What is In Vitro Fertilization (IVF)? How is IVF Treatment Performed?

IVF treatment, applied to individuals who cannot conceive naturally, can be defined as the process of bringing together reproductive cells in a laboratory environment.

IVF, which is one of the assisted reproductive techniques, begins with the collection of eggs from the female partner and sperm cells from the male partner. After fertilization occurs in the laboratory, the resulting embryo is placed in the female partner's uterus. From this point onward, the pregnancy continues similarly to a naturally conceived pregnancy. IVF can be performed using two different methods. One of these is referred to as conventional IVF, where the eggs and sperm are placed in the same environment, allowing for natural fertilization to occur. The second method is called intracytoplasmic sperm injection (ICSI), in which sperm is directly injected into the egg cell. Both treatment methods can be successfully applied, but the choice of which method to use is determined by the physician based on the health status and reproductive capabilities of the couple. The goal of IVF treatment is to achieve a healthy pregnancy.

What is In Vitro Fertilization (IVF)?

When couples are unable to achieve pregnancy after one year of regular and unprotected sexual intercourse, it is recommended that they undergo health checks. If the female partner is over 35 years old, the waiting period is reduced to six months. For natural conception to occur, the female reproductive system, along with hormonal regulation and various other organs, must work together in harmony. Initially, the hypothalamus in the brain stimulates the pituitary gland, also located in the brain. The pituitary gland secretes LH and FSH hormones. These hormones travel through the circulatory system to the ovaries, stimulating the ovarian follicles in the ovarian reserve. As a result, some of the eggs begin the maturation process. The healthiest egg is released into the fallopian tubes, which act as a channel between the ovary and the uterus, upon ovulation. The egg has a lifespan of about 24 hours during which it can be fertilized. However, sperm, the male reproductive cell, can survive in the female body for 4 to 5 days. Therefore, fertilization can occur if intercourse takes place before or on the day of ovulation.

Throughout this process, the follicle containing the egg secretes estrogen, causing the uterine lining to thicken. After fertilization, the egg travels to the uterus, and pregnancy begins when the embryo attaches to the thickened uterine lining. During this entire process, different reproductive issues may arise in either the male or female partner. In such cases, the couple may consider IVF, which is one of the assisted reproductive techniques, after undergoing examinations and tests. In IVF treatment, eggs collected from the female partner are fertilized with sperm obtained from the male partner in a laboratory setting, and the resulting embryo is then transferred to the female partner's uterus through embryo transfer. Approximately two weeks later, a blood test is conducted to check the female partner's Beta HCG levels. If the test result indicates a successful pregnancy, the pregnancy process begins. Pregnancies achieved through IVF are no different from those conceived naturally, and the pregnancy process continues normally.

How is IVF Performed? What are the Necessary Conditions?

IVF can be defined as the process of placing the healthiest embryo, obtained by fertilizing the eggs collected from the female partner with the male partner's sperm in a laboratory, into the uterus. Before starting IVF treatment, both the male and female reproductive capabilities are evaluated. Then, hormone therapy is initiated to promote the maturation of the female partner's eggs. Following this, a trigger injection is administered to facilitate the release of eggs from their follicles. During the egg retrieval procedure, the female partner's mature eggs are collected with the aid of transvaginal ultrasound. At this time, sperm is also obtained from the male partner. The reproductive cells are brought together in a laboratory to achieve fertilization. The healthiest embryo, or in other words, the best IVF embryo, is then transferred to the female partner's uterus under ultrasound guidance. After this procedure, the couple is sent home approximately half an hour later. In some cases, multiple embryos may need to be transferred to the female partner's uterus, which can lead to multiple pregnancies. It should be noted that while IVF can be applied to individuals of any age before menopause, the chances of pregnancy decrease after the age of 40. There is no upper limit on the number of procedures. In IVF treatment, women under 35 years of age must have had regular unprotected intercourse for one year, while those over 35 must have done so for six months without achieving pregnancy. One of the frequently asked questions is, "How does IVF work?"

Stages of In Vitro Fertilization: How Does IVF Work?

The procedures carried out by the IVF center begin with a preliminary consultation. The physician listens to the couple's history, then conducts examinations and ultrasound assessments to evaluate the woman's reproductive system. An AMH test is performed to determine ovarian capacity. If necessary, tests such as HSG (hysterosalpingography), hysteroscopy, blood counts, thyroid function tests, and serological tests may be conducted. A sperm analysis is requested from the male partner, and if necessary, a consultation with a urologist is arranged. After the examinations, tests, and evaluations, the treatment method to be applied to the couple is determined. The couple is informed in detail about the stages of IVF treatment. The stages of IVF are as follows:

Ovarian Stimulation: Hormone therapy is initiated to promote the maturation of the eggs in the female partner's ovarian reserve. Initially, GnRH analogs are administered to suppress the ovaries. Following this, hMG and FSH are applied to stimulate the ovaries, thereby increasing the number and quality of eggs. Approximately 8 to 10 days later, when the follicle size reaches 18 to 20 mm, an HCG trigger injection is administered.

Egg Retrieval: About 34 to 36 hours after the trigger injection, the egg retrieval procedure, known as OPU (Oocyte Pick-Up), is performed. Under sedation and analgesia, this procedure lasts approximately 13 to 30 minutes and is conducted in a vaginal examination position, during which the individual does not feel pain.

Sperm Collection: The male partner provides a sperm sample through masturbation in a designated sperm collection room. The collected sample is sent to the laboratory. In cases where there are no sperm in the semen, sperm can be surgically retrieved from the testicles.

Fertilization: In the classic IVF method, the retrieved eggs and sperm cells are combined in a laboratory-cultured environment to await fertilization. In ICSI (Intracytoplasmic Sperm Injection), sperm is injected directly into the egg. In both methods, fertilization results in the formation of an embryo.

Embryo Transfer: The final stage of IVF treatment is the embryo transfer, where the previously obtained embryo is transferred to the female partner's uterus. This transfer is performed under ultrasound guidance without the need for anesthesia, with the embryo being placed inside the uterus using a catheter.

How Long Does IVF Treatment Take?

IVF treatment typically lasts about 15 to 18 days. After this period, the Beta HCG level is checked through a blood test 10 to 12 days later to determine if pregnancy has been achieved.

IVF Center: What is the Best IVF Success Rate?

Among the factors affecting the success of IVF treatment, the age and ovarian capacity of the female partner are paramount. The younger the female partner, the higher the success rate of IVF. Although the male partner's age is also important, it is the age of the female partner that is decisive. The success rate for first-time IVF attempts is around 70% for those aged 20 to 30. The success rate is about 50% for those aged 30-35 and drops to 45% for those aged 35-37. For those aged 38-40, the success rate is approximately 30%, and for those aged 40-42, it falls to 20%.

Medications Used in IVF Treatment

Hormonal medications specifically tailored to promote the maturation of the eggs are used in IVF treatment. After the embryos are transferred to the female partner's uterus, progesterone and estrogen hormones are administered to support implantation.