-3 hours per week, both during treatment and during pregnancy.
If you experience bleeding in early pregnancy or symptoms such as lower abdominal pain, and after surgery or oocyte retrieval, you should not exercise and should first seek medical advice.

Yes. If the course is uncomplicated, sexual intercourse is not a problem. In the event of lower abdominal pain or bleeding during pregnancy or after a procedure, we recommend abstaining from sexual intercourse and contacting your doctor if you are uncertain. During a natural-cycle frozen embryo transfer cycle, you should always use contraception.

Make sure you drink enough fluids and move regularly - especially on flights or long car journeys. During pregnancy, we recommend travelling only to countries with good medical care. You should also avoid travelling to countries where Zika virus infections occur. Before planning a trip to an exotic destination, you should seek advice as a precaution, for example from the Swiss Tropical and Public Health Institute (www.swisstph.ch) or the Centers for Disease Control and Prevention website (www.cdc.gov).

Yes. Eat as balanced a diet as possible and follow the same recommendations as during pregnancy:

• Wash fruit and vegetables thoroughly
• Do not eat raw meat or raw fish
• No alcohol or nicotine
• Drink sufficient water (approx. 2 litres daily)

Only consume pasteurised dairy products

Up to 300 mg of caffeine per day is considered safe. This corresponds to approximately 2-3 cups of
coffee spread throughout the day.

Necessary medication should only be taken after consultation with your doctor. Some medicines need to be adjusted before pregnancy. Always inform your doctor about all medicines you are taking. Please also inform us about any newly started medication.

Travel is generally possible after treatment. You should not travel for 48 hours after oocyte retrieval. We recommend avoiding long-haul flights (> 6 hours) where possible until the pregnancy test and during the first 12 weeks of pregnancy.

You should not work on the day of oocyte retrieval. If you require a medical certificate, please contact the doctor responsible for your treatment.

Mild lower abdominal pain during the first few days after oocyte retrieval is normal. Severe pain, however, should always be medically assessed.

Rest and recovery

• Immediately after the procedure, we recommend spending the rest of the day quietly so that you can
  recover from the sedation. You should rest after the procedure and should not immediately resume
  physically strenuous activities.

Avoidance of strenuous activities

• For 48 hours after oocyte retrieval, you should avoid strenuous physical activity and exercise.

Pain control

• It is normal to experience mild to moderate pain or cramping after the procedure. Painkillers such as
  ibuprofen or paracetamol can generally be used to relieve the symptoms.

Monitoring symptoms

• Please watch for the following symptoms, which may indicate possible complications:
• Severe, unbearable abdominal pain or cramping
• Fever, chills
• Sudden heavy bleeding or severe dizziness
• If you experience these symptoms and they do not improve despite taking medication, please
  contact us. Outside office hours, the emergency number 079 552 05 31 is available, or you can attend
  a nearby hospital.

Further medication

• The medication you need to continue depends on your treatment.
• Planned fresh embryo transfer: luteal phase support is provided with Utrogestan 200 mg vaginally
  1-1-1 until the pregnancy test.
• Planned double stimulation: luteal phase support is provided with Utrogestan 200 mg 1 (vaginal)-0-1
  (oral) until the follow-up appointment.
• If double stimulation has already been performed and the second oocyte retrieval has now taken
  place, no further Utrogestan is required and vaginal bleeding (a period) will start within the next few
  days.
• If you are not taking Utrogestan, a period will start a few days after the puncture.

Information from the laboratory

• On the day of oocyte retrieval, the laboratory will tell you how many mature oocytes were retrieved.
  If fertilisation is performed, you will be informed the day after oocyte retrieval how many oocytes were
  successfully fertilised. After 5 or 6 days, you will then be informed how many embryos could be
  cryopreserved.

Fresh embryo transfer

• If a fresh embryo transfer is planned, you will receive the appointment for the embryo transfer
  directly. Please attend the appointment with a full bladder.

Follow-up after the procedure

• We will perform a follow-up examination 3-7 days after oocyte retrieval.

Emergencies

• For urgent questions, our on-call telephone service remains available to you: +41 79 552 05 31

After the procedure, we recommend spending the rest of the day quietly. The sedation may make you feel tired. Physically strenuous activities should be avoided.

For 48 hours after oocyte retrieval, you should avoid exercise and heavy physical exertion.

Please contact us if you experience:

• severe or unbearable abdominal pain
• fever or chills
• sudden heavy bleeding
• severe dizziness

Outside office hours, you can reach the emergency service on +41 79 552 05 31 or attend a nearby hospital.

Further medication depends on your treatment:

• If a fresh embryo transfer is planned, luteal phase support is provided with Utrogestan 200 mg
  vaginally in the morning, at midday and in the evening until the pregnancy test.
• If double stimulation is planned, take Utrogestan 200 mg vaginally in the morning and orally in the
  evening - until the follow-up appointment.
• After the second oocyte retrieval in a double stimulation cycle, no further Utrogestan is required.
  Menstruation will begin within the next few days.
• If you are not taking Utrogestan, your period will start a few days after oocyte retrieval.

Yes. As a rule, you will have a follow-up appointment 3 to 7 days after oocyte retrieval.

Ovarian hyperstimulation syndrome is a complication that can occur after ovarian stimulation for IVF treatment. Typically, severe lower abdominal pain begins a few days after oocyte retrieval. The abdomen is bloated, taking a deep breath may be difficult and urine output decreases. If pregnancy occurs, the symptoms worsen. Even during stimulation, it is possible to recognise whether ovarian hyperstimulation may develop. In that case, a very large number of follicles grow and the oestradiol concentration measured in the blood rises markedly. If hyperstimulation appears to be developing, ovulation is triggered with a medication that has only a short duration of action. All oocytes are retrieved. In IVF treatment, the oocytes are fertilised and all resulting embryos are frozen (freeze-all strategy). No embryo transfer is performed. If a large number of oocytes are retrieved (more than 15 oocytes), similar but less severe symptoms may occur and usually improve significantly after a few days. If you feel unwell or are concerned, you can always contact us via the emergency number.

With double stimulation, a second ovarian stimulation with oocyte retrieval is carried out approximately one week after the first oocyte retrieval. The aim is to obtain more oocytes. Studies have shown that in some cases even more oocytes can be retrieved in the second round. Your doctor will discuss with you whether double stimulation may be beneficial. A fresh embryo transfer cannot be performed in the case of double stimulation.

After hysteroscopy, you should follow several important recommendations: If you have bleeding, do not use tampons; use sanitary pads only. Avoid baths and swimming for as long as bleeding continues; showering is permitted. Sexual intercourse should be avoided if you have bleeding or pain. You should not exercise during the first 48 hours after the procedure. After that, light activity is possible - pay attention to your body’s signals and stop if you experience pain. No later than four weeks after the procedure, you should arrange a follow-up appointment with your fertisuisse doctor to discuss the next steps. In a medical emergency, you can reach the fertisuisse on-call doctor on 079 552 05 31.

For some examinations and procedures, such as hysteroscopy, an endometrial biopsy or embryo transfer, it is better to have a full bladder. A full bladder causes the uterus to be stretched. Urine in the bladder conducts ultrasound waves very well, allowing the uterus and uterine cavity to be seen much more clearly.

Light bleeding after oocyte retrieval or hysteroscopy is common. If you experience heavier bleeding or bleeding during pregnancy, please contact our practice or an emergency department immediately. During pregnancy, it is important to know your blood group. Painless spotting to light bleeding is common at the beginning of pregnancy. You do not need to worry about this.

Typical symptoms include fatigue, breast tenderness, mild pulling sensations in the lower abdomen, frequent urination, absence of menstruation and nausea.

Approximately one week after ovulation, the embryo implants in the uterine cavity. At this time and afterwards, light spotting, usually pink or brown, may occur. This bleeding is often referred to as implantation bleeding.
Heavy bleeding similar to a menstrual period and bleeding accompanied by pain must always be medically assessed during pregnancy. Painless spotting and light bleeding during the first three months are common and often harmless and do not require emergency assessment unless lower abdominal pain also occurs.

Yes. Fertility treatment can be emotionally challenging, regardless of how the pregnancy was achieved. If needed, we are happy to support you and arrange an appointment with our psychological team.

Yes. If you are already receiving TCM treatment, discuss whether you should continue with your therapist. We are also happy to recommend experienced practitioners specialising in reproductive medicine.

In Switzerland, basic health insurance covers the costs of certain basic diagnostic investigations. Reproductive medicine treatments such as IVF or ICSI are generally not covered and must be paid for by the couple themselves. Before treatment begins, we will provide you with a transparent cost plan.

Health insurance covers the costs of all diagnostic investigations for infertility, less the patient’s cost-sharing contribution. Health insurance generally also covers the costs of most treatments, except IVF/ICSI and social freezing (freezing of unfertilised oocytes). Your doctor will clarify coverage by your health insurance in advance.

If intrauterine insemination treatment is planned, your doctor will first submit a request for prior cost approval to your health insurance provider. The insurer usually responds to the request within 3-4 weeks. You will then receive a copy of the letter. In most cases, the health insurance provider covers the costs. Sometimes additional examinations are requested.
It is important that you inform us if you change your health insurance provider.

Yes. Within the framework of the applicable legal requirements, unfertilised oocytes may be frozen in Switzerland and used for a later attempt. They are stored at our centre under strictly controlled conditions.

If you experience unexpectedly heavy bleeding after oocyte retrieval, severe pain, or suddenly feel
weak and dizzy. If you experience bleeding in early pregnancy that is as heavy as a menstrual period.
If you have urgent questions that cannot wait until the following day.

To make or change an appointment. It is best to send us an email - this is also possible at weekends or in the evening.

For urgent questions or symptoms, you can reach our on-call telephone service at: +41 79 552 05 31

Anti-Müllerian hormone (AMH) is a proteohormone or glycoprotein that plays a role in sexual differentiation during embryonic development. Mutations in the AMH gene are responsible for sexual differentiation disorders. AMH is also produced by the ovaries. Determining AMH concentration is also important for evaluating ovarian reserve.

Anovulation refers to the absence of ovulation in the female cycle. In this case, we speak of an anovulatory cycle. Anovulatory cycles typically occur in PCOS, but also in hyperprolactinemia (excessive prolactin concentration in the blood). Disorders of the hypothalamic-pituitary-ovarian axis also frequently lead to anovulatory cycles. Chronic anovulation is a common cause of female infertility.

Medical advances have made it possible to cultivate embryos to the blastocyst stage. In most cases, an embryo reaches the blastocyst stage within 5-6 days. The pregnancy rate is higher when an embryo is transferred at the blastocyst stage.

Endometriosis is a common, benign, often painful chronic condition affecting women, in which tissue similar to the lining of the uterus (the endometrium) is found outside the uterine cavity (ectopic).

Like normal uterine lining, endometriosis tissue changes during the menstrual cycle and can cause tissue bleeding, scarring and pain. Endometriosis usually occurs in the lower abdomen or pelvic area, for example on the uterus or fallopian tubes. The ovaries are also often affected. When the uterine muscle is affected, it's called adenomyosis (adenomyosis uteri). It can spread to the vaginal wall and the bowel (large intestine). In rare cases, endometriosis has been described in the lungs, other internal organs and the brain. Endometriosis can be a cause of infertility in women. The causes of endometriosis have not yet been fully clarified, and there is no causal treatment or prevention available. Treatment of the disease includes surgical removal or destruction of the lesions and hormonal inhibition of the cycle to reduce the likelihood of endometriosis recurring. Complete removal of widespread, diffuse endometriosis in the uterine wall (adenomyosis) can only be achieved by removing the uterus.

Intracytoplasmic sperm injection

ICSI (intracytoplasmic sperm injection) is the most common method of artificial insemination. With its help, even men with severe fertility problems have the chance to fulfil their desire to have children.

According to the World Health Organisation (WHO) definition, infertility (Latin: infertilitas) is when pregnancy does not occur within one year despite regular unprotected sexual intercourse.

In vitro fertilisation

IVF (in vitro fertilisation) is a method of artificial insemination. In vitro fertilisation in a test tube was first successfully performed in 1978. However, simply mixing egg cells and sperm cells together is not enough. IVF treatment consists of carefully coordinated steps.

OAT syndrome (oligoasthenozoospermia syndrome) is a pathological change in sperm. It is characterised by too few (oligo), insufficiently motile (astheno) and an increased number of malformed (terato) sperm. It is often associated with male infertility.

Preimplantation genetic testing

Preimplantation genetic testing refers to the examination of an embryo before it is transferred to the uterine cavity. In PGS or, more correctly, PGT-A, the number and distribution of the embryo's chromosomes are examined. In PGT-M, specific altered genes that lead to serious hereditary diseases are sought.

Artificial insemination must be performed for preimplantation genetic testing. After the eggs have been retrieved and fertilised, the fertilised eggs are cultured in an incubator. When the embryo begins to hatch (usually after 5-6 days), some cells are removed from the embryo's shell (trophectoderm biopsy). The shell later becomes the placenta. These cells are genetically tested. In women over the age of 37, this can reduce the pregnancy rate per embryo transfer and the time to birth. Pre-implantation genetic diagnosis is also used for couples whose children are at risk of life-threatening hereditary diseases (monogenic diseases).

The time-lapse incubator can be used to assess the dynamics of embryo growth. Until the blastocyst stage (five to six days), each individual embryo is photographed every five minutes. This creates a time-lapse film that provides valuable information about embryonic development. Optimal development can increase the chances of pregnancy. Time-lapse incubation is also an important prerequisite for pre-implantation diagnostics. When the embryo begins to hatch, some cells are removed from the embryo's shell (trophectoderm biopsy). The shell later becomes the placenta. These cells are genetically tested. In women over the age of 37, this can reduce the pregnancy rate per embryo transfer and the time to birth. Pre-implantation genetic diagnosis is also used for couples whose children are at risk of life-threatening hereditary diseases (monogenic diseases).