1)It will be made a treatment plan.

In this stage it will be listened to couples what they have been done in the past of treatments, pregnancy, birth, miscarriage. The former assay and film results will be evaluated. The IVF treatment process will start the 2. or 3. day of her period. First day it will be ultrasound check. See about it is any hardship in the ovaries and in the womb, we look at the FSH and estrogen levels in women’s blood. If conclusion is appropriate to starting treatment, the age of women, infertility and the blood results, after that is will be selected type of treatment after capacity of ovaries, then starts hormone therapy to allow oviposition. The so-called controlled ovarian stimulation at regular intervals to assess response to treatment and egg development in this period with ultrasound and blood hormone evaluate the development periode.

2) Stimulation of the ovaries

The first step of the treatment, ovarian hormone injections are warning as many as possible to obtain good quality eggs from 16 to 20 mm diameter. The reason to create a large number of eggs, is to creat many embryos as posible and selecting the best embryo, placed into the uterus. This is the reason to creat many embryos, not just one.

The development of eggs is determined by taking intermittent ultrasound and blood estrogen levels. Comparison tube baby treatment at a dose of 20-30 eggs obtained when applying the medicine, but nowadays sa many eggs to increase the costs of treatmenti which has been shown to increase the of complications and that increase the success of the treatment. Our current knowledge is no longer with us but we’ll get fewer higher quality eggs “mild” treatment shows that there are more accurate. The second or third day of menstruation, hormone will applied with needle under the skin, the average of this process is about 9 days. The person under treatment will be teached how to making self injection by our team. Some of the needle must be done in the morning and on the afternoon. Usage hours is not so important, there is flexibility to 1-2 hours early or late. In some cases the cure will start on the 21st day of the menstrual cycle, or a pre-treatment is applied with the use of birth control pills. Sometimes oral medication is using to support needle to ovulation. To follow the development of follicles in which the eggs are 3, 4 or 5 times is called the control mothers. Doings checks satiated stomach in the morning hours. If the ultrasound is done in the controls and the need for hormonal evaluation. Drug doses are regulated by the doctor. Information is given about the timing of next control to the family. The controls do not need to participate in the candidate father.

3) Collection of eggs

Approximately after 10 days process of ovarian stimulation, sufficient number and size of follicles reaches, the egg ripening hormone hCG is done with a needle end (pregnyl or Ovitrelle). This needle, among the people “egg cracking needle” as the pass. The collection of eggs is planned after 36 hours of construction time of this needle. This needle should be encouraged to do at the specified time. There is no flexibility available. Mothers should come to hospital with empty stomach for the collection of eggs (without eating and drinking anything for 8 hours 4 hours). Egg collection procedure, anesthesia sedation for patients to feel the pain (sleepiness) under, is accompanied by transvaginal ultrasonography. Collecting the liquid in the follicle during this process, depending on whether the egg is received in liquid, then we collect the eggs. If we can not find egg in follicular fluid, the follicle will be washed with special liquid. The attempt to reach the eggs that may have been left inside the follicle. Egg collection procedure takes about 20-30 minutes. After the procedure, patients can be sent home after being followed by 1-2 hours. The next step in this cases, the selection and fertilization of eggs will be collected and transferred into the uterus.

Same day as the Egg collection day, they will be asked to give sperm from the father candidate. The men who can not produce sperm, it will be used TESA MICRO Method to get sperm.

What is micro-TESE surgery? How is it done?

Many Years ago TES surgery was performed, now it has been left it to micro-TESE method. TESA Method is, it will be taken a small piece of testicular tissue with surgery but, TESA MICRO method is, by using a microscope during surgery to find the area with sperm, and tissue samples will be taken from this area of the testicle. Thus, not only increases the chances of finding a small amount of sperm in the testicle but it prevents damage to the testosterone hormone. Surgery is usually performed under general anesthesia by urology specialists.

For the fertilization process, sperm samples being obtained from fathers. For this purpose, is to understand how many days of sexual abstinence the father is needed, information shall be communicated to the family by IVF team.

4) Fertilization Process (IVF or ICSI method)

After the mature MII oocytes and fertilized eggs has been selected, 6 hours after the egg collection day, the fertilization will be performed in laboratory conditions. According to the condition of sperm cells, fertilization will happen with classic method (IVF), or in special cases to increase the chances, will fertilization will done by microinjection (ICSI- intracytoplasmic sperm injection) into the egg with this method can also  the sperm be given directly to the egg.

5) Development of the Embryo Laboratory Environment

The day after the fertilization process eggs will be controlled and about the eggs are fertilized or not will be checked. At this stage, the laboratory team will examine how many eggs are fertilized and the team will call the family to tell what day transfer will happen. The embryos are stored in devices called lab incubator and progress will be monitored.

6) Embryo Transfer

Embryo transfer; Considering the number of fertilized eggs and evaluating the quality of the developing embryo, after the embryo retrieval transfer will be performed from the next 2, 3, 4, 5 or 6 days. For each couple it may be different success transfer day.For some families, while day 2 or day 3 more appropriate in terms of the chances of pregnancy can provide the highest performance on the 5th day of the transfer to some other couples. Before the embryo transfer, doctor gives information about the quality and the quantity of the embryos to be transferred. You do not need to be with empty stomach for the embryo transfer. The day family will be called in to the hospital for embryo transfer, they need to spend time in the hospital for 3-4 hours. Then there is not a exact time period to be make the transfer of absolute in that same day. Transfer will performed after the intensity of the center at an appropriate time.It needed a sufficient amount of urine from the mother prior to transfer. Transfer is performed under ultrasonographic observation and is no different from a normal gynecological examination. Embryos are selected via a catheter is left inside the uterus. Process painless and comfortable application does not require anesthesia.

After the transfer the mothers will be discharged after 1-2 hours of rest. If there is any doubt about the adhesion of the embryo, the family can travel to their country / city with out any problems.

The transfer process is easy, but is an important step. There is important to not stress it will be useful to you.

If there is a quality embryos, they will be used from your remaining embryos frozen and stored.

7) Testing and Tracking Process

Two weeks after the embryo transfer, its possible to check about you are pregnant or not in blood beta HCG test. In this waiting period, you should be careful to stay away from stress. Two days later, the patients with a positive pregnancy test results are asked to repeat the test again. The relationship between the results of tests carried out two days apart evaluated by assessing whether to continue the pregnancy healthy. The presence in the blood of a healthy pregnancy pregnancy (β-hCG) test should be determined approximately two-fold increased when viewed two days apart. About 10-15 days after the conclusion of the pregnancy test is positive start appearing gestational sac on ultrasound.

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