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Basic principle; stimulation of the ovaries with COS, injection for ovulation after the follicles reach a certain size, egg collection after 35-36 hours, fertilization of egg cells with sperm cells, follow-up of the resulting embryos and transfer of the embryo into the uterus on the second, third or fifth day, depending on the current conditions.
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Although there are various treatment protocols, the most commonly used is the Short Protocol. Evaluation is made with vaginal ultrasonography within the first two days of menstruation. If there is an ovarian cyst larger than 10 mm, the treatment is either postponed or the cyst is evacuated and treatment is started. In patients with an expected average response, a dose of 150-300 IU is sufficient. The first evaluation is made after 4-5 days. The gonadotropin dose is determined according to the patient's age, ovarian reserve and previous stimulation results, if any. Endometrial thickness is measured. Follicle development is evaluated in ultrasonography. If necessary, the drug dose is adjusted by checking the Estradiol level in the blood. As the follicles continue to grow, Antagonist injection is added to the treatment to prevent premature ovulation. After necessary frequent ultrasonography, hCG injection is applied for ovulation when the leading 2-3 follicles reach a diameter of 18-20 mm. After 35-36 hours, eggs are collected under sedation anesthesia and guided by vaginal ultrasonography. Meanwhile, a sperm sample is taken from the patient's partner. Mature eggs are fertilized on the same day by microinjection method and their development is monitored. According to the number and quality of embryos; Transfer is made on day two, three or five. If there are sufficient number and quality embryos, fifth day transfer is preferred. If we have embryos of good quality that can be frozen after the transfer, the embryos are frozen with the consent of the couple.
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Progesterone support must be given after the transfer. This support is continued until fetal heartbeats are seen or until the 8th week of pregnancy.
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11-12 weeks after transfer. A blood pregnancy test is performed daily. If the test is positive, an ultrasound check is appropriate after a week. Routine pregnancy follow-up begins after the gestational sac is seen in the uterus.
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