Although some couples have knowledge and experience about IVF treatment, a significant portion of them do not have information about the stages of this process. While I have mentioned special situations in my other articles, I wanted to give general information in this one.https://www.youtube.com/watch?v=i7RqvYoLoD4 Initial Assessment The treatment process actually begins with the initial examination …
Although some couples have knowledge and experience about IVF treatment, a significant portion of them do not have information about the stages of this process. While I have mentioned special situations in my other articles, I wanted to give general information in this one.
Initial Assessment
The treatment process actually begins with the initial examination and evaluation. There is a standard assessment that we need to make. The uterus and ovaries are examined with an ultrasound, some blood tests are requested from the woman, the man’s sperm analysis if it has not been done recently, and a hysterosalpingogram (HSG) if necessary. If the couple has a special medical condition, if they have had unsuccessful IVF attempts or recurrent miscarriages before, other routine tests should be added to the requested tests.
Preparation
In the meantime, we start some vitamins and supplements, which are important for both the treatment and the pregnancy process. Of course, lifestyle changes also affect the outcome. Positive changes such as quitting smoking, being at the right weight, eating right, exercising, sleeping well, and reducing stress are also reflected positively in the treatment outcome. We also start correcting the problems detected in the test results during this period.
Then, the couple is evaluated together with their medical conditions and test results, and a treatment plan is made. If there are any operations that need to be performed, they are performed before the treatment or postponed until after the egg collection process. It should not be forgotten here that every couple is ‘unique’. In other words, a method that did not work in your cousin’s treatment may be a solution for you, or any technique you see on TV may be useless for you.
Stimulation of the ovaries with drugs
Although there are exceptions, the egg growth process of IVF treatment generally begins on the 2nd-3rd day of the menstrual period. In the first examination, we evaluate the ovaries and look for the presence of functional cysts. This examination is very important to determine the appropriate drug dose. In the presence of cysts or in some other cases, it is possible to postpone the treatment until the next menstrual period.
We use hormone injections that can be administered under the skin in the treatment. Our patients can apply these on their own or have them done at health institutions. It is very important to do it at the given dose and the hours. The egg development part of the treatment takes an average of 8-12 days and a doctor’s check-up is required 3-4 times at intervals during this process. At each check-up, we look at the general condition of the ovaries, the number of growing follicles, the diameter of the largest ones, the lining of the uterus and, if necessary, the blood hormone levels. After each check-up, we decide again which drugs and doses to continue the treatment with.
‘Cracking’ injection
Finally, the follicles reach a certain size, blood hormone levels increase and a ‘cracking’ injection is necessary for the eggs to mature before collection. Of course, this injection is misnamed. We do not want the follicles to ‘crack’ – ovulation to occur. We schedule an appointment for egg collection a certain number of hours after this injection, usually 34-36 hours. Our aim is to collect mature eggs without ovulation. This injection, which is the most important injection of the treatment, should be administered on time and correctly. During this period, we recommend that the man also masturbates and comes to the egg collection procedure with a 2-5 day sexual abstinence.
Egg collection
The egg collection procedure (OPU) is performed in operating room conditions and with very light anesthesia. The procedure usually takes between 5-15 minutes. The patient, who wakes up in a short time, is discharged within a few hours after all checks are made and the number of eggs and sperm status are reported. A few hours after collection, microinjection is performed on the mature eggs.
The next day, we are informed about the fertilization of the eggs and the embryos are monitored in the laboratory. If fresh embryo transfer is to be made, the embryos are placed in the uterus between the 2nd and 5th days from collection. The remaining good quality embryos can be frozen and stored.
A second option is to freeze all the embryos without transferring them and transfer them in a later menstrual period by only preparing the inside of the uterus. Although it slightly prolongs the process, the couple is physically and mentally more prepared in this method and most importantly, the pregnancy rates obtained with the transfer of frozen embryos are higher than with fresh transfer. This difference is related to the uterus being more protective against the embryo in this method.
Embryo transfer
The transfer procedure is painless and is performed on a gynecological table. It takes around 5-10 minutes. It is also a very delicate and special procedure for us. No matter how experienced you are, you hold your breath and experience that excitement. Some women may hesitate to undergo the transfer procedure because they think they will feel uncomfortable. In this case, we perform the procedure with light anesthesia.
You can walk, climb stairs, and travel within the city on the day of the transfer. Remember that the process you are experiencing after this level is the same as a naturally occurring pregnancy, except for the medications you use. You will be informed in detail about the medications you will use and what you need to do.
I wish everyone who wants to experience the happiness of becoming a parent.
