It is every couples dream to have a child at one point. Some couples might think it is too early to have a child during the first years of their marriages and carry this decision to the further stages of their marriages. However everything might not go as planned and the couple might face serious complication due to health problems while trying to conceive. In these conditions the treatment that is applied is IVF. It is possible to have a child with the support of IVF treatment. Nowadays most couples apply for IVF treatment and get successful results.
Modern medicine offers many opportunities for those who want to have a child. IVF treatment is a method of assisted reproduction. During the IVF treatment, the fertilization process will take place in a lab where the female reproductive cells and male reproductive cells are fertilized in the laboratory.
The First Test-Tube Baby In The World
The founder of the modern IVF treatment is Bob Edwards. The first child to be born as a result of an IVF treatment is Louise Brown who was born in England in 1978. Since 1971 every treatment that has taken place has been a basis of modern day IVF techniques.
The Latest Technological Developments In IVF Treatment
- IVF treatment techniques have been developing every day and has been integrating in our lives in many ways. These new techniques are based on increasing the success rates of IVF treatment. If needed to explain briefly;
- The IMSI microinjection technique which allows us to select the best quality sperm in order to achieve high fertilization rates.
- A testicular biopsy (micro-tese) which is performed under the microscope.
- PGD embryos (pregenetik diagnozis) which allows genetic examination of the couples in order to select the healthy embryo.
- The Frozen technique which allows the cryopreservation process of sperm and eggs for later use of the embryo
- Embryoscope which has an incorporated time lapse system that has a camera that continuously captures images and records them as a video of the embryonic development.
- Immune system-related Immunological Treatments.
To Whom Can IVF Treatment Be Applied?
- In people without a history of infertility,
- In condition where both tubes are blocked,
- Ovum disorders,
- In conditions when there are no sperm found in the semen,
- If sperm quality disorders are present,
- In immunological cases,
- When cervical factors are involved,
- If the fallopian tubes have been taken surgically,
- In cases which inadequacy in the number of sperm or eggs are present,
- The presence of cysts on ovaries which cause infertility,
- Patients who experience hormonal disorders,
- If there is a problem concerning sperm motility,
- In cases of repeated miscarriages IVF can be applied.
IVF Treatment Cannot Be Applied To Whom?
- Men without sperm production
- Women who have lost the function of egg production
- Women who are in menopause
- In women who have hormonal imbalances
- In women who have had an operation which the uterus has been removed.
- It is unfortunately not possible to apply IVF to patients with the above conditions.
What Are The Success Rates Of IVF?
The success rates of IVF will depend on the patients age.
Under the age of 30: 60 %
Around the age of 35: 40 %
Around the age of 40? 15 %
However, these rates only apply to patients who have tried IVF once. IVF success rate in patients who have had the treatment 4 times before will be over 90%.
What Are The Procedures Of IVF?
The First Step (The first examination for couples who have applied for IVF treatment)
The previous treatments which the couple have seen and problems should be told to the specialist. The previous tests, if any, should be handed over to your specialist before starting the treatment,
All kinds of previous surgeries should be reported,
Hormone assays of women,
Other diseases which can affect the treatment should be reported,
According to this data, IVF treatment is scheduled and the day which the treatment will be applied is determined.
The Second Step (Excitation of ovaries & creating the ovum)
In order to select the best embryos to be placed into the uterus, multiple ovum production is necessary. To achieve the best quality ovum, medications such as needle therapy is applied.
The Third Step (Collection of the ovum OPU)
At this stage, the developing eggs have been collected and stored under laboratory conditions for fertilization. During this time the male will need to give a sperm sample. The sperms are taken through masturbation. In patients who cannot give sperm by this method, micro-tese method is applied. On average, this process takes about half an hour.
The Fourth Step (Fertilization (IVF or ICSI method))
With the collected eggs and sperm fertilization process will be performed in the laboratory where after fertilized eggs will be stored. (The fertilized eggs are stored in the incubator)
The Fifth Step (Embryo transfer)
The fertilized eggs which have been waiting in lab conditions for 2 to 3 days will be placed in the uterus. During this procedure the patient will not feel any pain and will take about 5 to 10 minutes. Sexual intercourse is not recommended until the first pregnancy test. After the transfer, the female can take a warm shower.
The Sixth Step (Pregnancy Test)
The pregnancy test can be done 12 days after the embryo transfer. This test is a regular test which can be done in every hospital.
There are two main techniques in fertilization process in the laboratory:
Classic IVF (in vitro fertilization): the sperm is left beside the ovum and is expected to fertilize the ovum by itself with no interference.
Microinjection (ICSI): The sperm is directly injected into the egg through a straw with semen under the microscope-to ensure fertilization. The microinjection method is commonly used during IVF treatment. ICSI fertilization is a technique that is applied during the fertilization stage to ensure that sperm and egg are fertilized at a high rate successfully. Microinjection is a method widely used in severe male infertility. The reasons are:
Low sperm count,
The lack of sperm motility
IVF Treatment Failure
The most common problem seen during IVF treatment is failure. There are many factors that affect the success of IVF treatment. The most important factor is maternal age. Ovarian reserve, stress, smoking, excess weight, fluid tubes, the decrease in sperm quality also affects the success of the treatment. Failure of IVF can be seen in the following conditions:
- If the genetic structure of the embryo is disrupted,
- In cases which the medication that helps ovum development is not used regularly,
- The membrane that covers the outside of the embryo being too thick,
- Presence of congenital abnormalities associated with the uterus,
- In cases where myomas which will interfere with the embryo are seen,
- Previous infections or diseases that cause adhesions,
- Women with genetic disorders,
- Endometriosis ( chocolate cyst ),
- Infectious diseases that occur in the tubes.
Side Effects Of Medications That Are Used In IVF Treatment
There is a need for medication in order to obtain eggs for IVF treatment. There are some side effects of these medications. These are:
- Mood swings
- Allergic reactions
- Abdominal pain
- Diarrhoea, vomiting and nausea
- Slight pain in the area of injection, bruising and irritation
- Tenderness in the breast area
- High temperature
IVF Can Be Applied Up To What Age?
IVF treatment can be applied up to the age of 44. But after 42 years of age, the success rate decreases.
What Are The Risks Of Miscarriages After IVF Treatment?
If the necessary medical support during the first three months of pregnancy is applied, the miscarriage rates are very low when compared to normal pregnancies.
Will An Ectopic Pregnancy Occur?
The possibility of ectopic pregnancy during IVF treatment is around 1-3 %.
How Many Times Can IVF Be Applied?
After the third time the success rates will decrease. In further cases pregnancy can occur, however the success rates will be lower when compared to the first and second times.
After The First Treatment Has Failed, When Can The Patient Apply For The Second Treatment?
Medically after the first IVF treatment has failed, two months later the second application can be applied.
After The Transfer, When Can The Patient Be Back To Normal Activities?
The patient can return to normal activities apart from sexual intercourse and sports immediately after the transfer.
Is It Ok To Travel During IVF Treatment?
In the period until pregnancy occurs, if the doctor can’t see any inconvenience it will be ok to travel. However, after a couple of days after the transfer process and once the pregnancy occurs, the doctor may prohibit travelling in case of any complications which can occur.
What Should Be Done During IVF?
- The patient should quit smoking
- Daily 0.4-1 mg Vitamin A that contains folic acid should be used
- A healthy diet
- Consume foods which are high in fibre
- Drink 6-8 glasses of water daily
- Regular exercise should be done
- If infection is involved this condition should definitely be discussed with your doctor
- If a new drug is involved, such as antibiotics, you should discuss this with your doctor
- Injection medications should be stored in the refrigerator
- All needles should be applied at the exact reported time and amount
- The purpose of suppressing certain hormones the doctor prescribed drugs should be used regularly
- Pre-treatment of hep B and C, HIV, Rubella IgG, blood count, determination of blood groups should be made
What Should Be Done During IVF?
- Beverages which contain caffeine such as coffee, tea or coke should not be consumed more than a glass a day
- Alcoholic beverages should not be consumed after embryo transfer
- Heavy exercise and heavy sports should be avoided during treatment
- Extremely hot environments should be avoided