ln a normal pregnancy, the male sperm penetrates a woman’s egg and fertilizes it in her body after ovulation when a mature egg is released from the ovaries. The fertilized egg then burrows into the uterine wall. In other words, the new cell (zygote) formed by the combination of sperm and oocyte after sexual intercourse settles in the womb of the expectant mother. The zygote that divides and multiplies here develops and provides the formation of the fetus.
In the most general definition, IVF treatment includes the fertilization of the egg cells taken from the woman and the sperm cells from the male in the laboratory environment and the implantation of the fertilized embryo in
to the woman’s uterus. Since the first successful IVF procedure in 1978, much progress has been made in the IVF method.
Stage 1: Egg production stimulated by hormone therapy
Normally, women grow, mature and hatch once a month. If a single egg is taken in IVF procedures, the egg may not be fertilized or a healthy embryo may not develop after fertilization. For this reason, a large number of eggs are tried to be obtained by using ovarian stimulating drugs in IVF. Treatment is started according to the vaginal ultrasonography performed on the second day of menstruation and the results of the hormones obtained from the blood. When starting the treatment, the drug doses are determined according to the person’s body mass index (kg / m2), the ovarian reserve, if IVF has been performed before, the drug doses used in previous treatments and the number of eggs collected. Drug doses a
nd treatment protocols are determined specifically for each patient and individualized treatment protocols are applied.
Several different medications may be needed, such as:
Medications used for ovarian stimulation: An injectable medication containing a follicle-stimulating hormone (FSH), a luteinizing hormone (LH), or a combination of both may be taken to stimulate the ovaries. These medications allow more than one egg to develop at a time.
Medicines used for oocyte maturation: When the follicles are ready for egg retrieval, (HCG) or other medications are taken to help the eggs mature.
Medications used to prevent premature ovulation: These drugs prevent the body from releasing developing eggs too early.
Medications used to prepare the lining of the uterus: On the day of egg retrieval or during embryo t
ransfer, your doctor may recommend that you start taking progesterone supplements to make the lining of your uterus more open for implantation.
Although the process of stimulating the ovaries shows individual differences, it takes about 10-12 days, during this period, the development of the follicles in the ovaries is monitored by vaginal ultrasonography at intervals of 2-3 days, and the hormone levels in the blood are checked to measure the response to drugs. When the follicles in the ovaries reach a certain size, rhCG or GnRH analogue is made, which allows the eggs to mature. It is very important that this needle is made at the right time and in the right way. If the needle in question is not made at the right time and in the right way, the egg will not reach sufficient maturity and the procedure may fail. Approximately 36 hours after this last injection, egg collection process begins.
Stage 2: Eggs taken from the ovary
A mild sedative or anesthetic is given to the expectant mother to avoid pain or other discomfort during
egg retrieval. Using an ultrasound vaginal probe attached to a thin hollow needle, the doctor aspirates eggs from the woman’s ovaries. This process takes approximately 12-30 minutes. These samples are sent to the laboratory without wasting time. If the ovaries are not accessible by transvaginal ultrasound, an abdominal ultrasound may be used to guide the needle. Eggs are removed from the follicles with a needle attached to a suction device. Expectant mothers may experience cramping and a feeling of satiety or pressure after egg retrieval.
Stage 3: Sperm removal
On the same day as the egg collection, a sperm sample is requested from the future father. The sperm provided by masturbation is immediately sent to the laboratory. Sperm can be taken from the ovaries surgically from
the father candidates whose semen does not contain sperm. Sperm is separated from semen fluid in the laboratory.
Stage 4: Egg and sperm are combined to ensure fertilization
In classical IVF treatment, sperm and eggs are mixed in a petri dish and then they are brought together in a culture medium prepared in the laboratory and fertilized. During this period, your doctor checks for signs of fertilization and monitors the growth of the embryos. In cases where microinjection technique (ICSI) is used, sperm is injected into
the egg. ICSI is usually performed when fertilization attempts have failed during previous IVF cycles, when there is a problem with the quality or number of sperm (semen).
Stage 5: Fertilized eggs are placed in the mother’s womb
After fertilization, embryo development is followed and the transfer process is performed on the appropriate day. However, the transfer days vary according to the strategies of in vitro fertilization centers, the number of eggs obtained by the couple, and the quality of the developing embryo. The number of embryos to be transferred is selected according to the quality and period of the developing embryos, taking into account the age of the woman and previous unsuccessful in vitro fer
tilization trials. On the day of embryo transfer, the embryo is transferred to the woman’s uterus with the help of a thin catheter. Strengthen and support the uterine lining and
FREQUENTLY ASKED QUESTIONS ABOUT TUBE BABY TREATMENT
What is infertility?
Failure to achieve pregnancy despite regular sexual intercourse for at least 1 year without any protection method is called infertility. Also included in this definition are the couples who could not reach the end of a pregnancy.
What is IVF & Microinjection? What are the differences?
The process of fertilization by bringing together the sperm cell and egg cell in a laboratory environment is called the “IVF method”. While applying the microinjection technique, a single sperm cell taken from the father-to-be is placed into the egg cell obtained from the expectant mother with a thin needle under the microscope and thus fertilization is achieved. Therefore, the chance of fertilization and pregnancy with microinjection method increases, especially in male-induced infertility.
What are the factors that affect women’s fertility?
Genetics, growing age at marriage and becoming a mother, whether menstruation is regular, sexually transmitted diseases, excessive weight and insulin resistance, smoking-alcohol-excessive caffeine consumption and stress can be counted as factors affecting fertility.
As a result of IVF treatment, will the egg reserve of women be depleted?
No, a baby girl is born in the womb with a certain reserve of eggs. A part of this reserve is lost until a
dolescence, then every month starting from puberty, the ovaries select the eggs that will grow in the next period in the week before menstruation begins and take off. Only 1 or 2 of them develop and crack and prepare the appropriate ground for pregnancy. If pregnancy does not occur, the same cycle starts again in the next period. Eggs obtained in IVF treatment are eggs prepared for that month, and new eggs will develop from the egg reserve in the next month.
Do women with IVF treatment enter menopause at an early age?
No, women are born with a certain egg reserve. In women with IVF treatment, the eggs in the ovary that month are developed and removed. With or without IVF treatment, the woman will enter menopause at the genetically determined time.
Is every egg that develops fertilized?
No, when medicines for egg development are started, not all eggs show the same growth rate. In addition, fertilization and division developments after egg collection and microinjection do not go the same. Some may even show no improvement or stop at any stage of development. Studies conducted so far have shown that the most important factor under these developmental differences of embryos may be related to the egg-sperm and naturally the genetic str
ucture of the embryo.
Is there an age limit for IVF treatment? Does age affect the chance of pregnancy?
Any woman with an egg can have an IVF treatment. After the age of 40, the rates of pregnancy, continuation of pregnancy and taking a baby home decrease. After the age of 45, even if there is an egg, pregnancy rates are around 1% – 5%. As the age progresses, the chance of pregnancy decreases.
Does clogged tubes prevent pregnancy? Does the congestion in the tubes reduce the success of IVF?
Congestion in the tubes adversely affects the normal pregnancy process. Because the meeting of the egg and sperm in pregnancy in a normal way, the first 5 days of the embryo and its transmission into the uterus afterwards take place in the woman’s tubes. Since fertilization takes place outside in IVF treatment, the chance of pregnancy does not change if the tubes are blocked. However, in some cases, the possibility of embryo attachment decreases due to the liquid accumulated in the tubes, and it may be necessary to close or remove the tube or tubes with LS. In such a case, your doctor will give you detailed information.
Does having fibroids reduce the chance of pregnancy?
Fibroids extending to the inner cavity of the uterus may prevent the embryo from implantation, development or cause miscarriage or premature birth. If the embryo is placed in or near the area where the myoma is located, it may cause miscarriage as the blood supply may be impaired. Again, when the advanced stages of pregnancy are reached, fibroids can degenerate or turn around themselves and cause pain and sometimes premature birth. The simplest test showing the presence of fibroids in the uterus is the uterine film called Hysterosalpingography. Further examination is a small operation called Hysteroscopy, which allows examination by entering the uterus with an optical instrument.
Does the presence of fibroids reduce egg reserve?
No, the presence of fibroids does not reduce egg reserve. The location of the ovaries and myoma is separate from each other. Myomas are found in the uterus, if pregnancy is desired and there is fibroid, the patient can be informed about wh
ether the fibroids can prevent pregnancy after a specialist physician’s examination, and if necessary, treatment options including surgical intervention are brought to the agenda.
Do hormone drugs used increase the risk of cancer?
No, there is a report stating that drugs used in IVF treatment increase the risk of cancer.