turk health expert
turk health expert

IVF (In Vitro Fertilization)

What is infertility?

Infertility generally refers to the condition where a pregnancy cannot be achieved despite unprotected intercourse for a period of one year.

When should medical support be sought?

In a healthy couple who desires to have a child, it is typically expected for pregnancy to occur within one year under normal circumstances. After this period, medical assistance can be sought from a doctor. However, couples who are unable to conceive under the following conditions may seek medical help before the end of one year:

  • Female

    • Being over 35 years old

    • Irregular menstrual cycles or amenorrhea (absence of menstruation), severe dysmenorrhea (painful periods)

    • History of previous pelvic infection, abdominal surgery, or complicated appendicitis

    • History of two or more miscarriages

    • History of sexually transmitted infections

  • Male

    • History of previous testicular surgery, testicular injuries, or infections affecting the testicles (such as mumps during childhood)

    • Sexual disorders and/or erectile dysfunction

    • History of sexually transmitted infections

    What are the methods used in the treatment?

    Assisted reproductive treatments and the processes involved can be summarized as follows:

    It is recommended for both partners to visit the doctor together during the initial examination. After the examination, the doctor may request certain tests to confirm the diagnosis and provide detailed information about treatment options.

    Based on the specific medical needs determined after the diagnostic process, ideal treatment options are determined.

In Vitro Fertilization (IVF)

In this method, once the stimulated oocytes reach a specific size and maturity with the support of hormone medication, they are retrieved from the prospective mother through an "oocyte collection" procedure performed under anesthesia. The collected oocytes are then placed in a specialized solution in the laboratory, where they are kept in an incubator that mimics the conditions of the uterine environment. On the other hand, the sperm obtained from the patient's partner undergoes special laboratory procedures to facilitate the fertilization of mature oocytes under a microscope. If the sperm count is too low to achieve fertilization, in vitro fertilizationcan be manually performed in the laboratory using intracytoplasmic sperm injection (ICSI) technique. After the procedure, the fertilization and division of the oocyte are closely monitored. The embryos that develop and reach a certain quality are selected within 2-5 days and are then transferred into the uterus using a thin catheter. The number of embryos to be transferred into the uterus varies depending on the age of the prospective mother, the quality of the embryos, and previous attempts. However, in many countries, the number of embryos to be transferred is determined by legal and ethical limits.

Hormone Therapy

Hormone therapy is used to trigger ovulation in patients who experience disruptions in the normal ovulation process, such as irregular menstrual cycles. The hormonal support provided for the maturation of the oocyte can increase the chances of pregnancy.

Intrauterine Insemination (IUI)

The process involves the direct injection of specially prepared and processed sperm into the woman's uterus (womb) during her ovulation period, using specialized equipment by the physician.

This procedure increases the chances of pregnancy by placing the sperm closer to the site of fertilization (fallopian tubes). It enhances the likelihood of pregnancy, particularly due to the separation of rapidly moving healthy sperm and the stimulation of the oocyte through hormone therapy.

Minimally Invasive Surgery

In some cases, infertility can be caused by a mechanical obstruction. For example, partial or complete blockage in the fallopian tubes, where fertilization occurs, can prevent the onset of pregnancy. Similarly, conditions that disrupt the quality of the implantation site, such as scar tissue or endometriosis within the uterus, can also be causes of infertility. The elimination of these structural/mechanical problems through laparoscopic methods is used in infertility treatment in some cases.

Reproductive Endocrinology

Some endocrinological (hormonal) disorders in both prospective mothers and fathers can be the cause of infertility. Therefore, resolving these issues may be necessary (or even sufficient) for successful pregnancy. After conception, it is important to closely monitor these problems until childbirth for the well-being of the baby. Once an endocrinological issue is identified, obstetricians/gynecologists refer their patients to an endocrinologist for ongoing monitoring and management in this regard.

Other In Vitro Treatments

In Vitro Maturation (IVM)

Mature oocyte cryopreservation, or oocyte vitrification, is a technique where immature oocytes are collected and matured in a laboratory setting instead of maturing inside the patient's body through hormone therapy. The immature oocytes are cultured in the laboratory for a period of 24 to 48 hours to allow them to mature, and then the fertilization process is carried out. Afterward, as in traditional treatments, the embryos are transferred to the uterus.

Microinjection – Intracytoplasmic Sperm Injection (ICSI)

The method you're referring to is called intracytoplasmic sperm injection (ICSI), which is used in cases where the sperm is unable to fertilize the oocyte. A single sperm with normal structure is selected and injected into the oocyte using a fine glass needle under high magnification with the aid of a microscope. By placing a single sperm into a single oocyte, the aim is to obtain several embryos. The subsequent process is then followed similar to in vitro fertilization (IVF) procedures.

Other Methods

Embryo Freezing

The process you're referring to is the freezing of embryos for future use, in case there are an adequate number of embryos available and good-quality embryos remaining after the transfer to the prospective mother. If pregnancy is not achieved or if the couple desires a second child in the future, the frozen embryos can be thawed and transferred to the uterus. Sperm freezing and oocyte freezing procedures are also methods used to preserve fertility for future purposes with similar goals and successful outcomes.

Preimplantation Genetic Diagnosis (PGD)

This refers to the examination of the chromosomes (genetic structure) of the unborn baby through certain tests. It is performed before the transfer of the embryo to the mother and is a crucial diagnostic method for couples at risk of carrying genetic diseases or having affected children. PGT (Preimplantation Genetic Testing) is recommended for couples who have experienced recurrent pregnancy losses, advanced maternal age, or multiple unsuccessful IVF attempts.