IVF in Turkey

Louise Brown, who was born by cesarean section in 1978 as a result of artificial insemination, broke new ground as the first in vitro fertilization application in the world. Up to now, over 5 million children have been born with the in vitro fertilization method. A new perspective was gained after 1992, a solution was found for men with sperm problems with the microinjection (ICSI) method, and even with sperm testis biopsies belonging to men who do not have sperm, this method can be applied. Pregnancy difficulties occur when women are 35 years of age or older or as a result of the depletion of egg reserves at an earlier age. Men also have problems with the development of sperm. In such cases, since healthy sperm cannot be obtained, a healthy pregnancy cannot be established. In patients undergoing IVF treatment, a success rate of 20 to 60% is achieved for all factors of the patient. IVF centers need to be well organized and have a quality system. The success of the treatments applied is related to the quality of the techniques, equipment, and materials used by the IVF centers, and most importantly, the training and professionalism of the team that will use this technique and equipment. There are some different methods for this treatment.

Vaccination (Insemination)

It is the process of placing the sperm directly into the uterus, which is prepared by the woman to produce 1-2 eggs with pills or injections, and then selected by special methods just before the egg cracks. In order for the couple to be vaccinated, the woman must be under the age of 38 and have a normal ovarian reserve, both tubes must be open, the uterus must be normal, and the man must have at least certain number and motility rates in the sperm test.

IVF (Classical In Vitro Fertilization)

It is the process of fertilization of the eggs collected from the woman with the sperm taken from the man under special laboratory conditions. IVF requires the presence of a certain amount of live sperm from the man. In this method, a certain number of sperm is placed in the same environment with each egg, and self-fertilization is expected without any intervention. It is now a less and less used method in modern IVF clinics and its success rates are lower than microinjection.

 ICSI (Microinjection)

In this process, embryos are created by injecting sperm one by one into each mature egg collected. Therefore, even men with a very low number of sperm can have children with this method. Another advantage of the microinjection method is that the collected mature eggs are fertilized more than the IVF method.

Testicular sperm extraction (TESE) Operation

In the TESE operation, the absence of sperm cells in the semen analysis is called “azoospermia”. Simple aspiration methods can also be used to obtain sperm when there is azoospermia due to obstruction in the canals. In azoospermia, where the canals are open, the process of searching for sperm by microsurgical method from inside the testis under the microscope is called TESE. This procedure, which is performed under anesthesia, is more sensitive than the multiple biopsy method without the use of a microscope. The success rate is higher since the channels where sperm can be found are detected by seeing with a microscope. In addition, the complication rate that may occur in men with TESE surgery is minimal.

There are 2 possible causes of azoospermia, depending on the obstruction: In the case of obstruction, although there is not a very important problem in the sperm production of the man, it is possible that the sperm cannot pass from the testis to the semen due to an obstruction in the genital tract between the testis and the penis due to previous surgery or infection, or the congenital absence of these reproductive tracts. If there is not an obstruction which is the more common group? The problem is insufficient sperm production may be a hormonal, genetic, or past infection. In most cases, there is no specific reason to explain the situation.

Stages of IVF Treatment

• Evaluation of the infertile couple by the way of gynecological and urological examinations,
• Choosing and planning the treatment method,
• Developing the eggs by stimulating them with drugs (Ovulation induction)
• Egg collection under anesthesia (OPU procedure)
• Fertilization of the egg with sperm (ICSI) Embryo transfer

Before IVF Treatment

In recent years, the most frequently applied treatment for couples who cannot have children naturally is in vitro fertilization. In IVF treatment, the woman's eggs and the man's sperm are combined in a laboratory environment. Then, these combined cells are kept in certain temperature environments and fertilized. The method of placing 1 or 2 of the healthiest embryos into the uterus with the help of a thin catheter is called in vitro fertilization treatment. When pregnancy occurs with IVF treatment, the next process does not differ much from the normal pregnancy process.

When examining the important things before the treatment; first of all, prospective mothers and fathers should do research on this issue before starting IVF treatment. It should be known what will be encountered. It is very important to choose the right doctor and clinic before starting IVF treatment. Although this form of treatment is costly, it is very important that it is done by professional teams. Before starting IVF treatment, both mother-to-be and father-to-be should not use cigarettes and alcohol throughout the treatment. Especially if the expectant mother has medications that she uses constantly, she should share the information with her doctor. Before starting IVF treatment, extremely hot environments such as Turkish baths and saunas should be avoided.

Before IVF treatment, both the expectant mother and the father-to-be should stay away from excessive sports and exercise. Before IVF treatment, if the expectant mother or father has had a febrile illness in the last 2 months, she should definitely share it with her doctor. In addition, if a man or woman has had a problem such as infection or inflammation in the genitals in the last few months before IVF treatment, they should definitely share it with the doctor. Especially men should prefer comfortable and loose underwear before IVF treatment. Before IVF treatment, if there is a weight problem and the nutrition program cannot be provided on its own, help from a dietitian should be sought. Attention should be paid to the diet, especially fruit, vegetable, mineral, and calcium-based nutrition.  It is best to stay away from prepared foods as much as possible. In addition, it is beneficial to stay away from excessively oily, salty, and fried products. Plenty of fluid intake should also be taken into consideration before IVF treatment. However, the person who will undergo IVF treatment should definitely stay away from acidic drinks. As much as possible, they should consume fruit juice, milk, and mineral water, and besides these, they should consume at least 2 liters of water a day. You should definitely be there at the appointment time given by the doctor. Because the most important condition for being successful in the IVF method is timing. Before IVF treatment, you should pay attention to the hygiene of the places where you will be examined. This will both make you feel comfortable and will give positively affect the communication you will establish with your doctor. It will be very beneficial for you both to feel better and to learn the answers to all the questions in your mind before IVF treatment. It is one of the most important issues to trust your doctor before IVF treatment. With this confidence, you should listen carefully to everything your doctor has to say and avoid misapplications. Because a situation that is not understood can cause undesirable results.

After IVF Treatment

In IVF treatment, there is nothing very special that needs to be done after the transfer. After the embryo transfer, couples can rest for about half an hour in the clinic where the procedure is performed and then go home. It is okay for couples coming from abroad to travel 2-3 hours after the transfer. Couples coming from longer distances can return to their homes after staying one day in Istanbul, if necessary. After the transfer process, it is enough for the expectant mother to listen for 3 days. He can then return to his daily life. While sleeping, sneezing, coughing, and turning to the right and left have no harmful effects on holding. Furthermore, climbing, and descending stairs is completely safe. is useful to stay away from heavy exercise and heavy work until pregnancy occurs, and to be careful not to make sudden movements. Fullness in the breasts, pain in the groin as if menstruating and pink-brown drip-shaped discharges are the conditions that can be seen after the transfer process. There is no need to be afraid or worried when you encounter these situations. However, if the discharge is like a red menstrual discharge, you should definitely consult your doctor. After the transfer process, having a shower is not harmful. Avoid drinking acidic drinks, coffee, and herbal teas both after the transfer and while you are pregnant.  Smoking and alcohol should be strictly avoided. It is beneficial to avoid excessively spicy and oily foods, pay attention to consuming fresh vegetables, fruits, and protein-based foods, and consume plenty of water. Never use a prescription drug without first talking to your doctor.

• You shouldn't perform strenuous sports workouts within the first few days.
• Swimming is not advised to prevent vaginal infections.
• It's not advisable to lift and carry heavy objects.
• Alcohol and smoking should not be combined.
• You should wait two weeks before engaging in sexual activity.
• Medications to be used should be taken in consultation with the doctor. Progesterone injections and other drugs are given for luteal support should be used as described, not interrupted. Generally, luteal support with progesterone continues until the end of the 12th week of pregnancy. After this week, the placenta provides progesterone support in the body.
• Unpasteurized milk and fresh cheese should not be eaten to avoid possible listeria infection.