Question 1

What is Infertility?

Accepted Answer

"The inability to conceive despite regular sexual intercourse is referred to as infertility. In medical terms, a period of one year is defined for diagnosing infertility in couples; however, this period is not waited if any known or anticipated impediment to pregnancy is identified. Additionally, for women aged 35 and older, this period is reported as 6 months. The frequency of regular sexual intercourse is defined as 2-3 times per week."

Question 2

How is infertility diagnosed and what tests are required?

Accepted Answer

"The initial application of couples desiring children begins with the examination and preliminary assessment of the couple. Subsequently, the following tests need to be conducted:
* Ultrasonography and blood tests for the female patient, as well as imaging of the uterus and fallopian tubes through procedures such as HSG or hysteroscopy.
* Semen analysis for the male following the appropriate period of sexual abstinence, and if necessary, ultrasonography and blood tests.
Upon the results of this evaluation, if an infertility diagnosis is established, a decision is made on whether the couple needs in vitro fertilization (IVF) or requires ovarian stimulation and insemination treatments. Sometimes, before these treatments, if there are issues such as fibroids, polyps, uterine adhesions or abnormalities, ovarian cysts, endometriomas, or fluid accumulation in the fallopian tubes (hydrosalpinx) that may hinder pregnancy or negatively impact IVF treatments, the treatment of these problems is prioritized."

Question 3

What are the stages of in vitro fertilization treatment?

Accepted Answer

If a decision is made for in vitro fertilization (IVF) for a couple wishing to have a child, the steps in the treatment process can be outlined as follows:
* Firstly, under the doctor's control, egg-stimulating treatments are applied with the monitoring of ultrasound and blood tests, performed every few days or as deemed necessary for the female patient.
* When the desired size and number of eggs are achieved, the egg retrieval procedure (OPU) is scheduled under anesthesia in the operating room.
* On the same day, after a 3-5 day sexual abstinence, the male needs to provide a semen sample through masturbation at the IVF center. In cases where IVF treatment is applied due to male factors, sometimes surgical extraction of sperm from the male is necessary. In this case, an intervention is performed on the male patient under anesthesia in the operating room at the IVF center.
* After the egg retrieval and sperm extraction procedures are completed, fertilization procedures are carried out in the embryology laboratory. Fertilization control is conducted the next day, and in the following days, embryo development is monitored. Depending on the number and quality of embryos, the embryo transfer day is decided based on the patient's individual factors.
* On the embryo transfer day, the patient, along with their partner, arrives at the IVF center with a full bladder at the designated time. The embryo transfer procedure is painless and does not require anesthesia. The patient witnesses the moment of embryo transfer.

Question 4

How many days does in vitro fertilization treatment take?

Accepted Answer

Since each patient's response to treatment varies, the duration of treatment also differs. After the overall assessment of the patient is completed, in vitro fertilization (IVF) treatment usually takes about 2-3 weeks. Sometimes, depending on the individual factors of the patient, when longer treatment protocols are applied or when multiple egg retrieval and egg accumulation pool methods are implemented in the same cycle, this period may exceed 3-4 weeks.

Question 5

Tüp bebek tedavisinde yaş sınırı var mıdır?

Accepted Answer

"It has been reported that the highest success rates in IVF treatments are in the twenties and thirties. It should be noted, especially after the age of 35, that the quantity and quality of eggs are adversely affected, leading to a decreased chance of success in IVF treatments.
If there is no problem that poses a threat to the woman's fertility and does not jeopardize her health, and if the ovarian reserve is considered suitable in terms of quantity and quality, IVF treatment can be applied.
However, it should be remembered that pregnancies occurring after the age of forty carry an increased risk of miscarriage, as well as risks of abnormal pregnancies (such as Down syndrome), and the potential health risks for the mother associated with pregnancy."

Question 6

Is there a risk of multiple pregnancy in in vitro fertilization?

Accepted Answer

"In in vitro fertilization treatments, when multiple embryos are transferred, there is a risk of multiple pregnancies. Sometimes, even after the transfer of a single embryo, a monozygotic twin pregnancy can occur through embryo splitting.
While some countries have no restrictions on the number of embryos to be transferred, in our country, laws limit the number of embryos to be transferred based on the individual factors of the patients, with a maximum of two embryos. In Turkey, for IVF procedures in patients aged 35 and older, two embryos can be transferred, whereas in patients under the age of 35, a single embryo transfer is recommended for the first two attempts, and for the third and subsequent attempts, a maximum of two embryos can be transferred."

Question 7

Are genetic diseases a cause of infertility?

Accepted Answer

"Some genetic diseases in both women and men can be a cause of infertility."

Question 8

How long does the egg collection process take?

Accepted Answer

"The egg retrieval procedure is performed under anesthesia and typically takes between 10 to 30 minutes."

Question 9

Is pain felt during embryo transfer?

Accepted Answer

"The embryo transfer procedure is painless and does not require anesthesia. The expectant mother is allowed to observe the procedure, and it is completed under ultrasound guidance."

Question 10

Do pregnancy rates decrease after frozen embryo transfers?

Accepted Answer

"The pregnancy rates obtained after thawing and transferring frozen embryos are similar to the pregnancy rates in fresh cycles."

Question 11

Can eggs be frozen? Who is it recommended for?

Accepted Answer

To ensure the continuity of reproductive function in both women and men, the process of egg freezing can be applied. In today's world, both globally and in our country, there is an increasing demand for egg freezing, especially among women due to factors such as career aspirations, the desire to pursue a professional life, and the postponement of the desire to have children. In our country, laws allow the practice of egg freezing, particularly for women who will undergo medical treatments such as surgery, chemotherapy, or radiotherapy that may negatively affect ovarian reserve. Additionally, egg freezing is also performed for women at risk of early menopause.
Thanks to these procedures, individuals diagnosed with cancer at a young age (such as breast cancer, hematological cancers, solid tumors, ovarian tumors, etc.) or those undergoing treatments that may adversely affect ovarian reserve (in the presence of endometriomas, for example) are provided with the opportunity to have children in the future.

Question 12

Do cancer treatments disrupt sperm production?

Accepted Answer

"Cancer treatments can disrupt sperm production."

Question 13

What happens to the remaining embryos?

Accepted Answer

If, after the procedures of in vitro fertilization, a couple has a sufficient number of high-quality embryos suitable for freezing, with the couple's approval, the embryo freezing process can be applied. These embryos are stored for specific periods, and decisions regarding their disposal or thawing are made in collaboration with the couple, with regular notifications submitted to the Ministry of Health. Additionally, embryo freezing can be performed in cases where embryo transfer needs to be postponed for various reasons.

Question 14

Can natural pregnancy occur after in vitro fertilization treatment?

Accepted Answer

"Sometimes, especially in couples with unexplained infertility, spontaneous pregnancy can occur after in vitro fertilization treatments."

Question 15

When is gender determined in in vitro fertilization?

Accepted Answer

"Similar to all other pregnancies, gender determination in IVF pregnancies can be done through ultrasound with today's advanced technological capabilities around the 12-14th weeks. In some cases, for medical reasons such as preventing gender-related hereditary diseases, embryo biopsy can be performed, allowing for earlier gender determination before planning embryo transfer."

Question 16

Can women who have gone through menopause have a baby with in vitro fertilization treatment?

Accepted Answer

"Scientific research is ongoing regarding the stimulation of ovaries in patients at risk of early menopause, and some promising results have been reported. However, in older menopausal patients, pregnancy is not possible due to the absence of ovarian reserve. While the use of donor eggs is practiced abroad, such procedures are not legal in our country."

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