In Vitro Fertilization (IVF)

In Vitro Fertilization (IVF)

IVF is one of the most common methods of auxiliary reproduction methods in modern medicine and can be defined as fertilization of female and male reproductive cells under conditions outside the body and transfer of the resulting embryo or embryos to the uterus of the woman. 

Who Can Have IVF Treatment?

  • Women whose uterine ducts ( tubes) are occluded
  • Where sperm numbers are low, sperm movement is slow or rate of normal sperms is low
  • Patients who haven’t responded to impregnation method
  • Unexplained infertility cases
  • Women who have widespread adhesions in the abdomen because of endometriosis and in whom a pregnancy cannot be achieved by treatment
  • Certain hormonal disorders
  • Where pregnancy couldn’t be achieved using other treatment methods
  • In order to obtain a healthy baby by identifying certain hereditary diseases at embryo stage (in combination with genetic diagnosis methods before implantation)
  • In order to select healthy embryos by genetic diagnosis methods in women with repetitive miscarriages

Stages of IVF Treatment

  • The patient starts to use birth control pills on the first day of menstruation as from the moment she has decided to start the treatment. The aim of taking birth control pills is to regulate menstrual cycle of the patient and eliminate the risk of formation of an ovarian cyst until the next menstrual cycle when the treatment will be started. 
  • In the next menstrual cycle, the ovaries are stimulated by taking medications containing hormones. These medications help the development of multiple egg cells and increase the likelihood of pregnancy.
  • The growth of the stimulated eggs is monitored by ultrasound.
  • Close to a time when the stimulated eggs have reached a certain size, “trigger shot” is made.
  • Within about 36 hrs as from trigger shot, egg retrieval is performed in the IVF center. 
  • Sperm samples are taken from man on the day of egg retrieval procedure. 
  • In the laboratory, retrieved egg cells are fertilized using conventional IVF or microinjection method depending on sperm cell quality. By courtesy of this fertilization, the embryo which is the cornerstone of the baby developing in the womb is created. In microinjection method, it is ensured that sperm directly enters into the egg and success rate increases where sperm quality is low.
  • Fertilization detected under a microscope takes about 12 to 15 hrs. Embryo transfer is performed within 2 to 4 days. 
  • After embryo transfer, there is a waiting period of 12 days for its implantation.
  • On day 12 after the transfer, the result is obtained by a pregnancy test.

Methods Used in IVF Treatment

IVF and Microinjection Methods

In IVF method, sperm given by man and eggs taken from woman are brought together in a laboratory environment and self-fertilization is expected to take place. 

Sperms with insufficient fertilizing capacity, lack of mobility and severe disfigurement cannot penetrate the egg by themselves and fertilization cannot be achieved. In such cases, a sperm is injected into an egg and fertilization is achieved. This procedure is called microinjection (ICSI) .

TESE and TESA Methods

Methods referred to as TESE and TESA are used in men who don’t have sperm or who cannot ejaculate even though they produce sperm.

In TESA method, tissue is removed from the testicle using a needle, then sperm cells are found in that tissue and used for fertilization. 

Whereas in TESE method, a piece of tissue/tissue sample is directly removed from the testicle and sperm is extracted from this tissue. 

In Vitro Maturation (IVM) 

In conventional IVF treatment, eggs are retrieved after they mature and included in the process. Whereas in In vitro maturation (IVM), the eggs are retrieved before they are fully mature and allowed to mature in a laboratory environment. The purpose of this treatment is to continue treatment of any patients who may suffer harm from medications used to mature the eggs, without administering these medications. 

In this method, it is not always possible to obtain eggs with desired quality.  In addition, pregnancy rates are somewhat lower.

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