Who is IVF treatment recommended for?
In Vitro Fertilization (IVF) treatment is a beacon of hope for couples who cannot achieve pregnancy through natural means. This treatment method may be recommended for couples with various causes of infertility. Each couple's situation is unique, and suitability for treatment is determined after a detailed evaluation. Generally, IVF treatment is recommended in the following situations:- Female Factor Infertility:
- Blocked or Damaged Fallopian Tubes: Blocked or damaged fallopian tubes can prevent the egg and sperm from meeting, making natural fertilization impossible.
- Endometriosis: The growth of tissue similar to the uterine lining outside the uterus can impair ovarian function and tube structure, making pregnancy difficult.
- Ovulation Disorders: Conditions that prevent regular ovulation, such as Polycystic Ovary Syndrome (PCOS), may bring IVF into consideration when other treatment methods have not been successful.
- Diminished Ovarian Reserve: As a woman ages, ovarian reserve and egg quality decrease. This situation may necessitate IVF treatment even at younger ages.
- Male Factor Infertility:
- Problems with Sperm Count, Motility, or Morphology: When severe problems are detected in sperm analysis, IVF treatment with microinjection (ICSI) can be applied.
- Sperm Duct Obstruction or Sperm Production Disorders: In severe male factor infertility, sperm can be obtained from the testicles using surgical methods (TESA/TESE/Micro TESE) and used in IVF treatment.
- Unexplained Infertility: In couples where the cause of infertility cannot be found despite all tests, IVF treatment may be initiated after a period of trying other treatments (e.g., intrauterine insemination - IUI).
- Genetic Disease Carriers: If one or both partners are carriers of a genetic disease, IVF treatment may be preferred to apply preimplantation genetic testing (PGT) on embryos and select healthy embryos.
- Failure of Other Treatments: When simpler infertility treatment methods (such as medication or IUI) fail, IVF treatment is the next step.
As Ankara IVF Center, we conduct a comprehensive evaluation to create the most suitable treatment plan, taking into account each couple's specific situation. Discussing all options and expectations in detail before starting treatment is one of the most important steps in this process.
Step-by-step treatment process
IVF treatment consists of a series of careful and planned stages. Each of these stages is crucial for increasing the chance of pregnancy. Here are the IVF stages:
Initial Assessment and Preparation
Before starting treatment, a detailed health history of the couple is taken, and comprehensive physical examinations are performed. For women, tests such as hormonal tests, a uterine film (HSG), and ultrasonography are requested; for men, tests such as sperm analysis are requested. As a result of these evaluations, the cause of infertility is determined, and a personalized treatment plan is created. At this stage, the guidance of an experienced physician like Prof. Dr. Kubilay Vicdan is critical for treatment success.
Ovarian Stimulation
While typically only one egg develops in a natural menstrual cycle, IVF treatment aims to obtain more eggs. For this purpose, specific hormone medications (usually in the form of injections) are administered to the woman. These medications promote the growth of follicles (sacs containing eggs) in the ovaries and the maturation of multiple eggs. This process usually lasts 10-14 days.
Monitoring Egg Development
During ovarian stimulation, egg development is closely monitored. Regular ultrasonography checks measure follicle sizes, and blood tests monitor hormone levels. These follow-ups help adjust medication doses and ensure eggs are collected at the right time.
Trigger Shot
When the follicles reach sufficient size and the eggs mature, a special hormone injection called a "trigger shot" is administered to ensure the final maturation of the eggs and prepare them for the egg retrieval procedure. The timing of this injection is extremely important, as the egg retrieval procedure (OPU) is planned approximately 34-36 hours after this injection.
Egg retrieval and laboratory stage
Egg retrieval and the subsequent laboratory processes, which are among the most critical stages of IVF treatment, involve the fundamental steps for embryo formation.
Egg Retrieval (Oocyte Pick-Up - OPU)
Egg retrieval is usually performed under light anesthesia (sedation) and takes approximately 15-30 minutes. Under vaginal ultrasound guidance, eggs are collected from the mature follicles in the ovaries using a thin needle. This procedure is generally painless, and the patient recovers quickly. The collected eggs are immediately transferred to the laboratory.
Sperm Collection and Preparation
On the same day as egg retrieval, a sperm sample is collected from the male partner. If sperm cannot be obtained naturally or if there is severe male factor infertility, previously frozen sperm can be used, or sperm can be obtained from the testicles using surgical methods (TESA/TESE/Micro TESE). The collected sperm sample undergoes special processing in the laboratory to select the healthiest and most motile sperm.
Fertilization
In the laboratory environment, the collected eggs and prepared sperm are brought together. Fertilization generally occurs through two methods:
- Classic IVF (In Vitro Fertilization): Eggs are placed in a special culture dish, and a certain number of sperm are added around them. The sperm are expected to fertilize the egg naturally.
- Microinjection (Intracytoplasmic Sperm Injection - ICSI): This method is preferred, especially in cases of male factor infertility. A single sperm is injected into each mature egg using a special needle under a microscope. Microinjection significantly increases the chance of fertilization.
Embryo Development and Monitoring
After fertilization, the resulting embryos are monitored in special incubators. Embryologists regularly observe the development of the embryos and select the healthiest, best-developing embryos. Embryos are usually cultured in the laboratory for 3 to 5 days. Embryos that reach day 5 are called "blastocysts" and may offer a higher chance of pregnancy for transfer.
In some special cases, embryos may need to be genetically examined before being transferred to the uterus. Preimplantation Genetic Testing (PGT) is an important option for couples carrying a risk of genetic diseases.
High-quality embryos not used after transfer can be frozen and stored for future pregnancy attempts.
Embryo transfer and post-transfer
Embryo transfer is the most exciting and hopeful stage of IVF treatment. It is the process of placing embryos developed in the laboratory into the mother's uterus.
Embryo Transfer
Embryo transfer is generally a painless procedure and does not require anesthesia. Using a thin and flexible catheter (tube) guided by ultrasound through the vagina, the selected embryo or embryos are placed inside the uterus. The number of embryos to be transferred is determined by the physician and the couple's mutual decision, based on the woman's age, embryo quality, and previous treatment history. Generally, single embryo transfer is recommended to reduce the risks of multiple pregnancies.
Post-Transfer Process
After embryo transfer, the patient is advised to rest for a short period. Afterward, normal daily activities can be resumed, but it is important to avoid heavy physical activities and stress. Hormone-supporting medications (such as progesterone) recommended by the physician should be used regularly. These medications help the uterus accept the embryo and maintain the pregnancy.
Pregnancy Test
Approximately 10-12 days after transfer, a Beta-hCG blood test is performed to check for pregnancy. This waiting period can be emotionally challenging for couples. During this time, patience and adherence to your doctor's advice are crucial. If the test result is positive, ultrasound examinations begin for pregnancy monitoring. In case of a negative result, the situation is re-evaluated, and next steps are planned.
Frequently asked questions
It is quite natural for couples to have many questions about IVF treatment. Here are some of the most common questions we encounter:
How long does IVF treatment take?
One cycle of IVF treatment, excluding the initial assessment and preparation phase, lasts approximately 2 to 3 weeks from the ovarian stimulation process to the pregnancy test. However, when initial assessments, tests, and the planning process are also taken into account, the entire treatment process can take several months.
Is IVF treatment painful?
Egg retrieval is usually painless as it is performed under light sedation. Mild cramping or discomfort may be felt after the procedure. Embryo transfer is generally painless and does not require anesthesia. Overall, the level of pain or discomfort felt during the treatment process varies from person to person but is tolerable and can be managed with medication.
What are the success rates of IVF?
IVF success rates vary depending on many factors such as the woman's age, the cause of infertility, embryo quality, the treatment protocol applied, and the experience of the center. Success rates are higher in younger women, while these rates may decrease with advancing age. The chance of pregnancy success is highly individualized, and giving a general rate can be misleading. As Ankara IVF Center, we aim to provide the most realistic expectations by evaluating each couple's specific situation.
Is there a risk of multiple pregnancies?
Yes, in IVF treatment, the risk of multiple pregnancies (twins, triplets, etc.) increases if more than one embryo is transferred to the uterus. However, in modern IVF practices, especially in younger patients with a good prognosis, single embryo transfer (SET) is preferred to minimize this risk. This approach is safer for both maternal and infant health.
What should be done if the treatment fails?
It is natural to feel disappointment if IVF treatment fails. However, this does not mean you should lose hope. After an unsuccessful attempt, you can re-evaluate your situation with your physician and plan different strategies or additional tests for the next treatment. With patience and the right approach, many couples eventually realize their dream of having a baby.
On your journey to parenthood, Ankara IVF Center stands by you with our scientific knowledge and patient-centered approach. Prof. Dr. Kubilay Vicdan and our team offer all the support to determine the most suitable treatment plan for you and to help you navigate this process as comfortably as possible. Remember, you are not alone on this journey. Contact us to get one step closer to your dreams and learn about your personalized treatment options.
For more information or to have your questions answered, you can schedule a free initial consultation.