What is IVF?
In vitro fertilization (IVF) is one of the most widely used assisted reproductive therapies today, which is one of the methods that enable prospective parents who have some problems with fertility to have a baby.
In IVF treatment, the oocyte (female egg cell) and sperm (male semen cell) are fertilized outside the body under carefully prepared laboratory conditions and a certain number of these fertilized egg cells (embryos) are taken from the fertilized egg cells and placed in the uterus.
Who can undergo IVF?
-People with both tubes blocked: In this case, in vitro fertilization is used because it is not possible for the sperm to reach the egg and fertilize it.
-Low sperm count, motility or morphology, i.e. a low proportion of normal sperm: The problems of low sperm count, movement or normal sperm ratio can be seen separately or together. If the man’s sperm count and movement are normal, but the proportion of sperm with a normal appearance is below the limit, IVF treatment is applied to the patient.
-Patients who do not get results with intrauterine vaccination: If intrauterine vaccination treatment is not successful after 3-4 attempts, the patient may prefer IVF (in vitro fertilization).
-Cases of unexplained infertility: Up to 20% of infertility cases remain unexplained despite all investigations. In such cases, in vitro fertilization treatment is considered appropriate, especially in female patients aged 36 and over.
-Severe cases of endometriosis: It is the endometrium that keeps women’s menstrual periods regular. Endometriosis is when the membrane tissue inside the uterus settles outside the uterus, in the ovaries, in the lining of the abdomen or in the tubes. Adhesions in the lining of the abdomen and cysts in the ovaries can form after bleeding during menstruation in areas outside the uterus. Advanced endometriosis patients may require IVF treatment. In vitro fertilization is the first option especially for endometriosis patients over the age of 35 who cannot have a baby.
How is IVF Treatment Administered?
Stimulation of the ovaries
On the 3rd day of the menstrual period, hormone-containing medication in the form of injections is started to stimulate the ovaries. The aim of these drugs is to increase the chance of pregnancy by stimulating the development of more than one egg cell. The ovarian stimulation period is 12 to 14 days, but this period may vary from person to person as the medication does not work on everyone in the same time. Egg development should be closely monitored by ultrasound every 2-3 days while the medication is being used.
Egg Collection
When the eggs reach the desired maturity and size, another hormonal injection is used to cause the egg cells to hatch. Approximately 34-36 hours after the administration of this injection, egg collection can be performed. Since this is a delicate procedure, the time of the injection is of great importance.
In the egg collection procedure, the patient is put to sleep in the morning on an empty stomach and the egg collection procedure lasts approximately 15-20 minutes. For IVF, the eggs are accessed vaginally. For this procedure, an ultrasound-guided needle is used to suck out the eggs. The number of eggs can be around 10-12 per patient, but this number can vary between 1 and 40. There may be cases where no eggs are retrieved, but this is not common. This procedure does not require hospitalization and patients can return home after a few hours.
Fertilization of Eggs
The collected egg cells are fertilized in the laboratory using conventional in vitro fertilization (IVF) or microinjection (ICSI), depending on the quality of the sperm cells. This fertilization results in the formation of an embryo in the womb. Fertilization, which can be seen under a microscope, takes place over a period of 12 to 15 hours. This result is communicated to the patient and a date is set for the embryo transfer.
Embryo Transfer
The transfer takes place 48-72 hours, or 120 hours depending on the situation, after the collection of the pre-embryo or zygote, i.e. fertilized embryos. The embryos are transferred into the uterus by carefully passing a thin plastic tubular catheter through the cervix. In patients under 35 years of age, 1 embryo is transferred in the first and second treatment, and a maximum of 2 embryos in all other patients. This procedure is simple and painless and the patient is discharged immediately. A hormone called progesterone is administered vaginally or as an injection. After about 2 weeks, a pregnancy test is performed and the expectant mother who has tested positive will have an ultrasound 10 days later to see the gestational sac.