In vitro fertilization is a preferred reproductive technique in the presence of an obstacle to spontaneous conception or in cases where pregnancy cannot be achieved despite simple treatments (such as vaccination).
In the in vitro fertilization treatment, the egg taken from the woman is brought together with the sperm from the man in the laboratory and fertilization is provided. The resulting embryo (baby cell) is placed into the mother’s uterus with special catheters with the help of ultrasound.
1) Evaluation of the couple
The evaluation of women and men should be carried out by an experienced specialist. Some hormone tests (such as AMH, TSH, Prolactin), ultrasound control with a complete gynecological examination, medicated uterine film for evaluation of tubes; Some blood tests with spermiogram are usually sufficient for initial evaluation. As a result of the evaluation, if there is a problem that needs to be corrected before treatment, it is appropriate to solve them and start some vitamins in the pre-preparation period.
2) Stimulation Period of Ovaries
The most appropriate treatment protocol is determined by considering your examination findings and previous treatments. In the treatment, long-term protocols, which last about 3 weeks, or short-term protocols, usually started less than 2 weeks (mean 11-13 days) can be preferred. Ultrasound and blood tests will be required at regular intervals during and during treatment (short protocols usually require 3-4 times ultrasound and 2 times blood testing within a period of 11-13 days).
Egg enhancers are needles around the navel and are basically similar to the egg-growing hormones found in your body. The dose of egg-developing needles is determined by your doctor based on your egg reserve, age, weight and, if any, the response of your ovaries to previous treatments.
3) Fracture Needle Application and Egg Collection (OPU) Period
After reaching the required egg size and number with the needles made from the core, the timing of the maturing needles called cracking needles is made. There are basically two different types of content (hCG containing / GnRH analog containing), although they are available on the market under different names. Your doctor will determine which dose should be used. Approximately 35 hours after the cracking needle is applied, the egg total process (Oocyte Pick Up; OPU) is performed.
Egg collection is a painless procedure that requires 10-15 minutes with the help of intravenous anesthetic drugs called sedation anesthesia. As with any anesthetic medical application, the patient should be hungry for 6 hours before the procedure and not eat or drink anything.
On the day of the egg collection process, sperm samples will be taken from your partner and prepared before fertilization process and the highest quality ones will be intensified. In order to use fresh sperm with high mobility, it is recommended that your partner perform sexual abstinence for 2-3 days before the procedure.
New medicines will be added to your treatment on the day the eggs are collected (such as progesterone).
Fertilization of the eggs with sperm is performed by the embryologist in the laboratory. Various technical methods are available for fertilization:
** In Vitro Fertilization (IVF) Method: In this method, the collected eggs are placed in special culture containers and sperm are expected to fertilize the egg by placing enough sperm around each egg. The presence of fertilization is evaluated with a microscope after 16-18 hours.
** Intra Cytoplasmic Sperm Injection (ICSI) Method: In this method, after the eggs are extracted, 1 sperm selected by the embryologist is placed into each egg under the microscope (injected with special needles) to ensure that the sperm enters the egg. This is the more preferred method today. The presence of fertilization is evaluated with a microscope after 16-18 hours.
** IMSI (Sperm Microinjection Selected by High Microscopic Magnification): The IMSI method is a method for sperm selection, especially in couples with formal defects and allows for a more detailed evaluation of sperm than standard microscopes. With this method, the diagnosis of head anomalies, etc., can be made more precisely in the sperm cell evaluated with magnification of 6000-8000 times.
5) Laboratory Monitoring of Embryos
16-18 hours after fertilization, the embryologist checks whether fertilization occurs. Embryos are followed by special called incubators.
6) Embryo Transfer
The timing of the embryo transfer will be done by your doctor. If the inner membrane of the uterus or hormone values are not suitable, the transfer process may be postponed to the next month and your embryos may need to be frozen.
If the embryo transfer is to be performed in the month in which the egg is collected, the transfer procedure is carried out at the 3rd-4th. or on the 5th day. The day of embryo transfer will be determined by the physician and embryologist with regard to the number of embryos, quality and, if any, your previous treatment results.
If you have good quality embryos left behind after transfer, you can freeze and store them.
The transfer process is painless and does not require any anesthesia application in patients who may have vaginal examination. Before the procedure, you are asked to be squeezed into the urine by drinking water so that the ultrasound transfer catheter and the location of the embryo can be clearly monitored. After transfer, you are taken to the room to rest for about 1 hour. You can be discharged after explaining the drugs to be used after the transfer and the points to be considered.
7) Evaluation of Transfer Result
You can learn the result of treatment with beta hcg test to be examined from the blood after the average 12 days after the transfer. You must share your result with your doctor.