Frequently Asked Questions

What is Infertility?

We talk about infertility when couples cannot achieve pregnancy despite one year of unprotected sexual activity. Infertility occurs in about 10-15% of all couples.

When to see a doctor for IVF?

Women under the age of 35 should see a doctor if pregnancy is not achieved after one year of unprotected sexual activity. Women older than 35 should see a doctor if pregnancy is not achieved after six months of unprotected sexual activity.

Is IVF the first treatment of choice?

IUI can be attempted before IVF in unexplained and male-related infertility. IUI is not recommended if there is a decrease in the ovarian reserve of the woman, if the couple has been waiting a long time to get pregnant, or if there is a problem in the woman’s fallopian tubes. In IUI, ovulation is induced in the woman. The sperm sample collected from the prospective father is washed in a special mixture and transferred into the woman’s uterus.

Are genetic diseases a cause of infertility?

In humans, each cell normally contains 46 chromosomes (23 pairs). Two of them are the X and Y chromosomes, which are sex chromosomes. Females have two X chromosomes (46XX), while males have one X chromosome and one Y chromosome (46XY). Any abnormalities in the sex chromosomes lead to infertility. The loss of genetic material in some parts of the Y chromosome in males leads to azoospermia (low sperm count) and morphology-motility abnormalities, which may lead to infertility. Similarly, impaired X chromosomes in females lead to ovarian problems and therefore to infertility. Genetic defects in autosomal chromosomes other than sex chromosomes also cause recurrent miscarriages, infertility, and genetic disorders in foetuses.

Can women who do not menstruate get pregnant?

In cases of hypogonadotropic hypogonadism, called primary amenorrhea, in which the hormone cycle stimulating the ovaries does not function properly, women do not menstruate. Supplementing these deficient hormones helps achieve ovulation, following which pregnancy can be achieved by directing the couple to the appropriate assisted reproductive technique. In other cases where there is no menstruation, such as the genetic syndrome known as turner syndrome (45, X0), premature ovarian failure leading to early menopause, and menopausal women, pregnancy cannot be achieved with the woman’s own eggs. Pregnancy can be achieved in these cases through egg donation.

What defines a successful IVF treatment?

IVF centres determine their success according to their pregnancy rate and live birth rate. The success rates of IVF centres increase with the correct execution of all the steps of IVF. A well-performed ovulation induction, egg collection at the right time, and the correct microinjection with the selected sperm, which will in turn lead to the transfer of a healthy embryo, will all play a part in increasing the chances of successful pregnancy. When choosing an IVF centre, attention should be paid to the experience of the centre, the technical infrastructure of its laboratory, and its healthy pregnancy rates.

How long does the egg collection procedure last?

Egg collection is performed under anaesthesia. During the course of this procedure, which lasts 5-10 minutes, the follicles in your ovaries are collected via ultrasound, and the eggs in these follicles are extracted under the microscope by the embryologists.

Is embryo transfer a painful procedure?

Embryo transfer is a painless procedure that does not require anaesthesia. Additional information regarding the follow-up care and medication is provided by the medical staff.

Is there an increased chance of diseases in pregnancies achieved with frozen embryo transfers?

According to scientific studies, frozen embryo pregnancies do not show any increased risk of congenital anomalies or genetic diseases in the foetus compared to fresh embryo pregnancies. Nowadays, embryo freezing is a standard practice in IVF procedures, and it is used as a success-boosting method.

Does frozen embryo transfer lower pregnancy rate?

No, it does not. In a centre with a state-of-the-art embryology laboratory where the freezing and thawing processes are mastered, pregnancy rates will be higher with frozen embryo transfers than with fresh embryo transfers. The medication used during the treatment process may have adverse effects on the woman’s uterus. Thanks to frozen embryo transfer, the uterus has time to “rest” and to be cleansed from the effects of the medication. Therefore, frozen embryo transfers are used as a success-boosting method in patients with recurrent IVF failures.

Can the ovaries be frozen? Is it recommended?

The cryopreservation of ovarian tissue is a method that can be performed on women who are undergoing cancer treatment or who are at risk of early menopause. Ovarian tissue sampled via laparoscopic surgery prior to chemotherapy or radiotherapy is stored frozen, then later returned into the body to resume reproductive functions after the cancer treatment. Although successful pregnancies and deliveries were achieved after transplantation, it is still considered as an experimental treatment method. It is recommended for women who are to undergo chemotherapy or radiotherapy for cancer, who are preparing for a bone marrow or stem cell transplantation, and who have high-dose chemotherapy sessions planned due to immune system disorders.

Do cancer treatments and chemotherapy impair sperm production?

Chemotherapy is a treatment method that aims to destroy cells which divide rapidly. The target cells are cancerous cells, but chemotherapy also destroys root hair cells, gastrointestinal cells, and reproductive cells, which are the sperm and egg cells. In the same way, radiotherapy damages the germ cells that make up the sperm and the sperm cells. Depending on the type, frequency, and total dose of treatment, chemotherapy and radiotherapy can lead to irreversible azoospermia, and thus infertility in men. Cryopreservation of sperm prior to cancer treatments is the only proven method of preserving male fertility.

Which infections lead to blocked tubes?

The fallopian tubes link the ovaries to the uterus. Any infections of the tubes may lead to blockage in the tubes, and therefore to female infertility. The most common infection-causing agents are streptococci, staphylococcus and mycoplasma bacteria, and sexually transmitted chlamydia and gonococcal infections. Tuberculosis can also rarely cause blockage in the tubes. Infections can settle in the tubes due to use of intrauterine devices, sexual intercourse, miscarriage, abortion and postpartum, sexually transmitted infections, and appendicitis. The blockage in the tubes might prevent natural pregnancies.

Can the medication used in IVF treatments cause cancer?

To date, studies have shown that the medication used in infertility treatments do not increase the chance of cancer in women. There is no increased risk for breast and uterine cancers. Regardless, women who have undergone hormone therapy should still have regular routine controls.

Which should out-of-city and foreign patients prepare for their IVF treatment?

You can have your preliminary tests done in your own city and share the results with your IVF doctor. Thus, we can determine whether there is any obstacle to the IVF program or to achieving pregnancy. Prenatal vitamins should be taken at that point. IVF treatments start on the 2nd day of the woman’s menstrual period and last approximately 15-18 days. During this period, you will have a total of 6-7 examinations at the clinic. Patients who have menstrual irregularity may use relevant medication according tin line with the doctor’s decision. Bring along all necessary official documents and all medical records in accordance with legal procedures.

How long does an IVF treatment last?

The stages of IVF consist of ovulation stimulation, egg collection, embryo development and embryo transfer. The treatment starts on the second day of the period of the woman. During the ovulation stimulation process, the woman usually has blood tests and ultrasound scans daily or every two days. This stage lasts 9 to 12 days. Once the eggs reach the desired level of maturation, a trigger injection is given. Two days later, the eggs are collected. A sperm sample is collected from the prospective father that day, and the eggs are fertilised. The embryos thus formed are monitored and assessed according to their number and quality; then they are transferred into the mother’s uterus.

Can a natural pregnancy occur after an IVF treatment?

Couples who have been diagnosed with unexplained infertility, PCOS, infertility due to mild male factor and low-ovarian reserve, who have had a successful IVF treatment, may later become pregnant naturally. Natural pregnancy is not expected in couples treated for tubal factors and severe male infertility.

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