In its shortest definition, in vitro fertilization is the fertilization of eggs obtained from the prospective mother's ovaries with specific techniques, in laboratory conditions, with the prospective father's sperm outside the body, and the transfer of the embryo formed as a result of fertilization to the mother's uterus. The embryo transferred to the mother's uterus will develop and enable pregnancy to occur.
IVF can be applied in two different ways:
1- Classic in vitro fertilization application = IVF = in vitro fertilization
2- ICSI = Microinjection = Intracytoplasmic sperm injection
The second of these two techniques is the more commonly used method today. The advantage of the second method is that it provides an advantage for people with low sperm count and poor spermiogram results. The stages of IVF that we have listed are largely the same in both methods, the only difference is as follows:
What is the Difference Between IVF and ICSI Treatment Stages?
In the IVF technique, thousands (50 thousand) sperm cells are placed around the egg cell obtained from the mother candidate in a special environment in the laboratory, and one of these sperms fertilizes the egg cell by itself.
In ICSI, also known as microinjection technique, a single sperm cell is taken outside the body under laboratory conditions and transferred into the egg cell with microscopic techniques. In other words, here, the sperm does not enter the egg cell on its own. Apart from this difference, the other stages are the same in both techniques.
Stages of IVF Treatment
The number of these stages may be given differently in various sources, some stages may be explained together in a single step, but the same stages are applied in every center. The stages are explained here by dividing them into 5 sections.
STAGE ONE: Initial examination and examination of candidates:
At this stage, the candidate's past treatments and pregnancy, birth, and miscarriage stories are listened to. Past tests and film results are examined. IVF treatment is planned according to these factors and the day the treatment will begin is decided.
SECOND STAGE: Stimulation of the ovaries and egg formation:
At this stage, egg-enhancing drugs (injection treatment) are applied to create a large number of eggs in the ovaries. The aim of creating a large number of eggs is to create many embryos with many eggs and to separate the good embryos and transfer them to the uterus. For this reason, the aim is to create more than one egg, not one.
THIRD STAGE: Egg collection procedure (OPU):
At this stage, the developing eggs are collected and stored for fertilization under laboratory conditions. During this time, the father candidate also provides sperm. Sperm can be obtained from father candidates who cannot provide sperm using the micro TESE method.
FOURTH STAGE: Fertilization (IVF or ICSI method):
At this stage, the fertilization process is carried out with the collected eggs and the obtained sperm. The fertilized eggs are preserved in the laboratory.
FIFTH STAGE: Transfer of the embryo into the uterus:
At this stage, the fertilized eggs that are stored in the laboratory are transferred into the uterus in a painless process that takes 5-10 minutes. After fertilization, the eggs are kept in the laboratory for 2-3 days and then transferred. A pregnancy test is performed 12 days after the transfer to check if the pregnancy has occurred.
How Long Does IVF Stages Take? How Many Days Does It Take?
Since many women or men work or will attend treatment in a center outside the city, the length of IVF treatment is an important issue for them. The duration is more comfortable for men because if a man wishes, he can only be present at the IVF center for one day during the first examination (stage 1) and fertilization (stage 4). Women, on the other hand, must be present at every stage. Unless there is an extraordinary situation, there is no need to stay in hospital at any stage of IVF treatment, treatments are performed on an outpatient basis. The entire treatment is completed in approximately one month from beginning to end.
In short, we can summarize the duration of the stages as follows:
– The first phase is completed in approximately one day.
– The second phase starts on a later appointment date and continues for approximately 15 days.
– The egg collection method in the third stage takes about half an hour, then it is possible to leave the application center after resting for 1-2 hours. In the meantime, the fertilization application is carried out and the fertilized eggs are stored in the incubator.
– It is necessary to go to the IVF center again approximately 2-3 days after the egg collection procedure. The reason for this is the transfer of the embryo into the uterus, this procedure is completed in 5-10 minutes and it is possible to leave the IVF center after resting for one or two hours.
– After this, the candidates are free until the pregnancy test is performed. It is necessary to apply to the center for a pregnancy test 12 days after the transfer day, or it is possible to have this test done at the health institutions in the place where you are. This is a normal pregnancy test performed in every hospital, it is not a different test.
On Which Day of the Menstrual Period Does IVF Treatment Start?
In IVF treatments, the egg-enhancing treatment (just like insemination) usually starts on the third day of the menstrual period, but can start between the 2nd and 5th day of the menstrual period. Egg suppression treatment starts earlier and usually starts a week before the menstrual period starts (if a long protocol is to be used).
Are the Stages of IVF the Same for Every Person and Every Clinic?
Depending on the candidate's age, hormonal status, and the cause of infertility , treatment methods and procedures, and the medications applied may sometimes vary, but the general stages in each IVF clinic are as mentioned here. The main stages do not vary, in every IVF treatment, egg development, egg collection and transfer stages are definitely present and do not vary.
Is Sexual Intercourse Forbidden During IVF Treatment Stages?
During the in vitro fertilization phases, sexual intercourse is prohibited. Before going to the first examination, the father candidate must not have had intercourse (not ejaculated) for an average of 3 days. The reason for this is that a sperm test may be needed. If pregnancy is achieved, the sexual intercourse ban continues until the pregnancy reaches a certain stage, and when the pregnancy is approximately 2-3 months, if the person's doctor does not find any problems, the sexual intercourse ban is lifted. In pregnancies achieved with the whole baby application, the sexual intercourse ban is not applied continuously until birth. This issue should not be violated without consulting a doctor.
How Should Smoking and Nutrition Be During IVF Stages?
Smoking and alcohol are prohibited not only for IVF, but also for all expectant mothers, including those planning a natural pregnancy. If the father-to-be smokes, he should not smoke around the mother-to-be. The mother-to-be should pay attention to healthy eating habits and use vitamin pills if recommended by her doctor.
Are There Any Harms in Travelling During the IVF Stages?
Especially since some patients come from out of town for treatment, it is necessary to travel by car or plane. Travel can be done until pregnancy occurs if the doctor does not see any harm. After pregnancy is achieved, the doctor may prohibit travel for a while. In addition, long journeys should not be taken for a few days after the transfer application.
What are the Prices and Costs of IVF Stages?
These prices vary between different centers. It is possible to get price information by calling IVF centers and hospitals where IVF is performed. Insurance companies (SGK, SSK, BAĞ-KUR, Private insurances..) cover the expenses to certain extents and conditions according to new laws.
Do the State or Social Security Institution Cover the Medicines Applied During the IVF Stages? What is the Price?
The social security institution also covers the drugs used, patients only pay a copayment. These are generally costly drugs for patients without insurance.
Where can IVF Treatment Stages be Applied?
There are around 100 hospitals and private centers in Turkey where IVF treatment can be applied. Today, since it has become quite widespread, private clinics have been established in almost every major city. In addition to private IVF clinics, IVF applications can also be performed in state hospitals, training and research hospitals, and university hospitals.
What is the Best Age to Start IVF Treatment?
If the doctor has informed the candidates that IVF treatment is necessary for infertility problems, it would be best to start the treatment as soon as possible. In this case, the most ideal age is the youngest age. Because as the age progresses, the chances of the candidates achieving pregnancy naturally decreases, as does the chance of achieving pregnancy with the IVF technique. The most important reason for this is that the ovarian reserves of the mother-to-be decrease as she ages, and especially after the age of 35, the ovarian reserves decrease more rapidly.
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