IVF treatment is a treatment method that enables couples who have infertility problems to have a baby using medical developments and specialist help. Firstly, the eggs are developed to a certain maturity by giving the prospective mother medical treatment. Then, the sperm collected from the male are used to inseminate the eggs that are collected and to produce an embryo under laboratory conditions, and this embryo is then inserted into the mother’s womb at the correct time.
It is important to conduct a gynaecological examination before starting IVF treatment. The cervix must be examined and the structure of the womb and ovaries must also be examined with an ultrasound.
The first aim is to determine the causes of infertility, then to choose and apply the correct treatment. The causes of infertility must be explained and the tests that are going to be conducted for a definitive diagnosis must be explained to the prospective parents in the first interview. After preparative treatments, the treatment process begins with the prospective mother’s menstruation and can be finished within 15-18 days.
THE STEPS OF IVF TREATMENT:
PRE-TREATMENT INTERVIEW AND EVALUATION
In this interview, the prospective mother’s test results (hormones and thyroid tests, prolactin levels and FSH which determines the ovary capacity, oestradiol or AMH tests, endometrial screening, HSG) and the male’s sperm analysis (spermiogram) are evaluated. A vaginal ultrasound conducted during the prospective mother’s gynaecological examination helps determine if there are any situations that need treatment. In some cases, hormone medication can be given to enable the synchronisation of the treatment.
STIMULATING THE EGGS WITH MEDICATION AND FOLLOW-UP
The eggs are generally stimulated when the menstruation begins (normally within the first 3 days of menstruation). After applying the first dose of these medications which are applied through the abdomen with thin needles, the patient can apply the other doses themselves. These medications must be applied for 8-12 days. During this time, the prospective mother is regularly examined. In these examinations, the doctor evaluates the number and size of the follicles with an ultrasound. The oestradiol and progesterone levels are tested in the last days of the treatment. The ultrasound and blood test results are then evaluated and the maturing injection is begun and then the egg collection dates are determined.
LAST MATURING AND COLLECTION OF EGGS
If there are enough follicles at the right size and the blood hormone levels are good, then a maturing injection that helps mature the eggs is given. The time when this injection is given is important; the eggs can then be collected 35-36 hours after the injection is given.
The egg collection procedure is conducted under a mild anaesthetic. The follicle fluids in the ovaries are collected with an ultrasound in 10-15 minutes and the eggs within these follicles are taken to the embryology laboratory for the embryologists to separate the eggs within the follicles under a microscope.
The eggs are collected and then examined 2 hours later by embryologists under a microscope and the insemination procedure is conducted on the mature eggs either with the IVF or the ICSI method. Due to the success rate of the ICSI method being higher, the ICSI method is preferred at the Near East University IVF Centre.
One day after the egg collection process, the insemination of the eggs is evaluated and their daily development is followed by embryologists. Generally, the most suitable time to transfer the eggs is between the third and fifth after collecting the eggs. Sometimes, the transfer can be delayed by freezing the embryos, for prospective mothers who have a high number of eggs and high hormone levels.
This does not affect the quality of the embryo. When the transfer procedure is going to be conducted, the patient’s bladder must not be full. After the patient has laid down on the examination table, a speculum is inserted into their vagina and the cervix is revealed. Then, the embryos are transferred into the womb through a thin catheter. During the transfer procedure, the patient does not feel any pain and does not require an anaesthetic. The patient, who is taken to their room to rest after the transfer, is then given detailed information on what precautions they should take and which medications they need. 12 days after the transfer day, a pregnancy test is conducted to determine the results.