IVF is an assisted reproductive technique for couples that can not have a baby and it has been used for a long time. It is the most preferred infertility treatment at the present time. Couples can have a baby with IVF, which may need be necessary in some conditions such as infertility, infection, blocked fallopian tubes, low sperm, weight or over age. IVF comprehends a treatment process that sperm is transferred directly into a woman’s uterus outside the body. After fertilized eggs undergoes embryo, first stage of development, it is implanted in women’s uterus, subsequently there is no difference between getting pregnant normally and within vitro fertilization.

   IVF’s difference from normal pregnancy is that the fertilization process takes place outside the body and fertilized egg is implanted in women’s uterus. Intrauterine Insemination (IUI) can be preferred before IVF, especially male infertility. This technique is carried out by placing sperms directly into a woman’s uterus.

There are two processes to implant eggs with IVF;

• It occurs by being placed sperms next to eggs and waiting for sperms entering the cytoplasm of the egg.
• It occurs by being injected sperm into the center of the egg.
• Doctors decide one go two processes according to couples’ features. The purpose is to get a chance of great success for couples.

What is the difference between Intrauterine Insemination and IVF? When is Intrauterine Insemination used?

   Intrauterine Insemination is the most preferred infertility treatment before IVF, especially unexplained male infertility. Women’s ovaries are induced as well as IVF, sperms are transferred into women’s uterus by using a cannula after eggs cracking. One of women’s tubes must be unblocked at least to use Intrauterine Insemination. The results of sperm test must be normal or near normal. Additionally, women must not be suffering from adenomyosis.

What kind of process does IVF involve?

         Women menstruating regularly have only one egg. It is aimed at increasing this number by using hormonal drugs in IVF.  Although each therapy protocol varies, there are two essentially parallel hormonal therapies that provide ovum development and block ovulation. Ultrasound and blood tests are carried out during hormonal therapy to follow ovum’s development and regulating dosage if necessary. Mature ova are collected with a simple needle aspiration technique and made fertilized by sperms. Ovum collecting process is performed under general anesthesia as well as sedation and local anesthesia. This process of fertilization occurs by both placing sperm with ova in classical IVF technique and injecting each sperm to an ovum under microscope. The doctor explains which techniques is best for you. Fertilized ova are left in the laboratory for 2-3 or in some cases 5-6 days to develop in heat and atmosphere controlled culture environments and embryos develop. The best qualified embryos are picked up and placed back into women’s uterus, which the number of embryos is discussed with couples. The process of transferring embryo does not require anesthesia ve sedation except for rare cases.

In which cases are IVF used?

   It should be consulted a center of IVF about infertility if pregnancy can not be achieved in one and over year despite of unprotected regular sex.

Until what age can IVF qualified for couples? What age is too late for IVF?

   Women’s ovarian reserve is tested at first in IVF. It is evaluated by hormonal tests and ultrasound on the third day of menstruation. If ovarian reserve test has a good predictive value, IVF can be performed up to age of 45. However, embryo is needed to be analyzed in term of chromosome because of negative effects of aging. Moreover, women over 38 starting IVF should get preimplantation genetic diagnosis (pgd) done to analyze embryo. Women’s number of eggs decreases, ovulation does not work well, the quality of age gets low after age of 35. Even if ovarian reserve is good for IVF, it has low possibility to get success. Thus, it is important for women having fertility problem to start IVF without losing time. There is not a technique for old, aged women having problem in ovarian reserve to get pregnant. Old age women eager to have a baby and having low ovarian reserve can get pregnant by egg freezing in out country. Pregnancy over the age of 35 are considered high risky and it should follow by perinatologists .

Is there age limit in IVF for men?

   Men produce sperm through their whole life, but quality of sperm decline as they get older. 54 percent of sperm quality may decline in men over the age 50. It may be resulted from DNA’s impairment.

Is there a risk of multiple pregnancy?

   Embryos transferring more than two is forbidden according to Assisted Reproductive Techniques Regulations in our country. The rate of twin pregnancy is rather low with one embryo while it is about one third with two embryos. Three or four babies rarely occur with two embryos; one of embryos or in some cases two of them split and turn to identical twin. Couples that can not having a baby for a long time despite of IVF AND IUI may be eager to get multiple pregnancy. Doctor and couples should decide together to be transferred the number of embryo because it is risky. Embryos not transferred can be frozen and stored for 5 years. The rate of multiple pregnancy with assisted reproductive techniques is between 20 and 30 percent. A big part of multiple pregnancy consists of twins and  rarely trines and more.