FAQ

The process of fertilization by combining spermatozoa and egg cells in a laboratory environment is called "IVF method".

While applying the microinjection technique, a single sperm cell taken from the father candidate is placed in the egg cell obtained from the mother candidate with a thin needle under a microscope and fertilization is achieved. For this reason, the chance of fertilization and pregnancy is increased with the microinjection method, especially in male-induced infertility.

Methods used to detect and avoid transmission to the embryo of serious diseases caused by genetic abnormalities and/or chromosomal abnormalities that sometimes make getting pregnant imposible, cause premature pregnancy loss or lead to the birth o a child with special needs

What is PGD? And why it is important?

Pre-implantation genetic diagnosis (PDG) or the pre-implantation genetic test (PGT) is a genetic analysis of the embryo that is performed by studying a biopsy of its cells prior to transfer to the mother’s uterus. The information obtained means that we can:

• Avoid the transfer of embryos that, would lead to premature pregnancy loss or that would not lead to the birth of a healthy child.
• Locate and prevent serious illnesses in the embryo caused by genetic abnormalities.

Types of Pre-Implantation Genetic Diagnosis

• Chromosomal abnormality PGT-A. An aneuploidy detection pre-implantation genetic test.
• PGT-M pre-implantation genetic test for detecting monogenic disorders.
• PGT-SR for structural abnormality diagnosis.

Genetics, elder age of marriage and motherhood, regularity of menstruation, sexually transmitted diseases, excessive weight and insulin resistance, smoking-alcohol-overcaffeine consumption and stress can be counted as factors affecting fertility.

No, a girl is born with a certain reserve of eggs in the womb after 4 months of pregnancy. Some of this reserve is lost until adolescence, then every month from puberty, the ovaries select the eggs that will grow in the next period within the week before the menstruation begins and set off. Only 1 or 2 of them develop and crack and prepare the appropriate ground for pregnancy. If pregnancy does not occur, the same cycle begins again in the next period. The eggs obtained in IVF treatment are the eggs prepared for that month, new eggs will develop from the egg reserve again in the next month.

No, women are born with a certain reserve of eggs. In women with IVF treatment, the egg in the ovaries are developed and removed that month. The woman will go through menopause at the genetically determined time with or without IVF treatment.

No, not all eggs have the same rate of development when medications for egg development are started. In addition, fertilization and division developments do not go the same way after the egg collection and microinjection. In fact, some may not develop or may stop at any stage of development. Studies conducted so far have shown that the most important factor under these developmental differences of embryos may be related to genetic structure of egg-sperm and naturally the embryo.

Any woman with an egg can have IVF treatment. After the age of 40, pregnancy, continuation of pregnancy and taking a baby home rates decrease. After the age of 45, even if there is egg available, pregnancy rates are around 1%-5%. As the age increases, the chance of pregnancy decreases. In our experience so far, we have achieved pregnancy and healthy births with their own eggs in our 45 and 46-year-old patients.

The obstruction in the tubes negatively affects the normal pregnancy process. Because the meeting of eggs and sperm during pregnancy in the normal way, the first 5 days of life of the embryo and then its transmission into the uterus take place in the tubes of the woman. However, since the fertilization process takes place outside in IVF treatment, the chance of pregnancy does not change if the tubes are blocked or obstructed. However, in some cases, due to the fluid accumulated in the tubes, the possibility of holding the embryo decreases and it may be necessary to close or remove the tube or tubes with LS. In such a case, your doctor will provide you with detailed information.

Myomas extending to the inner cavity of the uterus may prevent the implantation and development of the embryo or cause miscarriage-premature birth. If the embryo settles in or near the area where the myoma is located, it may cause miscarriages because the blood supply may deteriorate. Again, in the subsequent stages of pregnancy, myomas may cause pain by degenerating or turning around themselves, and sometimes result in premature birth. The simplest test for the presence of myoma in the uterus is a uterine film called hysterosalpingography. Further examination method is a small operation called hysteroscopy that allows examination by entering the uterus with an optical device.

No, the presence of a myoma does not reduce the egg reserve. The ovaries and the site of the myoma are separate. Myomas are located in the uterus, if pregnancy is desired and there is a myoma, the patient can be informed about whether the myoma can prevent pregnancy after a specialist physician examination, and if necessary, treatment options including surgical intervention come to the agenda.

No, there is no evidence that the medications used in IVF treatment increase the risk of cancer. Many studies have been conducted on this subject matter and no direct relationship has been noted between these medications and ovarian, uterine and breast cancer.

Drugs used in IVF treatment may cause some weight gain due to edema and appetite in the body. Since these medications are at a level that can produce normal hormonal effects in the body, side effects related to weight gain can be seen. These medications do not cause a weight gain that cannot be lost later. Also, due to the psychological situation that this period imposes on the patient, depression-like behaviors and as a result, changes in eating habits and weight changes can be experienced.

There may be complaints such as itching, mild pain, burning and irritation, as well as bruising at the injection site, depending on the sensitivity of women in the areas where the needles are applied. During IVF treatment, conditions such as tenderness in the breasts, hot flushes, excessive emotionality and groin pain- bloating, constipation, frequent urination are also observed.

Hair dyes are not dangerously toxic, so dye can be applied to your hair during IVF treatment and while you are pregnant. A small amount of hair dye may enter your skin during the dyeing process. This is quite a small amount that the chemical has no harmful effect on your baby's developing body. Only organic-based, ammonia-free hair dyes should be preferred during pregnancy.

Resting after IVF treatment is not recommended. After the embryo transfer, you can return to work the next day. Resting does not increase the pregnancy rate. During the treatment, our patients can only take leave from the workplace (2 days in total) on egg collection and embryo transfer days

Factors that affect success in IVF include the age of the woman, egg reserve and quality, avoiding stress, keeping weight gain under control - starting treatment at ideal weight, presence of some structural problems (such as myoma, uterine anomalies), sperm count and quality, smoking and alcohol use, the inner membrane of the uterus not being thick enough and strong enough to adhere to the embryo, and genetic problems of the couple.

Yes, it's ok to travel by car and plane after your treatment.

The number of embryos to be transferred to patients is limited by the Ministry of Health to prevent multiple pregnancies. In women over 35 years of age, a maximum of 2 transfers and 1 transfer under 35 years of age are required. 2 transfers are allowed after the first 2 unsuccessful attempts under 35 years of age.

Increased embryos can be frozen upon the consent of the couples. Frozen embryos can be used by thawing if a possible negative result is obtained after IVF treatment or if a 2nd child is requested later. There is no difference in pregnancy rates between the transfer of frozen embryos and the first transfer.

Although there is no obvious reason for couples in unexplained infertility, pregnancy does not occur. It is the patient group with the highest rate of pregnancy in IVF treatment. Sometimes the problem arises during the treatment. Poor-quality eggs and fertilization problems can only occur during and after the collecting the eggs and the microinjection process. 

Treatment started on the 2nd or 3rd day of menstruation ends after approximately 16-17 days later. Pregnancy test is performed in the blood by waiting 10-12 days after embryo transfer.

Pregnancies with IVF method are now followed up as normal pregnancies. This can only be considered as a risk if there has been multiple pregnancy. Besides, as a general information, infertile couples have a higher risk of genetic anomaly compared to other members of the society. Therefore, the genetic problem and, of course, the risk of miscarriage will relatively be higher in the pregnancies that these couples will obtain, regardless of the way they have been obtained.

Strict rest after embryo transfer is not recommended. There is no evidence that resting increases the pregnancy rate. After embryo transfer, you can rest for 20 minutes and return to normal daily life. It would be appropriate to impose restrictions on sexual intercourse and performing works requiring high effort.

Yes, normally, gender selection can be made by genetic examination after IVF treatment. However, it is legally prohibited to choose gender in Turkey as stated in the IVF Regulation. Therefore, genetic examination is not performed for gender selection. In our country, gender selection can only be made in presence of genetic diseases carried by the gender chromosome.

Preimplantation genetic diagnosis (PGT) is a diagnostic method recommended for couples under the risk of a serious genetic disease in their children. In the embryos of couples carrying some genetic diseases such as cystic fibrosis and thalassemia, the disease can be diagnosed and the embryo can be eliminated by this way without pregnancy and termination of pregnancy thanks to PGT. Preimplantation genetic diagnosis offers an alternative pathway not only for couples with such genetic disease risks, but also for couples who cannot produce a healthy pregnancy due to recurrent miscarriages caused by structural chromosome disorders (e.g. translocation, inversion, etc.).

Since urinary pregnancy tests are sensitive to a certain hormone level, they may give false negative results in early pregnancy. (For example, if the test is sensitive up to a value of 100, it will give negative results by mistake when the value is 25 in the early period) In addition, visual results can sometimes be misinterpreted. For these reasons, the pregnancy test will give the healthiest result in the blood to be performed 10-12 days after the embryo transfer according to the physician's habit in IVF treatment. In normal pregnancy, detection of pregnancy hormone in the blood may occur at the earliest 2 weeks after the intercourse.

In addition, another important information is that the blood pregnancy test will increase approximately 2 times when followed up at 2-day intervals in a healthy pregnancy at the early stages. Afterwards, when this value reaches a value such as 2000, pregnancy becomes visible in ultrasonography for us.

In assisted reproduction method of IVF, nutritional order is very important. The reason is that in order for the treatment to be successful, it is necessary to have a healthy body. In case of smoking habit, quitting smoking should be a primary measure. Again, being at ideal weight before pregnancy is one of the factors affecting the success rate. Regular protein-rich food consumption should be considered (3 times a week). Daily water consumption is recommended to be around 2-3 lt. The consumption amount of dried legumes such as chickpeas and beans should be increased. If tea and coffee consumption is high, restrictions can be imposed (2-3 cups a day). Acidic beverages should be avoided. Foods rich in folic acid and folic acid should be consumed.

In addition, pre-treatment with other metabolic problems (thyroid, insulin resistance, diabetes etc.) before IVF treatment can positively affect both the chance of success and the healthy pregnancy.

Termination of pregnancy by abortion does not pose a problem in terms of being able to conceive again if there are no complications (such as fragmentation, infection, adhesion) during or after the procedure.

However, it may sometimes be necessary to investigate whether the couple is genetically normal before a new trial, especially in early pregnancy losses. It should be kept in mind that the result can be obtained in 2-3 weeks when asked for genetic testing from the couple.

Some hormone tests (such as FSH, LH, estrogen, progesterone) are performed on certain days of menstruation (2nd, 3rd or 21st day). Others do not have day restrictions. Only some of them may require hunger.

The first step in IVF treatment is to prepare the woman. The expectant mother can be prepared in two ways; the first is the long protocol, which starts on the 21st day of the menstruation and whereby eggs are collected within approximately 3-3.5 weeks, and the second is the short (antagonist) protocol, which starts on the 2nd-3rd day of the menstrual cycle and whereby the eggs are collected within approximately 10-12 days.

The transfer of the embryos obtained by this way into the uterus is done either fresh (in the same period as the egg collection) or freezing-thawing (first freezing and storing the embryos and then placing them in another period deemed appropriate by the physician) depending on the special conditions of the patient and the habits of the physician.

In such a case, no final decision should be made with a single analysis. Confirmation should be provided with a second analysis after 3 weeks, if the same or close result is obtained, the necessary information should be obtained by researching with genetic and hormone tests or testicular ultrasonography. Afterwards, if necessary, the patient should be consulted with an andrologist-urologist.

If there is no sperm in the sample, it is possible to obtain sperm from the testicle by the surgical method called micro body. Preferably, when the woman's eggs are ready simultaneously, the surgical procedure microTESE is planned first, and after the sperm is obtained, in vitro fertilization is performed by collecting the eggs. However, sometimes the microTESE operation can be performed before the female partner is prepared for diagnosis, if sperm is found, it can be frozen and stored and then the female can be prepared.

After the embryo transfer, the attachment to the uterine wall will occur within 1-5 days, particularly on the 5th day (blastocyst). Considering the egg collection day, it can be said that it will occur within the next 6-10 days. In other words, the embryo will be attached on the 10th day after egg collection if the transfer is achieved. 

There may be vaginal bleeding after embryo transfer for 2 main reasons, the first of which may be trauma during the embryo transfer, that is, bleeding due to irritation during the passage of the catheter through the cervix (in particular in difficult transfers). The second is the bleeding, which occurs during attachment of the full embryo and is called implantation bleeding in medicine. However, both of these are short-term and small amounts of bleeding in the form of light spotting.

There is no difference between frozen embryo transfer and fresh transfer in terms of pregnancy rate. In some cases, embryo transfer with freezing-thawing can positively affect the pregnancy rates.

There are some risks and side effects at every stage of IVF treatment, even if they are small. The side effects of the medications applied are tolerable and temporary. Although it is very rare, pelvic infection may develop after the egg collection process. This problem can also be corrected by antibiotic treatments. There may be bleeding in the ovaries. These bleeds are not much. In very rare cases, it may be necessary to intervene for bleeding. However, it is not a serious risk.

Hyperstimulation (excessive ovarian response) problem, which is the most important risk known, no longer occurs with the new treatment protocols and experienced physicians.

Polycystic Ovary Syndrome is a common specific ovulation problem. These patients can consult a physician with a wide range of complaints. In the mildest forms, the patient can only apply with the complaint of not being able to conceive without any menstrual problems or cosmetic-metabolic problems. Some women have male-type overweight and with excessive hairs and some women cannot menstruate for years. If this is the only problem, these women are usually the patient group with the most successful results in treatments.

The most important conditions to be considered in PCOS patients are insulin resistance, diabetes and other metabolic problems that should be recovered before treatment, as these are directly related to the chance of success and the health of the woman-pregnancy. In addition, the physician should monitor the patient very carefully in terms of the risk of hyperstimulation.

Studies conducted in cases where "in vitro fertilization-IVF" is applied in which sperms of a certain number and mobility can be used efficiently in IVF applications, that is, selected mobile sperms are placed in the same environment with egg cells and released to the natural fertilization process, have shown that there is a relation between the success of sperm fertilization and the severity of sperm deformities. Since the sperms with the most appropriate shape and structure possible are selected by the embryologists who apply the sperm procedure in the microinjection method, the morphological evaluation does not have effect as negative as thought in IVF treatment, except in some special cases.

Of course, special deformities such as Globozoospermia, where the fertilization ability of sperm is very difficult, need to be excluded from this situation.

AMH (Anti-Müllerian Hormone) test is a blood test to detect the egg reserve. There is no specific time period or precondition such as hunger for the test to be performed. This test result should still be interpreted by a specialist physician after the ultrasound-guided egg reserve is checked, and the test result should not be interpreted alone.

If the BetaHCG result is negative after the first IVF test, the woman is expected to menstruate. After the next menstrual period, 1 month break can be taken and the treatment can be started again. However, the main decision-maker here will be the physician.

In elderly women, the chance of fertilization and pregnancy decreases with the decrease in egg reserve and quality. Although there are some vitamin-antioxidant preparations sold in the market to increase egg quality, there is no clear data that these increase quality.

In IVF treatment, mature eggs are collected and fertilization is achieved by microinjection. In medication-free IVF treatment (IVM), the eggs collected before they are fully mature are matured at the laboratory environment. The purpose of this treatment is to continue the treatment of patients who may possibly be harmed by the medications used for maturation of the eggs without giving these medications. The eggs whose growth is monitored are collected when they reach the desired size, and the eggs are allowed to mature at the laboratory environment for 24 hours. Then, the sperm taken from the patient's spouse is injected into the eggs by microinjection method and the obtained embryos are frozen and then transferred in another month. Today, we need less and less IVM methods, especially thanks to new treatment protocols.

14 days before the embryo transfer date and the last menstrual date is determined as 14 days before the embryo transfer. Or, the embryo transfer date is written in the last menstrual section of the ultrasonography device. Then, the gestational week is calculated by adding 2 weeks in the resulting gestational week.

It is generally recommended to stay away from extremely hot and humid places such as saunas, Turkish baths and not to swim in the pool and sea.

No, normal business and social life can continue. If there is smoking or alcohol use, restrictions should be imposed. Besides, no restrictive changes are recommended other than avoiding sexual intercourse and lifting heavy things after egg collection. However, most importantly, it is necessary to apply the medications recommended by the physician regularly and completely, and not to make any changes in any medication and dose without consulting the physician.

It is thought that in vitro fertilization treatments generally do not increase the pregnancy rates after 5 trials. However, we conducted 16th and 17th trials with a couple who came after 15 trials in 11 years among my own patients. The birth of their twins, which they obtained after the 17th trial, was also performed by us. However, these are, of course, extreme numbers; generally, a limit such as 5 trials is pronounced.

Menopause is a process. Sometimes menstrual interruptions may occur in cases such as sudden mental traumas, excessive stress, diet, and physical exercise, such events do not mean menopause. Findings such as irregular menstrual bleeding after the age of 40, fever from time to time, and mental tension usually inform the premenopausal period. Then, the findings continue to increase. Failure to menstruate for 6 months and distress-sweating-fever and vaginal dryness may suggest menopause. Nevertheless, in order to be able to pronounce menopause, FSH hormone is measured and other symptoms are evaluated and the diagnosis is made if the patient cannot have menstruation for more than 6 months. Not every menstruation and irregularity is menopausal. To diagnose menopause, it is necessary to consult a physician and act accordingly upon examination and ultrasound data. Sometimes, women with PCO (polycystic ovary) or women with very low levels of hormones secreted by the brain, regulating the ovulation, may also have irregular menstruation and non-menstruation. It is absolutely necessary to consult a physician for definitive diagnosis.

Chemotherapy and radiotherapy may cause loss of reproductive function in women. Because these treatments can have a toxic effect on reproductive cells and ovaries, and therefore, women may lose their productivity. Being treated for cancer is not always an obstacle for being a mother. Before cancer treatment, women's eggs can be retrieved and frozen and stored. The same applies to the storage of spermatozoa in men. In particular, in young men and women, storage of reproductive cells before chemotherapy and/or radiotherapy to be taken after the diagnosis of cancer is the primary measure to be taken to become a mother/father in the following period.

Freezing egg/sperm cells in order to protect reproductive health before surgical interventions due to cancer etc. in women and men allows us to save the chance of becoming a mother/father in the future. However, if the woman also loses her uterus surgically, only that woman can have her own child through surrogacy, which is still prohibited by law in our country.

Single women are allowed to freeze their eggs in Turkey within the framework of the rules laid down in accordance with the legislation of the ÜYTE (REIT). First of all, the woman should definitely have an examination by an expert for egg reserve control and it is necessary to decide whether to perform egg freezing with these 2 data by looking at AMH (Anti Mullerien Hormone). Women with legally low ovarian reserve, a family history of early menopause, and having no previous children may freeze their eggs.

It is very important that you take all your previous examinations and follow-ups with you to the IVF units for pre-interviewing in terms of physician evaluation and requesting the missing examinations. Particularly if there is a uterine film, semen analysis, and hormone tests performed, these should be evaluated by the physician you will visit.

Septum, polyp or adhesions detected in the uterus are evaluated according to their location. Every polyp, every septum-like formation does not prevent pregnancy. If necessary, your doctor will give you detailed information about the hysteroscopy operation to be performed according to their size and the place they appear in the uterus.

Laparoscopy is an endoscopic surgery in which the abdomen can be observed. It is the best method called the gold standard in revealing the damage and problem in our patients who have problems with tubes. It is usually performed within one week after the end of menstruation and under general anesthesia. If there are serious problems with the tubes, for example, laparoscopy surgery is recommended in cases called hydrosalpenx, where the tube or tubes are blocked from the tip and filled with liquid. 
In addition, laparoscopy can also be performed in problems such as ovarian cysts, myoma or ectopic pregnancy.

If an ectopic pregnancy has occurred, the pregnancy can be tried again after 3 months, considering that it was diagnosed and treated in the first 2 months. If an operation is planned after ectopic pregnancy (laparoscopy), new treatment can be started 2 menstrual cycles later.

Today, there are patient-friendly treatments in IVF treatment. In other words, low-dose treatments that can be self-applicable by the woman and that do not harm the health of the woman or her baby are applied in the long term.

If the woman is working during the treatment process, she will not need to take continuous leave from her job. They should only take one day off for egg collection and embryo transfer. In addition, after the transfer, the patient does not need to obtain permission since there is nothing to do other than taking his/her medication regularly. However, the patient may sometimes psychologically think that the chances may be higher if the woman is rested, particularly after the embryo transfer. Such a request is respected by considering the comfort and psychology of the patient.

Women and men are evaluated together in couples who apply due to the desire to have a baby. Almost 20% of couples applying to IVF centers do not have any problems in men or women; we call this group "unexplained infertility". In unexplained infertility tests and examinations, the unseen problem sometimes occurs while working with eggs and sperm cells during the laboratory stage, and pregnancy cannot be achieved even though there is no significant problem there. Here, of course, the age of the woman and ovarian reserve will also affect the success of getting pregnant very closely.

A decline in genetically normal eggs is natural and becomes more common after the age of 34. However, there are also factors that decrease the ovarian reserve for women of any age. This includes smoking, ovarian scarring from endometriosis, and pelvic infections.

Complications from surgeries and other medical treatments, including cancer treatments, may also result in low-quality eggs. Aside from this, a small percentage of women, simply, are born with a lower number of eggs.

A low ovarian reserve does not mean that the available eggs are abnormal. With IVF treatments, women 40 years of age or older have a live birth rate of 20 per cent. A limited reserve may lower the chances of successful conception. However, Memorial Fertility center offers alternative solutions that may increase the odds.