Frequently asked questions about IVF treatments

No. Some of the hundreds of eggs discharged every month by the ovaries are made available for use via hormone treatments. Thus, not selected, but the ones to be discharged are used for that month. So the procedure does not speed decline of egg production.

No. In terms of, for instance, illnesses, these babies are no different than babies born in natural ways. These babies inherit their parents’ genetic code and use the common gene pool to continue their species.

With medical support during the first three months of pregnancy, the rates of miscarriage are similar to those of normal pregnancies.

Embryos obtained in quality centres and not used can be frozen stored (cryopreservation) for five years with the written consent of the couple.

No. This genetic diagnosis method can only assess certain diseases. In some required cases, it allows the couples to choose the embryo suggested.

It is the embryo which has more potential of providing pregnancy during the process of embryo selection, which is done in order to determine the stronger embryo, in the lab until the fifth day of embryo development.

No. If you haven’t had a surgical operation and if the scan does not date back more than 3 years, you don’t need a new scan.

Some centres may choose to have an office hysteroscopy test scan (Office H/S) which is simpler and less painful instead of a new HSG if your HSG not new. In an office H/S the inner parts of the uterus can be monitored easily by using a transvaginal camera.

We prefer that you or your partner do the injections. It is possible to learn the application of medication which usually involves injection with a small needle under the skin in a short time. Even if you do not want to do this, learning how it is done will let you check the ones who do it for you. Medication to be used in IVF will be explained to you in detail.

The length of the OPU (ovum pick up) depends on the number of follicles in the ovaries. Yet, on average, it takes about 15-30 minutes. Considering pre-procedure preparations, the procedure itself and post procedure and rest, you should at least allocate 3 hours for the procedure.

OPU (ovum pick up) is not a very painful procedure which can be done even without any medication. Nevertheless, intravenous sedatives and painkillers help to go through the procedure in the least discomfortable way. Besides, if a patient chooses to be fully sedated during the procedure, the doctor can make arrangements accordingly.

You might feel sleepy due to the anaesthetic effects of medication. There might some abdominal discomfort. If you feel well enough, you can go back to work the next day.

No. However, if there are plenty of follicles, it might not be possible to count all properly. In that case, there might be more eggs than monitored via ultrasound scan. However, if ultrasound scan shows few follicles, there is a chance of not having any eggs.

Rarely, in some cases, although there are lots of follicles in the ovaries, there might be no eggs within the follicles (empty follicle syndrome). Although this situation is known as to be a result of “apoptosis” which leads to the early decline of the ovaries/eggs, the mechanisms behind it cannot be explained fully.

The average fertilization rate is 65%. Some couples may experience a higher rate, whereas, although rarely, some couples may, unfortunately, see no fertilization.

In OPU, eggs are collected by entering the ovaries via transvaginal ultrasound with a thin needle. After they are collected, mature ones are determined and then, they are prepared for fertilization.
Sperm is collected by masturbation from men, whose semen contains sperm. For those whose semen does not contain any sperm, there is the option of searching for sperm via a surgical operation to the testes and if found, they are collected.
These types of patients are known as azoospermic males, and the chances of finding sperm in that way is about 50%. If azoospermia is a result of obstruction, then sperm can definitely be found.

They can be frozen anytime up to six days after fertilization decided by the IVF team.

No one knows for certain. However, laws limit this duration to three years. It is known that storing for this and even longer periods of time proved successful.

Not all embryos show the desired development. In order to freeze them, they should be at a desired development and shape. If you have frozen embryos before the day of embryo transfer, you should be made aware of that.

You can go back to your daily life in two days after the transfer. If your job is stressful and tiring, you may want to talk to your doctor about it.

You shouldn’t have sexual intercourse until we get the results for pregnancy tests.

You can lie down on a bed in a position you are comfortable with or you may sit on a chair. Except for WC and such essential needs it will be enough to rest for a few days. If you live out of town (in another country), we suggest you rest for one day before the travel.

You can have a warm shower the day after the operation. We suggest you refrain from having hot baths.

• The response of the ovaries may be insufficient, thus, the treatment may be cancelled before ovum pick up.
• Although the ovaries may produce follicles, there might not be any eggs in them. There are two main reasons for that. The follicles might just be empty (empty follicle syndrome). This case is seen in less than 1% of the patients. In the other case, the follicles might hatch prematurely; before ovum pick up. This is seen in about 2-5% of the patients depending on the stimulation protocol applied. In such a case, the ovum picked will be empty.
• The eggs might not be fertilized. This is a very rare occasion in the century of microinjection. However, due to defective eggs, in about 2-5% of the patients’ eggs may not be fertilized (fertilization failure).
• Eggs fertilized may not divide. This, also, is a rare case and is, usually, due to defective eggs.
• In azoospermic men, sometimes it is not possible to find any sperm even after surgery. In such a case, the treatment will be cancelled before ovum pick up.
• Sometimes in PGD, healthy embryos cannot be found. Thus, embryo transfer is not possible.

Although it is stated by some that the stimulation of ovaries may lead to increased risk of breast and ovarian cancer, this hasn’t been proven yet. Because infertility is already a factor for the risk of cancer, the increase of risk observed in some studies is not definitive in deciding whether the cause is the treatment or infertility.

Studies and long-term observations are still continuing on this issue. It is suggested for women who have received IVF treatment not to skip any of their regular annual gynaecological examinations and (depending on their age) mammography.

It is known that the risk of ovarian cancer is higher in women with a family history of this type of cancer and who live in industrial societies; however, it is also known that pregnancy, breastfeeding and birth control pills decrease the risk.

A one-month-break will be enough to start the second trial. There are no differences between waiting longer or that much in terms of the success of the treatment. The couple’s mental state and budget are more important. For couples who feel ready, trials can be maintained without giving long breaks. Although the chances of pregnancy are almost the same for the first three trials, the rate decreases after that.

IVF pregnancies carry a higher risk of premature births and miscarriages compared to normal pregnancies. Besides, the risk increases with genetic anomalies such as azoospermia.
The risks of premature birth or miscarriage are higher in IVF pregnancies. Besides, in some specific cases, (ex: azoospermia in men) especially with genetic anomalies, the risk may slightly increase.
In addition to those, being pregnant for twins, for a start, multiple pregnancies bring their own complications to women. For such pregnancies, the most important and risky period is the first three months of pregnancy. Close care and monitoring are required in this time.

It is not possible to produce sperm out of stem cell, yet. Studies to develop immature sperm cells in a laboratory and then having pregnancy with those have been tried a lot; however, there have been very limited numbers of pregnancies. Thus, this method has been abandoned.
There is still need to get mature sperm or a spermatid having started to develop the tail for microinjection in azoospermic patients from whose testes biopsy samples are taken.

There are lots of statistical criteria to evaluate the success of a centre. The most common ones are “the pregnancy rates after transfer” and “the rate of having and bringing a child home”. The latter means the success of pregnancy after IVF treatment and involves the birth of a healthy baby taken home. This may be the most important criteria.
There are many factors affecting the success of IVF treatment, yet, the most important ones are the condition of the laboratory, the laboratory’s efficiency and the skills of the person handling the transfer.