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In vitro fertilization is an assisted reproductive technique used to enable couples diagnosed with infertility to have children, and is also known as IVF. IVF is short for “in vitro fertilization” and means combining sperm and eggs in a laboratory environment.
IVF treatment is a treatment method used in cases where a man and a woman cannot have a baby despite having unprotected sexual intercourse. In order for couples to be evaluated within the scope of infertility; pregnancy should not occur despite regular unprotected sexual intercourse for 1 year if the mother is under 35 years of age, and for 6 months if the mother is over 35 years of age.
In the in vitro fertilization method; eggs collected from the mother candidate are combined with the father candidate’s sperm in a laboratory environment and embryos are obtained. These embryos are transferred to the mother candidate’s uterus after their development is monitored in the laboratory for a while. Approximately 12 days after the in vitro fertilization embryo transfer, the mother candidate is given a pregnancy test and the result is learned. In vitro fertilization treatment is a treatment process that requires teamwork. It should be carried out with a team consisting of a gynecologist (gynecology and obstetrics specialist), andrologist (urology specialist), embryologist, nurse and auxiliary personnel. Click to watch the stories of our patients who have undergone in vitro fertilization.
IVF treatment is recommended for couples who cannot conceive naturally despite unprotected and regular sexual intercourse for 1 year . This period is 6 months for couples where the woman is 35 and over . Couples who cannot conceive within this period should see a doctor for health checks and to determine their reproductive capacity. If there is a condition that prevents reproduction in the man or woman after the examination and tests, IVF treatment is recommended for the couple. Reproductive health problems of couples who do not want to wait this period and do not want to have children immediately are determined and appropriate treatment methods are created.
In cases where the reasons listed below apply, IVF treatment may be recommended. For women:
For men:
In order to increase the chance of success in treatment, couples also have certain responsibilities. Couples are advised to adopt a healthy lifestyle approximately 3 months before starting treatment. For example, quitting smoking can be shown as the first lifestyle change expected from couples who are considering having children. Smoking is extremely harmful to both egg and sperm cells. Like smoking, alcohol should also be quit or reduced to a minimum. Consuming plenty of fruit and vegetables, losing excess weight, and simple exercises such as walking, running, and cycling are recommended to protect reproductive health.
Step 1: Meeting with Bahçeci Doctors, Examination and Tests In the first meeting , the causes of infertility are explained to the couple who wants to start treatment. Detailed information is given about the tests to be performed. It is important for both the woman and the man to be present in the first meeting for information and to answer questions. When coming to the clinic, the patient should bring all the tests done so far, a hysterosalpingogram if any, and reports of previous operations or previous infertility treatments. In addition, if the couple has a different disease such as heart disease or diabetes, the reports and information about these should also be provided to the doctor. It is not mandatory to be on a certain day of the menstrual period for the first examination. This assessment can be made on any day. Additional tests can be requested if deemed necessary after a detailed gynecological examination and ultrasonography. The goal is to first reveal the causes of infertility. The appropriate treatment method for the patient is selected and the treatment is applied at the appropriate time with the appropriate techniques.
Step 2: Controlled Egg (Ovarian) Enlargement Treatment The expectant mother comes for an examination on the second or third day of her period and the status of the ovaries is evaluated with an ultrasound. Depending on the patient’s condition, hormone values can also be checked that day. According to the results, the physician gives some hormone medications to stimulate the patient’s ovaries and ensure the development of a large number of eggs, and the patient is informed about the medications. The ovaries are regularly stimulated with hormone injections containing FSH and HMG, and the development of a large number of follicles (vesicles thought to contain egg cells) is ensured. The number of developing follicles directly affects the chance of success in the treatment. Therefore, the starting dose of hormone injections is determined according to the woman’s age, weight, and previous treatments, if any. Follicle development is monitored by measuring the estrogen level in the blood and the number and dimensions of follicles in ultrasonography, and by evaluating these data together, the dose of the FSH and HMG-containing injections is determined during the egg development phase. After approximately 8-10 days of hormone injections, when the largest follicles reach 18-20 mm in size, a trigger shot is applied. Step 3: Egg Collection and Sperm Collection Procedure The process of taking the eggs developed in an in vitro fertilization treatment to the outside environment is called egg collection (OPU). Approximately 34-36 hours after the trigger shot, the eggs are collected vaginally with a short surgical procedure under general anesthesia. Egg collection is a painless procedure performed under general anesthesia and lasts approximately 10 minutes . After resting in the clinic for about 2 hours, the patient can return home. The eggs taken to the laboratory are prepared for the microinjection process. The male patient gives a sperm sample by masturbating into a wide-mouthed and sterile container in the sperm room. There should be no lubricants, soaps or similar lethal substances during masturbation. The sperm collected is sent to the laboratory and the fertilization process is started after the necessary procedures.
Step 4: Fertilization Process in Bahçeci Laboratories Eggs are evaluated under a microscope in the laboratory and suitable ones are fertilized with selected sperm and observed for embryo development. Two different methods are used for the fertilization process. In the classical in vitro fertilization application, sperm and egg cells are placed in the same environment and motile sperm are allowed to reach the egg in their natural environment and fertilize it. In the microinjection method, the selected sperm cell is injected into the egg using microcannulas. The decision on which method to use in the treatment is made by evaluating the egg and sperm characteristics of the couple and their previous treatment history. After the fertilization process, the eggs are placed in special devices called incubators, which are manufactured to best mimic the uterine environment, and embryo development is monitored daily . The purpose of daily follow-ups is to select the highest quality embryo with the highest probability of attaching to the uterus. In the Bahçeci laboratory, special incubator devices with dynamic embryo imaging systems are used in the stages of growing, monitoring and selecting embryos. These devices, also known as embryoscopes, allow live monitoring of embryos without any changes in their environment, and thus the selection of the embryo with the highest potential for pregnancy can be made more accurately and more safely. Step 5: Embryo Transfer Embryo transfer is the shortest but most important stage of the treatment. Failure to transfer an embryo or embryos that have been developed and selected throughout the entire treatment to the uterus at the right time or under suitable conditions can jeopardize the success of the entire treatment. Therefore, the experience and success of the doctor performing the transfer are as important as the quality and selection of the embryo. Anesthesia is used in very rare cases in the transfer procedure, which is usually painless. It is performed between days 2 and 6 after the OPU (egg collection procedure) depending on the number and development of the embryos, age, number of previous attempts and many other parameters. The embryo that has reached a certain maturity is placed into the uterus with the help of a special catheter. If there are still good quality embryos that are still developing in the laboratory after the transfer, this situation is communicated to the couple. If desired, the embryos can be frozen and stored in our center for later use. It is extremely important that the embryos are frozen and stored in order to provide an additional treatment opportunity. Step 6: Post-Transfer Drug Treatment Drug treatment is started after the transfer to support the embryo’s attachment to the uterus. Our doctor informs the patient in detail about this and makes the necessary explanations about the dosage and administration of the drugs. Generally, the hormone injections and pills you have been using during your treatment are continued after the transfer. You need to continue these medications until the day you have the pregnancy test. Breast tenderness, pink-brown spotting and pain in the groin may occur after the embryo transfer, these are normal. You can consult your doctor if your complaints increase. Step 7: Things to Consider After Transfer The patient should rest for half an hour in the center after the procedure. After the 1-day rest period at home, the patient can continue their daily life by avoiding heavy lifting and sudden movements. They can go to work or travel. There is no harm in couples coming from out of town traveling 2-3 hours after the transfer. The information given to the patient about medication use after the procedure should be applied correctly by the patient in the following days. Smoking, coffee and alcohol should not be consumed, and sexual intercourse should be avoided until the test day. The patient is advised to take light walks and eat healthy. Step 8: Pregnancy Test 11 days after the transfer, the expectant mother comes to our clinic and the Beta HCG test is performed. This test is performed by taking a blood sample. In some cases, the test may be repeated two days later. Pregnancy can also be detected with a home urine test, but these tests may not reflect the definitive result. Therefore, a Beta HCG test should be performed to understand the pregnancy.
The embryo to be transferred in IVF treatment is determined by its quality. Embryo quality is evaluated according to the patient’s age, the number of embryos obtained, and the maturity of the embryo in its development. In some patients, day 2 transfer is appropriate, while in some patients day 3 transfer is more appropriate. In some patients, the embryo is monitored until day 5 and the transfer is performed while it is in the blastocyst stage. The embryologist and physician decide on the day and number of embryos to be transferred based on the number of previous treatments the patient has had, the quality of the embryo, and the patient’s age.
There is a common belief that twins or triplets occur in IVF treatment. Although it is commonly known in society, this is not true. Today, according to the law, 1 embryo is transferred to patients under the age of 35. This prevents the possibility of multiple pregnancies. If the woman is over 35, 2 embryos are transferred. There is a possibility of twin pregnancies in patients in this age group, but contrary to popular belief, no more than 2 embryos are transferred.
Treatment usually begins on the second or third day of the expectant mother’s period. These days are the ideal time to begin treatment to grow our existing eggs with the help of hormone injections and medications. During the treatment process, the woman must come to our IVF center at certain intervals for egg measurement examination, blood tests and medication control. The expected maturation of the eggs, collection and transfer procedures and IVF treatment are completed in an average of three weeks.
The success rate in treatment varies depending on age and the cause of infertility. The most important factor that determines success is having a sufficient number and quality of eggs. In other words, the status of the egg reserve directly affects the success of treatment. The number of eggs in women decreases with age, so we can say that the age of the woman is very important in treatment. It is important for couples who want to have children to start treatment without wasting time in order to increase the chance of success.
IVF pregnancies are no different from pregnancies achieved naturally. Therefore, IVF patients can have a normal birth. However, if the mother is older, has undergone some medical operations, or if multiple pregnancy poses a risk factor, a cesarean section is recommended. The most reliable method is preferred for the health of both the mother and the baby.
If the criteria are met, a health report can be issued for SSI discount from state hospitals and university hospitals.
Due to the law, we cannot provide price information on our website. You can fill out our contact form or call us at 444 39 49 to get detailed information about any topic you are curious about regarding IVF treatment. You can become a member of our Facebook group Umut Ol Umut Bul for all your questions.
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