Fertility can be caused by female or male factors. Sometimes, a disorder is diagnosed in both of the subjects. Today, the most advanced treatment modality to solve the infertility problem is in vitro fertilization.
Couples who are candidates for in vitro fertilization;
- The patients whose fallopian tubes are obstructed or whose fallopian tubes are removed due to infection, ectopic pregnancy and other similar causes are the most suitable candidates for in vitro fertilization. In vitro fertilization was first introduced to clinical practice for patients with obstructed tubes. The mother of Louise Brown, the first baby born with in vitro fertilization in 1978, received in vitro fertilization therapy as her tubes were obstructed.
- Even if the tubes are patent, patients with impaired relation between the tubes and ovaries due to history of abdominal surgery, infection or endometriosis and adhesions in abdominal cavity. These problems can be detected with laparotomy and hysteroscopy.
- Patients who underwent surgeries that can reduce ovarian reserve such as ovarian cyst, cancer or endometrioma surgeries.
- Patients with ovulation problems and polycystic ovary syndrome, candidate mothers with advanced age whose ovarian reserve and quality reduced
- Idiopathic infertility cases. The patients who cannot achieve pregnancy, but have no documented problem regarding female or male infertility in the light of available tests and examinations are called idiopathic infertility cases. Insemination therapies are primarily performed for this group of patients and in vitro fertilization is recommended if conception fails.
- Patients with problems that hinder sexual intercourse, such as vaginismus in women and ejaculatory problems in men.
- Men with problems in semen analysis; in vitro fertilization is performed for spouses of men whose sperm count is lower than 5 million/ml in spermiogram performed twice in at least 1-month interval, men whose count of sperm with forward motility is zero or very low, men with severe deformity in sperm.
- Men with no sperm in semen analysis. This condition is called azospermia. Sperm can be found and collected from testes with surgical methods and next, in vitro fertilization can be performed.
- The men who undergo surgery due to a testicular tumor and receive chemotherapy and radiotherapy for anti-cancer treatment. These patients should be informed before the surgery and the treatment that sperm production will be affected and it should be clarified that sperms can be frozen and stored to be used for in vitro fertilization in the future.
- Men with poor sperm production due to history of mumps and other viral inflammatory diseases in adolescence or adulthood
- Men with undescended testis. The testes located in abdominal cavity before the birth should descend down to the scrotum in the birth for male babies; if the testes have not descended, they should be surgically placed to the scrotum not later than 1 year of age. If this condition is not recognized, it can cause infertility in the future. Sperm can be searched in the testes with surgical method and in vitro fertilization can be performed for such patients.
- Men with congenitally undeveloped sperm canals or history of inflammatory diseases and occluded sperm canals due to surgeries. Sperms are harvested from the testicles of those patients with syringe and vacuum in order to be used in in vitro fertilization.
- Couples who cannot achieve pregnancy with other treatment methods
- Couples with immunologic problems
- Couples with genetic problems