Vitro Fertilization (IVF)
In Vitro Fertilization (IVF) is a treatment method that increases the probability of conception in couples who have little or no chance of achieving a normal pregnancy. IVF involves the fertilization of male and female reproductive cells outside the body.
The first successful IVF treatment was carried out in 1978 in the United Kingdom. In our country, the first IVF birth was achieved in 1989 by Ege University. Today, many couples facing difficulties in conceiving resort to this method. The foundation of IVF practices was laid in 1971, forming the basis of the modern IVF treatment techniques used today.
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Who is Eligible for IVF Treatment?
IVF treatment techniques have continually evolved with technology, impacting the lives of many couples with new methods. All these developments have been implemented with the aim of increasing the success rate of IVF, taking into consideration the factors that negatively affect it.
These Developments Include:
- Micro-TESE (Microsurgical testicular sperm extraction, performed under a microscope)
- Preimplantation Genetic Diagnosis (PGD, a technique for examining embryos of couples and selecting the healthy ones)
- Assisted Hatching (Thinning the embryo shell with a laser)
- Frozen (The process of storing embryos, sperm, and eggs in a frozen state for later use)
- Embryoscope (A technique that allows monitoring embryo development under a camera and selecting those with healthy development)
First Step in IVF Treatment
If couples have previously faced negative outcomes in the pregnancy process, these experiences are first reviewed. Past treatments, pregnancies, miscarriages, and other relevant events are learned. Existing test results and analyses are evaluated.
- Any surgery reports or related notes
- Sperm analysis
- Blood tests for the couple
- Reports related to any previous treatments
- Hysterosalpingography (HSG)
- Chromosome Analysis
- Reports on other existing diseases, if any
All this gathered information is used to create an IVF treatment plan, and the date for the procedure is finalized.
Reproductive Techniques
IVF (In Vitro Fertilization): This is the process where an egg collected from the ovaries is artificially fertilized by sperm outside the body. IVF is a distinct treatment method chosen when other fertility treatments have failed.
GIFT (Gamete Intrafallopian Transfer): An egg from the woman’s ovaries and sperm from the man are injected into the woman’s fallopian tube. Fertilization is then expected to occur in the tube. This method is not commonly preferred in current fertility treatments.
ZIFT (Zygote Intrafallopian Transfer): Another assisted reproductive technique, ZIFT, is similar to IVF and GIFT. However, in this procedure, unlike GIFT, a fertilized embryo is used and placed in the tubes, not inside the uterus as in IVF.
ICSI (Intracytoplasmic Sperm Injection): This involves injecting a sperm cell from the male into an egg cell from the female under a microscope using very small catheters. Fertilization, which does not occur naturally, is achieved in a laboratory setting. This method is preferred in individuals with significant issues in sperm count and quality.
IVM (In Vitro Maturation): This involves collecting immature eggs either after a short period of medication use or without any medication, and maturing them in a laboratory environment. The matured eggs are then fertilized in the lab to create embryos. These embryos are then placed inside the uterus.
Success in IVF treatments is higher with a skilled team and a quality laboratory environment. The most critical factor affecting IVF success is the causes of infertility. In patients with reduced ovarian production, the success rate of IVF drops by 15%, while individuals with ovulation issues have a 38% higher chance of success.
Steps in IVF Treatment
- Initial examination and couple evaluation
- Ovarian stimulation and egg development
- Egg Retrieval
- IVF or microinjection (ICSI) procedure
- Embryo transfer
- Pregnancy Test
Who is Eligible for IVF Treatment?
One of the frequently asked questions by individuals researching IVF treatment is who this method is applicable to. IVF is considered for treatment in cases where a couple has not achieved pregnancy despite having regular, unprotected sexual intercourse for a year. Necessary examinations are conducted, and the couple is evaluated for the treatment process.
- The male partner’s semen sample not having sufficient or quality sperm for natural conception methods,
- Despite the woman not being of advanced age, observations of reduced ovarian reserve following examinations,
- Advanced female age (above 38 years) and the absence of pregnancy despite having regular unprotected intercourse for six months,
- Endometriosis causing disruption of the tube-ovary relationship (Endometriosis: a disease that occurs in women during reproductive years),
- Disorders in ovulation,
- Blockage in the female fallopian tubes,
- Unexplained infertility despite normal results in all conducted procedures.
The Factor of Female Age
As women age, there is a decrease in both the capacity and quality of ovulation. Depending on an individual’s genetic makeup, this decrease can be rapid or slow. The impact of menstruation on the IVF process is also a question of interest for many women. Although menstruation is related to the presence of eggs, it does not affect egg quality. If ovarian capacity and functions appear appropriate on hormone and other tests on the 3rd day of the menstrual period, IVF can be performed up to the age of 44. However, for women aged 38 and above, it is recommended to investigate the chromosomal normality of embryos with a genetic diagnosis procedure before the application.
With increasing age, the probability of natural conception decreases. While live birth rates are around 40-45% in women under 35, this rate drops to around 10% in patients aged 40 and above.
Reasons for Failure in IVF Treatment
During the treatment process, failures can occur at certain stages. The reasons for failure are often unknown.
Primary Reasons Include: Poor quality of embryos, errors in medication treatment, embryos being kept in the wrong environment, and thickening of the embryo membrane, all of which can hinder the formation of an IVF pregnancy.
Secondary Reasons Include: Problems originating from the mother’s body, such as abnormalities in the uterine lining, polyps, fibroids, immune system disorders, adhesions due to infection, and coagulation disorders, which can lead to negative outcomes in IVF treatment.
Tertiary Reasons Include: Issues encountered in the fallopian tubes and chocolate cysts can impact the success of IVF treatment. Adhesions in the fallopian tubes due to infections or damage to the tubes in previous surgeries are problematic. Blockages in these tubes, accumulation of fluid inside them, and the flow of this fluid into the ovaries can make it difficult for the embryo to implant in the uterus, leading to negative outcomes in the IVF treatment process.
The Male Factor in Failure
In IVF treatments, problems generally arise from women. However, failure is not solely due to the mother, but can also be due to the father. Particularly, poor quality and low quantity of male sperm require the use of existing sperm. The use of the father’s sperm, especially if it is of insufficient quality or quantity, can create problems. Embryos formed with eggs fertilized by genetically poor-quality sperm often do not reach the desired quality.
When embryo quality is not sufficient, failure often occurs due to the inability to implant in the uterus. Therefore, the reproductive cells from the male need to be both abundant and of good quality.
How is Failed Treatment Recognized?
After the embryo is injected into the uterus during the treatment process, a waiting period of about 2 weeks is required. A blood pregnancy test is done after this period. If the test results are positive, indicating pregnancy, the treatment is considered successful. However, if the test results are negative, it indicates that the treatment was unsuccessful.
Determining the success or failure of IVF treatment is not as straightforward as with natural pregnancies. In some cases, symptoms such as abdominal pain, increased appetite, or bleeding may occur in pregnancy, but these are not scientifically proven indicators. Therefore, instead of deciding on the success or failure of the treatment, it is important to maintain a positive mindset throughout the process.
IVF Treatment Success Rate
The success rate of the treatment process varies depending on different factors specific to individuals (especially age) and the experience of the center where the treatment will be administered. For individuals aged 30 and below, the success rate can reach up to 60%. For those aged 40 and above, this rate can drop to around 15%.
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To achieve success in the treatment process, our doctors perform specialized analyses. All these steps, including the evaluation and initial examination at the IVF center, are communicated to you. You can learn from our expert team the most frequently asked questions and ways to achieve positive results in treatment. Please add your information in the section below and contact us, so we can get in touch with you.
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