Prof. Dr. Thomas Strowitzki
Director, Gynäkologische Endokrinologie und Fertilitätsstörungen, University of Heidelberg
Abstract
Techniques of reproductive medicine and embryo transfer
Among the forms of fertilization outside the body, essentially two techniques have have gained acceptance: the classical in vitro fertilization IVF and the intracytoplasmic sperm injection ICSI.
As a rule, a hormonal stimulation is provided for artificial insemination to achieve a multifollicular growth. The ovum collection takes place almost exclusively through the vagina under ultrasound control. In IVF, approximately 100,000 sperm are added to each mature egg in vitro, for ICSI a single sperm is injected directly into the egg. Embryonic development in vitro is observed either over 2 days to the 4-cell stage or over 5 days to the blastocyst stage.
In Germany, the embryo transfer of two embryos of different developmental stages is predominantly carried out. Pregnancy rates per embryo transfer are currently about 32% per embryo transfer, with age-dependent differences. The multiple birth rate is about 22%, according to DIR 2015 (German IVF Register). Up to now, 6.5 million children have been born worldwide via IVF and ICSI.
From the extracorporeal fertilization techniques, a variety of additions have been made possible by the availability of eggs and embryos outside the body and new techniques of cryopreservation. The in vitro maturation IVM, that is, the recovery of immature egg without upstream hormonal stimulation with post-maturation in vitro, as well as the freezing of unfertilized egg with vitrification and the freezing of fertilized egg and embryos, have gained importance. The focus is on the techniques of genetic diagnostics on embryonic cells, the PGD (Pre-implantation genetic diagnosis). The PGD is widely used for aneuploidy screening abroad. In Germany it is also possible under strict conditions and with a very limited indication.
Curriculum Vitae
Professor Strowitzki studied medicine at the University of Saarland and the Ludwig Maximilians University of Munich, where he also completed his specialist training. From 1990 to 1998, he led the Department of Reproductive Medicine at the Großhadern Clinic of the Ludwig Maximilians University of Munich. Since 1999, Professor Strowitzki has been the Medical Director of the Department of Gynecological Endocrinology and Fertility Disorders at the Heidelberg University Clinic. He is chairman of the Ethics Committee of the Medical Faculty of the University of Heidelberg and editor of the journal Gynäkologische Endokrinologie.
