IVF Treatment

What is IVF Treatment?

Infertilityi.e. infertility, not being able to get pregnant despite regular sexual intercourse for a year means. In vitro fertilization is the last stage in infertility treatments. In this treatment, the eggs collected from the woman are combined with the sperm taken from the man in the laboratory environment, the resulting embryo is placed in the mother's womb.

How is IVF done?

In vitro fertilization treatment both men and women are evaluated together at the first application.

Conditions requiring IVF are as follows:

• If the woman has ovulation problem,

• Egg reserve, that is, if the existing egg number is insufficient,

• In patients with endometriosis,

• Tubes clogged, tubes removed or tied,

• Recurrent miscarriage and pregnancy losses (in such a case, genetically tested, considered healthy in vitro fertilization is required for strong>embryo transfer),

• In case of infertility due to advanced age,

• In case of unexplained infertility,

• Low motility in male sperm, deformity in sperm or sperm in semen (azoospermia)

• ● Congenital uterine disorder, absence of uterus and severe adhesions in the uterus, in patients who require surrogacy (it is not legal in our country).

Patients who cannot undergo IVF treatment are as follows:

• Unmarried infertile couples,

• women who have entered the menopause or the patient whose egg insufficiency is severe enough to prevent in vitro fertilization,

• Conditions in which no sperm can be obtained in men despite the surgical method (TESE or TESA).

WHAT IS THE IVF TREATMENT PROCESS? WHEN DOES IT START, HOW MANY DAYS IT TAKES?

The purpose of IVF treatment is to ensure egg development in the mother. Egg enlargement drugs are started on the second or third day of the menstrual cycle at the latest. For follow-up, the patient should come for examination at regular intervals.

During the menstrual period, ovulation hormone and thyroid tests are checked (FSH, LH, TSH, E2). According to the hormone results, the drug dose is determined, the drug is started to grow eggs for 3 days, the egg development, number and diameter are measured in ultrasound. Frequent examination may be required at 3-4 day intervals during egg follow-up. The diameter at which the eggs should grow is 16-18 mm, when this size is reached, cracking needle is made. The cracking needle is usually applied subcutaneously.

HOW IS EGG COLLECTION DONE IN IVF TREATMENT?

Fracture injection on average 36 hours after eggs are collected. This process is done from the bottom, that is, vaginally. The inside of the eggs, which are seen with the help of ultrasound, are emptied with a thin needle. Rarely, laparoscopic collection from the abdomen may be required.

The eggs are collected 36 hours after the injection. During the egg collection, the patient is put to sleep and does not feel pain. Collected eggs are taken to the laboratory. After fertilization, the growing embryo within 3-5 days is transferred to the mother guess, this process is called embryo transfer. The entire treatment takes an average of 10-15 days.

What are IVF needles?

In vitro fertilization needles are used for egg development and cracking used. In cases where a large number of eggs develop, other injections may be included so that the treatment does not have side effects. Almost all IVF needles are applied subcutaneously. The patient can inject himself, rarely bleeding, bruising at the injection site may occur.

How is IVF placed in the mother's womb?

The maturing embryo reproduces within 3-5 days and enters the womb of the mother will be inserted. Embryo transfera painless job It does not require anesthesia. On the day of transfer, the expectant mother is asked to be constricted with urine, so that embryo transfer from the cervix will be easier. The embryos, which are transferred from the cervix to the inner cavity of the uterus with a thin, plastic cannula, are followed by ultrasound and the transfer process is completed.

What should be considered after IVF transfer?

After embryo transfer, the patient can go home. It is recommended to spend the same day resting. There may be minimal bleeding, it is not something to be afraid of. Swelling, pain and tenderness in the breasts are normal. Abdominal pain may be mild, accompanied by constipation and bloating. Medications to be used after the procedure are very important.

Pregnancy test after embryo transfer in IVF treatment?

A blood test can determine whether there is a pregnancy on average 15 days after the transfer. The first blood test may be positive with the cracking needle effect, it is very important to regularly increase the pregnancy test in the blood called beta HCG in the follow-ups. If the Beta HCG value is increasing, it is interpreted as pregnancy has occurred. Definitive diagnosis is made by seeing the gestational sac. The appearance of the sac occurs approximately 4 weeks after the transfer procedure.

If the beta HCG value is negative even though it has been 15 days since the transfer, that is, if it is below 5 IU/L, the treatment is interpreted as unsuccessful. Sometimes a situation called chemical pregnancy occurs, that is, the beta HCG test rises, it is thought to be a pregnancy, but it decreases in the next blood tests. This is not pregnancy.

Is IVF TREATMENT RISKY, WHAT ARE THE RISKS?

As in every practice, there are some risks in in vitro fertilization. In general, the risks are low, with little difference between the normal conception and the in vitro fertilization patient. Possible distressing situations can be summarized as follows:

● OHSS, that is, overstimulation of the ovaries, cyst formation, may rarely require hospitalization

● Risk of miscarriage, especially in multiple pregnancies

● Er Risk of premature birth

● Multiple pregnancy (twins or triplets)

What is embryo freezing?

If a large number of embryos are obtained in the treatment, it is necessary to freeze the quality ones among them. Thus, in the absence of pregnancy, the next in vitro fertilization is done with frozen embryo. There may be 20% damage to embryos that are frozen and thawed.

When using frozen embryos, egg collection is not performed, only the uterus The inner wall is made ready for the embryo to be transferred. Hormone drugs are used for this process.

What is PGD (Preimplantation Genetic Screening) in IVF treatment?

PGD is the result of embryo to be transferred > genetic examination. It is considered in patients with frequent miscarriage and recurrent IVF failure. A sample is taken from the embryo, which is formed within 72 hours after egg collection, is examined genetically, and the embryo that is thought to be healthy is transferred. This procedure is not used for every patient in in vitro fertilization.

What is ovarian hyperstimulation syndrome?

If the number of eggs developed as a result of ovulation therapy is high, ovarian cysts > transforms, the ovaries become very large in volume, blood tests can be disordered, urine decrease, abdominal pain and water collection can occur in the abdomen. It can be life threatening. It needs immediate treatment and precautions. Over hyperstimulation syndrome is usually mild and does not require hospitalization. The severe condition occurs in 0.1% of in vitro fertilization patients. It carries the risk of lung and heart failure, there may be a clotting condition called thromboembolism.

Natural cycle IVF treatment

Egg-enhancing drug is not used in natural cycle treatment, and the egg growing in the natural cycle is followed. With the cracking needle, the egg is matured and the egg taken with the egg collection process is fertilized with sperm in the laboratory. In these patients, the pregnancy rate was found to be low.

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What is in vitro maturation? When is it used in IVF treatment?

It is maturation of the immature egg cell in a laboratory environment. It is used in patients who have had hyperstimulation before.

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