What is In-Vitro Fertilization (IVF)?
The eggs and the sperms are removed from women and men respectively. The eggs and the sperms are then fertilized under laboratory conditions. This procedure implemented outside the body is called IVF (in-vitro fertilization).
Phases of In-Vitro Fertilization
The purpose of IVF treatment is to maximize the quantity of samples at one time by developing multiple follicles during menstrual period.
During pre-treatment phase, ovulation induction is performed (by means of long and short needles) to increase the egg cells. The developed follicles are monitored by ultrasound until proper sizes are achieved. In the meantime, the measured E2 and LH levels are analyzed together with the response of samples. As the follicles are developed, the date of sample collection (OPU) is determined. The sampling procedure is performed with general anesthesia under ultrasound guidance. The sampling procedure is recommended during morning hours since 6-hour fasting is required. Following the sampling procedure, the patient rests for 2 hours in our center.
The egg samples collected after OPU shall be processed and all residues shall be removed. Then, mature eggs shall be selected and prepared for ICSI. In the meantime, the sperm samples collected from prospective father are prepared through specific cleaning procedures. The sperm samples are collected with micropipettes and only one sperm is injected to the ovarian section. This procedure is repeated for all egg-sperm matches. After injection, the samples are kept in serums under proper temperature and carbon dioxide level and then placed in incubator. The fertilization rates and development quality are monitored on regular basis.
The high quality embryos (blastocyst) are prepared for transfer procedure by the fifth day following embryo development.
During the embryo transfer, the patient lies down for gynecological examination. The physiological disinfection is made with a sterile serum as speculum is attached to the uterus. Subsequently, the cervical section is cleaned by special culture liquids. The embryologist brings the embryos to be transferred in a catheter. The doctor performing this procedure injects the embryos by ultrasound procedure implemented on the stomach area. Embryo transfer is a painless procedure whereas anesthesia is not required.
Vaccination, fuse or balm hormone medications are prescribed to the patient following this procedure in order to support endometrium. This treatment is also called luteal phase support and it continues until the tenth week of pregnancy. If pregnancy fails but menstrual period continues, then the medication therapy shall be ceased.
Pregnancy test is performed for the patient by the 12th day following embryo transfer.
ICSI (Intra-Cytoplasmic Sperm Injection)
Microinjection procedure (ICSI) refers to the transplantation of a selected sperm cell inside every egg through a special microscope. This is the most preferred method for recent IVF cases. Microinjection is applied to all patient groups in our hospital.
For an embryo developed naturally, it is required to be separated from external cell (zona pellusida) for adherence to intrauterine layer. The purpose in assisted hatching procedure is to refine this external cell prior to transfer procedure. The chance of pregnancy is increased by the adhesion of embryo to this cell. This procedure is also implemented with mechanical, chemical or laser methods. In our center, the Assisted Hatching technique is applied on free of charge basis for the applicants.
What is Blastocyst Transfer?
In IVF treatment, the embryo transfer in 5th or 6th day after development phase is called as Blastocyst Transfer. Embryos are monitored in the laboratory in accordance with development stages. Yet, the embryos reaching the blastocyst phase are selected and transferred to the prospective mother. Pregnancy is highly possible by the transfer of such embryos, but this would not be an appropriate procedure for all patients. If the male embryo amount is low, it becomes risky to monitor embryos in the laboratory for 5 days. In the contrary case, any single embryo would not be available for transfer. If the embryo amount is high, then blastocyst transfer is very advantageous for better selection of the embryo to be transferred. If the transfer procedure performed in the third day on the applicant, the transfer for the fifth day shall be recommended for the second test.
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