IVF is an assisted reproduction technique used to help couples diagnosed with infertility to have a child. It is also known as IVF. IVF is an abbreviation for “in vitro fertilization”, which means combining sperm and egg in a laboratory setting. This process produces embryos.
These embryos are transferred to the expectant mother's uterus after their development is monitored in the laboratory. Approximately 12 days after the embryo transfer, the expectant mother is given a pregnancy test to find out the result.
IVF treatment is a treatment process that requires team harmony. It must be carried out by a team consisting of a gynecologist (obstetrician and gynecologist), andrologist (urologist), embryologist, nurse and auxiliary staff.
- Low Egg Reserve
- Tube blockage
- Problems related to the uterus
- Early menopause
- Cysts and fibroids
- Polycystic ovary
- Endometriosis
- Hypo hypo
- Hormonal problems
- Vaginismus
- Cancer history/treatment
- Genetic diseases
- Obesity
- Unexplained infertility
- Sperm disorders
- Azoospermia
- Canal blockages
- Varicocele
- Hormonal causes
- Undescended testicle
- Past febrile illnesses
- Sexual dysfunction
- Diabetes
- Cancer history / treatment
- Obesity
- Unexplained infertility
- Sexually transmitted diseases
The first step is a preliminary interview. We listen to your medical history and examine your previous treatment and test results, if any. This is actually the most important stage in order to plan the treatment process correctly.
The preliminary interview does not have to take place on a certain day of the menstrual cycle. It can take place on any day.
The expectant mother is examined on the second or third day of menstruation. The doctor will examine the expectant mother to obtain information about her ovarian capacity and uterus. An AMH test is ordered to show the state of the egg reserve. If necessary, a uterine X-ray (HSG) or hysteroscopy may be requested.
In addition, thyroid function tests, prolactin hormone level, blood count, blood group and serologic tests such as hepatitis and HIV tests may also be requested.
According to the results of the examination, the physician prescribes hormone medication to stimulate the ovaries of the patient to develop a large number of eggs and the patient is informed about the medication. The process of using hormone drugs for about 8-14 days begins. The aim of using the injections is to obtain mature eggs. The use of the injections is quite simple, you can apply them yourself.
If the number of developing follicles is too low or too high, this directly affects the chances of success. For this reason, the dose of hormone injections is determined according to the woman's age, weight and previous treatments, if any.
The expectant mother takes the injections regularly and visits her doctor at intervals to be determined according to egg development
Follicle development is monitored by measuring the estrogen level in the blood and the number and size of follicles observed on ultrasonography. We determine the dose of injections containing FSH and HMG by evaluating these data together in the process.
As the follicles grow, estrogen levels in the blood rise. In some special cases, the hormones LH and progesterone are also measured.
Follow-up examinations can be daily or every other day depending on the response of the ovaries. After about 8-10 days, when the largest follicle reaches 18-20 mm in size, an HCG injection (also known as a hatching injection) is administered and egg collection is started approximately 34-36 hours after this injection.
The externalization of the eggs developed during the treatment is called egg collection (OPU - oocyte pick-up). The procedure takes about 10 minutes and is performed under anesthesia.
The patient lies in the vaginal examination position and does not feel any pain while the eggs are collected. After the procedure, the patient can return home after resting in the clinic for a maximum of 1 hour.
On the same day, the male patient gives a sperm sample by masturbation in the sperm room. There should be no lubricants, soap or similar lethal substances during masturbation. The sperm is transferred to the laboratory where fertilization is performed after the necessary procedures.
In some special cases, such as when fresh sperm is not available for fertilization, previously frozen sperm can be thawed and used.
Fertilization is performed by two basic methods:
Classical in vitro fertilization: By placing sperm and egg cells in the same environment, mobile sperms reach the egg in their natural environment and fertilization is achieved.
Microinjection: Selected sperm cells are injected into the egg using microcannula.
After fertilization, the eggs are stored in devices called incubators, which mimic the uterine environment in the best possible way.
We monitor the development of the embryos on a daily basis and select the highest quality embryos that are most likely to attach to the uterus.
With devices known as embryoscopes, we can observe embryos live 24/7 without disturbing their environment for stress-free development; thus, we can select the embryos with the highest potential more accurately and more safely.
Embryo transfer is the shortest but most important stage of IVF treatment. Failure to transfer an embryo that has been developed throughout the entire treatment to the uterus under the right conditions can jeopardize the success of the entire treatment.
Depending on the number and development of embryos, age, number of previous attempts and many other parameters, it is performed between days 2-6 after OPU (egg collection). The embryo that has reached a certain maturity is implanted into the uterus with the help of special catheters.
After the transfer, it is recommended to perform a pregnancy test with Beta HCG on day 12 in fresh cycles and day 15 in frozen cycles.
Therefore, the experience and success of the transferring doctor is as important as the quality and selection of embryos in IVF treatments.
The success rate varies depending on age and the cause of infertility. The most important factor determining success is having enough eggs in sufficient number and quality. In other words, the condition of the egg reserve directly affects the success of treatment.
The number of eggs in women decreases with age. Especially in the mid-30s, a significant decrease in egg reserve is observed. In addition to the decrease in number, poor quality also becomes evident after this age. Therefore, the younger the expectant mother, the higher the number and quality of eggs.
It is important for couples who want to have children to start treatment without wasting time in order to increase the chances of success.
One of the most important factors affecting the success of IVF is the quality of the embryology laboratory and the experience of the embryologists. After egg collection, all procedures for embryo development take place in the embryology laboratory.
A successful laboratory is one that is equipped with the latest technological infrastructure, has high quality materials and equipment, and is able to produce and select the best quality embryos from the egg and sperm cells with as little loss as possible.
IVF treatment is a team work. The doctor, embryologist, geneticist, nurse, in short, the fact that everyone involved in the treatment is specialized in their field and the harmonious working system is one of the important factors affecting success. It is important that the physician's experience, diagnosis and treatment protocols are evaluated within the framework of the special conditions and needs of the couples and a personalized treatment plan is created.
Couples also have some responsibilities to increase the chances of success in treatment. Couples are recommended to adopt a healthy lifestyle about 3 months before starting treatment. Couples who apply for IVF treatment in order to have a child should pay attention to some recommendations, which provide great support in the treatment process. In this process, controlling stress and eating a healthy diet with regular exercise also have a positive effect on the treatment outcome.
