The inability to conceive due to sperm or ovaries also affects couples psychologically. Which method will be used in IVF treatment, which is applied to make the couples’ dreams of having a child come true, is decided in line with the health status of the patients and the evaluations of the experts. The aim of the treatment is always the realization of fertilization and a healthy pregnancy period.
What is it in Vitro Fertilization (IVF) Treatment
In vitro fertilization is an assisted reproductive method that involves the fertilization of egg cells (oocyte) and semen (sperm) taken from the woman in a laboratory environment and the placement of the fertilized embryo into the uterus of the woman. Pregnancy obtained from a certain number of embryos selected and placed in the uterus progresses in the same course as the pregnancy achieved by normal means. In this sense, the only difference between natural pregnancy and IVF treatment is that fertilization is carried out in laboratories with suitable conditions.
The first successful IVF treatment case, founded by Robert G Edwards in 1971, was seen in England in 1978. The first successful pregnancy in Turkey was concluded with the in vitro fertilization method at Ege University in 1989. Thanks to the development of medical techniques and technologies, different in vitro fertilization techniques are applied, and successful results are obtained.
Which Methods are Used?
Depending on the fertilization of the ovaries, in vitro fertilization treatment is applied with classical in vitro fertilization (IVF) or microinjection (ICSI) methods. The frequently preferred IVF method is generally selected in cases where there is no problem in sperm count and quality, and sperm fertilization is performed by itself. In the ICIS method, the egg is ready for injection, and the sperms are placed in a single egg.
When is it Applied?
For the application of IVF treatment, it is necessary to have sexual intercourse for at least one year without using birth control methods and not to be pregnant during this period. This condition is also called infertility. In the absence of pregnancy during this period, IVF treatment is applied.
Age Limit In Vitro Fertilization
In vitro, fertilization treatment is applied up to the age of 45 in women whose ovarian functions are found suitable by tests performed on three days of the menstrual period. At the same time, it is also checked whether the embryos are ideal with the genetic diagnosis method. However, women over 40 are less likely to have this method successfully than younger women. The decrease in the number and quality of eggs in women, especially after age 35, also affects the chances of success.
Although there is no age limit for men, it is considered that sperm quality decreases due to changes in sperm DNA as age progresses.
Who can Have In Vitro Fertilization (IVF)?
In vitro fertilization (IVF) treatment is applied depending on some factors:
- In women, the ovaries (fallopian tubes) are closed, damaged, or removed,
- The presence of stickiness that will prevent the fallopian tubes from catching the formed eggs,
- Presence of women at an advanced age when fertility is low,
- Failure to achieve pregnancy with drug therapy,
- In men, the number of sperm is low and of poor quality, or there are no sperm cells at all.
- Especially women who are older than 30 years of age and have irregular menstrual bleeding, men with low sperm count, as well as men with testicular health problems, should apply to IVF centers to achieve pregnancy.
In some cases, it is expected that normal pregnancy will occur by treating various health problems primarily with drugs or surgical methods. If normal pregnancy is not seen after these problems are resolved, IVF treatment is applied. For example, laparoscopic surgical applications are used first in intra-abdominal adhesions that prevent eggs from being retained. If the adhesions that develop due to ovarian cysts or inflammations are treated and the fallopian tubes acquire the function of holding the eggs, if pregnancy cannot be achieved by regular means, in vitro fertilization treatment is applied again.
In vitro fertilization treatment is also applied to women with endometriosis. This disease occurs when the endometrium tissue, excreted during the menstrual period and covers the inside of the uterus, is found in the fallopian tubes or intestines.
This treatment is also applied in immunological infertility, in which antibodies develop in the ovaries that prevent sperm from adhering. The microinjection method provides successful results, especially in cases where pregnancy cannot be achieved due to infertility seen in men.
What does the Treatment Process Include?
After evaluating the couples’ general health status and the reasons for their infertility, specialist physicians inform the couples and the treatment process begins.
Stimulation of the Ovaries
Stimulation of the ovaries and obtaining a large number of eggs form the basis of IVF treatment. Medicated treatment, including hormone injections, is started on the 3rd day of the women’s menstrual period. Women can inject themselves after being informed. The arousal process, which lasts about 10-12 days, varies from woman to woman, depending on the reaction of the ovaries to the drug treatment. In this process, where the ovaries should be followed closely, an average ultrasound control is performed every 2-3 days. In these controls, the dose of the drugs is adjusted according to the hormone levels of the women. At the same time, in some cases, a hormone antagonist is given from the navel to prevent premature rupture of the ovaries.
Collecting the Eggs
After the eggs reach a specific size, a hormone injection is applied to crack them, and the collection process is carried out. Timing is of great importance in the collection process. Eggs are collected 34-36 hours after the hormone injection, mostly under general anesthesia. In the procedure, the needle guided by ultrasound is passed through the vagina, and the eggs are reached. While generally, 1 to 40 eggs are obtained, there may be cases where eggs are not accepted, although very rarely. Couples are discharged a few hours after the collection, which takes 20-30 minutes on average.
Fertilization of Eggs
Collected eggs are fertilized by various methods in a suitable laboratory environment, and embryo formation is ensured. On average, fertilization takes place between 12 and 15 hours. After that, the day will be placed in the uterus by selecting quality eggs.
Embryo Transfer
Depending on the quality of the embryos, a maximum of 2 days is expected to transfer fertilized eggs, also known as pre-embryo or zygote, into the uterus. Transfer involves leaving the embryos taken into the catheter by passing them through the cervix. Embryo transfer, which is performed without the need for anesthesia, is served with ultrasonography.
While the number of embryos transferred is one in women under 35, the maximum is two in other women. After embryo transfer, couples can leave the hospital immediately.
After the transfer, progesterone or estrogen hormone supplementation is made by injection for two weeks.
Pregnancy Test
A pregnancy test is performed to understand whether pregnancy has occurred on average 12-14 days after embryo transfer. If the test is positive, an ultrasound control is performed approximately ten days later to see the condition of the gestational sac..
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