IVF & Fertility
In vitro fertilisation (IVF) is a process of fertilisation where an egg is combined with sperm outside the body, in vitro (“in glass”). The process involves monitoring and stimulating a woman’s ovulatory process, removing an ovum or ova (egg or eggs) from the woman’s ovaries and letting sperm fertilise them in a liquid in a laboratory. After the fertilised egg (zygote) undergoes embryo culture for 2–6 days, it is implanted in the same or another woman’s uterus, with the intention of establishing a successful pregnancy. IVF is a type of assisted reproductive technology used for infertility treatment and gestational surrogacy.
Supression Of The Hormones
During the program, to get an appropriate response from the drugs, untimely and irregular effects (e.g. ovulation) of the hormones that your body secretes, have to be blocked. Generally, the drugs which would suppress the hormones are started on the 2nd or 21st day of the menstruation. These drugs are applied subcutaneously (under skin) once a day.
At the end of this period which normally lasts 1 to 3 weeks, the hormone levels are evaluated with blood analysis. This period can be prolonged if the hormones are not suppressed. In %5 of the patients, the program can be canceled if their hormones are not suppressed. These patients can restart to the program in their next menstrual cycle.
Short protocol: Hormone treatment is started on the 2nd day of the menstruation. The drugs are used to suppress untimely and irregular effects (e.g. ovulation) of the hormones that your body secretes. In this protocol, both the time and the amount of medication are shorter.
Induction Of The Ovaries
When the hormone levels reach the desired level, hMG (LH + FSH) or pure FSH are used are injected intramusculary or subcutaneously. Injections have to be done everyday at the same time. Additionally, the numbers of follicles are evaluated by ultrasound. The time of follicle development varies from 1 to 3 weeks depending on the response of the ovaries. %10 of patients are cancelled, because their ovarian response to the drugs is not adequate. This decision is made with the approval of the couple. Those who do not have adequate response, can reattend the program with the necessary follow-up and different drug protocols
Vaginal ultrasound examinations are performed. Because it provides more detailed information compared to the abdominal ultrasound and saves you from discomfort because full bladder is not necessary. Follicles are liquid-filled sacs which are seen as dark colored, oval shapes under ultrasound and are thought to have oocyte inside. As the lubricant gel used is water-based, it does not have any side effects and does not stain your clothing.
Hormone levels are traced by obtaining blood samples on certain days before beginning to use ovary stimulants. You will be informed in advance for such examinations.
Since laboratory examinations are initiated after obtaining blood samples from all patients, personal delays will affect all patients called on that day. For this reason, you are asked to be careful for timely fulfillment of your appointment for blood sampling or ultrasound examination.
When the follicle number and size, hormone level and the endometrium reaches the desired level, human corionic gonodotropin (hCG), is injected intramusculary to mature the eggs to trigger ovulation. 36 to 40 hours following the hCG injection, ovulation occurs. In IVF procedure, eggs are retrieved by emptying the follicles prior ovulation. As timing is very important, you have to pay maximum attention to follow the given information about hCG injection. On the hCG injection day, you will be explained and given a form explaining how you should get your injection done at a specific hour after 8 pm.
Egg Retrieval-Oocyte Pick Up
On the day of oocyte pick-up, please come to the hospital in the morning with your spouse, with empty stomach (avoid eating, drinking and smoking 6 hours before oocyte pick-up).
First, a sperm sample will be taken from your husband (in certain cases if necessary, sperms will be extracted from testicles with operation). Oocyte pick-up will be performed in the operating room under sterile conditions. During this procedure, you will be given mild anesthesia for a painless and comfortable operation. The egg retrieval is done with a needle guided by vaginal ultrasound and an aspiration system. During and following anesthesia, pain complaints are rare. The same day, you will be discharged from the hospital after the doctor visit and information will be given about the egg number and the following processes. Usually the whole procedure takes 1-2 hours but we recommend that you spare your whole day to the IVF and do not make any other plans for that day. Rarely, no eggs can be retrieved from the follicles. The most common reason for that is not getting your hCG injection in the right time or right manner.
Starting from the day of egg retrieval, vaginal gel should be used. This application should continue until your doctor asks you to stop. Therefore do not stop your medication without consulting your doctor.
Not every retrieved egg yield to an embryo. Embryo transfer might be canceled if fertilization failure or inadequate embryo formation occurs. For this reason, you should call us the next day of retrieval and get information about the fertilization. In the following days, appropriately developed embryos will be transferred to the uterus. As this procedure is done as a normal vaginal examination, there is no need for anesthesia. We recommend that you have a light breakfast before you come to the center. Previously decided number of embryos will be transferred into the uterus with a plastic catheter in gynecological examination position. This procedure has to be done with full bladder. You can be discharged following this process, after a short rest. Again your IVF doctor will give you information about ET and the days following it. We recommend a home rest the same day but the following day you can go back to your routine life style.
Pregnancy test will be performed on the 12th day following the ET by detecting beta-hCG hormone level in blood. A pregnancy can also occur despite the bleeding.
For this reason this test has to be done. Depending on the test result, about 10 days later, vaginal ultrasound examination is needed to see fetal sac (embryonic sac).
The average price of in vitro fertilization (ivf) in Turkey is $3150, the minimum price is $2100, and the maximum price is $5400. You can contact us for details.