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IVF Treatment

The treatment method used by couples who want to have a child in case of infertility, which is known as “infertility” among the people, is called in vitro fertilization treatment. Infertility is a disorder that can be seen in 15 to 20 individuals out of 100 in the society. The reason for this situation, which occurs due to the inability to fulfill the reproductive function, may be due to a specific problem related to the reproductive organ or to more and more independent factors. If it is not possible to cure the disease despite the diagnosis and if the infertility is permanent, then it becomes impossible for the person to have children naturally. Due to the psychological and sociological problems caused by not being able to have children, people resort to treatment methods, and among these, the most commonly preferred type of the modern period is known as in vitro fertilization treatment. As a result of the studies on infertility, the factor causing this situation could not be found exactly, and when the statistical data were evaluated, no differences were found between the distribution of men and women in the group between 15 and 20 of 100 people. In this sense, it can be said that it is advantageous to benefit from the in vitro fertilization method in order to have a child, since it cannot be treated without the cause of infertility. Although IVF treatment is a long-term treatment performed as a result of the follow-up of specialist physicians, there are some issues that a person should pay attention to before, during and after the treatment in order to have a healthy child. If these points are followed, it is possible to have a healthy child with in vitro fertilization treatment.

Before IVF Treatment

Before IVF treatment, both men and women need to prepare for some issues. These are the elements that will support both the formation of healthy sperm and the healthy ovulation process.

Patient-Physician Interview in IVF Treatment

In order to apply for IVF treatment for pregnancy, the doctor should make a preliminary interview with the mother and father at the first stage. The health history of the couple who is faced with infertility is recorded by the doctor. In parallel with this story, the test, film and epicrisis data requested from the couples are discussed. Then, various examinations are made by the physician to both women and men, and then the in vitro fertilization protocol to be applied is selected. After the doctor examines the woman, it is investigated whether a surgical application is necessary and if there is an anatomical problem, surgical application is performed with the hysteroscopy technique. While choosing the treatment protocol at this stage, the age of the pregnant woman, egg capacity, previous surgical operations, hormone level and protocols in previous IVF trials are listed and the protocol selection is completed in the relevant treatment.

Stimulation of the Ovaries in IVF Treatment

One of the most important factors in getting a positive result in IVF treatment for pregnancy is that the ovaries of the woman who wants to become pregnant can produce a large number of eggs. For this reason, stimulant drugs are applied to increase the development of the ovaries that are taken under control. Generally, these drugs are known as subcutaneous or intramuscular injections. This warning process continues for 10 days and egg development is monitored during this period. As a result of the controls made several times in this process, by looking at the ultrasonography data, if necessary, the dose can be changed by looking at the hormone level. If there is a decrease in estrogen as a result of the examinations, it means that the process is progressing normally.

Egg Collection Process in IVF Treatment

In the follow-up process for egg development, if it is seen that the egg has matured sufficiently, an injection is performed to complete the last developmental stage. The collection of eggs in the relevant treatment process is carried out at 36 hours after the last drug injection. At this stage, the expectant mother who is considering pregnancy may be sedated with sedatives or sedatives or anesthetized. The process of this process is like ultrasonography in the developmental follow-up phase. Only in this process, a needle to which the ultrasonography device is attached is passed through the vagina and eggs are collected from the ovaries. After this process, which lasts for thirty minutes, the fertilization process takes place with the sperm cells taken. On the other hand, the couple who rested for 2-3 hours after the egg collection process is discharged and the couples are informed by recommending drugs.

Egg Collection Complications

Although it is very rare, it is possible for some complications to develop during OPU, which is one of the natural stages of the in vitro fertilization process as egg collection. Some of these complications, which are seen with a very low frequency rate, are; ovarian bleeding, bleeding in the vaginal area and pelvic infection.

Fertilization (Fertilization)

After the OPU process Among the collected eggs, mature ones are determined and kept in the incubator at a suitable temperature for 2-4 hours, then fertilization is started. At this stage, the man is asked to masturbate and give sperm. If the man is unable to give sperm or has azoospermia, sperm is obtained from the man by micro TESE application. Now the preparation for the fertilization of the eggs is completed. After fertilization, the embryo is formed and the embryo develops in the uterus and the baby is formed. Fertilization can be performed in two alternative ways. With the In-vitro Fertilization method, sperm cells taken from the male are left near the egg cell and one of these sperm can fertilize the egg by itself. This method is known as the classical IVF treatment method and it is aimed to give 50-100 thousand sperm for each egg cell. The other method is the microinjection method. With this method, only one sperm is delivered to an egg by microscopic methods and fertilization is completed. Although the microinjection method is more common in the modern period, the probability of fertilization is higher. Egg cells that are suitable for in vitro fertilization with microinjection are in the Metaphase-II stage. Since the eggs in the metaphase-I stage are not completed in terms of maturity, they cannot be used for fertilization

Embryo Transfer in IVF Treatment

After fertilization is completed, a determined number of embryos are placed in the mother’s uterus, and this application is called embryo transfer. The pregnancy test, which will be carried out in the 12-day period following the transfer process, is also tested whether the pregnancy has occurred or not. This application phase is done 2 to 5 days after fertilization. The structure of the embryo is in the form of 4 or 8 cells during this period. On the other hand, the embryo remaining on the 5th or 6th day acquires a hollow structure and this state is called blastocyst. In some rare cases 5-6. Transfer can be performed on days, but this application is called blastocyst transfer. Embryo transfer process takes place with an operation of 5-10 minutes. Since it is a painless and uncomfortable operation, there is no need for anesthesia. You are discharged from the hospital shortly after the completion of the procedure. In order to perform the procedure, the speculum is placed in the examination position on the gynecology table and the cervix is ​​cleaned with special liquids before that. Embryos brought by the embryologist from the laboratory are placed into the uterus through a catheter. The decision of how many embryos will be placed in the uterus is determined by a number of basic criteria. It is considered inconvenient because of the risk of twin or triplet baby transfer from a large number of embryos. On the other hand, a small number of embryos are transferred to pregnant candidates who are young and have high quality embryos, and more embryos are transferred to pregnant candidates who are older and have low embryo quality. If the zona layer on the outside of the embryo to be transferred is thick, zona thinning is done by laser method and then the transfer is made. After embryo transfer, if the remaining quality embryos are to be used in the future, they can be used by freezing them. During the embryo transfer process, progesterone drugs are often recommended and the way of use is explained by the physician. The drugs given can be given as capsules, vaginal gels or injections. In addition, if vitamins and different drugs are prescribed, they should also be used with caution. 12 days after the embryo transfer takes place, it reaches the stage where a pregnancy test can be performed. Immediately afterwards, it is possible to visualize the baby with ultrasound again in a period of 10 to 14 days. During the embryo transfer application, a trace amount of stain or bleeding can be seen and this often ends on the same day, but if you observe that the severity of bleeding is excessive, a doctor should be consulted. Again, there may be low-intensity groin or low back pain after the transfer application, and in this case, painkillers should not be used without a doctor’s recommendation. After the embryo transfer stage, it is necessary not to have sexual intercourse until the doctor’s permission is given. If there is no positive result from the pregnancy test at the end of the 12-day period, sexual intercourse can be started and if pregnancy occurs, sexual intercourse is prohibited until the doctor’s permission is obtained. In the stages following the pregnancy process, if there is no negative effect on the growth of the pregnancy in the 2-3 month period, the prohibition of sexual intercourse is lifted.

Post-Transfer Medication

After embryo transfer, hormone drugs are often prescribed by the doctor and the way of use, dose and frequency are described to the patient by the doctor. In addition to these drugs, the use of vitamin drugs is also recommended when necessary. The regular use of these drugs as described, the healthy progress of the treatment process and the accurate data collection. It is very important to keep track of.

After IVF Treatment

In IVF treatment, it is important to show sensitivity and support the development by following the doctor’s recommendations after the completion of the application stages and the confirmation of pregnancy. Especially during this period, the mother should continue to use the recommended drugs and vitamins regularly, comply with the prohibition of sexual intercourse and avoid physical fatigue. Alcohol use and smoking should also be avoided. There may be some situations that may develop out of routine after treatment. These may be the practices performed during the treatment process, the use of drugs and the factors that trigger personal general health problems. The unsuccessful outcome of the treatment process is also included in the post-treatment process.

Pregnancy test

A blood pregnancy test is performed 12 days after the completion of the embryo transfer. Since the drugs used by the patient cause a delay in menstruation, it should not be thought directly that one is pregnant in case of delay in menstruation. Pregnancy test should be done and the situation should be learned by looking at the result. If a positive pregnancy result is detected in the blood, 10 days are waited for the ultrasound application and the pregnancy sac can be viewed with ultrasound, and the number of implanted embryos can be displayed. At this stage, 2 or 3 embryos can be seen, but embryos that can settle naturally at this stage may be lost later.

The Reason for Failure in IVF Treatment

During the IVF treatment for pregnancy, the reproductive cells taken from the mother and father are brought together in a laboratory environment. After this fertilization, an embryo suitable for transformation into a baby is formed, and then these embryos are kept in culture media and fed. As a result, the embryo that is ready for pregnancy is transferred to the mother’s womb, and those that cannot be used are stored for future use by freezing. Embryo transfer is the last stage for pregnancy practice, but since failure is as much as the success rate at this stage, the factors causing it should be examined. According to the general judgment, if pregnancy does not occur despite the high quality embryo transfer applied 3 times, and also, the absence of pregnancy despite the use of more than 10 embryos in total indicates a failure in in vitro fertilization treatment. However, there is no harm in in vitro fertilization from a medical point of view, and it is recommended to apply for treatment again before one or more failures are seen as repeated failures. There are 3 different degrees of negative results experienced during the IVF treatment process. The first of these, the primary causes, are defined by poor quality embryo formation, incorrect drug treatment and feeding of the embryo in faulty environments, and in addition, the thickening of the embryo membrane. Although these mentioned negativities are a major factor in the unsuccessful outcome of in vitro fertilization, eliminating the problems in these matters in further trials increases the probability for pregnancy to occur. Besides the primary reasons, there are also secondary reasons; These are usually problems arising from the expectant mother. Deformations in the inner wall of the uterus, fibroids and polyps, infection-related adhesions, coagulation disorders and disorders in the autoimmune system are among these, and as a result of these conditions, IVF treatment fails. In vitro fertilization failures caused by secondary causes should be examined and problems arising from the mother’s womb should be eliminated. Since the probability of successful results from IVF treatment without eliminating these problems is very low, in vitro fertilization treatment should be applied after the operation and treatment process has been initiated in order to eliminate the factor that hinders the development of IVF. Another group of failures in IVF treatment is the tertiary causes, which are also treatable causes. Chocolate cysts and tube malfunctions are among the tertiary causes. Adherence of the fallopian tubes due to infection or damage to the tubes as a result of a previous surgical procedure are among the tertiary causes. Due to the obstruction of the tubes, the accumulation of fluid and the shift of the fluid to the ovaries, the IVF will be difficult to adhere to and the treatment may fail. Although these three general factors listed in failures in IVF treatment are related to the mother, there are also problems that may arise due to the father-to-be. If the sperm quality of the father-to-be is low, the sperm count is insufficient, and the quality of the embryos created with poor genetic factors, the quality of the embryos will also decrease, and in such a case, the embryo will not be able to hold on to the mother’s uterus and in vitro fertilization treatment may fail. With all these failed in vitro fertilization practices

As a result of this, the mother and father-to-be should first of all keep their morale high and remember that the practice is repeatable. First of all, prospective parents who have negative results in the first IVF treatment are examined to determine the factors that cause this situation, and after the completion of the examinations, the factors that cause unsuccessful IVF application should be determined and eliminated.

Complications That May Occur in IVF Treatment

IVF treatment is performed as an operation that requires drug use, injection and anesthesia as a medical application process and is followed by specialist physicians. Before starting the application, a number of tests are performed on the mother and father-to-be, it is aimed to diagnose all the risks that may occur during the application process and the risk of complications that may arise is reduced. It should be noted that despite all the tests, the human body, which is a complex structure, may give unexpected reactions during the IVF treatment process. At this point, if you encounter any negativity during and after the IVF treatment, it is recommended that you consult your doctor as soon as possible.

IVF Success Rates

When the data on IVF treatments of mothers and fathers who cannot have a baby due to infertility are statistically interpreted, it is observed that the success rate in pregnancy with IVF varies especially with age. The success rate in IVF pregnancy is 60% in patients under the age of 30, 40% around the age of 35, and 15% in those over the age of 40. These rates are valid for conditions in which the treatment is tried only once, and since in vitro fertilization is a repeatable operation, when the statistical data on repetitive treatment is examined, it is seen that the success rate reaches up to 90% in the fourth attempt. On the other hand, after the failure in the first attempt, the factors that cause this situation are determined through examinations, and then the removal of drugs and operations ensures a high rate of success in the next application of the treatment.

Is It Possible to Have Twins in IVF Treatment?

After the fertilized eggs prepared with IVF treatment become embryos, only one is not placed in the mother’s womb. It is aimed to start the pregnancy by placing more than one embryo and at least one of them clinging to the mother’s uterus. As the number of embryos placed during the application increases, the probability of twins and even triplets increases. Therefore, it is possible to have twins with IVF treatment.

Is There a Low Risk in IVF Application?

The biggest fear of every expectant mother during pregnancy is the possibility of miscarriage. At this point, the fear of miscarriage is higher, especially in women who become pregnant with IVF treatment. According to the results, the possibility of miscarriage in IVF treatment is higher than in normal pregnancy, and this is due to hormonal factors. In a naturally occurring pregnancy, while a single egg grows in the mother’s womb, hormone production occurs at a rate dependent on this egg. In IVF treatment, more hormone production occurs due to the placement of 10-15 eggs at once in the mother’s womb. In this case, when the progesterone hormone is insufficient against the produced estrogen, the risk of miscarriage increases, but by providing support during the treatment process, the progesterone hormone is reinforced and thus the miscarriage risk is brought to the same level as natural pregnancy.

If IVF Treatment Fails, Can It Be Applied Again?

In IVF treatment, a large number of embryos are fertilized in the laboratory during the fertilization phase, and a certain number of embryos are transferred to the mother’s womb. The remaining embryos are stored in laboratories under special conditions by being frozen with the approval of the parents-to-be, and are kept ready for use in the next IVF applications in case the treatment fails. In case of failure of IVF treatment, re-application can be made. Moreover, in the event of a failure in the first application, as it will be easier to identify the factors causing it, it will be easier to eliminate the related negative factors and the success rate of repetitive applications will increase.

How Many Times Can IVF Treatment Be Applied?

When unsuccessful results occur in IVF treatment, it becomes easier to detect the factors causing this situation and drug and operation interventions are made to increase the success rate for the next applications. In this sense, although there is no application limit in IVF treatment, the diagnosis of whether to have a baby with this method is made by the specialist physician, and the family is informed and alternative methods are applied.

When to Start Needles in IVF Treatment?

During IVF treatment, various needles that are different from each other and have different purposes are used. It is not possible for every needle to be used or the method of use being the same for every patient. The patient’s problems are used. In the first stage, hormone injections are used to increase the egg quality of the patient. Treatment begins with these needles. Afterwards, egg collection is performed. After the eggs that are fertilized correctly in the external environment are placed, the use of various needles continues to ensure their quality development. In short, in vitro fertilization treatment starts with needles and continues for a while after fertilization.

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