What Is In Vitro Fertilization?
Briefly, in vitro fertilization therapy is fertilizing egg with sperm at laboratory settings followed by transfer of resultant embryo into uterus in couples who cannot conceive through natural means.
First IVF baby was born in 1978. The technology has been constantly developed since that data and new methods added to in vitro fertilization therapy increased success rates substantially.
What are basic phases of In Vitro Fertilization?
First, baseline evaluation is done to make the diagnosis.
For women, age of varies and number of eggs are determined and uterine structure is examined with ultrasound. Hormone tests are ordered that are deemed necessary. Sperm analysis is performed for men. Moreover, hepatitis B and C and HIV tests are ordered for both mother and father candidates.
Following such examinations, birth control pills are advised to women, who have certain diseases, such as ovarian cyst, to minimize the risks that may develop throughout the pregnancy. Those pills can be used for 2 to 5 weeks.
After baseline evaluation is completed, best in vitro fertilization therapy is planned according to the results. In vitro fertilization therapy is usually started on Day 2 or 3 of the menstrual cycle.
Monitoring the Ovulation
If no ovarian pathology is observed in ultrasonographic examination, FSH and HMG are administered to increase number of and grow the eggs. Since it is quite easy to use these medications, self-administration is possible. Patients are informed by our specialist teams about details of their use.
Second examination starts 4 to 5 days after the baseline evaluation and final condition of ovaries is checked with vaginal ultrasound; number of eggs is measured. Next, drugs are injected to prevent early hatching of eggs.
Eggs become sufficiently mature usually 8 to 10 days later. If the ultrasound shows three eggs measuring 17 mm in size on average, egg-releasing drug, called hCG, is administered. At this point, it is necessary not to be late to retrieve eggs. Oocyte pick-up should be performed 34 to 36 hours after the injection.
After egg-releasing drug is administered, the next step for candidate mother is oocyte pick-up. This procedure is performed in operating theatre under mild general anesthesia. A needle is advanced through vaginal route to ovaries with ultrasonographic guidance and eggs are retrieved very carefully. The procedure lasts 15-20 minutes on average.
After the procedure is completed, the patient is asked to rest for about 2-3 hours. When effects of anesthesia wear off, patients with good overall health are discharged.
Sperms of man are collected on the day oocytes are retrieved. Sperms and eggs are placed into a special device, called incubator, and fertilization is expected. If fertilization fails, a viable sperm is injected into the egg with ICSI, also called microinjection.
There should be two healthy cells of man and woman in fertilized cell 16 hours after the fertilization. This implies that fertilization is healthy.
Embryos obtained with fertilization are placed into special devices to ensure their growth. Beyond this point, embryos are expected to achieve 2-cell phase and 8-cell phase on Day 3 followed by a multi-cellular stage, called blastocyst, on Day 5.
Quality of embryo is checked before the embryo transfer and best embryos are selected and transferred to uterus on Day 3 or 5. Best time for transfer is dictated by quality of embryo.
Pursuant to the regulation:
- 1 embryo is transferred in first two cycles in women younger than 35,
- 2 embryos in women older than 35,
- 2 embryos in women with history of two failed IVF cycles.
Here, the aim is to avoid multiple pregnancies.
Pregnancy is checked with a blood test approximately 12 days after embryo is transferred. If pregnancy test is positive, it is repeated 48 hours later and if blood test results increase 2 folds, first ultrasound examination is scheduled.