IVF

IVF Treatment Steps

We can examine the IVF treatment steps in 7 main steps. These; Evaluation of the couple and Creation of the Treatment Plan, Stimulation of the Ovaries, Egg Collection (OPU), Microinjection (ICSI) , Embryo Culture and Follow-up, Embryo Transfer , Pregnancy Test, Why Quality Markers are Important in the IVF Laboratory.

In vitro fertilization is one of the assisted reproductive techniques applied to couples who cannot conceive spontaneously and other treatment methods have not been successful. In IVF treatment, 1 or 2 of the best quality embryos obtained in the laboratory environment are transferred to the uterus of the expectant mother and pregnancy is achieved.

IVF Treatment Steps: Evaluation of the Couple and Creation of the Treatment Plan

The first step in couples who want to have a baby but cannot conceive spontaneously is to evaluate the couple in detail. For this purpose, a detailed history of the man is taken and sperm analysis is planned. Then, the detailed history of the mother-to-be is taken, and an examination is performed to evaluate the uterus and ovaries.

In couples whose in vitro fertilization decision is made after the first evaluation, individualization of IVF treatment and the creation of a couple-specific treatment scheme increase the chance of success. In addition, treatment can be started after routine screenings of the woman or man and, if necessary, other tests are performed and evaluated.

Yumurtalıkların Uyarılması

When in vitro fertilization treatment is started, the first step is to stimulate the ovaries within the specific drug use schedule and dose determined according to the age, ovarian reserve, previous trial history, if any, and weight of the expectant mother. The aim of IVF treatment is to obtain as many eggs as possible in a controlled manner. However, ovarian stimulation with the lowest required dose and with close follow-up will both increase the number of eggs to be obtained and prevent the risk of dangerous situations such as overstimulation syndrome (OHSS).

The ovarian stimulation phase lasts approximately 8-10 days. In this process, we want the expectant mother to come to our center for blood follow-up and ultrasound control at regular intervals. Then, when the egg sacs, namely follicles, reach the desired size, we ensure that they become mature and ready for collection with the application of cracking needles.

Egg Collection (OPU)

The eggs inside the follicles developed by ovarian stimulation are collected by the egg collection process. We almost always perform the egg collection procedure under light anesthesia to increase patient comfort. Egg retrieval is performed by entering the ovarian tissue with a needle guided by a vaginal ultrasonography probe and takes approximately 10-15 minutes. After 1 hour of rest after the procedure, the expectant mother can return to her home.

Microinjection (ICSI)

On the day of egg collection, the sperm produced by the father-to-be by masturbation is prepared and microinjection (ICSI) is performed to ensure fertilization from the mother-to-be’s eggs to the mature ones. In the micronejection process, a single sperm is transferred into each mature egg. The next day, the fertilization status of the eggs is evaluated. With this method, the fertilization rate is around 80%. However, this rate may decrease in case of sperm or egg abnormalities.

Embryo Culture and Follow-up

After micronejection, the egg is removed in a special medium, in a special device called an incubator. Incubators are devices that we place the embryos until the transfer process, imitating the mother’s body and the uterus in terms of heat, humidity and gas ratios. Embryos are removed only once each day until the day of transfer and evaluated for cell number, dead part ratio, cell lineup, level of expansion, inner cell mass and outer cell (trophectoderm) layer quality. If a continuous embryo monitoring system (time lapse) incubator is used, the embryo is not taken out of the incubator. Embryo quality is understood by evaluating the images taken with the cameras in the device in the computer environment.

As well as the cell qualities of the mother and father-to-be, the quality of the devices and mediums used in the laboratory, the quality of the materials used, and the ideal level of the laboratory environment in terms of heat, humidity and gas ratios also affect the embryo quality and therefore the chance of pregnancy.

According to the number and quality of the embryos of the couple, the transfer process is 3. or 5. day is decided. 5. With embryo transfer, the chance of pregnancy is higher.

Embriyo Transferi

The day of transfer is determined according to the number and quality of embryos the couple has. In our center, 75-80% of our patients with whom we have applied freshly are 5. We are transferring embryos at the blastocyst stage. With embryo transfer at the blastocyst stage, the embryo with a higher probability of attachment to the uterus can be selected, and thus the pregnancy rates are 3. day is higher compared to embryo transfer.

While the ideal number of cells in terms of embryo quality is 7 to 8 cells in the 3rd day transfer, in the blastocyst stage, that is, in the 5th day. The ideal quality in day embryos is 3-4-5- expansion level and inner and outer cell quality is A or B.

Embryo transfer is performed with urine constricted and under observation by ultrasonography from the abdomen. Our embryologist loads the embryo to be transferred into the transfer catheter and we, the physicians, gently and duly transfer the embryo into the uterus. This process takes about 2-3 minutes, and at that time, the urethra makes it easier to enter the uterus by flattening the angle of the uterus.

After the transfer, it is sufficient for the expectant mother to rest for 1 hour in our center. Then he can return home.

Pregnancy test

After embryo transfer, 3. 11 days from day transfers, 5. We can understand the presence of pregnancy with the blood pregnancy test performed 9 days after the day transfers. We accept that the initial value is above 30 muu/ml as a positive result.

Why Are Quality Indicators Important in IVF Laboratory?

The equipment of the IVF laboratory, the quality of the tools and materials used, the ambient temperature, humidity and gas ratios affect the quality of the embryo that will develop and thus the chance of success after the treatment.

For this reason, it is also important for success to meticulously select the materials used, to carefully measure and record the temperature, humidity and gas ratios in the laboratory every day, to meticulously record and monitor quality indicators such as fertilization rates, embryo division rates, embryo development rates at the blastocyst stage.

In addition, it is important for success to follow the statistics of the operations performed by the personnel working in the laboratory, and to keep the records carefully and carefully.

We also attach importance to quality in our center in Ankara. In this context, after a rigorous audit, our center was awarded the ISO 15189 accreditation certificate by the Turkish Accreditation Agency (TÜRKAK). In addition, our center has ISO-9001/2015 certificate, which is an indicator of international service quality.

At the same time, our IVF Laboratory; It has successfully completed the UK-based UK NEQAS International Quality Expertise (UK NEQAS International Quality Expert) Program and has certified its compliance with international standards in vitro fertilization laboratory conditions.

In this article, we examined the IVF Treatment Steps . If you wish, you can also read my article on Vaccination Treatment .

Contact information :

Author : Prof. Dr. Mehtap Polat
Telephone : +90 530 011 41 33
E-mail : [email protected]

Prof. Dr. Mehtap Polat

18 yılı aşkın meslek hayatım boyunca mesaimin neredeyse tama yakını bebek sahibi olmak isteyen çiftlere yönelik tedavilerle geçti. Çocuk isteği olan ve tedavi gereği olan çiftlerin bu süreçte ne kadar kırılgan, naif ve hassas olduklarının farkındayım. Bu nedenle hastalarımla yaptığım ilk görüşme anından itibaren, kendilerine olabilecek en yüksek başarı oranını sunmak için bilimsel veriler ışığında güncel, kaliteli, özenli ve çifte özel bireyselleştirilmiş tedavi uygulamanın gayreti içindeyim..

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