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In infertility cases, the most successful of the treatments called assisted reproductive methods is in vitro fertilisation.

What is in Vitro Fertilisation Treatment?

In vitro fertilisation treatment is briefly defined as the fertilisation of a woman's egg and a man's sperm in a laboratory.

 

What does the IVF treatment involve?

 

1- Development of Eggs

Eggs and sperm must be obtained for pregnancy to occur. There are two ovaries in the female body. Eggs are formed and lost every month in the ovaries. (Regardless of whether these eggs are collected by IVF treatment or not, this process continues until menopause by decreasing every month). For IVF treatment, FSH hormone that enlarges the eggs or drugs ensures the secretion of FSH from the brain are administered as support. These drugs are administered with needles as small as an insulin injector around the navel and this treatment lasts for an average of 10-12 days. After the drugs are administered, the ovaries are monitored with ultrasound. When the fluid sacs called follicles in which the eggs grow reach a certain size, hatching injections are applied to mature the eggs.

 

2- Egg Collection (OPU)

The eggs are collected 35.5-36 hours after the administration of ovulation (maturation) medication. Egg retrieval is an aspiration procedure performed under anaesthesia. A needle is inserted vaginally through a guide on the ultrasound and fluid is extracted from the follicles in the ovary (aspiration). The duration of this procedure depends on how many follicles (fluid sacs in the ovaries containing eggs) the expectant mother has. Egg retrieval can take between 10 to 30 minutes on average. Those with a low number of eggs, follicular aspiration is used. The aspirated (withdrawn) follicular fluid contains the egg and is given to the embryologist in a tube after aspiration. This fluid is analysed under a microscope and the eggs are separated.

 

3- ICSI (Intracytoplasmic Sperm Injection)

The collected eggs are kept in an incubator (a device that provides the conditions of the mother's uterus in the laboratory) for a certain period of time and then denudation (egg peeling) is applied. In this way, the egg is purified from the surrounding helper cells. At this point, the embryologist can provide information about the maturity level of the eggs. The ICSI procedure is applied to the eggs that have completed their maturation. For this procedure, the best quality spermatozoa are selected and injected into the egg with the help of a special cannula. In this way, the fertilisation process is facilitated. The fertilised eggs are put back into the incubator in the laboratory. 24 hours after the ICSI procedure, the number of fertilised eggs are checked. The fertilised eggs (embryos) are re-evaluated on the 3rd day after the ICSI procedure. If the transfer is not performed on the 3rd day after fertilisation, they are stored in the incubator until the 5th day. A type of incubator called Embryscope © has also been developed that can take continuous images of the embryos. In this device, the embryos do not need to be taken out of the device for evaluation.

 

4- Transfer

The transfer is performed 3 or 5 days after the ICSI procedure. If there is a sufficient number and quality of embryos, the transfer is preferably performed on the 5th day. The reason for this is to select the right embryo. On day 3, even some of the embryos that look perfect under the microscope may not make it to day 5, or even if they do, they may be morphologically (structurally) problematic. Day 5 embryo transfers can therefore be more successful. If there is a small number of embryos, i.e. not enough embryos to allow selection, there will be no significant difference in terms of success between day 3 or day 5 transfers. Transfer is the most important step in the IVF process. Since the transfer is a painless procedure, it does not require anaesthesia except for special cases (vaginismus etc.). With the help of a very thin cannula, embryos are placed in the endometrium (inside the uterus) by passing through the vagina and cervical canal. This process is completed in 5 to 10 minutes, excluding the preparation phase. The transfer is performed under ultrasound for guidance. The expectant mother can go home after resting for a certain period of time.