In common with many in vitro fertilization units worldwide, the County Hospital in Baden (Kantonspittal Baden, KSB) has a long-standing tradition of offering couples photographs of the embryos that are to be transferred. In 2002, a drastic change in the Swiss law on reproductive medicine prohibited embryo freezing, and placed a limitation of only three fertilized oocytes to be kept in culture for transfer. This restriction prevented us from using characteristics of cleaved embryos as selection criteria and, instead, we began to look in more detail at features of oocytes and zygotes as prognostic indicators. We thus created a large database of images in parallel with compulsory data collection for the national Swiss IVF register, FIVNAT-CH. All of the images collected during treatment cycles were simultaneously placed within their clinical and historical context, providing a useful atlas of human gametes, zygotes and embryos in parallel with the corresponding details and final outcome of each treatment cycle. The database contains all of the images for each individual case, amounting to several thousand photographs. The restrictions imposed by the Swiss law limits the usefulness of extended culture to blastocyst stage as an effective treatment strategy and, therefore, in order to complement the KSB data with this important feature, we called upon the experience of the Kinderwunsch Zentrum at the Landes- Frauen- und Kinderklinik (LFKK) Linz in Austria to provide a similar set of cases that include images derived from extended culture to blastocyst stage. The atlas illustrates images for the oocytes, zygotes and embryos that led to embryo transfer in 111 clinical cases, and the complete set of images for each case is available on an accompanying CD that contains over 2000 photographs.

This unique combination of a photographic atlas, together with clinical details as well as access to a complete image database provides valuable insight into the daily practical approach to controlled ovarian stimulation, gamete culture and selection as performed by two experienced and successful IVF teams. In order to facilitate searching and comparison of images with reference to details of particular clinical and morphological features, we provide supplementary tables that group the cases according to female infertility cause, semen parameters, stimulation protocol, gonadotropin dose, oestrogen levels and final outcome.