IN VITRO FERTILIZATION (IVF)

FREQUENTLY ASKED QUESTIONS

+ - How many days does the IVF treatment take?

It takes about 1 month in total. Hormonal treatment for the first 10 to 14 days, collection of eggs 1 to 2 days after, embryo transfer after 2 to 5 more days, and the result of the pregnancy test after 10 to 12 days.

+ - How many eggs are collected in IVF?

It was observed that the risk of pregnancy was highest in patients with 15 oocytes collected; and that below or above that number, it would negatively affect pregnancy rates.

+ - How important is nutrition during IVF treatment?

Nutrition is very important during IVF treatment, and especially in the pre-IVF period, but the relationship between IVF treatment and diet is a fairly recent issue that has been discussed and studied especially in recent years. Scientific studies on this topic show that if the mother eats a 'Mediterranean diet' during conception, it is a good choice for pregnancy. In other words, it should be fed with green vegetables and protein, and carbohydrates should be avoided for healthy sperm and egg cells. Vegetable and protein-based nutrition is one of the factors affecting the success of IVF treatment.

Caffeine consumption should be limited. Tea and coffee should therefore have a certain limit: 2 cups of tea and 1 cup of coffee can be consumed every day.

Margarine and oils containing unsaturated fats should not be consumed.

Unpasteurized dairy products should never be eaten as well.

Smoking and alcohol should be avoided, and in particular, cigarette consumption should be reduced to zero.

Desserts with excessive carbohydrates should not be eaten. Milk desserts may be preferred.

Cola, chocolate, etc. Foods containing additives should be avoided.

Boiled and steamed foods should be preferred over grilled foods.

You can consume herbal teas, as long as you don't overdo it.

2 to 2.5 liters of water should be consumed per day.

Legumes like chickpeas, beans, and lentils should be consumed 2-3 times per week.

Foods rich in polyunsaturated fats like avocados, salmon, almonds, hazelnuts and pumpkin seeds should be consumed.

Fruits and yoghurt should also be consumed.

Finally, fast food should absolutely be avoided.

+ - What are the medications used during IVF treatment?

GnRH analogues and antagonists:

GnRH is a hormone that is released periodically by the gland we call hypothalamus in the brain.

This hormone acts on the pituitary gland and causes the production of hormones which we call FSH and LH.

FSH and LH also regulate egg development by affecting the ovaries.

This event repeats itself regularly every month.

If GnRH analogue drugs (that is, drugs that act like GnRH) are used continuously, then they prevent the release of FSH and LH from the pituitary gland, and the ovaries are not stimulated and become completely silent.

With the external administration of drugs containing FSH and LH, more follicles are stimulated at the same time.

GnRH analogues are used depending on the condition of the patient, and the way and amount of use for each patient may vary or may not be used at all.

GnRH antagonists, on the other hand, are another drug used to suppress the ovaries. Their suppressive effect appears from the moment they are administered. It is used daily for the desired patient.

Gonadotropins:

These are drugs containing the hormone HMG or FSH used for stimulation of the ovaries.

HMG or FSH stimulates the ovaries for egg development and helps the eggs to mature.

HMG is a medicine containing FSH and LH obtained from the urine of postmenopausal women.

Although these medications usually start on the 3rd day of your period, they can be started on different days.

These stimulate the ovaries, allowing the eggs to develop more than once.

However, since each patient's response will be different, it is necessary to monitor progress closely with ultrasound and estradiol hormone analysis, and to adjust the dose of the drug if necessary.

When adjusting the dose of the drug, the age of the patient, the structure of their ovaries, the level of basal hormones and previous applications are taken into account.

Drugs containing FSH and very small amounts of LH are preferred when it is advantageous to use them in certain patients.

In addition, drugs containing pure FSH and LH produced with recombinant technology can be used by adjusting their doses in patients who need them.

+ - What are the factors affecting the success rate of IVF treatment?

Woman's age (after 35 years the risk of pregnancy decreases)

High weight (BMI value above 30)

Reduced ovarian reserve

Sperm quality

Decreased sperm count, problem with sperm retention

Immune system problems that damage the ovaries and sperm

Unexplained infertility

Problems with the uterus and fallopian tubes

Presence of myoma, polyps, adhesions, endometriosis which prevent uterine retention

Smoking (for both in the couple)

Avoiding stress, avoiding alcohol, and eat a balanced diet

DO YOU HAVE ANY QUESTIONS?

    + - If a couple tries but fails to have a baby for 6 months, they may seek treatment for infertility. If the woman's age is over 40, this period is 4 months.

    In vitro fertilization, which is the most effective infertility treatment, means that the sperm selected from the candidate father and the eggs collected from the expectant mother are placed in the same container and fertilized in an artificial environment in a laboratory. For fertilization to be more precise, instead of waiting for a sperm and egg to be naturally fertilized in the container, the microinjection method, which is an advanced technique, places the sperm one by one at the same time inside the ovum with a special tool.

    + - This method is called ICSI. IVF treatment, respectively;

    1- ) Hormone therapy (ovarian stimulation) and monitoring,

    2- ) Collection of oocytes and sperm,

    3- ) In vitro fertilization and embryonic culture + transfer of embryos to the uterus,

    4- ) Pregnancy follow-up.

    If the IVF treatment does not work after a few attempts, it may mean that there are special conditions, and special tests may be needed. All these tests are aimed at identifying the cause of the failure; it could be a textural incompatibility between spouses, the mother's uterus perceiving the baby as foreign tissue, or coagulation problems for example. These tests are carried out in our hospital with the most advanced technologies.

     

    + - 1- ) Hormonal drug therapy in an IVF procedureThe aim of this treatment is to prevent the untimely and irregular effects (premature ovulation, etc.) of the reproductive hormones secreted in the body. The procedure to be performed may vary depending on the patient's response to hormones. First, the hormones are suppressed, and then the ovaries are stimulated in order to obtain the desired amount of eggs.

    Suppression of hormones

    Usually hormone suppressing drugs should start on day 2 or day 21 of the menstrual cycle. The drugs used for this purpose are mostly vaccine-type drugs applied subcutaneously. Sometimes nasal sprays are also used. The duration of suppression varies between patients, ranging from 1 to 3 weeks. At the end of this period, when the patient has her period, the hormonal values in the blood are examined. In 5% of patients participating in the program, the program may be interrupted because hormones are not suppressed during this time. These patients can join the program again later.

    + - In patients whose hormone levels have fallen to the desired level, the ovaries are stimulated with injections containing FSH (Follicle-Stimulating Hormone) to be given under the skin and the development of a large number of eggs is ensured.

    With the taking of the drugs, the development of the follicle (the sac containing the egg) in patients is monitored by ultrasounds and blood tests. The frequency of these examinations is determined by the doctor who follows you, and it varies from patient to patient. The period of follicular development also varies between patients between 1 and 3 weeks.

    + - Up to 10% of patients participating in the program may have to cancel the program due to a lack of proper ovarian response. This decision is made with the patient and his doctor. Canceled cases can return to the program with the necessary follow-up and with different drug protocols.

    During the follow-up, when the desired number and size of follicles and the desired level of intrauterine tissue are reached, patients are injected with HCG (chorionic gonadotropic hormone), which will prepare the final stage of the maturation of the egg. Making this injection is of great importance in IVF applications. The follicles will crack within 36 to 40 hours of this injection and the eggs they contain will be thrown into the reproductive ducts. The goal of IVF is to ensure that the eggs are delivered to the laboratory environment before these follicles rupture.

    + - For this reason, the procedure should be performed within the 35th hour after the injection. The day, time and dose of the HCG injection will be explained to patients verbally and in writing.

    Usually, HCG is given after 8:00 p.m. The day of the injection is the last day you will use medicines that stimulate the ovaries.

    Among these procedures, which are the first step in the IVF program, it is very important that patients who are called for follicular follow-up respect the appointment time.

    Finally the last steps are:

    2- ) Collection of oocytes and sperm: Collection of oocytes (eggs) and sperm is carried out in the operating room under sedation under sterile conditions.

    3- ) Embryo transfer: The eggs taken from the expectant mother and the spermatozoa taken from the future father are placed together by micro-injection. The development of the fertilized egg over 2 to 5 days is monitored in the laboratory. 2-3 fertilized eggs are left in the uterus of the pregnant woman.

    4- ) Pregnancy is followed by normal pregnancy tests.

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