IVF Treatment istanbul Turkey
IVF Treatment istanbul Turkey? How is it done?
IVF Treatment istanbul Turkey: The chance of conceiving naturally in a healthy 30-year-old woman is about 20% in a month, so only one out of 5 unprotected women who want a child can get pregnant at the end of a month. This rate reaches 75% after 6 months and 85% after a year. The remaining 10-15% of couples of reproductive age experience infertility problems. In this article, what is IVF treatment, how is IVF treatment done? We’ll talk about topics.
In couples who cannot conceive naturally despite having regular sexual intercourse for a year without using any birth control method, the causes of infertility are investigated and necessary tests are carried out. After the problems are detected, the treatment stages are started. After the cause of infertility is determined, the mother and father candidates decide together with their doctors which of the ovulation treatment, Intrauterine Insemination Method (IUI) or IVF treatment is more suitable for that couple.
What is IVF Treatment istanbul Turkey?
In our Istanbul clinic, IVF treatment can sometimes be the first treatment option depending on the problems of the couples, and sometimes it is a medical method applied to achieve pregnancy in couples who cannot get pregnant with other treatments. Today, even couples who were told that they could not get pregnant with IVF treatment are now able to have children.
In the IVF treatment method, the egg cells produced in the female body are taken out of the body and fertilized with the male’s sperm in the laboratory environment, and the resulting embryo is placed in the female uterus. The basic steps of IVF treatment are stimulation of the ovaries with needles, egg collection, fertilization of eggs and sperm in the laboratory (Intracytoplasmic Sperm Injection ICSI), embryo culture and embryo transfer / IVF Treatment istanbul Turkey.
Which treatments can be applied before IVF Treatment istanbul Turkey?
After the researches and evaluations, if the age of the woman is not advanced, the ovarian reserve has not decreased too much, the sperm count and quality are sufficient and the tubes of the woman are open, the following methods can be tried before the IVF treatment.
IVF Treatment istanbul Turkey
IVF Treatment istanbul Turkey: If the woman has problems with ovulation, medication is administered to enable ovulation to occur. Problems with ovulation are common in women with Polycystic Ovary Syndrome (PCOS) who experience menstrual irregularities.
Ovulation Treatment can be done with oral pills or daily hormone injections can be used. In general, oral medications are preferred first. 2.-3. The day begins, the development of the eggs is followed by ultrasound at certain intervals. Pregnancy is achieved by 15-20% with ovulation treatment. If pregnancy cannot be achieved despite trying 3-4 treatments, the situation is evaluated and vaccination or in vitro fertilization treatments are started.
Intrauterine Insemination Method (IUI)
In couples who have sexual problems due to medical diseases or psychological reasons such as unexplained infertility, sexual impotence, reflux of semen, vaginismus, in men with low sperm count, motility or structurally normal sperm ratio, if sperm is frozen due to cancer treatments, or in women, endometriosis disease, closed tube If ovulation disorders occur, Intrauterine Insemination Method (IUI) is applied (IVF Treatment Istanbul Turkey).
In the Intrauterine Insemination Method (IUI), the sperm taken from the man is prepared in the laboratory, and the motile and good quality ones are concentrated in a little liquid and given in the uterus with the help of a thin catheter. It is a method used in couples who cannot have children naturally. Success in the Intrauterine Insemination Method (IUI) varies depending on the sperm count. If the sperm count and quality are sufficient, the pregnancy success rate is 20%. If pregnancy cannot be achieved after 3-4 Intrauterine Insemination Method, IVF treatment is started.
IVF Treatment istanbul Turkey Intrauterine Insemination Method
Who is Eligible for IVF Treatment?
- In women with blocked tubes, severely damaged tubes, or no tubes,
- Hydrosalpinx, pyosalpinx- Tubes filled with fluid or inflammation,
- In cases where the sperm count, sperm movements or sperm morphology in the man is severely impaired and insufficient,
- In cases where there is no sperm cell in the semen, which is called azoospermia,
- In women who have endometriosis and cannot get pregnant with treatment,
- Women who have undergone surgeries such as ovarian cyst, uterine fibroids, ectopic pregnancy and cannot become pregnant,
- Women who have had inflammatory conditions involving the internal genital system and cannot become pregnant,
- In cases of unexplained infertility where all tests are normal,
- If pregnancy cannot be achieved despite trying other treatment methods,
- If the age of the woman is advanced, especially in women aged 38 and over,
- ovulation laziness,
- In women whose ovarian reserve is very low,
- early menopause,
- In polycystic ovary syndrome and other hormonal disorders,
- Cancer Patients: For the purpose of ovarian, egg and embryo freezing,
In cases where preimplantation genetic diagnosis is required for embryos in order to obtain a healthy baby by diagnosing some genetic hereditary diseases at the embryo stage (IVF Treatment Istanbul Turkey).
Tests for Women in IVF Treatment;
- Gynecological examination.
- Transvaginal ultrasound.
- Hormone Tests: Ovulation hormones and thyroid pituitary hormones.
- Ovarian Reserve Test: Tests that show the number of eggs in the ovaries.
- Genetic Tests: It can be done to find out if there is a genetic condition that causes infertility, pregnancy loss or birth defects.
- Some biochemical tests: If necessary.
- Hysterosalpingography (HSG-medicated uterine film) Contrast fluid is introduced into the uterus with a thin catheter placed in the cervix. This fluid is poured into the abdomen, filling the uterus and fallopian tubes. X-rays are taken to view the uterus and tubes. If there are irregular fibroids, polyps or adhesions in the uterine cavity, or if the tubes are clogged, this is seen in the films taken.
- Hysterosonography (Imaging of the inside of the uterus with saline): If necessary.
- Endometrial biopsy: If necessary.
- Diagnostic or therapeutic Hysteroscopy and/or Laparoscopy: If necessary.
IVF Treatment istanbul Turkey AMH Test
Tests for Men in IVF Treatment;
About half of the causes of infertility are due to male-related problems. The most important test in the search for men is semen analysis. In cases where the sperm test is not normal, the following evaluations may be required (IVF Treatment istanbul Turkey).
- Urological examination,
- Doppler ultrasound,
- Hormone tests,
- Sperm DNA fragmentation test,
- Genetic research (chromosome analysis): If the sperm test is severely damaged, if there is no sperm in the semen, if there is pregnancy loss or birth defects in the spouse, it can be done to understand whether there is a genetic condition.
How to Measure Your Ovarian Reserve
FSH, Estradiol (E2), anti-Müllerian hormone (AMH) measurements and the detection of antral follicle count (AFC) by ultrasound in women who apply to infertility and IVF Treatments give an idea about the response to ovulation treatments.
What Does Low Ovarian Reserve Mean?
In women with low ovarian reserve, blood tests have high FSH and E2 levels, low AMH levels, and decreased AFC on ultrasound. However, it may not be possible to accurately predict whether pregnancy will occur with these test results. Pregnancy can be achieved even with very low AMH levels.
Is there an age limit for women in IVF treatment
IVF treatments can be applied between the ages of 18-45. However, as women get older, the chance of pregnancy decreases due to both the increased chromosomal susceptibility of the produced egg and the decrease in ovarian reserve, and the risk of miscarriage increases.
The woman’s menstruation is not related to egg quality. While the live birth rate for women under 35 is around 40%, this rate is around 10-15% for women aged 40 and over. IVF can be applied up to the age of 45. However, it should be known that after the age of 40, the chance decreases with age.
Is there an age limit for men in IVF treatment?
Although sperm production in men continues until advanced ages, sperm quality and sperm motility decrease. Sperm DNA damage increases with age. These are the factors that reduce the success of IVF.
What are the Stages of IVF Treatment?
IVF Treatment istanbul Turkey Stages IVF
1- Stage: Stimulation of the ovaries and monitoring of egg development;
What drugs are used in IVF?
IVF Treatment Istanbul Turkey : After the examination and tests, the treatment method is determined according to the age of the woman and the ovarian reserve of the woman. The common purpose of ovulation treatments is to produce more than one egg. The ovaries are stimulated using hormone injections. The drug type and dose may vary depending on the patient and the treatment protocol applied.
Treatment is started on the 2nd or 3rd day of menstrual bleeding. On the second or third day of menstrual bleeding, the treatment protocol and the doses of the drugs to be used are decided according to the results of ultrasound examination and, if necessary, hormone tests in the blood. After the start of warning therapy, the patient is called for control at regular intervals. In these controls, the number and size of the developing follicles (small fluid-filled cystic structures containing eggs) are checked by performing vaginal ultrasonography. The aim of treatment is to obtain as many follicles with a diameter of 16-20 mm as possible.
While the needle treatment continues, another daily needle treatment is added to prevent premature cracking of the eggs. The goal in IVF treatments is to obtain a sufficient number of egg cells capable of fertilization. In order to achieve this goal and take control, the untimely and irregular effects of the hormones produced by the body must be eliminated. Otherwise, the eggs may crack spontaneously before the day of collection. In order to prevent this, drugs that suppress the cracking hormone are used.
Another factor evaluated during ultrasound follow-ups is the structure and thickness of the layer that covers the inside of the uterus, called the endometrium. Since the embryo will be placed in the endometrium, the thickness and structure of the endometrium is extremely important.
The duration of treatment is variable, but averages 10 to 17 days. If it decides that the follicles have reached a sufficient size with ultrasound and blood tests, hCG injection, which is an egg cracking needle, is performed to ensure final maturation (IVF Treatment Istanbul).
2- Stage: Egg Collection Process (OPU)
How is Egg Collection Procedure (OPU) Performed in IVF Treatment?
In order for the eggs to be collected, it must first be decided that they are mature. The eggs are collected approximately 35-36 hours after the injection of mature eggs (hCG). For this procedure, men and women come to the IVF center together. Since egg retrieval is performed with a mild anaesthetic, the expectant mother should be hungry and should not take food or fluids in the last 6 hours.
OPU is performed very easily and comfortably with vaginal ultrasonography. The patient is placed on the table in the gynecological examination position and vaginal ultrasonography is started after being covered with sterile cloths and cleaning the vagina -IVF Treatment istanbul Turkey-.
The egg collection process is the discharge of fluid-filled structures called follicles, which contain eggs by entering the ovary with a needle under the guidance of vaginal ultrasound. The liquid taken is given to the laboratory and it is examined under a microscope whether it contains eggs. The egg in the follicle fluid is placed in the culture fluid and removed to the incubator.
The process is continued until all follicles are aspirated. It takes about 15-20 minutes to aspirate the follicles of both ovaries. After the egg collection procedure, the patient can go home after resting for 1-2 hours.
After the eggs are collected, drug treatment containing progesterone hormone is started in order to prepare the inner wall of the uterus for embryo transfer.
3- Stage: Laboratory Stage- Fertilization (Intracytoplasmic Sperm Injection ICSI)
Image Source: IVF Treatment istanbul Turkey ICSI Microinjection
On the day of egg retrieval, the male also gives sperm. Masturbation is the ideal method for sperm retrieval. In men who do not have live sperm in their semen, sperm is searched surgically. The semen obtained is taken into a special container and is expected to liquefy. Liquefied semen is examined for sperm count, motility and shape.
Approximately 2-4 hours after the eggs are collected, the cells around them are cleaned and evaluated whether they are mature or not. Intracytoplasmic Sperm Injection ICSI process is performed by injecting a single sperm into each egg into mature eggs with the help of a special tool called micromanipulator.
The ICSI-done eggs are put back into the culture medium, and the development of the embryos is followed the next and the next days. When the appropriate stage is reached, one or two of the high quality embryos are transferred into the uterus.
Approximately 70% of the collected eggs are mature and suitable for fertilization. About 70% of them will also be fertilized. For example, a woman with 10 eggs will develop an average of 5 embryos. This is an average and the number may be above or below it.
Step 4: Embryo Transfer
IVF Treatment istanbul Turkey Embryo Transfer
How is Embryo Transfer Applied in IVF Treatment?
Embryos can be transferred any day between Days 2 and 5 from the two-cell stage to the blastocyst stage. During embryo transfer, the patient is placed on the table in the gynecological position. After the speculum is inserted into the vagina, the cervix is cleaned with sterile saline. The embryologist brings the embryos to be transferred from the laboratory in a catheter. Under ultrasound guidance from the abdomen, the Obstetrician leaves the embryos in the uterus.
Embryo transfer does not require anesthesia as it is a painless procedure. Progesterone hormone is continued in the form of injection, suppository or cream to support the endometrium after the transfer. This treatment, called luteal phase support, is continued until the 8th-10th week of pregnancy in case of pregnancy (IVF Treatment Istanbul Turkey).
To whom is the Preimplantation Genetic Diagnosis (PGD) test recommended in IVF Treatment?
Preimplantation genetic screening or diagnosis is the genetic examination of embryos with a cell sample (biopsy) taken from the embryos before they are transferred to the uterus of the expectant mother during in vitro fertilization treatment. It is recommended for couples whose children are at risk of having a genetic disease or anomaly.
The purpose of these procedures is to find a healthy embryo, to reduce the possibility of miscarriage and to increase the chance of IVF success. These processes require special laboratory equipment and experienced personnel.
Who Is PGD (Preimplantation Genetic Diagnosis) Applied to?
IVF Treatment istanbul Turkey Preimplantation Genetic Diagnosis PGD
- Chromosomal aberration: If the male or female has structural or numerical chromosomal aberrations or carriers, such as reciprocal or Robertsonian translocations, inversions, and deletions.
- In single gene diseases: If both husband and wife are carriers for the same single gene disease (Thalassemia, Cystic Fibrosis, Spinal Muscular Atrophy, Sickle Cell Anemia, and Huntington’s disease, autosomal dominance, X-linked diseases or autosomal recessive diseases) or in one of the couples if there is a single gene disease.
- Sex-linked diseases: X-linked recessive diseases: Hemophilia, Fragile X syndrome, Becker Muscular Dystrophy (BMD) and Duschenne Muscular Dystrophy (DMD). Sex-related dominant diseases: Rett syndrome, Incontinentia pigment.
- HLA typing: If a baby with tissue compatibility with a sibling is required. HLA compatible embryos are sought for the sick children of the couples. In this way, families with children with problems such as thalassemia, sickle cell anemia, hemoglobinopathy, leukemia and immune system failure have a suitable sibling for bone marrow and stem cell transfer.
- In determining the sex: Determining the sex of the embryos is done for medical reasons. Some diseases are at risk of occurring in only one sex.
- Advanced age mother-to-be: If the expectant mother is 38 years old and over,
- Patients with recurrent pregnancy loss
- Patients with recurrent IVF failures (3 or more),
- If you have a previous pregnancy or baby birth with a genetic problem or Down syndrome.
How is sperm obtained surgically in azoospermic men?
If there is no sperm in the man’s semen (Azoospermia), surgical methods are used to obtain sperm. Normally, sperm are produced in the testis and combine with the fluid from the prostate and ejaculate out of the penis in the semen. In azoospermia, there is no sperm in the semen. Azoospermia is seen in 1% of all men and 10-15% of men presenting with infertility problems.
The absence of sperm in the semen can be due to 2 different reasons:
- Obstructive azoospermia- Azoospermia due to obstruction: It is the state of obstruction in the system that transmits sperm out of the penis (epididymis, vas deferens or excretory ducts), therefore sperm production in the testis is normal.
- Non-obstructive azoospermia-Non-obstructive Azoospermia: There is a problem in sperm production in the testis.
Sperm can be obtained from 2 different sites:
- From the Epididymis: Percutaneous Epididymal Sperm Aspiration (PESA), Micro Epididymal Sperm Aspiration (MESA).
- From the testis: Testicular sperm aspiration (TESA), Testicular sperm extraction (TESE), Microscopic testicular sperm extraction (micro-TESE).
Sperm can be obtained in 2 different ways:
- Using an open surgical approach: from the epididymis (MESA) or testis (TESE, micro-TESE).
- By skin needle aspiration: Sperm aspiration from the epididymis (PESA) or testis (TESA).
Every method has certain risks and benefits, and not every method is suitable for every patient. The procedures can be performed under local anesthesia or a short general anesthesia. Needle sperm aspiration (TESA, PESA) methods are the simplest and less costly methods. It is performed under local anesthesia and takes about 10 minutes (IVF Treatment Istanbul Turkey).
In nonobstructive azoospermia, where there is a problem in sperm production in the testicles, it is more difficult to obtain sperm from the male and usually takes several hours. In TESE or micro-TESE methods, it is necessary to make an incision into the scrotum under general or spinal anesthesia to reach the testicles.
The sperm count obtained with these techniques is usually very low compared to the sperm count in the semen, so the microinjection-ICSI method should be used. If there is an increase in sperm after ICSI, the sperm are frozen and stored for later use so that the biopsy procedure does not need to be repeated.
How Many Days Is IVF Treatment Istanbul Turkey?
After the first evaluation, a personalized treatment method is determined according to the individual characteristics of each couple, age and ovarian reserve of the woman. Sometimes, women may need to use certain medications during the premenstrual period.
IVF treatment begins on the 2nd day of menstrual bleeding. Ovulation treatment lasts approximately 10-12 days, after this process, it takes approximately 15-20 days in total, including egg collection, fertilization of the eggs with the microinjection method with the sperm taken from the partner on the same day, and embryo transfer 2-5 days later. Pregnancy status can be understood with a blood pregnancy test performed 2 weeks after the egg retrieval day.
What is “Embryo Freezing” in IVF Treatment Istanbul Turkey, How is it Applied?
In IVF Treatment Istanbul Turkey, after one or two embryos are transferred into the uterus, the remaining healthy and good quality embryos are frozen and stored. Freezing the excess embryos obtained during IVF treatment provides the patient with both an economic and a psychological advantage. When the frozen embryos are to be transferred, needle treatments that stimulate the ovaries with hormones and egg collection are not required. Embryo freezing can also be considered as a procedure that increases the chance of success in IVF applications.
How is embryo freezing done?
IVF Treatment Istanbul Turkey embryo freezing
Embryo freezing includes the processes of freezing the embryos by gradually cooling with a special tool after equilibration in protective culture solutions (cryoprotectants) and storing them in liquid nitrogen (-196 C), while these cryoprotectants are removed from the environment and taken into special culture media.
Two basic techniques have been described in cell freezing. These are the slow controlled freezing method, which was the first to be applied in human cells, and the vitrification method, which is a newer technique. The slow-controlled method has been replaced by the vitrification technique in recent years. After thawing, the survival rate, embryo survival and pregnancy rates are higher in embryos frozen with the vitrification method.
In which cases are embryos frozen?
If your ovarian reserve has decreased, you may need to freeze-store your embryos for pregnancy for years to come.
When it comes to the embryo transfer stage in tube treatment, transfer can be made during that treatment period (fresh embryo transfer) or all embryos are frozen (Freeze all) and transfer is planned in the following months, depending on the patient’s condition.
In women with polycystic ovary syndrome, sometimes an excessive ovarian response occurs before egg retrieval, and too many eggs develop, the ovaries enlarge. In this case, a different egg cracking needle is used and the collected eggs are fertilized with sperm and all of the embryos (Freeze all) are frozen after the embryo is formed. The aim of this treatment protocol is to prevent the ovarian hyperstimulation syndrome, which we call OHSS. Embryo transfer is done in the following months after the inner wall of the uterus is prepared with pill treatments IVF Treatment istanbul Turkey.
Embryo freezing is performed in patients with preimplantation genetic diagnosis, in cases with risk of ovarian hyper-stimulation syndrome (OHSS), in the presence of a large number of good quality embryos obtained during IVF treatment, or in cases that require surgical intervention, medical diseases or hormonal treatment that prevent embryo transfer.
How is the uterine wall prepared for frozen and thawed embryo transfer?
IVF Treatment istanbul Turkey: On the 2nd day of menstrual bleeding, examination and vaginal ultrasound are performed and it is checked whether there are any myomas or polyps in the uterus and cysts in the ovaries.
Different treatment methods can be applied to make the uterine wall suitable for the placement of the embryo. One of the methods is the follow-up of the woman’s natural ovulation and the transfer of embryos that are thawed on the appropriate day after the egg is cracked. However, this method requires close follow-up, it is difficult to follow in patients living outside the city or abroad, and it cannot be applied to women who do not have ovulation such as polycystic ovary syndrome.
Another method is to provide ovulation with oral medications. 3-7 days of menstrual bleeding. Egg development is followed up by ultrasound after the drug is used. When the egg is large enough and matures, the cracking needle is made. Frozen thawed embryo transfer is performed 7 days after the injection.
The other and most commonly used method is to use the oral estrogen hormone to thicken the uterine wall, and when it thickens enough, to prepare the uterine wall for embryo transfer with progesterone hormone. Although progesterone hormone is used in different ways such as vaginal capsules, gel, and needle, the most preferred one is vaginal progesterone capsules.
How are frozen and thawed embryos transferred?
IVF Treatment istanbul Turkey embryo transfer
IVF Treatment istanbul Turkey: From the two-cell stage to the blastocyst stage, frozen embryos can be thawed and transferred any day between Days 2 and 5. As in the fresh embryo transfer, the patient is placed on the table in the gynecological position, the cervix is cleaned with sterile saline. The embryologist brings the thawed embryos to be transferred from the laboratory in the catheter. Under the guidance of abdominal ultrasound, the location of the catheter in the uterus is determined and the embryos are placed. After the transfer process, the expectant mother rests for an average of 20-30 minutes and can leave the clinic afterwards.
To support the endometrium after the transfer, progesterone hormone is continued in the form of injection, suppository or cream. This treatment, called luteal phase support, is continued until the 8th-10th week of pregnancy in case of pregnancy.
After the transfer, the expectant mother continues her daily life normally. In this process, it is very important for the expectant mother to avoid activities that will tire her excessively.
10-12 days after the transfer process, it is determined whether pregnancy has occurred by performing a pregnancy test in the urine or blood.
What are the differences between embryo and egg freezing procedures?
In egg and embryo freezing procedures, the ovaries are stimulated with hormone injections and eggs are collected at the ultrasound threshold. The medical treatments and processes done so far are the same. After that, the difference is that while the eggs are frozen directly in egg freezing, the first human cells that are formed after fertilization with sperm in the embryo freezing process are followed by the divisions of the embryos 2-5. Between days, healthy and good quality ones are selected and frozen. Embryo freezing cannot be applied to unmarried women (IVF Treatment istanbul Turkey).
How many years can frozen embryos wait?
According to the Reproductive Medicine Regulation, which was renewed on September 30, 2014, if excess embryos are obtained during in vitro fertilization treatment, the embryos are stored by freezing, with the consent of both spouses. If the storage period exceeds one year, the couples must submit a signed petition stating that their demands continue by applying for the storage of the embryo every year. In case of joint request of the spouses, death of one of the spouses, or if the divorce is forfeited, or when the determined period expires, the stored embryos are recorded and destroyed by the commission to be established in the directorate.
What is the success rate of embryo freezing?
IVF Treatment istanbul Turkey; The quality of the embryos to be frozen during the freezing process is very important. Since the best quality embryos will suffer the least damage from the freezing process, the viability rate after frozen embryo is 75-90%, while the probability of survival of bad quality embryos is very low (20-25%) if frozen. Therefore, only good quality embryos are frozen.
Considering the results all over the world, pregnancy rates after frozen embryo transfer vary between 25-50%. These rates vary according to clinical and laboratory procedures, the age of the patient, the cause of infertility, and the viability rate per thawed embryo.
Can a second pregnancy be achieved by applying embryo freezing during the IVF process?
If pregnancy is not achieved after transfer in the IVF trial, pregnancy is achieved and ends in miscarriage, or if the couple decides to give birth to a baby again after a pregnancy that ends with birth, pregnancy can be achieved by thawing the embryos obtained by fertilization of their own sperm and egg cells and frozen, and placing them in the uterus of the woman. . In this method, long-term hormone drugs do not need to be given to the woman, many stages in the in vitro fertilization process are skipped and for this reason, it provides convenience to the couples in terms of cost.
Are there any health problems in babies born with the frozen embryo procedure?
IVF Treatment istanbul Turkey; Some scientific studies have shown that in patients undergoing frozen embryo transfer, miscarriage after conception, premature birth, delivery of a low birth weight baby, infant death during pregnancy or at birth, placenta previa (low location of the placenta), placental abruption (separation of the placenta before the birth of the baby), delivery It shows that the risks of bleeding before pregnancy are lower than those of women who become pregnant with fresh embryo transfer. On the other hand, there is an increase in the rates of placenta accreta (placenta is embedded in the uterine wall), giving birth to a large baby (over 4500 g) and cesarean section.
When the patients who underwent frozen embryo transfer and the women who became pregnant with fresh embryo transfer were compared, the rates of attachment of embryos to the uterine wall, ectopic pregnancy, preeclampsia (pregnancy toxicosis), very low birth weight (<1500 g), very premature birth (<32 weeks), neonatal intensive It was determined that there was no difference between the rates of admission to the care unit and congenital disabilities.
Can women with poor embryo quality get pregnant?
One of the factors affecting the success of IVF treatment is that the embryo, which is the first human cells formed as a result of fertilization of the egg and sperm, should settle in the uterus and ensure the continuation of the pregnancy. In order for these to happen, the embryo must be of good quality.
Although the success rates are increasing with the developing technologies today, the success rates remain very low in patients whose embryo quality is not always good.
IVF Treatment istanbul Turkey: Factors affecting embryo quality may be female and/or male dependent. Genetic examination is required in order to diagnose whether there is any chromosomal abnormality in couples who constantly develop bad embryos. A balanced chromosomal disorder (translocation) may occur in either a woman or a man. In patients with balanced translocation, most of the fertilized eggs will be disease or carrier. In this case, preimplantation genetic diagnosis is made to the developing embryos and the healthy ones are selected and embryo transfer increases the chance of success.
Although recurrent poor embryo quality is often due to the egg, if there is a sperm problem, the man should also be examined in detail. Especially when the sperm is obtained by surgical methods (TESE), the quality of the immature (spermatid) sperms taken and the embryos developed when ICSI is performed are bad and there is no chance of pregnancy with their transfer.
Poor embryo quality can also be bad in the case of DNA damage in sperm. If there is DNA damage in the sperm, this does not prevent fertilization, but it can disrupt the development of the embryo. Sperm DNA analysis may be required for couples who do not have a healthy pregnancy due to poor quality embryo transfer (IVF Treatment istanbul Turkey).
Since the causes of poor embryo quality cannot be found most of the time, the treatment options that can be applied may be limited. In these cases, a supportive culture medium (co-culture) prepared from intrauterine (endometrium) cells can be called instead of synthetic nutrient solutions. In vitro fertilization may be an option in the natural cycle. Except those; Changing culture media, assisted nesting (assitse hatching) and using embryo glue (embryo glue) can be tried. Studies on the transfer of intracellular substances (cytoplasm), which are still in the experimental stage, are continuing. However, the scientific efficacy of almost all of these methods has not been proven (IVF Treatment istanbul Turkey).
Egg donation (donor oocyte) application, which is illegal and not done in our country, can be considered in patients who have undergone many trials and whose embryo quality is constantly poor. (IVF Treatment Istanbul Turkey)
What are the Success Rates in IVF Treatment?
The most important factors that determine the chance of taking a baby home in IVF are the correct diagnosis and the selection and rapid implementation of the most effective treatment without tiring the couple. Pregnancy rates in IVF treatments depend on many variables such as patient age, cause of infertility, duration of infertility, and number of eggs. The most important of these is the age of the woman.
The advanced age of the woman or the inadequate response of her ovaries to the drugs given are the most important factors limiting the effectiveness of the treatment. Pregnancy rates also decrease with advancing age.
About half of expectant mothers younger than 30 (several embryo transfers—some including frozen embryo transfers) become pregnant after one trying, with a live birth rate of around 30%. Women between the ages of 40 and 43, on the other hand, have less than 12 percent chance of getting pregnant in an in vitro fertilization trying, with a live birth rate of 7-8%.
IVF Treatment Istanbul Turkey IVF Success
Factors Affecting the Success of IVF Treatment
- Age of the expectant mother,
- Marriage period of the couples,
- The ovarian capacity of the expectant mother,
- The reason for IVF application (one or more problems related to men and women),
- Some problems related to the sperm of the father-to-be,
- Hormonal factors,
- Pre-existing diseases,
- Whether the pregnancy has developed before,
- Whether there was a previous miscarriage or live birth,
- Diseases that develop outside of the reproductive organs,
- Drugs used (ovulation drugs and luteal phase support),
- Compliance of the patient with the treatment process (drug use, regular check-ups).
What factors negatively affect the success of IVF treatment?
- If the age of the woman is 35 and over,
- If smoking,
- If the woman is overweight,
- If the marriage period is long,
- If there are recurrent IVF failures,
- If you have severe sperm disorder or azoospermia,
- If the ovarian reserve is low and few eggs are obtained,
- If the egg quality is not good,
- If the quality of the embryos is not good,
- If there is more than one problem related to male and female in IVF application,
- If drugs, treatment protocol and drug doses are not chosen appropriately for the patient in the treatment,
- If the patient cannot comply with the treatment process and does not use their medications regularly and does not come to the controls regularly,
- If there are gynecological problems in women, such as intrauterine adhesions, uterine fibroids or polyps, which can prevent the attachment of the embryo,
- If there is a hydrosalpenx in the tubes,
- If the intrauterine layer is thin during the treatment,
- If you have endometriosis disease,
- If there are hormonal disorders such as thyroid gland diseases, increase in milk hormone (prolactin),
- If you have polycystic ovary syndrome and insulin resistance,
- If there are congenital or acquired problems of the immune and coagulation system,
- There are some genetic disorders that require Preimplantation Genetic Diagnosis and if PGD has not been performed,
- If there are living conditions that may adversely affect the quality and number of eggs and sperm, such as smoking, stress, unhealthy diet, vitamin D deficiency,
- If you have diabetes.
Reasons for Failure in IVF Trying?
- If there is no pregnancy despite good quality embryo transfer
- If there is no pregnancy as a result of poor quality embryo transfer
Although the embryo quality is good, the chance of pregnancy in the next attempts is high in women who cannot get pregnant. After evaluating and correcting all the factors that may prevent the attachment of the embryo, there will be a chance of pregnancy when a retry is made.
In cases where the embryo quality is not good, this may be specific to that treatment month only and better quality embryos can be obtained in subsequent trying. If bad quality embryos are always formed in the next treatment months, and no problem can be detected in all tests and examinations, and if the embryo quality does not improve after the treatments, the chance of pregnancy is very low, and sometimes it may be necessary to stop the treatment (IVF Treatment istanbul Turkey).
Can Stress Be a Factor in IVF Failure?
IVF Treatment Istanbul Turkey: Decision-making, treatment and waiting for pregnancy results in IVF treatment are very stressful. The feeling of being unsuccessful in achieving pregnancy, the expectations of their families and their environment, and psychological pressures also cause anxiety disorders. Studies show that stress negatively affects the success of IVF treatment.
Adopting a stress-free lifestyle for mothers and fathers is an important factor in achieving a happy result. Good communication and understanding between couples, low consumption of nicotine and caffeine-containing products, and activities such as yoga, exercise, walking and similar meditative effects reduce stress.
The fact that the IVF doctor is understanding, patient and open to communication who can answer all questions about the treatment also allows couples to live this process away from stress (IVF Treatment istanbul Turkey).
Behaviors that women should pay attention to before and during IVF Treatment
Before starting IVF treatment, it is necessary to stay away from all toxic substances such as cigarettes and alcohol in the last three months. Smoking negatively affects the ovarian reserve, and fertilization rates are lower for eggs that have been exposed to smoking in the past.
Care should be taken to lead a regular life away from stress before and during IVF treatment.
Expectant mothers should pay attention to a healthy diet before treatment. It should be a healthy, versatile and balanced diet. A diet rich in protein can be beneficial. In addition, it is necessary not to eat a lot, but to eat little and often. IVF Treatment istanbul Turkey/ In a diet rich in fresh vegetables, fruits and nuts, foods such as unroasted walnuts, almonds, hazelnuts should be consumed frequently. It is recommended not to drink acidic and caffeinated beverages as much as possible.
Foods containing antioxidants such as folate and zinc can increase fertility for both men and women, neutralizing free radicals that can damage egg cells (IVF Treatment istanbul Turkey).
Low-carb diets can help you maintain a healthy weight, lower insulin levels, and lose fat while aiding menstrual regularity. Especially in women with polycystic ovaries, reducing carbohydrate intake increases the chance of pregnancy.
In addition to the amount of carbohydrates, the type is also important. Refined carbohydrates, including sugary foods and beverages, and processed grains such as white pasta, bread, and rice are absorbed too quickly and cause spikes in blood sugar and insulin levels. Refined carbohydrates have a high glycemic index. The glycemic indicates how quickly a carbohydrate food will raise your blood sugar and insulin. Constantly high levels of insulin reduce the production of reproductive hormones that will ensure egg maturation and ovulation.
Dairy products and lactose can affect ovulation, reducing fertility.
Maintain a healthy weight: Being overweight or underweight can affect your chances of getting pregnant. Too much or too little body fat can cause irregular periods or stop periods altogether, affecting your chances of conceiving. In a recent study, the pregnancy rate in overweight women was found to be significantly lower than in normal weight women undergoing IVF. In addition, in obese women, the rate of cancellation of treatment in IVF treatment is high and the rate of live birth is lower. Weight loss of obese patients increases the chances of pregnancy and helps to have a healthier and trouble-free pregnancy.
Exercise regularly: One study showed that women who exercised more than 4 hours a week were less likely to have a live birth, while another study showed that those who were active and exercised/sports in the past year had a higher chance of clinical pregnancy.
If you are not doing much physical activity and you are overweight, daily exercises can help increase your chances of pregnancy. Moderate physical activity can increase levels of powerful antioxidant enzymes that can help protect eggs and sperm.
Low-level exercises relieve stress. Avoiding high levels of cardiovascular exercise and exercising no more than four hours per week is recommended. In some IVF stages, exercise needs to be stopped completely.
In case of any disease or pain, the approval of the IVF specialist should be obtained before resorting to therapeutic drugs. During the treatment, any medication that your IVF specialist does not need should not be taken. In the case of a drug that must be used continuously due to a chronic illness, the doctor should be informed.
Some drugs can cause hormonal imbalances, reduce the effects of IVF drugs (IVF Treatment istanbul Turkey), and negatively affect the success of IVF treatment. Calcium channel blockers, tricyclic antidepressants, anti-androgens and other drugs affect your treatment negatively. can contribute. Anabolic steroids can have the same effect. To avoid any negative interactions, give your doctor a complete list of all the medications you take. This list should include all prescriptions, supplements, and over-the-counter medications you take.
Pre-existing or existing diseases and genital disorders should be reported to doctors before starting treatment.
Expectant mothers should pay attention to the dose settings of all drugs and needle treatments given during IVF treatment, and the hours of injections as recommended by their doctors. Timely and correct administration of drugs and attention to appointment times are important in the success of treatment.
Behaviors that men should pay attention to before and during treatment
IVF Treatment istanbul Turkey: It takes about 3 months for a sperm stem cell in the testis to turn into mature sperm. In general, maintaining a healthy weight, taking multivitamins, staying physically active and eating a balanced diet can improve sperm quality.
Men who smoke are more likely to have low sperm counts and low sperm motility. Some studies have shown that smokers’ sperm have increased DNA fragmentation. DNA damaged sperm can lead to problems with fertilization, embryo development, embryo implantation and increased miscarriage rates. The risk of pregnancy loss increases due to sperm DNA damage.
Increased scrotal temperature can inhibit sperm production. While the benefits are not fully proven, using boxing instead of panties, reducing sitting, avoiding saunas and hot tubs, and limiting exposure of the scrotum to hot objects such as a laptop can improve sperm quality.
Men can also start with vitamins and antioxidants that can help increase sperm counts and improve quality and have a beneficial effect on IVF results.
The father-to-be should inform his doctor if he has had a febrile illness, inflammation of the genitals or herpes in the last three months before the application of in vitro fertilization, and if he has any medications he has taken due to these diseases or other diseases.
In IVF Treatment istanbul Turkey, a sperm sample is taken from the man on the day of egg collection. The last 3 days should be sexual abstinence, this abstinence should not exceed 7 days.
Tips for a Healthier Weight Before IVF Treatment
- Starting a healthy diet and exercise plan with your partner will increase your chances of conceiving and having a healthy baby.
- Adequate and balanced nutrition from 5 different food groups should be provided.
- These are: Fruits and vegetables, starchy foods such as bread, rice, potatoes and pasta, milk and dairy products, proteins such as meat, fish, eggs and legumes, fatty and sugary foods.
- When adding these foods to your diet, you should cut out refined sugar and grains, processed foods, and salt.
- Avoid trans fats. These oils, which block the arteries, threaten fertility as well as damage the heart and blood vessels.
- Eat small or very small amounts of high-calorie foods (including chips, biscuits, fatty meats, pastries, cakes, fast foods, and desserts).
- Eat your meals at regular intervals and avoid unhealthy snacks.
- Drink water instead of alcohol or sugary drinks.
- Let vegetables make up half of your plate at lunch and dinner.
- Use a smaller plate to help you eat smaller portions.
- Increase your daily activity. Do regular physical activities such as walking and climbing stairs.
- Set a realistic weight goal. This keeps you motivated and can help you feel active. It’s good to be able to lose half to one pound a week until you reach your goal weight.
When you make these lifestyle changes, they will make a difference in your overall health, even if you don’t lose weight. Start making these changes before you conceive and continue them throughout your pregnancy and beyond.
Is there a risk of IVF treatment?
IVF treatment has short and long term risks. The most common risks of IVF treatment are;
Side effects of IVF Drugs;
- Egg retrieval procedure (OPU) risks,
- Ovarian Hyperstimulation Syndrome (OHSS),
- Ectopic pregnancy risk
- Early pregnancy complications
- Low risk,
- Multiple pregnancy risk.
Short Term IVF Treatment Risks;
These risks may be observed during that treatment period or immediately after the end of treatment.
1- Side effects of drugs
During the ovarian stimulation period of IVF treatment, hormone injections are used to stimulate more than one egg to develop in the ovaries. The short-term risks of IVF treatment are usually due to drug side effects. Very few women can react to the drugs used during IVF, and these side effects are mostly mild. These:
- Pain or bruising from injections,
- Breast tenderness,
- Mood Changes: Feeling bad or irritable, Restlessness,
- Allergic reactions,
- Mild pelvic and abdominal pain
- Hot flashes,
2- The risks of egg retrieval (OPU)
Eggs are collected after hormone therapy is used to make the ovaries produce more eggs. The eggs are collected approximately 36 hours after the egg cracking injection is made.
Egg retrieval is done under anesthesia and usually takes about 10-15 minutes. Patients usually return home after a few hours. Both egg retrieval and anesthesia may have risks, but the rates of these risks are very low (IVF Treatment istanbul Turkey).
In a study examining the results of approximately 380,000 egg collections in Germany, 0.07 percent of women reported vaginal bleeding, 0.05 percent intra-abdominal bleeding, 0.001 percent intestinal injuries, and peritonitis or peritonitis (inflammation of the peritoneum).
Some women may feel worse in the first few days after egg retrieval, some report menstrual cramps, while others may experience bloating and abdominal discomfort. After about 5-7 days, the ovaries return to their original size.
3- Ovarian Hyperstimulation Syndrome (OHSS)
Normally, a controlled mild stimulation of the ovaries is desired during the IVF procedure. However, sometimes due to moderate or severe stimulation of the ovaries, a picture known as ovarian hyperstimulation syndrome (OHSS) may occur with fluid accumulation in the abdomen and enlargement of the ovaries. OHSS is a frequently encountered problem especially in the treatment of women with polycystic ovary syndrome. Women with OHSS have symptoms of abdominal swelling and pain, nausea, vomiting, and increased thirst. In rare, severe forms, there may be excess fluid in the abdomen, difficulty breathing, and decreased urination (IVF Treatment istanbul Turkey).
Long-Term Risks of IVF Treatment
- Ectopic Pregnancy Risk
- Early Pregnancy Complications
- Miscarry Risk
- Multiple Pregnancy Risk
- Do IVF drugs have cancer-causing effects?
- Is there an increase in the rate of anomalies in children born through IVF?
- Does stimulating the ovaries with hormone therapy destroy the ovaries and cause early menopause?
1- The risk of ectopic pregnancy
Previous diseases in the tubes, endometriosis, previous tubal surgery, history of pelvic infection, being over 35 years old, smoking are risk factors for ectopic pregnancy. The risk of ectopic pregnancy is 3-5 times, and at the same time, intrauterine and ectopic pregnancy is at least 30 times higher than natural pregnancy. In women with hydrosalpinx, the risk of ectopic pregnancy is reduced following closure or removal of the Fallopian tubes / IVF Treatment istanbul Turkey.
2- Early pregnancy complications
The risk of bleeding in the early stages of pregnancy is four times higher in women who become pregnant after IVF treatment. The increased level of anxiety in women who became pregnant following IVF treatment may be associated with an increase in the number of hospital admissions.
3- Miscarry Risk
There is no scientific evidence to suggest that the risk of miscarriage increases after IVF treatment. There is no difference in the incidence of miscarriages and chromosomal disorders between IVF treatment and those who conceive naturally.
4- Multiple pregnancy risk
If more than one embryo is transferred to the uterus, the risk of multiple pregnancy increases. The risk of gestational hypertension, gestational diabetes, preeclampsia, increased cesarean section rate, anemia and bleeding during delivery is higher in multiple pregnancies.
Multiple pregnancies can also seriously harm the health of babies. At least half of twins are born prematurely and underweight, which can lead to serious (in some cases long-term) health problems and even death. Also, the probability of an early or late miscarriage is much higher.
Can multiple pregnancies be prevented?
Multiple pregnancies can be prevented by transferring only one embryo instead of two or three. Remaining embryos can be frozen for later use. Although single embryo transfer does not have a significant effect on success rates, it may not be suitable for all expectant mothers, especially older women.
5- Do the drugs used in IVF treatment have cancer-causing effects?
Some cancers, including cancers of the female reproductive system and breast, are hormone dependent. On the other hand, infertility itself is a risk factor for certain cancers, including breast, ovarian and uterine cancers. Some conditions increase the risk of cancer in women with infertility, such as the absence of ovulation, endometriosis, and having never given birth.
Scientific studies show that in vitro fertilization treatments do not increase the risks of ovarian cancer, malignant melanoma, endometrium, cervix, breast, thyroid or colon cancers.
Regardless of the number of IVF treatments or the type of drugs used, there is no evidence to suggest that there is a direct cause-and-effect relationship between IVF treatment and cancer.
6- Is there an increase in the rate of anomalies in children born through IVF?
Studies have shown that birth defects in babies born by in vitro fertilization are not different from babies born by natural methods. No change is observed in later developments such as behavior and intelligence. However, a minimal increase in sex chromosome disorders can be observed, especially in patients with severe male factor and microinjection. In some studies, it has been reported that there is a very slight increase, which is not statistically significant, in anomalies such as cardiac anomalies, anomalies of the cerebrospinal system and hypospadias.
7- Does stimulating the ovaries with hormone therapy destroy the ovaries and cause early menopause?
In IVF treatment, the growth of follicles is provided with egg-developing needles. These follicles contain egg cells. The maximum number of eggs collected during an IVF treatment period does not exceed 15-20. Since there are thousands of follicles waiting to grow in the ovary, the growth of so many eggs at the same time does not cause any harm to the ovaries. Stimulation of the ovaries with hormone therapy does not cause premature menopause by destroying the ovaries (IVF Treatment istanbul Turkey).
Freezing Eggs (Egg Freezing Process)
What is egg freezing?
It is one of the fertility preservation methods used to ensure the continuity of fertility. Egg freezing is a method that can be applied by women who do not want to give birth under current conditions and want to become a mother in the future. Eggs collected from the ovaries are frozen and stored for future use, thawing when pregnancy is desired, fertilization is achieved with sperm and an embryo is obtained, and pregnancy occurs with embryo transfer (IVF Treatment istanbul Turkey).
In which situations and at what age range should egg freezing be considered?
According to the Reproductive Medical Regulation, which was renewed by the Ministry of Health in 2014, the process of “freezing sperm and eggs”, which was allowed in Turkey in previous years only in cases of medical necessity, is now unmarried, who has not completed his family yet, who wants to have a child in the future, and whose egg reserve has decreased. It can also be applied to women who are approved by a specialist doctor with a health board report.
Although the egg freezing process can theoretically be done between the ages of 14-45, where we can obtain eggs, the number of eggs and egg quality decreases over the age of 38. For these reasons, it is important for women who want egg freezing to apply for egg freezing under the age of 38 in order to collect enough and high quality eggs so that they can freeze their eggs without losing their reproductive abilities and use these eggs in the future to have a child (IVF Treatment istanbul Turkey).
Who is suitable for egg freezing?
Egg freezing is done for two main reasons. The first is for social reasons; that is, it is performed in women who do not have medical diseases but are at risk of decreased ovarian reserve. These are single women, whose age is advancing and who are diagnosed with low ovarian reserve, who postpone their marriage due to not being able to complete their education, not being able to obtain economic freedom, not being able to provide suitable economic conditions, not being ready for pregnancy, and not being ready for pregnancy.
The second main reason is medical reasons; It is performed in women with a reduced risk of ovarian reserve due to familial early menopause history, familial breast cancer history, presence of endometriosis, or some genetic diseases such as Turner Syndrome, Fragile-X syndrome, Muscular dystrophy, BRCA-1 carrier, X chromosome deletions, early menopause in twins. .
In some diseases such as Sickle Cell anemia, rheumatological diseases, myelodysplastic syndrome, before the use of toxic drug treatments on eggs or after the diagnosis of cancer, the person will receive radiotherapy and / or chemotherapy, which is harmful to the reproductive cells, and a serious surgical operation will be performed that will lead to the loss of reproductive functions. Eggs can be frozen with.
How is egg freezing done?
The treatment starts on the 2-3rd day of menstruation and it takes about 12-15 days for the ovaries to be stimulated with daily hormone injections. With the help of ultrasound, a light anesthesia is given and the eggs are collected.
How are the eggs stored? How is it used?
After being balanced with preservatives called “cryoprotectant” in the IVF Center laboratory, the eggs are frozen at -196 degrees using a special method called vitrification and stored in nitrogen tanks for many years. While dissolving, these cryoprotectants are removed from the environment and taken into special culture media.
Can cancer patients have children?
After being diagnosed with cancer, the eggs can be frozen because the person will receive radiotherapy and/or chemotherapy, which is harmful to reproductive cells, or because cancer surgery will result in the loss of reproductive functions.
How long can frozen eggs be stored?
According to the Reproductive Medical Regulation, which was renewed in 2014 by the Ministry of Health in Istanbul, frozen eggs are stored in centers for a maximum of five years. If the person wishes to extend the storage period to longer periods at the end of 5 years, this period can be extended with the permission of the Ministry.
What is the success rate of egg freezing?
IVF Treatment istanbul Turkey: Girls are born with a certain number of eggs that they will use throughout their lives, while there is no new egg production, the number of eggs gradually decreases over the years. When a baby is five months old in the womb, there are 6-7 million egg cells in its ovaries. With the physiological destruction of egg cells, only 1-2 million egg cells remain at birth. This rapid loss of egg cells slows down after birth, and by the time of the first menstrual period, there are 300-400 thousand egg cells. During the reproductive age period, approximately 400 ovulations occur once a month. During the reproductive period, the decrease in the number of egg cells is constant, on average 1000 egg cells are lost per month, but after the age of 37, the rate of loss increases.
IVF Treatment istanbul Turkey; When the number of egg cells falls below 25 000, the decrease accelerates until the number of egg cells is approximately 1000 and menopausal symptoms begin to appear. Although there is ovulation, the number of destroyed egg cells is higher, and the number of eggs decreases dramatically with rapid loss in the near-menopausal period. During menopause, the number of egg cells decreased below 1000. It is estimated that 13 years before menopause, while menstruation continues regularly, the ovaries give signs of a rapid decline in fertility.
The maximum chance of conceiving is around the age of 25. Conceiving rates gradually decrease towards the age of 30, and after the age of 35, there is a very significant and significant difference. While it decreases even more at the age of 40, it becomes almost impossible for a woman to become pregnant when she reaches the age of 45. In fact, she is menstruating, but menstruation does not indicate that she can become pregnant, because there is no ovulation in menstrual cycles at this age.
“Over reserve” refers to the number of eggs in the ovaries at the age of the woman, while “ovarian aging” is used to describe the decrease in the number of eggs and egg quality of the ovaries with advancing age. While age-related decrease in ovarian reserve is an expected physiological condition, decrease in ovarian reserve at young ages occurs as a result of some risk factors. The age factor is very important as the success of egg freezing depends on the number and quality of eggs to be obtained. (IVF Treatment istanbul Turkey) The success rate decreases with increasing age.
IVF Treatment istanbul Turkey; Although egg freezing is a successful and safe application, it is ideal for women in their early thirties who do not have a pregnancy plan / chance in the near future. Older women should be informed about the low chance. Awareness raising and information campaigns should target young women and should not be deemed to be a guarantee against the risk of childlessness.
What are the advantages and disadvantages of egg freezing?
Advantages of egg freezing process; The leading obstacles to having children are the decreasing ovarian reserve with age and the decrease in egg quality in women. Egg freezing is an opportunity for women who have not yet met the appropriate conditions for marriage to preserve their fertility. Before cancer treatments or surgical treatments that may damage the ovaries, these patients can have a chance to have children by freezing the eggs.
Disadvantages of egg freezing process; In order to achieve more successful results in the egg freezing process, it is planned to freeze more eggs, not the only egg produced each month. Usually the desired figure is 8-10 eggs. For this reason, ovaries are stimulated with hormones before egg freezing, this treatment requires time and cost. In women with low ovarian reserve, it is necessary to repeat the whole egg freezing process several times in order to reach this number.
Where should the egg freezing process be done and what should be considered in the health centers?
In vitro fertilization specialist performs egg freezing procedures. Although it is important to choose an IVF Center with a reliable and well-structured laboratory, due to the decrease in the reserve of the ovaries, the experience and reliability of the physician who can stimulate the ovaries of the patients who have few ovaries or who will receive serious treatments such as cancer in the best way, collect the eggs in sufficient number and quality and deliver them to the laboratory. attention should be paid.
Freezing Storage of Sperm
IVF Treatment istanbul Turkey Freezing Storage of Sperm
What is sperm freezing?
Sperm freezing is a method of collecting and analyzing sperm, storing them for long periods after freezing, and thawing them whenever desired and using them in infertility treatments. This general process is known as cryopreservation.
The benefit of sperm freezing is that it allows the man to maintain his fertility using his sperm. Sperm freezing gives you the chance to have children at a later date.
Who should consider freezing sperm and why?
Reasons why men freeze and store their sperm include:
- Before vasectomy (surgical sterilization), he may ask for sperm to be stored in case he changes his mind about having children in the future,
- Advancing age,
- Low number or quality of sperm and its progression,
- If there will be difficulty in giving a sperm sample on the day of egg collection during IVF treatment,
- If her husband works abroad and cannot come to the clinic on the day of egg collection during IVF treatment,
- For cancer patients to preserve their fertility before gonadotoxic chemotherapy or radiation,
- If he will undergo testicular surgeries,
- People with diabetes or multiple sclerosis, spinal cord disease or injury, degenerative diseases.
- How is a sperm sample given?
- Sperm are collected through masturbation. He can give sperm samples at home or in the clinic, but should only use a sterile lubricant that does not harm the sperm. About two to five days before giving sperm, sexual activity should be avoided.
In men who do not have any sperm in the semen sample (azoospermia), sperm can be obtained by surgical methods such as Percutaneous Epididymal Sperm Aspiration (PESA), Micro Epididymal Sperm Aspiration (MESA), Testicular sperm aspiration (TESA), Testicular sperm extraction (TESE).
How is sperm stored?
IVF Treatment istanbul Turkey; The sperm sample is expected to liquefy for 30 minutes at 37°C. The sample count, motility and sperm morphology are checked. It is prepared by washing with a sperm density gradient.
In the sperm freezing process, it uses substances that minimize the damage to the sperm cells during the freezing and thawing process. In the sperm freezing process, low molecular weight chemicals called Cryoprotective agents (CPA) are used to protect the sperm from freezing damage.
Semen is diluted with an equal volume of CPA. The Sperm Freezing Solution is slowly added to the sperm and carefully tilted after each added drop. Sperm and sperm freezing solution (CPA) are left at room temperature for > 10 minutes. The cryovials are marked with patient identification and the semen mixture is loaded into the cryovials.
After the identity is checked, the cryovials are placed in liquid nitrogen. Cryovials are suspended above liquid level in a liquid nitrogen storage tank and immersed in liquid nitrogen vapor for 30 minutes. Cryovials are quickly transferred to liquid nitrogen and stored at -196 °C.
How long can sperm be frozen?
Cryopreserved samples can survive for extended periods if properly handled and frozen. Sperm males can remain in liquid nitrogen for decades until they are ready to start a family. It has been reported to freeze human sperm undamaged for up to 24 years. Even with sperm stored for years before thawing, the couple can achieve a healthy pregnancy.
Does freezing process harm sperm?
Sperm freezing has been used successfully since 1953. The process is safe, standardized and continues to evolve as technology advances. Studies show that there is no increase in the rate of birth defects.
What are the risks of sperm freezing?
Taking a semen sample by masturbation does not have any risks and side effects. If surgical extraction (PESA, TESA, MESA, TESE, or micro-TESE) is required, as with any surgery, there are minor risks of bleeding or discomfort.
What is the success rate of sperm freezing?
The major problem with sperm freezing is that not all sperm survive after freezing and thawing. The number of sperm obtained after thawing may be less, but the ability of live sperm to fertilize the egg after freezing and thawing is the same as fresh sperm. High success rates are achieved in IVF-ICSI treatment with frozen thawed sperm.
Frequently Asked Questions About IVF
How many different ways is IVF treatment applied?
IVF Treatment istanbul Turkey; After the examination and tests, the treatment method is determined according to the age of the woman and the ovarian reserve of the woman. In the embryo transfer stage, depending on the patient’s condition, transfer can be made during that treatment period (fresh embryo transfer) or the embryos are frozen (total milling) and the transfer is planned in the following months.
In women with polycystic ovary syndrome, sometimes an excessive ovarian response occurs before egg retrieval, and too many eggs develop, the ovaries enlarge. In this case, a different egg cracking needle is used and the collected eggs are fertilized with sperm and all of the embryos are frozen (total freezing) after the embryo is formed. The aim of this treatment protocol is to prevent the ovarian hyperstimulation syndrome, which we call OHSS. Embryo transfer is done in the following months after the inner wall of the uterus is prepared with pill treatments.
Another in vitro fertilization treatment is the transfer of frozen thawed embryos in women who could not get pregnant after fresh embryo transfer or who have had pregnancy and delivery but want to get pregnant again.
Is there a connection between the number of embryos transferred and the chance of pregnancy?
IVF Treatment istanbul Turkey: As the number of embryos transferred increases, the chance of pregnancy increases, and the risk of multiple pregnancy also increases. For this reason, the Ministry of Health has limited the number of embryos to be transferred in the Regulation on Assisted Reproductive Treatments (ART). Single embryo transfer is allowed in the first 2 attempts and in women under 35 years of age. 3. After the treatment trying and in women over 35 years of age, a maximum of 2 embryos can be transferred.
How many times can the IVF method be tried?
In vitro fertilization is not always a treatment method in which pregnancy can be achieved in a single attempt. In cases where pregnancy is not achieved in the first attempts, pregnancies are common after repeated treatments. There is no specific number on how many times IVF treatments will be tried. In line with the wishes of the spouses, with the doctor’s recommendation, the treatment can continue if the spouses’ health status is suitable. There must be sufficient number and quality of eggs and sperm necessary for the continuation of the treatment. In general, the success rate decreases after the third application.
Do the foods and drinks that are eaten in IVF treatment affect the success?
Applying a balanced nutrition program before starting IVF treatment increases the success rate of the treatment. For this reason, it is appropriate for women who are planning pregnancy to consume healthy foods that will increase their quality of life, to have adequate and proper nutrition and to adopt an active lifestyle. Instead of canned foods, fresh vegetables should be consumed and plenty of water should be drunk. Foods such as raw meat, milk and fresh cheese and foods containing heavy metals or mercury should not be consumed in order to cause any infection.
Is there any connection between weight and the chance of pregnancy with IVF?
Excess weight and obesity significantly reduce the chances of conceiving couples. It is a known fact that women with ideal weight can have a baby without any treatment. Nutritional disorders and weight can cause infertility in men due to reduced sperm quality. IVF Treatment istanbul Turkey, Consumption of foods containing trans fats and heavy metals reduces sperm motility.
In which season should IVF be done? Does it matter?
In IVF treatments, there is no seasonal difference in egg retrieval rate, egg quality, number of embryos, attachment of developing embryos and pregnancy success, and the continuation of the pregnancies obtained. The treatment time is decided by choosing the most appropriate time interval according to the medical and social conditions of the patient.
What causes bleeding in IVF?
Some patients may experience light spotting bleeding for a few days immediately after egg retrieval. Light vaginal bleeding after embryo transfer and before pregnancy test is called luteal phase bleeding. Patients may worry that the treatment has failed. When these hemorrhages occur, the success of the treatment decreases somewhat, but there is still a chance of pregnancy. For this reason, drugs that support the luteal phase such as progesterone should be continued and the pregnancy test result should be awaited.
Are there any restrictions on sexual intercourse in IVF treatment?
IVF Treatment istanbul Turkey; The time interval for restrictions on sexual intercourse depends on the stages of IVF treatment that your doctor will recommend. You can have intercourse during the needle treatment to reproduce the eggs. At least 2-3 days of sexual abstinence is required, since sperm will be collected from your partner on the day of egg collection, it is not recommended to have sexual intercourse 2 days before egg collection.
After collecting the egg, it is possible to have sexual intercourse using a condom, considering the possibility of multiple pregnancy. Your doctor will decide whether there is a risk of sensitivity and infection in the uterus and ovaries due to sexual intercourse and egg collection.
There may be different opinions about sexual intercourse after embryo transfer. In addition to the views that argue that having sexual intercourse and orgasm may prevent the embryo from holding, there are also opinions that suggest that having sexual intercourse and orgasm does not reduce the chance of pregnancy.
Sexual intercourse is not recommended for couples with moderate or severe ovarian hyperstimulation syndrome (OHSS) due to fluid accumulation in the abdomen and enlargement of the ovaries as a result of moderate or severe stimulation of the ovaries. There may be a risk of bleeding from the ovaries and pain during sexual intercourse (IVF Treatment istanbul Turkey).
What is the difference between Intrauterine Insemination Method (IUI) and IVF?
In the treatment of the Intrauterine Insemination Method (IUI), sperm are prepared in the laboratory. Motile and healthy sperm are condensed in 0.5 ml of liquid and are prepared for the inoculation process. On the day when the woman’s egg is ready for fertilization, this liquid is injected into the uterus with the help of a thin catheter. The sperm in the liquid go to the tubes with their own movements and fertilize the egg here. In this way, fertilization takes place naturally in the tubes within the female body. The resulting embryo moves through the tubes into the uterus and settles on the uterus wall (IVF Treatment istanbul Turkey).
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IVF Treatment istanbul Turkey