Do You Know About IVF Treatment?

1. Is the age of the woman important for the chance of success in IVF?

A woman’s age over 38 is a parameter that negatively affects successful results. In women over the age of 40, pregnancy rates are much lower. With advancing age:

• Ovarian reserve is reduced (high FSH).
• The number of developing follicles and the number of eggs obtained decrease.
• Eggs will not be of proper quality.
• The risk of genetic or chromosomal problems increases in eggs.

2. Are there risks to IVF?

Normally, controlled mild stimulation of the ovaries in IVF is a desirable situation. However, sometimes, as a result of moderate or severe stimulation of the ovaries, a picture known as ovarian hyperstimulation syndrome (OHSS) may occur with fluid collection in the abdomen and enlargement of the ovaries. Although the incidence of severe hyperstimulation is less than 1%, the incidence of this picture decreases with close monitoring of the patients during ovulation treatment.

Bleeding and subsequent infection rarely occur while the eggs are being collected. We usually stop this type of bleeding by using tampons without any intervention.

IVF treatment does not have any proven risks that will affect the health of the mother and the baby. According to the results of the researches, we can easily say the following: The rate of birth defects in babies born by in vitro fertilization method is not different from babies born by natural methods.

In addition, the risk of multiple pregnancy and premature birth, increased blood pressure and diabetes may increase with IVF treatment.

3. Which drugs are used in IVF?

In IVF treatment, injections that stimulate daily egg development are started on the 2nd or 3rd day of menstrual bleeding to stimulate the ovaries. At a certain stage of the treatment, another daily needle treatment is added to prevent premature cracking of the eggs.

Then, when it is decided that the eggs have matured by ultrasound monitoring, an egg cracking needle is applied. After the eggs are collected, drug treatment containing progesterone hormone is started to prepare the inner wall of the uterus for embryo transfer.

4. Do the drugs used have a carcinogenic effect?

According to studies, there is no relationship between drugs used in IVF treatment and ovarian cancer. In addition, even if the drugs have side effects, in the event of pregnancy, these will be eliminated.

The hormones used may have non-serious side effects; but these are temporary. There are no permanent side effects. It has not been shown to have a carcinogenic effect in large series in the world. The hormones used in the treatment are controlled by adhering to strict rules and are widely consumed all over the world.

5. Is there an increase in the rate of anomalies in children born through IVF?

There is no significant change. However, there may be a minimal increase in sex chromosome disorders, especially in people with severe male factor and microinjection. Although some studies show a slight increase in anomalies such as heart anomalies, neural tube defects and hypospadias, in general we do not see a significant change compared to normal infants.

In large series in the world and in our experience to date, there is no increased risk for anomaly compared to normal pregnancies. No differences were observed in the development of these babies, such as behavior and intelligence, throughout their lives.

6. Does stimulating the ovaries with hormone therapy cause premature menopause by destroying the ovaries?

At the beginning of puberty, a normal woman has about 400,000 small eggs, and these eggs are quickly depleted over the years. In the normal menstrual cycle, most eggs are lost before they can develop, only one of which ovulates.

In IVF treatment, 10 or more follicles are developed with egg-developing needles. But these are follicles that will naturally disappear anyway. Therefore, IVF treatment does not cause any harm to the ovaries.

7. How many days does the IVF last? How many days does the treatment take?

• IVF treatment goes through certain stages, starting with the first interview and examination. Some factors that cause infertility are examined and treated.
• IVF treatment covers an average of 20 days and consists of several stages. Usually, the ovaries are stimulated on the 2nd or 3rd day of the menstrual period, and the treatment is continued with daily needle use.
• The second stage is the collection of the ovaries. Depending on the stimulation of the ovaries, this process takes 10-12 days. The collected eggs are fertilized with the sperm taken from the partner on the same day. At this stage, the microinjection method is applied. The treatment is completed by transferring the developing embryos to the inner cavity of the uterus within 2 to 5 days.

8. What should/should not be eaten in IVF treatment? Does it matter?

Eating healthy is of course very important in every aspect of life and at any age. Therefore, a balanced diet before starting infertility treatment increases the success rates in vaccination and in vitro fertilization. While the IVF treatment is in progress, there is no need for both the woman and the man to make changes in the nutrition program. Of course, as long as you eat a healthy and balanced diet.

9. Is there a connection between the number of embryos transferred and the chance of pregnancy?

As the number of embryos transferred increases, the risk of multiple pregnancy increases with the chance of pregnancy. For this reason, the number of embryos to be transferred is limited by the regulations of the Ministry of Health.

Single embryo transfer is allowed in the first 3 trials and in women under 35. Afterwards, a maximum of 2 embryos can be transferred.

10. How many times can the IVF method be tried at most?

As long as the person can produce eggs, he can continue the IVF application. But in general, the success rate decreases after the third application. In vitro fertilization treatment can be applied as much as desired, if you have sufficient quality and quality eggs and sperm.

11. Is there any connection between weight and the chance of pregnancy with IVF?

Excess weight and obesity significantly reduce couples’ chances of conceiving. Women with ideal weight can have a baby without any treatment, this is a known fact. Excess weight and obesity significantly reduce the chances of pregnancy.

Again, overweight and nutritional disorders can reduce sperm quality in men and cause infertility. Especially foods containing trans fats and heavy metals slow down sperm motility.

12. In which season should IVF be done? Does it matter?

It does not matter. The quality of the eggs, the number of embryos, the attachment of the embryos and the success of pregnancy do not matter in which season the IVF treatment is performed.

13. What causes bleeding in IVF?

Bleeding during IVF treatment is not an expected situation. However, it is normal for some women to experience light bleeding that lasts for a few days immediately after egg retrieval.

Luteal phase bleeding should be mentioned here. Vaginal bleeding after embryo transfer and before pregnancy test. Often people worry that the treatment has failed. However, when these bleedings occur, there is still a chance of pregnancy, even if the success of the treatment is slightly reduced. For this reason, luteal phase support drugs should not be discontinued.

14. Are there any restrictions on sexual intercourse in IVF treatment?

• It is possible to have intercourse during the needle treatment to reproduce the eggs.
• At least 3 days of sexual abstinence is required, as sperm from the male will be taken on the day of egg retrieval. For this reason, sexual intercourse should not be performed, especially 2 days before the eggs are collected.
• You can have sexual intercourse after the egg is collected, but condoms should be used to reduce the possibility of multiple pregnancy. However, there may be sensitivity or risk of infection in the uterus and ovaries due to egg collection. This should be learned by consulting a doctor.
• There are different opinions about sexual intercourse after embryo transfer. Generally, there is a thought that having sexual intercourse and having an orgasm can prevent the embryo from attaching. But there is no evidence based on scientific research on this subject.
• We do not recommend sexual intercourse in couples with ovarian hyperstimulation syndrome (OHSS) due to fluid accumulation in the abdomen and enlargement of the ovaries as a result of moderate or severe stimulation of the ovaries. Because bleeding and pain in the ovaries can be experienced during sexual intercourse.

15. Why does IVF fail?

No need to worry if the first application fails. If good embryos are given in two or more applications but there is no pregnancy, we consider in vitro fertilization failure. In such a case, we take the couple back to treatment and examine them in detail, and we investigate what causes prevent conception.

In women;

• Intrauterine adhesions
• Abnormalities that can prevent the attachment of the embryo, such as fibroids or polyps in the uterus, endometriosis (chocolate cyst),
• A uterine fibroid or hydrosalpenx (fluid-filled enlarged appearance of the tubes after previous inflammation),
• Hormonal disorders-thyroid gland diseases,
• Milk hormone (prolactin) secreted from the pituitary in the brain,
• Polycystic ovary disease and the increase in insulin hormone can prevent the embryo from adhering to it. Even polycystic ovary can cause miscarriage. In such cases, whether there are congenital or later developmental problems related to the immune and coagulation system, it is necessary to investigate with advanced blood tests and start drug treatment if necessary.

For men, it is very important to have a detailed sperm analysis. If there is a significant decrease in sperm count, lack of movement or deformity in sperm;

• Chromosome analysis,
• Y chromosome microdeletion test,
• Genetic tests such as sperm FISH test should be done.

If problems are found in these tests, it is necessary to use Preimplantation Genetic Diagnosis (PGD) (genetic examination and diagnosis before transfer to embryos) techniques in a new IVF treatment.

16. Until what age can IVF treatment be applied?

• There is no clear limit. But after the age of 40, the success rate drops to 15%. After the age of 45, we can say that the success rate is almost non-existent. The first factor that determines the success rate in IVF is age.
• Women aged 40 and over are unlikely to improve the quality of their eggs. But interventions such as increasing the dose of drugs used to stimulate ovulation and choosing the best among many eggs can increase the chances of pregnancy. If all these do not work, the use of eggs donated by a relative or another woman may be considered, but this practice is not legal in Turkey.
• Fertility level can be controlled. For this, the amount of FSH, E2, AMH hormones can be checked by performing a blood test on the 3rd day of menstruation. These results indicate the capacity of the ovaries.
• As the amount of FSH hormone increases, the probability of finding an egg in the ovaries that can provide pregnancy decreases. FSH levels increase as a woman ages. But we know that the number of eggs is also low in young women and women with high FSH levels.

17. How do you interpret the developments in IVF treatment in recent years? Is there an increase in the demand for IVF?

“Cannot have children” in previous years. couples can achieve their dreams thanks to infertility treatments in recent years. When we look at the history of IVF treatment, we see that it was first applied in England in 1978. Today, assisted reproduction technique is widely used in many countries.

• 1 out of every 6 women of reproductive age receives professional help due to infertility.
• 3% of women of childbearing age use ovulation pills.
• 1% of them are applied assisted reproductive technologies.

We can list the reasons for the increase in the infertility rate as follows:

• Change in social roles and demands,
• late marriage,
• Postponing the woman’s birth age,
• Widespread use of birth control methods,
• Legal evacuation possibilities,
• economic concerns,
• increased risk of exposure to sexually transmitted diseases,
• Gradual decrease in sperm count. Access to treatment methods and the spread of these practices in society are also increasing. The reasons for this;
• Infertility is no longer socially accepted and is no longer a taboo,
• Increasing the level of education,
• Internet, newspaper, etc. dissemination with the media,
• We can think of it as the development and expansion of infertility treatment centers.