What is Infertility?

The time of egg collection is determined according to the size of the eggs monitored by ultrasound and sometimes according to the hormone levels in the blood.

On the 2nd or 3rd day of menstruation, egg stimulating treatment is started. After about 10-12 days of medication, egg cells are collected under anaesthesia using transvaginal ultrasound (ovum pick-up). On the same day, healthy egg cells are fertilised with the man's sperm in the laboratory (IVF). The development of the fertilised embryos is monitored under a microscope every day. On day 5, one or two embryos of good quality are transferred into the uterus by a transcervical catheter (embryo transfer).

The cost of an IVF procedure is approximately 3250-3500 euros.

The chances of pregnancy in the first IVF cycle in our centre is 55-60%, depending on the age of the patient.

The failure rate for the first IVF cycle is 40-45 %. The most significant reasons for failure are poor embryo quality, thin endometrium and advanced maternal age (>38 years).

Yes, the success rate increases as the number of IVF cycles increases. The success rate is 55-60% in one IVF cycle. This rate increases to 80% after 3 IVF cycles.

In rare cases, IVF may be tried 8-9 times.

IVF cycles cannot be performed 2 months in a row. It is necessary to take a break for at least one month.

In order to increase the chances of IVF success, get rid of excess weight before treatment, quit bad habits (smoking, alcohol, substance abuse), eat a healthy diet and learn to manage stress, if any.

Yes, it is possible to conceive naturally after IVF, albeit to a lesser extent. Couples who have conceived with IVF treatment, especially those diagnosed with unexplained infertility, polycystic ovary (PCOS), mild male factor and low ovarian reserve, can conceive naturally after IVF in later periods, if the tubes are open in the woman and if the man has sufficient sperm count.

IVF treatment is applied when certain medical conditions are met. However, couples who cannot conceive despite unprotected intercourse can also undergo direct IVF.

IVF treatment cannot be applied in the presence of severe congenital anomalies of the uterus, active sexually transmitted diseases, diseases that prevent the woman from carrying pregnancy physically and mentally.

An IVF treatment lasts 21 days from the start of treatment.

IVF injections last on average 10-12 days.

The time of egg collection is determined according to the size of the eggs monitored by ultrasound and sometimes according to the hormone levels analysed in the blood.

Under sedation anaesthesia, using transvaginal ultrasound guidance, the egg cells are aspirated one by one and sent to the embryology laboratory.

In women with intact ovarian reserve, an average of 10-12 eggs are collected.

Usually, IVF treatment is not a painful process. Depending on the number of eggs that develop, there may be some pain in the groins. Since egg collection is performed under anaesthesia, no pain is felt. Since the embryo transfer procedure is performed with a full bladder, it may cause a slight feeling of discomfort due to fullness in the lower abdomen. However, embryo transfer is absolutely painless.

During the egg enlargement treatment, you may feel a slight pain in the groin.

Blastocysts are embryos that have reached day 5-6 of development. These embryos are preferred for transfer.

40-50% of the collected egg cells can develop into blastocytes.

Day 5 embryo transfer has a 60% chance of pregnancy in women under 35 years of age.

A day 5 embryo is a better quality embryo that has reached a more advanced stage of life. Therefore, the chance of pregnancy is higher with day 5 embryo transfer.

A 'good quality' embryo is one in which there are 3-4 cells on the second day, 7-8 cells on the third day, the cells forming the embryo are equal in size and there are no empty spaces in the embryo.

Today, ICSI (intracytoplasmic sperm injection) is preferred. The ICSI is also used in our centre.

In IVF, the collected eggs and sperm are placed in a tube in a laboratory environment and fertilisation is expected without intervention. In ICSI, selected healthy spermatozoa are injected into the egg cell by an embryologist.

The embryo is inserted into the uterus with a plastic catheter at a distance of 1.5 cm from the fundus of the uterus under transabdomnal ultrasound guidance  with a full bladder.

We recommend that the expectant mother rest for 3 days after the embryo transfer. Heavy exercise should be avoided until the pregnancy test is performed and sexual intercourse should be avoided for about 2 weeks.

The endometrium can be made more receptive to pregnancy with the hormones estrogen and progesterone.

Absence of bleeding and cramping pain after the transfer are signs of successful implantation.

To increase the chances of IVF implantation, you should adopt a healthy lifestyle. That is, you should be of normal weight. You should adopt balanced and healthy eating habits. You should avoid stress and quit bad habits if you have any. You should rest in the clinic for 30-60 minutes after the embryo transfer. Then it continues to rest at home for 3 days. It is recommended to drink plenty of fluids. Avoid heavy sports and physical activities for one week and abstain from sexual intercourse for 2 weeks. Omega-3 rich and antioxidant foods should be consumed, alcohol and smoking should be avoided and the stress factor should be well managed.

With IVF, if embryo transfer is performed on day 5, a blood pregnancy test can be performed 9 days after the transfer, and if embryo transfer is performed on day 3, a blood pregnancy test can be performed on day 11 after the transfer.

You can return home one day after the embryo transfer.

You should take progesterone-containing medicines until the 12th week of pregnancy, folic acid-containing medicines throughout the pregnancy and, if frozen embryo transfer has been performed, estrogen-containing medicines until the 7th week of pregnancy.

If pregnancy occurs with IVF, progesterone hormone treatment is continued until the 12th week of pregnancy.

The rate of twin pregnancy with IVF is 1% in single embryo transfer and 10% in two embryo transfer.

With current treatment protocols, IVF is not dangerous. Ovarian hyperstimulation syndrome (OHSS), which is used to be seen in patients with PCOS, is now almost never seen with the use of GnRH analogue instead of hCG for sudden LH rise and the postponement of fresh embryo transfer by freezing all embryos and the preference for frozen embryo transfer afterwards. In the early periods after egg retrieval, bleeding into the abdominal cavity may occur at a low rate and infection may develop within a few days. These conditions occur at a rate of one in a thousand.

The embryos are placed in a special incubator and kept at 37 degrees Celsius. The development of the embryos is monitored daily with an embryoscope.

Frozen embryo transfers can be performed one after another.

Egg freezing cycles cannot be performed one after another. A one-month break should be taken to allow the effects of the ovarian stimulating drugs to wear off in the ovaries.

ICSI is performed fresh, that is frozen eggs are first thawed and then ICSI is performed.

No, the pregnancy rate does not decrease after frozen embryo transfer. On the contrary, frozen embryo transfers performed in good IVF centres have a higher pregnancy rate than fresh transfers. Hormone medications used during IVF treatment may adversely affect the uterus in some patients. However, in frozen embryo transfer, the uterus is freed from the effects of these high hormone levels. Therefore, pregnancy rates are higher in frozen embryo transfers.

If the spare embryos are in good shape, have reached day 5 and are of good quality, they are frozen at the patient's request.

Scientific evidence to date suggests that the drugs used in infertility treatments do not increase the risk of cancer in women, including breast and uterine cancers. However, we recommend that women who have received hormone therapy have regular routine check-ups.

In the light of the data available to date, no increased risk of congenital anomalies or genetic diseases in fetuses has been detected in pregnancies obtained by frozen embryo transfer compared to fresh embryo pregnancies. Today, embryo freezing is used as a standard method in IVF to increase the chance of pregnancy.

Suitable candidates for PRP in IVF are those: 
who have previously failed IVF, 
who have insufficiently thickened inner lining of the uterus (endometrium),
who do not have a very serious problem with her ovaries,
who are usually of advanced age and have a greatly reduced ovarian reserve,
who are entering menopause and aiming to restart ovarian function."
 

Since the clinical application of PRP application is limited, it is difficult to talk about a general success rate. However, it is thought that PRP application brings an average of 60% success to IVF.

The positive effect of PRP applications can be observed for 3-4 months. However, its long-term effect is not known exactly. Still, there is no harm in repeating PRP application several times.