In vitro fertilization, which is one of the methods that enables individuals with various fertility problems to have children, is one of the most preferred assisted reproductive techniques today. In vitro fertilization treatment, which is applied in cases where women cannot become pregnant naturally, includes many methods, especially vaccination.

What is IVF?

IVF treatment; It is an assisted reproduction method that involves the fertilization of egg cells (oocyte) taken from the woman and the semen cells (sperm) taken from the man 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 case of IVF treatment, which Robert G. Edwards laid the foundations in 1971, was seen in England in 1978. Today, thanks to developing medical techniques and technologies, different in vitro fertilization techniques are applied and successful results are obtained.

Which methods are used?

In vitro fertilization treatment is applied with classical in vitro fertilization (IVF) or microinjection (ICSI) methods, depending on the fertilization of the ovaries. The frequently preferred IVF method is generally preferred when there is no problem in sperm count and quality, and sperm fertilization is performed by itself. In the ICIS method, the egg is made 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 1 year without using birth control methods and to avoid pregnancy during this period. This condition is also called infertility. In the absence of pregnancy during this period, IVF treatment is applied.

Age Limit in IVF

In vitro fertilization treatment is applied up to the age of 45 in women whose ovarian functions are found suitable by the tests performed on the third day of the menstrual period. At the same time, it is also checked whether the embryos are suitable with the genetic diagnosis method. However, women over the age of 40 are less likely to have this method successful than younger women. The decrease in the number and quality of eggs in women, especially after the age of 35, also affects the chances of success. There is no age limit for men, but it is considered that the quality of sperm 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, and men with low sperm count as well as men with testicular health problems should apply to IVF centers in order to achieve pregnancy.

How does Treatment Process work?

After evaluating the general health status of the couples and the reasons for the failure to conceive, specialist physicians inform the couples and the treatment process begins.

Stimulation of the Eggs

Stimulation of the ovaries and obtaining a large number of eggs form the basis of IVF treatment. On the 3rd day of the women's menstrual period, medicated treatment including hormone injections is started. 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, ultrasonography control is performed every 2-3 days on average. 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.

Egg Retrieval

After the eggs reach a certain size, a hormone injection is applied in order to crack them and the retrieval process is carried out. Timing is of great importance in the collection process; Eggs are collected 34-36 hours after the injection of hormones, 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 obtained, 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. After fertilization, which takes place between 12 and 15 hours on average, the day is planned to 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 for the transfer of 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 performed with ultrasonography. The number of embryos transferred is one in women under the age of 35, while it is two in other women. After the embryo transfer, the couples can leave the hospital immediately. Progesterone or estrogen hormone supplements are given by injection for two weeks following the transfer.

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 10 days later to see the condition of the gestational sac.

What are the risks of In Vitro Fertilization (IVF) Treatment?

Like every treatment method, there are usually some predictable and manageable risks in IVF treatment. Risks; It occurs due to the drugs used or the procedures applied during the treatment.

Ectopic Pregnancy

The development of the fertilized egg outside the uterus instead of inside the uterus is called an ectopic pregnancy. The probability of ectopic pregnancy, which usually occurs due to problems in the fallopian tubes, during IVF treatment is lower than natural pregnancy. Ectopic pregnancy, which can be diagnosed with ultrasonography and blood tests at an early stage, can be treated with medical methods or surgical operations.

Multiple Pregnancy

The high number of embryos transferred to women increases the success rate in IVF treatment. However, as the number of embryos increases, the risk of multiple pregnancy also increases. Multiple pregnancies occur in one out of every four successful IVF attempts. Multiple pregnancy has negative effects on the health of both women and babies. In this case, the risks of preterm birth and miscarriage are higher than single embryo transfer. Preeclampsia, also known as diabetes, hypertension and pregnancy poisoning, may develop during pregnancy due to multiple pregnancies in women; Complications such as bleeding more than normal may occur during delivery. Babies, on the other hand, have physical and mental developmental disorders as well as death due to preterm birth. Spasticity, failure to develop lung capacity, cerebral hemorrhage, multiple organ disorders and permanent disabilities are the most common problems. In order to prevent multiple pregnancies, which can cause serious consequences for mothers and babies, the number of transferred embryos should be minimized. Transferring a single embryo in the first two attempts to women under the age of 35 and transferring a maximum of two embryos to other women reduces the risk of multiple pregnancy.

What is the success rate of the treatment?

The success rate in IVF treatment varies according to many factors. However, it is possible to talk about a one-third success rate in general. While the success rate in women under 30 is 45-50%, it is around 15-20% in advanced age. It is predicted that all in vitro fertilization trials will be successful with the developing techniques in the following periods.

· The effective factors for the success of the treatment are listed below;

· Age of women

· Infertility of unknown cause

· Quality and number of sperm

· Status of the ovarian reserve

· Condition of the fallopian tubes and uterus

· The presence of endometriosis disease and fibroids that prevent the egg from sticking in the uterus

· Alcohol and smoking

· Overweight

· Stress