In vitro fertilization, which is one of the assisted reproductive treatment methods, is a treatment method that has been successfully applied for many years for people who cannot conceive naturally.
What is IVF Treatment?
IVF The treatment method offers the opportunity to have a child with a healthy birth to families who cannot have children due to problems such as infertility of unknown cause, advanced age, low sperm count or quality in men, infection in women and obstruction in the fallopian tubes.
The person's delay in having a child, or in other words, the age factor may also prevent the formation of pregnancy. However, the person can benefit from IVF treatment until the age of 45. Before proceeding to the stages of IVF treatment, it should be well understood what IVF treatment is.
How Does Pregnancy Happen Through Natural Ways?
In order for a person to conceive naturally, the hypothalamus in the brain must first stimulate the pituitary gland. . Thus, the pituitary gland secretes LH (Luteinizing hormone) and FSH (Follicle stimulating hormone) hormones. Hormones reaching the ovaries through the circulatory system stimulate the egg follicles (vessels) in the ovarian reserve. After this stimulation, some of the eggs mature and the healthiest ones are cracked and thrown into the fallopian tubes, a kind of channel between the uterus and the ovaries.
After this point, the egg follicle secretes estrogen hormone and thickens the endometrium, known as the uterine wall. The thickening of the uterine wall allows the embryo to attach to the uterus during a possible pregnancy and to continue the pregnancy in a healthy way.
Fertilization is provided by the combination of sperm and egg, which are reproductive cells, in the fallopian tubes, and the embryo is formed as a result of fertilization. As the egg travels from the fallopian tubes to the uterus, it can remain alive in a woman's body for 24 hours. However, the male reproductive cell sperm can remain alive in the female body for 3-4 days. In other words, a person can get pregnant if he has sexual intercourse a few days before the egg is released into the fallopian tubes.
During this whole process, fertilization may not occur due to many different ailments. unprotected and regularly If pregnancy cannot be achieved despite having sexual intercourse throughout the year, the couple should consult a physician and the causes of infertility should be investigated. In vitro fertilization treatment can be started after the condition that prevents pregnancy is detected. In this case, pregnancy can be achieved with different techniques according to the current situation of the person.
How is IVF Treatment Performed?
In vitro fertilization is an assisted reproductive treatment method used for couples diagnosed with infertility to have children. In IVF treatment, the eggs collected from the mother-to-be are brought together with the father-to-be's sperm in the laboratory and fertilized. The healthiest of the embryos resulting from fertilization are transferred to the uterus of the expectant mother. After all these procedures, 11 days later, a pregnancy test is applied to the expectant mother and it is observed whether pregnancy has occurred.
In this method, which can also be defined as artificial insemination, mostly IUI, (Intrauterine insemination, vaccination) IVF, (In vitro fertilization) IMSI (Intracytoplasmic morphologically selected sperm injection) and ICSI (Intra cytoplasmic sperm injection) methods are used.
What is Laser Nesting?
If the membrane (zona) surrounding the embryo is thick and hard, it may be difficult for the embryo to attach to the uterus because the membrane cannot be torn off. In such cases, pregnancy does not occur because the embryo, which cannot get out, cannot adhere to the uterus. With the laser method, a hole is created in the membrane by making a laser shot of the appropriate size and dose. The embryo is easily attached to the uterus by getting to the uterus.
Who Can Be Applied to IVF Treatment?
In vitro fertilization treatment is applied to people who cannot achieve pregnancy despite regular and unprotected sexual intercourse for 12 months. Since the chance of conceiving after the age of 35 is lower, this period is 6 months. In vitro fertilization treatment can be applied in the presence of the reasons listed below. >
What are the Stages of IVF Treatment?
In vitro fertilization treatment, which starts with a doctor's consultation and consists of 7 stages, ends with a pregnancy test. The stages of IVF treatment can be listed as follows:
1) Interview with the Physician
Couples who cannot conceive naturally, should first consult with the physician in case they apply to the hospital for IVF treatment. Both couples are expected to attend this examination. The doctor first listens to the couple's story. After a detailed gynecological examination, the physician checks the reproductive system of the expectant mother with ultrasound. Additional radiological imaging and laboratory tests are performed when deemed necessary. At this stage, it is primarily aimed to diagnose the existing infertility in the couple. After the diagnosis is clarified, the next stage is passed.
2) How Much Estrodiol (E2) Should Be Used in IVF Treatment?
Estrodiol (E2) is used to determine whether the reproductive function is regular in women of childbearing age. It is one of the laboratory tests performed before the procedure in IVF treatment. It reaches zero in women in menopause.
E2 level varies according to the laboratory where the measurement is made. Normal E2 levels for age periods or in special circumstances:
- 30 – 400 pg/ml for women of childbearing age
- Pregnancy 10-35 pg/ml
- Follicular phase 30-119 pg/ml
- Peak 149-350 pg/ml
- Luteal phase 97-216 pg/ml
- Ovulation tracking 29-97 pg/ml
- 0 – 30 pg/ml for postmenopausal women
- 10 – 50 pg/ml for men ml
- For children < 10 pg/ml
3) Egg Stimulation
At this stage when IVF treatment begins, the expectant mother should On the second or third day, the doctor is called for examination. The ovaries of the expectant mother are evaluated with ultrasound. If necessary, additional laboratory examination is requested to investigate the hormone values of the person. In the light of the results obtained, drug therapy is initiated to the expectant mother to stimulate the eggs. Regular and prescribed medications The person is informed in detail to use the recommended dose. With FSH and hMG injections, the ovaries are stimulated and the development of the follicles is ensured. Since follicle development directly affects the chance of IVF success, it is extremely important to determine the dose of drugs and needles correctly at this stage. After approximately 8 to 10 days of needle use, the follicles are 18 to 20 mm. comes in size. Then, an egg cracking injection is given to the expectant mother and her follicles are cracked. This procedure, performed under general anesthesia, is painless. Mature eggs collected from the vaginal route are taken to the laboratory environment to be prepared for the next procedure.
5) Artificial Fertilization
The collected eggs are examined under a microscope in the laboratory environment. The healthiest ones are fertilized with sperm from the father-to-be. Two different methods are used at this stage. The first method is the classical IVF application. In the first method, eggs and sperms are left in the same environment and sperm are expected to fertilize the egg. The second method is microinjection. In this procedure, which must be done with extreme precision, the sperm is injected into the egg using a microcannula. Which method will be used in the treatment differs according to the characteristics of the egg and sperm, and the previous treatment methods. After the fertilization of the eggs, the healthiest embryos are separated.
6)Embryo Transfer
Another important step in IVF treatment is embryo transfer. For this procedure, which usually does not cause pain or pain, anesthesia can be applied to those with a low pain threshold. In this procedure, which is carried out between the 2nd and 6th days after the egg collection, the embryos are transferred to the uterus of the expectant mother with the help of a catheter. At this point, it is the couple's discretion whether to freeze other embryos obtained. There may be complaints such as mild spotting or groin pain after embryo transfer. If the severity of the complaints increases, the physician should be informed.
7) Supportive Treatment
After the embryos are transferred to the uterus, it facilitates the attachment of the embryo to the uterus. For the river, drug treatment is started for the expectant mother. Re-use of needles and drugs used during the treatment is recommended. Although these complaints do not indicate that the embryo is adhered to 100%, they are common symptoms reported by some patients. There is no conclusive evidence that adherence was successful other than the rise of beta HCG.
On the 11th day after embryo transfer, blood is taken from the expectant mother and Beta HCG test is performed. This test, which enables the definitive determination of the presence of pregnancy, can be repeated two days later in some cases. In case of pregnancy, IVF treatment ends.
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