After your initial evaluation by your doctor, you should make another doctor's visit before starting IVF treatment. At this visit, you will discuss your treatment plan with your doctor. During one of your doctor's visits, your uterus can be measured using a catheter. Catheter; It is a thin, flexible tool that is used to place the embryo in the womb. Since the catheter is first inserted into the cervix and then into the uterus, the size, shape and direction of the uterus can be determined by the measurement. This is beneficial for embryo implantation. Blood tests will be done to identify any infections you or your partner may have.
A sperm sample is requested from the man so that it can be analyzed. If an abnormal situation is encountered in the sperm analysis, another sample may be requested for further examinations.
Nurses will tell you about your treatment plan and how you should use your medications.

Stimulating the Eggs:

The IVF treatment process begins in the menstrual cycle, depending on the egg stimulation process. (about a week before the woman's period) During this period, the woman uses GnRH analog drugs to stimulate her eggs. This drug effectively reduces the release of hormones that control the development of eggs in the ovaries. When you have your period, vaginal ultrasound and blood tests are performed to check whether the drug reduces egg development. If not, the drug treatment is continued for another week or two. When the function of the ovaries temporarily ceases completely, true stimulation therapy begins. Hormone therapy is applied for about 10 days to stimulate the ovarian follicles. Blood tests and ultrasound will be needed throughout treatment to determine follicle sizes. The use of the drug continues for about 10 - 12 days. Once sufficient egg stimulation is achieved, another hormone, hCG, is injected. Eggs are collected 36 - 38 hours after hCH injection.

Egg Collection and Fertilization of Eggs:

Egg retrieval is performed under anesthesia. Egg retrieval usually takes between 20 and 50 minutes. The fluid taken from the follicles is immediately taken to the embryology laboratory. In the laboratory, eggs are placed in a special solution and placed in the incubator. The time the eggs spend in the incubator depends on how mature they are. On the day of egg collection, the male collects the sperm sample by masturbation and delivers it to the laboratory. The sperm sample can also be collected outside the center in special cases. In particular, couples who may have difficulties in giving sperm samples outside the home by masturbation without a partner can obtain sperm samples at home. After the sperm is obtained, it should be delivered to the embryologists in the center within 1 hour at the most, if this period is more than 1 hour; The male sample should obtain in the center. If it is obtained outside the center; The sample should be delivered to the IVF laboratory at room temperature (without exposure to extreme heat and cold), without exposure to light. In rare cases, a second sperm sample may be requested on the same day. The next step is to combine the eggs with the sperm. The fertilization rate of eggs is usually 80%. Eggs are checked 24 hours after retrieval. Fertilization also took place during this time. Some embryos can be frozen and stored if deemed necessary. If pregnancy does not occur after treatment, frozen embryos can be used for the next transfer. In this way, the patient will not repeat the egg stimulation process again. The patient is discharged within 2 - 4 hours after the procedure and is asked to rest at home for 24 hours. It is natural to have pain in the waist, in the groin similar to menstrual pain, red or brown bleeding (from the reservoir) in the form of drops within 1 - 2 days after the egg collection process. Such bleeding does not have a negative effect on the chance of pregnancy as it is not from the uterus.
You may need to inform your doctor if any of the following conditions occur:
a) Fever higher than 38 degrees by measuring
b) Excessive vaginal (from the chamber) bleeding (some bleeding is normal)
c) Very severe and ongoing pain (some pain is normal)
d) Weight gain of more than 1 kg in 2 consecutive days
e) Inability to urinate with increasing pain 8-10 hours after the procedure

Embryo Transfer:

Embryo transfer is done within 1-3 days after the eggs are retrieved. The number of embryos to be transferred depends on the quality of the embryo, but the legal limit is three in our country. After the embryo transfer process, you need to rest for 2 days. 12 days after embryo transfer, a blood pregnancy test (blood beta hCG) is performed. Even if there is bleeding that is thought to be compatible with menstruation, a pregnancy test must be performed because sometimes there may be vaginal bleeding due to the embryo being placed in the uterus even though pregnancy occurs. If the test is positive, that is, if there is a pregnancy, the ultrasound is checked after about 3 weeks.

Ligation or Removal of Tubes
Some patients undergoing IVF treatment experience a problem of obstruction in their tubes. In cases where this obstruction occurs at the ends of the uterus, secretions accumulate in the tubes and these affect the embryos in a toxic way. As a result, the probability of conceiving is reduced by 50%. This problem experienced by the patients in question can be understood with the HSG method.

When the same problem is seen in the ultrasound evaluation, one of the options to remove or connect the tubes is applied. In cases where the removal of the tubes is on the agenda, the procedure is performed by entering the abdomen from the umbilicus using a laparoscopy camera; In cases where the procedure cannot be performed, tubes are tied in order to disconnect it from the uterus.

PGD (Preimplantation Genetic Diagnosis)
The PGD Method is a diagnostic method that serves the goal of IVF treatments, “To ensure that healthy babies are born into the world, not too many”. Thanks to this method, many couples at risk of having a diseased child can be analyzed before the transfer.

With the PGD Method, a diagnosis can be made by revealing the problems of women who have miscarriage due to a chromosomal disorder problem or who have unsuccessfully tried IVF treatments, who have chromosomal anomalies in their eggs at an advanced age, and who carry genetic risk.

In simple terms, one cell is taken from the embryos obtained in method applications and these are examined in terms of genetics. Thus, the possibility of transferring unhealthy embryos is prevented from the very beginning.

Embryo Freezing Method
The embryo freezing method, which enables the embryos obtained in IVF treatments to be preserved for later use, increases the probability of success in the treatments, while at the same time brings economic and mental advantages to the patients. Especially for embryos that have been thawed for reuse, it is a serious comfort that the patient is not taken into a new process.

In the first years of its implementation, it was observed that the embryos preserved by freezing were lost in terms of viability and quality when thawed for later transfer, and this problem was prevented with the developed vitrification method.

For the embryo freezing method, the consent of the patients is obtained and after that, the embryos are kept in special environments for a certain period of time. The method has a special value for these patients, as patients younger than 35 years of age are allowed to transfer one embryo in the first two trials, within the framework of the law enacted in Turkey. The embryos of the patients who approve the embryo freezing process can be kept for a period of 5 years, provided that the contract is renewed every year. Embryos of patients who do not give consent are destroyed by adhering to the protocols determined by law.

Single Selected Blastocyst Transfer
In some countries, including Turkey, restrictions are imposed on the number of embryo transfers. Accordingly, legal regulations on the subject have been brought in Turkey and 1 embryo transfer has been made mandatory in the first two IVF trials of patients younger than 35 years of age. The only chosen method of blastocyst transfer has been a great advantage for patients living in countries where this requirement has been imposed.

The most important feature of single-selected blastocyst transfer is that it has the most similarity to pregnancy obtained by normal means. It is possible to select embryos with high development potential that can be kept in the laboratory for five to six days in application processes. This feature increases the possibility of positive results and eliminates the possibility of facing multiple pregnancy.

Micro-TESE Method
After the discovery and implementation of this method, treatment became possible for many men who were considered impossible to have children due to the absence of sperm in the semen. With the introduction of the Micro-TESE Method among the treatment methods, the hope of these patients becoming a father is becoming a reality today.

In Micro-TESE applications, testicular tissue is examined with the help of a special microscope and the samples taken from here are taken to the laboratory for examination. When the desired result is obtained, that is, when sperm can be obtained, the process of injecting the eggs is applied. In some cases, freezing is done if necessary.

While sperm is obtained in all patients with obstruction in the sperm carrier channels, the same success can be achieved in half of the patients with production disorders due to the discomfort.

Thinning of the Embryo Membrane
One of the problems frequently encountered in patients who apply to IVF clinics is the inability to reach a pregnancy result despite the embryo development being achieved. In general, the reason for this problem is that the embryo cannot tear the membrane surrounding it and cannot settle on the uterine wall (endometrium). The method of thinning the embryo membrane is used to solve this problem and thus a significant increase in the pregnancy rate achieved by the patients is seen.

In vitro fertilization is the process of artificially fertilizing the egg cells taken from the woman and the sperm cells taken from the man in the laboratory environment and placing the obtained embryo in the mother's womb after it reaches a certain size, following the evaluations made after the couples who have problems conceiving in vitro fertilization apply to the hospital.

In vitro fertilization can be applied in two ways according to the clinical results of the patient. The first is the classical method IVF "in-vitro fertilization" and the second is ICSI "Microinjection (Intracytoplasmic sperm injection)".

The expansion of IVF from these two applications is the fertilization of the egg by one of the sperm by leaving the sperm taken from the father around the egg taken from the mother in a special environment in the laboratory.

Microinjection is the injection of a live sperm selected from the man into the egg taken from the woman. Today, this method is more preferred.

Who is IVF applied to?
In cases where the couple is not protected and cannot get pregnant within 1 to 2 years despite the desire for a child.
Both tubes are clogged.
Severe infection, ectopic pregnancy, tuberculosis, etc. as,
Polycystic ovary syndrome.
Severe sperm disorder in the male (number, low motility).
Problems caused by the late age factor in women.
The absence of sperm in the semen, in the medical term azoospermia.
Endometriosis is when the endometrioma, which is the inner layer of the uterus, is located outside the uterus, especially in the ovaries, peritoneum and rarely in other parts of the body.
Women with common intra-abdominal adhesions.
In patients with a complex disorder that occurs as a result of abnormal functioning of the ovaries and some glands due to hormonal imbalance in women.
Fibroids (cysts) that cause infertility, although they are known as benign tumors.
Unexplained infertility. (For this reason, the patient is first treated by vaccination, if the result is not obtained, in vitro fertilization is applied.)