Frequently Asked Questions

Frequently Asked Questions and Answers

What are the stages of IVF treatment?

This method has 6 basic steps. These are;
1. The goal of ovarian stimulation is to harvest as many mature eggs as possible. This necessitates a number of medications for the prospective mother. This phase begins on the third day of the menstrual cycle and lasts for the next twelve days. At this point in the process, the prospective mother is required to make frequent trips to the center. This will allow for better management of drug response and egg development.
2. The stimulated eggs are retrieved with a small procedure. Sedatives or local anesthesia may be used to keep the prospective mother comfortable during the procedure; however, some women report experiencing cramping the day after the procedure. At the stage when the eggs are harvested, the father-to-be also provides a sperm sample. Sperm cells can be taken from potential fathers with azoospermia (no sperm) using the Micro TESE method.
3. The sperms obtained from the man's ejaculate are prepared for fertilization of the eggs.
4. In the laboratory, sperm and eggs are placed in incubators for fertilization, and the incubators ensure fertilization occurs. It is possible to directly implant a single sperm into an egg in less fertile conditions. The eggs are kept under observation to ensure that fertilization has taken place. When cell division begins, these eggs are now referred to as embryos.
5. Fertilized eggs that have been stored in the laboratory for two to three days are inserted into the uterus using a painless procedure. The eggs are transferred after being kept in the laboratory following fertilization. This process takes 5-10 minutes. Sexual intercourse is not advised until the pregnancy test has been carried out. Paracetamol group drugs can be used for pain relief. One day after the transfer, you can take a warm shower.
6. Pregnancy test; A pregnancy test is performed 12 days after the transfer process to determine the state of pregnancy. The test is the same as any other pregnancy test performed in every hospital.

What are the required pre-tests and main tests in IVF treatment?

Preliminary tests for the diagnosis and treatment of infertility are as follows:
For women;
Complete blood count, blood group, hormone tests (FSH-LH-estradiol on the second or third day of menstrual bleeding), TSH, free T4, prolactin, HBsAg, AntiHBs, AntiHCV, Rubella IgM-IgG, Toxoplasma for pre-detection of existing infections or immunity They are IgM-IgG tests… If necessary, tests for other diseases, microbiological and genetic tests may also be requested. Hysterosalpingography (HSG) should be obtained to evaluate the fallopian tubes and the uterine cavity.
For men;
Blood group, HBsAg, AntiHBs, AntiHCV (hepatitis screening), hormone tests (FSH, LH, total testosterone, prolactin and TSH), spermiogram and genetic tests should be performed when necessary.

How long does IVF therapy take?

It takes about 15 days, excluding the examinations prior to the start of IVF treatment and the doctor's evaluation of the couples. Because male patients' only role in the treatment is to provide sperm, the treatment only takes 10 minutes for them. Procedures applied to women are completed within 10 days. However, women are not constantly treated during this process. During this time, the woman is kept under observation. The start of treatment begins by using hormones to stimulate the ovaries to produce multiple eggs. The obtained eggs are collected, fertilized with male sperm, and an embryo is formed. With the completion of the embryo transfer, IVF treatment is completed in a total of 15 days.

What are the Risks of IVF?

1. Overstimulation of ovaries. This may be mild, or it may cause serious issues. The severe form, which can put the patient at risk, is observed in 1-2% of all IVF patients. In this case, abdominal swelling, shortness of breath, nausea-vomiting, inability to urinate and abdominal pain are present.
2. Multiple pregnancies pose the greatest risk. There is a risk of twin-triplet-quadruplet pregnancies depending on the number of embryos transferred. This situation can significantly increase the risk of premature birth and cause babies to have a variety of problems during their neonatal period and later in life.
3. Although extremely rare, intra-abdominal bleeding due to vascular injuries during the egg collection process or pelvic infection after the procedure can occur.
4. The treatment can be stopped at any point during the process if something goes wrong.

What complications are encountered in IVF treatment?

One of the two most common complications in IVF treatment is the ovaries' over-response to drugs that stimulate the ovaries to produce more eggs. This is a serious complication known as ovarian hyperstimulation syndrome (OHSS). There are different levels of hyperstimulation, and an advanced level can endanger the patient's life. Multiple pregnancy is another significant complication. Multiple pregnancies are inconvenient for both the expectant mother and the fetus, despite the fact that patients who lack sufficient knowledge on the subject may desire two or three children in one application.

What are the risks that may occur during the IVF procedure?

The most important risks are multiple pregnancy and (OHSS) overstimulation syndrome.

What are the factors that negatively affect the success of IVF treatment?

The success rate of IVF depends on a variety of factors. The character of the patient and their approach to treatment are two of them. Other factors that have a negative impact on the success of IVF include:
• Woman's Age
• Ovarian Reserve
• Structure of Cells Obtained in Women and Men
• Intrauterine Membrane Issues in Women

Until what age can IVF be applied? How long should older patients wait?

IVF can be applied up to the age of 45. However, it should be known that the chance decreases after the age of 40. However, using a new method known as Preimplantation Genetic Screening (pgs), live birth rates can reach around 50% by transplanting embryos with normal chromosome structure and performing genetic screening at the age of 38 and beyond.

What is the success rate in IVF treatment?

The success rate varies depending on the patient's age, the center's team and equipment, and the indication. In applications performed due to a tube defect or unexplained infertility, the success rate in patients under 30 years of age is around 55-60%.

Who can have IVF?

Infertility is the inability to conceive within a year despite a couple's desire for a child and the absence of contraception. Infertility affects about 15% of couples worldwide, including in Turkey. IVF treatment is beneficial for all couples who are experiencing infertility and have tried other methods, such as insemination, without success. To be more specific, IVF treatment is available to all couples who meet the following criteria: neither partner is over the age of 45, sperm production is present, and neither partner has a pathological condition that prevents the embryo from implanting in the uterus.

Who is not a candidate for IVF?

In our country, in vitro fertilization and other forms of assisted reproduction are only used by married couples who meet all legal requirements. Legally married couples who have been advised by their doctors to undergo in vitro fertilization treatment are eligible to use the technique, as are those who do not have contraindications to the procedures or the drugs that will be used in treatment.

What are the conditions for success in IVF treatment?

Infertility research should be done simultaneously to the couples. The basic tests carried out in the initial phase are:
a. Sperm test for man
b. Blood (hormone) tests to investigate the woman's ovulation
c. Tests to investigate whether the woman's fallopian tubes are open and the uterus is normal. For this purpose, contrast uterine x-ray (Hysterosalpingagraphy, HSG) is obtained most frequently.
*The success rate in IVF is evaluated with more than one criterion.
-The first of these is the fertilization rate in the laboratory. This rate should be over 80% in centers with good laboratories.
-The second criterion is biochemical pregnancy (positive blood pregnancy test). This rate is around 50%.
-The third criterion is the pregnancy rate that can be visualized and followed by ultrasonography. This rate is around 40%.
-The rate of "live birth" is also important. This rate is around 30%. The core value that concerns patients should be the last.

Is there any age limitation in in vitro fertilization?

Until the age of 45, in vitro fertilization can be performed if hormone tests taken on the third day of menstruation and ovarian capacity seen in ultrasonography are both suitable. For women over the age of 38, however, it is advised that they use preimplantation genetic diagnosis to determine if their embryos have a normal number of chromosomes.

How many attemps can be carried out in IVF treatment?

The number of attempts in IVF is not limited. If the couple is a good candidate for this treatment, however, they can expect to become pregnant within the first three attempts, with a success rate of 95%. No matter how many times further attempts are made , they will always receive the same 5% increased chance of pregnancy.

Unfortunately, subsequent in vitro fertilization attempts do not increase the rate of conception much in couples who cannot achieve pregnancy despite three attempts. Additional applications include Preimplantation Genetic Diagnosis (genetic research prior to embryo transfer), co-culture (creation of an artificial womb in a laboratory environment), and changing sperm selection methods. However, there is not enough evidence that these methods increase success significantly.

When should I start IVF treatment?

In vitro fertilization (IVF) is a fertility treatment in which a woman's reproductive cells (oocytes) are fertilized by a man's reproductive cells (sperms) in a laboratory setting, and then an appropriate number of developing embryos are transferred into the uterus. Under natural conditions, this process takes place in the fallopian tubes of the woman.

In vitro fertilization (IVF) is a treatment method that can be initiated immediately following basic and advanced examinations for infertility, or it can be planned after the implementation of other specific treatments. The first application can be made whenever is most convenient for the couple, regardless of the woman's menstrual cycle, once the choice to undergo IVF has been made or the stage of IVF treatment has been reached. It is preferred that couples make this application together. After a thorough evaluation of the couple's history, infertility tests, and previous treatments, a plan is formulated in the initial consultation. Because IVF is such a delicate procedure, careful preparation is essential, either to ensure that all necessary steps are taken in advance (such as obtaining the necessary medical tests and legal documentation) or to record every step of the process afterwards.

Does smoking affect fertility?

High amount and duration of cigarette use may have negative effects on the reproductive system and hormone activity. Smoking has serious health consequences, including menstrual irregularity, infertility, and early menopause, and the effect may be felt most strongly at the level of the ovaries. A low birth weight or growth retardation in the fetus can result from this condition during pregnancy.

Does female age affect success?

Age is one of the most important factors in determining success for women, as has been mentioned several times in the previous questions. As a result of advancements in medical technology and women's aspirations to enter the workforce, modern-day fertility rates are lower than in the past. When a couple is unable to have children due to the male partner's poor sperm quality and they delay having children for social or financial reasons, the female partner's advanced age is one of the factors that negatively affects the treatment. To improve treatment outcomes in women over the age of 40, it is necessary to modify some of the standard approaches. The use of high doses of drugs, as was common in previous practices, to increase egg production did not improve pregnancy rates, but rather resulted in the collection of low-quality eggs. At our clinic, we opt for gentle methods, also known as "patient-friendly treatments," when possible. Not only do these methods improve a couple's chances of conceiving by allowing them to collect higher-quality eggs, but they also save money on medication and boost patient compliance.

Does obesity affect fertility?

Body weight greater than normal for height is determined by the body mass index. Body Mass Index (BMI) is calculated as kg/m2. It is stated that if this value is >30 kg/m2, regular egg development in women may be adversely affected. In these situations, the ovary responds poorly to hormone drugs, leading to a low number of developing follicles for use in in vitro fertilization. Adipose tissue distribution is also an important factor to consider. Central (or abdominal) obesity, as measured by a high ratio of waist to hip circumference, can have unfavorable effects on a pregnancy just like other forms of obesity, especially when combined with hormonal disruptions and insulin resistance. If necessary, increasing the likelihood of pregnancy and protecting patients from obesity-related problems during pregnancy can be achieved through endocrinological (hormone diseases specialist) consultation, appropriate diet and exercise accompanied by a dietitian, and starting treatment after weight loss. Pregnancy-related complications can include high blood pressure, diabetes, having a very large or very small baby, having a difficult birth, and other issues.

What are the factors affecting female fertility?

The most important factor is age. As a woman's age increases, the chances of conceiving decrease. After the age of 45, the chance of pregnancy is practically negligible. Previous sexually transmitted infections, infections affecting the ovaries and fallopian tubes also negatively affect the chance of pregnancy.

Are Medications Used in Treatment Harmful to Me?

Drugs used in treatment have not been linked to an increased risk of ovarian or any other cancer. These medications do not cause any kind of weight gain that would be harmful over time. Furthermore, there is zero possibility of the woman entering menopause prematurely due to the consumption of her ovarian eggs. Overstimulation of the ovaries can cause a condition known as "ovarian hyperstimulation syndrome," which is the only known side effect of drugs.

Are There Any Side Effects of Medications Used in Treatment?

Ovarian suppression drugs can cause uncomfortable side effects, including hot flashes, headaches, vaginal dryness, and mood swings. You should know that these negative effects are only temporary and will go away once you begin taking drugs to promote egg development. Some of the potential negative effects of drugs used to stimulate ovulation include injection-site redness and pain, tender breasts, drowsiness, backache, and groin tension and pain.

Are there any side effects of hormonal drugs used in IVF treatment?

Overstimulation of the ovaries (hyperstimulation) is the most important risk.

Who are genetically at risk?

Women aged 37 and over
Couples with a genetic or hereditary disease carriers
Couples with recurrent miscarriages and stillbirths
Couples with a history of a genetic disease in a close relative (such as a 1st cousin)
Structural anomalies found in the body
History of a child with mental retardation
People with growth retardation and short stature
Couples with a previous genetic disease
Couples with sex development anomalies
In couples who could not achieve pregnancy despite the use of multiple assisted reproductive techniques
A geneticist should draw up a detailed family tree and collect information about previous pregnancies in couples who have one or more of these risks. Sick children and family members should be examined and necessary tests should be requested.

Is it possible to identify genetic problems after pregnancy occurs?

Yes. There are some screening tests that should be applied during pregnancy. (11-14 screening test – double test – triple test…) These screening tests give us information about the genetic risk in pregnancy. When such a risk is determined, it is possible to perform a chromosome analysis of the baby by performing a biopsy from the placenta of the fetus at 11-14 weeks or by taking a sample from the fluid the baby is in at 16-18 weeks. Ultrasonography also helps us in this regard.

Are there any precautions that can be taken for genetic problems before pregnancy occurs?

If there are genetic diseases in the family and there is a preimplantation diagnosis of these diseases, embryos can be examined.

What are the advantages of preimplantation genetic diagnosis?

It increases the chance of pregnancy and reduces the chance of miscarriage.
Families have healthy children.
The family is protected from medical and psychological traumas due to termination of pregnancy.
In diseases such as thalassemia, the baby to be born with tissue typing provides treatment for the sick children of the family.
Pre-pregnancy diagnosis; is a much more useful and inexpensive diagnostic method compared to the health problems that patients face throughout their lives, the difficulties in the treatment of diseases and high treatment costs.

Who is preimplantation genetic diagnosis (PGD) used for?

Initial applications of preimplantation genetic diagnosis (PGD), the process by which genetic abnormalities in embryos are identified and healthy embryos are selected during in vitro fertilization, were limited to the diagnosis of certain genetic diseases. Today, PGD is performed with the following indications:
• In couples with a genetic or hereditary disease carriers,
• Those with chromosomal anomaly in their previous pregnancy
• Those who have had recurrent miscarriage in the first three months of their pregnancy
• For couples who could not achieve pregnancy in recurrent IVF applications.
• In chromosomal disorders or genetic diseases associated with severe male infertility,
• When IVF is applied to advanced age (over 35 years) patients

Are Babies Born As A Result Of IVF Treatment Healthy?

It is well established that structural abnormalities, congenital abnormalities, and genetic abnormalities among babies conceived through in vitro fertilization (IVF) treatment are not significantly different from those observed among babies conceived naturally. Couples should seek genetic counseling before undergoing IVF/microinjection treatment if the sperm count is extremely low or there are no sperm in the semen. Since men with this condition may experience certain genetic issues and there is a small chance that these issues could be passed on to future generations, caution is warranted.

Are IVF Pregnancies More at Risk of Resulting in Miscarriage?

No. When comparing IVF pregnancies to those that occur naturally, the risk is equivalent.

Is the probability of miscarriage in a normal pregnancy the same as in vitro fertilization?

Depending on the reason for IVF, a woman's risk of miscarriage may increase. However, this increase is not due to IVF treatment, but rather to other medical conditions that lead to IVF treatment. There is no significant difference in miscarriage rates between pregnancies obtained through normal means and those obtained through in vitro fertilization in women with blocked fallopian tubes.

How are embryos transfered to the uterus after the eggs are fertilized?

Embryo transfer is a simple procedure. The embryo is inserted into the uterus under ultrasound guidance with a thin plastic catheter through the cervix.

Is IVF religiously haram?

According to the statements made by members of the Presidency of Religious Affairs and the High Council of Religious Affairs, Islamic law does not prohibit in vitro fertilization. The objective of IVF is to have a child. It is not a sin to have a child by implanting the sperm of a married man into the uterus of a married woman. Islam is tolerant of all non-sinful organizational structures. Unauthorized statements and rumors based on hearsay should not be believed.

Will I have to stay in the hospital during the treatment?

No. You will only need to rest in the hospital for 3-4 hours after the eggs are collected and after the embryo transfer is carried out.

Will I have a lot of pain while the eggs are being collected?

No. Contrary to popular belief, egg collection is an easy procedure for most patients. In addition, sedatives and pain relievers are administered during this procedure, and sometimes the procedure is performed under aneasthesia.

When Can I Travel After Transfer?

If your home is not in the same city as the center of the procedure, you can spend the day of the transfer at the center and travel to your home the next day.

After Embryo Transfer Do I Have To Stay In Bed Until Pregnancy Test Will Be Performed?

No. If you do not have any pain and you feel good, you do not have to spend your time lying down. You can return to your daily activities the day after the transfer.

What are the reasons why the transferred embryos are of good quality but fail to implant?

In the case of recurrent miscarriages despite the transfer of two or three healthy embryos, couples should investigate further with additional tests. Evaluation of the uterus by hysteroscopy or hysterosalpingography, genetic analysis of men and women, possible endocrine disorders, presence of factors that increase blood coagulation, and hysteroscopy or hysterosalpingography. However, no cause can be determined for approximately 20-25% of the patient population. In cases where no cause is identified despite the investigation of potential factors, additional immunological examinations (for both partners) are necessary.

Will every egg be fertilized?

Eggs must be mature and structurally normal for fertilization. Not all eggs are suitable for fertilization. Not every fertilized egg turns into a healthy embryo.

What is done if the sperm count is very low or there is no sperm in the sperm analysis?

When the sperm count is low, microinjection is carried out. In cases where there are no sperm in the semen, sperm must be surgically extracted from the testis.

How do fibroids or polyps affect IVF treatment?

In the presence of polyps and fibroids, IVF treatment may be negatively impacted. The size of the fibroid and its relationship to the uterus are two essential criteria for diagnosing fibroids. Since myomas above a certain size can cause complications in a potential pregnancy, those that press against the uterus should be surgically removed, as they may prevent embryo implantation or result in early pregnancy loss. Prior to treatment, polyps larger than a certain size must be removed.

Do fibroids and blocked fallopian tubes affect pregnancy?

If fibroids exert pressure on the inner lining of the uterus, where the fetus will develop, the likelihood of conception is diminished. Fibroids that have emerged from the uterine wall, on the other hand, do not affect the likelihood of pregnancy unless they are extremely large. The blockage of fallopian tubes however prevents pregnancy.

What is PCOS (Polycystic Ovary Syndrome)?

Polycystic ovary syndrome, or PCOS, is characterized by the presence of multiple cysts in the ovaries and affects between 25 and 45 percent of reproductive-aged women. Ultrasound imaging has been shown to detect this anomaly. Regular menstruation, long intervals between periods, and inability to menstruate are common complaints among PCOS patients. Excessive hair growth and weight gain are the most typical symptoms.
Since it has been observed that patients with this condition do not develop regular eggs in their ovaries, it is one of the most common situations we encounter in women who seek out IVF centers to have children. Patients who have gained excessive weight are strongly encouraged to begin dieting immediately. Patients with a height/weight index below 28 kg/m2 respond well to treatment, and spontaneous pregnancies have been reported. Success rates improve when patients taking metformin, which improves insulin sensitivity, treat their condition. Drugs that promote egg development (clomiphene citrate, rec - FSH) are known to be effective in helping women conceive if they are given to them at the right time and in the right amounts.

What is micro TESE?

About 50% of infertile couples may have issues with the male partner. Treatment for azoospermia, in which a male has no sperm, should begin as soon as possible when certain conditions are present, including advanced female age and male-related factors like retrograde ejaculation (ejaculation of sperm backwards).
It is possible for men to have children with the ICSI method, even if there is no sperm in their semen. In contrast, ICSI treatment is only possible if the patient's testicles are producing a minimal number of sperm. To obtain sperm from a patient, a variety of techniques can be used. When a spermiogram reveals no sperm, a testicular biopsy is performed to determine the cause. If no sperm can be seen in a spermigram, this step helps determine whether the problem is with the sperm itself or with a physical obstruction. When sperm production is severely disrupted, TESE can be used to locate tiny sperm-making foci in the testis.
Testicular foci are sampled on the millimeter scale to determine if sperm are present. Micro TESE refers to the process of extracting sperm from their respective ducts. In cases unrelated to obstruction, such as those with sperm production issues, this method has a 36-68% chance of successfully recovering sperm. With the micro TESE method, the chance of finding sperm in each biopsy increases with less testicular tissue. In other words, this chance has higher success than the classical TESE procedure.

What can be done if sperm cannot be found?

In order to obtain sperm from men, testicular tissue samples are biopsied, and sperm are separated from these samples in a laboratory setting for use in in vitro fertilization. This procedure is known as TESE, and it is a very important option for this group of men because it is the only treatment when sperm is absent.

Is the ovarian reserve depleted as a result of these treatments?

Stimulation of the ovaries for IVF does not reduce the reserve.

How long can I take a break and start a second try after a failed IVF treatment?

A second application can be made 2 months after a medically unsuccessful application.

When will the person return to their normal activities after the transfer?

She can return to normal activities other than sexual life and sports immediately after the transfer.

When should couples who cannot have children despite a regular relationship seek treatment?

If the woman is under 35 years old and there is no problem in the history that may affect pregnancy, examination after 1 year, or 6 months if the age is over 35.

  • As the Umay IVF Center team, we strive to maintain the highest level of satisfaction by providing the quality service that patients and their families deserve in the field of IVF and treatments, which is our area of expertise.
Mücahitler Mh. Ömer Ersoy Cd. No: 20/B Şehitkamil/GAZİANTEP