IVF – IN VITRO FERTİLİLİZATION

IVF – IN VITRO FERTILIZATION  

In the latest statistics almost 12 % of the population in their reproductive age are infertile, so, if getting pregnant become a challenge for you and your partner, you are not alone. Fortunately, there are lots of reasons to be hopeful if you are infertile and wish to have a baby. Nowadays there are many safe and effective therapies for overcoming infertility and every year treatments keeps better, and more and more babies born using various techniques.

IVF – is the most common of the high-tech infertility treatments and accounting almost 99 % of all assisted reproductive technologies. Every year thousands of babies are born in the world as a result of IVF. This techniques has history of more than 35 years since 1978, when the first baby was born after in vitro fertilization and proved to be successful with no difference of developing of the children comparing with those who born from natural fertilization.

The procedure of IVF is significantly less expensive in Turkey comparing with Europe and USA, considering that we use newest modern technology and our highly qualified doctors has large experience and excellent success rates in IVF techniques. Moreover, it is scientifically proved, that stress is a very important factor, which can affect the result of treatment. So, you can use the advantage of travel to Turkey for change of your routine, to immerse yourself in a pleasant atmosphere of natural beauty and centuries-old treasures and get away from daily stress. You will enjoy your vacation time while we provide you with advanced treatment in world class facility by affordable price. All these factors will significantly minimize your stress and maximize your chance for success.

In our state-of art facilities we offer you the chance of having much-wanted child. Our IVF program consists of a multi-disciplinary team of physicians, nurses, embryologists and administration stuff providing with most comprehensive care to achieve a pregnancy.

In vitro fertilization (IVF) – is a series of procedures involves stimulating and retrieving multiple mature eggs from woman ovaries, fertilizing then with man’s sperm in dish in laboratory and then 3 – 6 days later implanting the embryos in the uterus. The procedure can be done using your own eggs and sperm or when necessary may involve eggs, sperm or embryos from a known or anonymous donor. In some cases, a gestational carrier (a woman who has an embryo in her uterus) might be used.

Nowadays IVF procedure becomes increasingly simple, safe and more successful.  In our facilities is used as an effective treatment for infertility caused by various factors including Fallopian tube damage / tubal factor, endometriosis, anovulation, premature ovarian failure, uterine fibroids, age related infertility, male factor infertility, low sperm count or motility, antibody problems that harm sperm or eggs, unexplained infertility, genetic disorders (preimplantation genetic diagnosis – a procedure that involves IVF) or as fertility preservation for cancer or other health condition (for instance, if the patient is about to start cancer treatment that could harm the fertility, the harvesting of the eggs with or without fertilization can be done and eggs or embryos can be frozen for future use).

IVF procedure involve several steps.

1. First of all patients and their partners will be evaluated by our doctor to determine their suitability for entering IVF procedure and to determine the plan of further procedure. During this evaluation US examination and some tests can be required (if you are scheduled for IVF using your own eggs and sperm), such as ovarian reserve testing, semen analysis, infectious disease screening e.t.c.) However, depends of you time availability, we can perform it here upon your arrival, or if your time of travel to Turkey is limited, with online consultations, our doctor will require the necessary list of the tests, which you can perform at your home country and then e-mail back to us to determine the most suitable treatment plan for you.
2. For the beginning of IVF procedure the woman may be given a drug to suppress the natural cycle to prevent ovulation until the desire time, then stimulation of the development of the eggs will be started with FSH (Follicle stimulating hormone), which usually takes 10 - 14 days as daily injection before your eggs are ready for retrieval. This hormone will increase the number of mature eggs you produce, so, doctor will has a greater choice of embryos to use in your treatment. During this period doctor will monitor the progress of ovulation induction with ultrasounds and blood hormone tests.

When the follicles are judged to have reached maturity (by ultrasound control), a one-time injection of HCG (human chorionic gonadotropin) is given to finalize the maturing process and 36 hours later the eggs retrieval procedure will be done.

3. Eggs retrieval performed on out-patient basis and takes about 30 minutes. To avoid any discomfort during the procedure short acting sedative and pain medications will be given. Special needle will be inserted through the vaginal wall into ovaries and fluid that contains the eggs will be removed. The process performed under ultrasound visualization. After procedure you may experience some cramping and small amount of vaginal bleeding.

At the same time the male partner is asked to provide a semen sample. The sample is analyzed then and washed with a special solution, so, the healthiest and most active sperm can be selected. If donated sperm are used, it is removed from frozen storage, thawed and prepared in the same way.

4. Next step of the IVF is Fertilization of the eggs.  This is done in the laboratory immediately after eggs retrieval either by adding sperm to a culture dish containing the retrieved eggs (traditional IVF), or through an Intracytoplasmic Sperm Injection (ICSI) – procedure, which performed by direct injection of a single sperm into an individual egg. ICSI technique allows couples with even very low sperm counts or poor quality of sperm to achieve fertilization and pregnancy rates equal to traditional IVF. It is also performed for the couples who not achieved fertilization in prior IVF attempts. However, prior the procedure, you and your doctor will determine which method of fertilization is best for you.

Eggs mixed with sperm then cultured in the laboratory for the next 24 hours, after which time the embryologist will establish if fertilization has occurred. Those that have been fertilized, now called embryos, continue to grown in the laboratory incubator for another one - two days before being checked again for early cell division.

Embryos may be transferred on day 3, 5 or 6 after egg retrieval. We have the ability in our laboratory to grow the embryos for 5 or 6 days until they reach the blastocyst stage, allowing then embryology team to determine, with greater certainly, which embryos are the best in terms of their potential for implantation. Moreover with this technique we transfer fewer embryos (comparing with day 3 transfer) and lower the risk of multiple births while increasing the chance of pregnancy.

             During these days you will relax and enjoy you holiday in Turkey, knowing that your future babies are in safe          hands.  

5. Before Embryo transfer you will discuss with doctor, how many embryos you have and what quality they are, then to decide how many will be transferred. The Embryo transfer performed on out-patient basis and usually it is painless minor procedure and do not require any pain medications. The transfer is done using a transvaginal ultrasound guided catheter which is inserted into the uterus through the cervix. We placed the embryo in the best location in the uterine cavity to increase the chance of pregnancy.

Remaining high quality embryos can be frozen (cryopreserve) and stored successfully for many years and allow couple to initiate another attempt at pregnancy without the need to undergo another ovarian stimulation and eggs retrieval process.

6. Following the procedure you will be recommended to stay in bed for several hours and after you can leave from clinic. Recommendation and medications for the next days will be given.

A pregnancy blood test will be done 2 weeks after the egg retrieval date. If result is positive, the blood test will be repeated 2 – 3 days later and we will follow your progress with blood tests and ultrasound for another 3 – 4 weeks and then you will be referred to your obstetrician for continued care of pregnancy.

In our modern facilities we offer full spectrum of procedures can be done in conjunction with IVF to accomplish the best result for you:

• Intracytoplasmic sperm injection (ICSI), when the single sperm is injected directly into a mature egg – increasing the fertilization rate even in those couple, when the man’s sperm count is extremely low.
• Percutaneous epidydimal sperm aspiration and testicular sperm extraction (PESA and TESE) – for the men, who has difficulties to obtain sperm, the sample can be taken from the semen. In cases, when man has no sperm in ejaculate but still produce them in the testes – sample can be taken directly from testis.
• Assisted hatching – a technique, where an embryo “hatches” from its surrounding membrane, allowing it to implant into the uterus. Usually recommended for and older woman, or in case of multiple failed IVF attempts.
• Preimplantation Genetic Testing (PGT) – prior to embryos transfer it can be tested for specific genetic diseases and correct number of chromosomes (typically after 5 – 6 days of embryos development) and then embryos that does not contain affected genes or chromosomes will be implanted into uterus. It is indicated for the patients who are at risk for genetic disorders, in older women, in recurrent pregnancy loss or repeated unsuccessful IVF.                          
• Donor eggs or sperm – if there are severe problems with either eggs or sperm, you may choose to use eggs, sperm or embryos from a known or anonymous donor.
• Embryos cryopreservation – any embryos that do not use in your IVF attempt can be frozen for later use. This will safe your money if you will decide to undergo IVF second time. Also you may donate embryos to another infertile couple, or you and your partner can ask to destroy the embryos.

The success rate of IVF depends of combination of various factors such as woman’s age, embryo status, reproductive history, cause of infertility, lifestyle factors. However, with the new techniques and doctor’s experience the success rate is continuously increasing and researchers are still finding the ways to improve IVF procedures for the future.

Choosing us you can be sure, that we make every effort to achieve the much-wanted pregnancy for you. You can trust us knowing that your eggs, sperm and embryos in our possession in the laboratory are always handles with trust, respect, expertise and care, being our constant priority throughout the IVF process. In our fully equipped medical centers using the latest technologies more and more couples become happy parents of their healthy babies.