Frequently Asked Questions

In insemination, fertilization is assumed to occur inside the body, but this is not confirmed. In IVF, fertilization takes place in a laboratory environment and can be verified.

Endometriosis, which is quite common in women of reproductive age, is a condition in which the tissue lining the inside of the uterus (endometrium) is found in another area, such as the ovaries or inside the abdomen. Since this tissue also bleeds during menstruation, severe pain may occur. In addition, due to the damage caused by this bleeding, pelvic pain may develop during sexual intercourse or at different times. This disease can also lead to cyst formations in the ovaries that are dark brown in color and known as chocolate cysts. These cysts can be removed with laparoscopic surgery, and it may also be possible to burn damaged tissues and endometriosis foci using methods such as cautery or laser. In milder cases, results may also be achieved with medication. Although these treatment methods may stop or reduce the progression of the disease, pregnancy may still not occur. In this case, the chance of having a child may be achieved through IVF treatment.

Embryo transfer (ET) is usually performed three days after egg retrieval. However, if it is considered more suitable for you, your embryo transfer may be delayed until the 5th or 6th day. The timing of the transfer will be clearly communicated to you by the IVF team. Embryo / embryos with normal development are selected for transfer. The recommended approach is usually the transfer of 2–4 embryos. The final decision is made by the family and the doctor. Transferring a high number of embryos may result in more than one embryo implanting in the uterus. If you have embryos with sufficient development remaining after the transfer, they will be frozen. The transfer procedure is a very easy and painless application. A very thin special catheter containing the embryos is passed through the cervix of the woman in the gynecological examination position and placed into the uterus. The embryos inside are injected into the uterus with the help of a syringe. During the transfer, the bladder needs to be partially full in order to visualize the uterus with the help of ultrasonography. It is a procedure that takes approximately 10–20 minutes. After the transfer, you will be informed about the medications you will use, the blood tests you need to have, and the matters you should pay attention to.

Not all embryos may always show the desired development. For the freezing process, all embryos must have development and appearance at the expected level. If you have an embryo frozen before the embryo transfer day, you will be informed during the transfer procedure. If this procedure is to be performed in the following days, the embryologist will inform you by phone.

The baby’s growth and development should be monitored carefully in particular. At the same time, the expectant mother’s blood pressure follow-up, rate of weight gain, and blood and urine tests should not be neglected. Expectant mothers should be given special information about nutrition. Other situations where information is very important include gestational diabetes, preeclampsia, and premature labor. In general, everyone should be made aware that they should immediately apply to a healthcare institution in all situations that cause fever, pain, or bleeding. Preeclampsia, which can be detected in the early stages with a simple blood pressure measurement and some simple tests and can be treated, may become more difficult to treat when diagnosed late. For the early diagnosis of this condition, which seriously puts the lives of the expectant mother and the baby at risk, regular antenatal check-ups should be attended even if there are no complaints.

Check-ups should begin as soon as your pregnancy is diagnosed. When the expectant mother suspects pregnancy or when the pregnancy test is positive, she should start doctor’s check-ups. The purpose of early antenatal examinations is to identify risk factors and create a follow-up plan. It is possible to diagnose abnormal pregnancy conditions such as ectopic pregnancy and to determine whether the pregnancy week calculated according to the last menstrual period is compatible with the pregnancy week detected by ultrasonography. The first doctor’s check-up is very important. Since the margin of error in determining gestational age by ultrasound is ± 3 days, this is guiding in cases where a decision regarding premature birth must be made, and in situations such as overdue pregnancy, it helps accurately determine the date on which labor should be initiated by the doctor. Expectant mothers who could not apply in the early period should also apply for an antenatal examination as soon as the pregnancy is diagnosed. In the first 3 months of pregnancy, the expectant mother’s health status should be evaluated. In fact, ideally, it is recommended that these screenings and folic acid use begin at least 1–2 months before deciding on pregnancy. However, it is never too late to take the right step. Hidden thyroid problems, hidden diabetes, infectious diseases, anemia, and vitamin deficiencies are investigated and, when detected early, can be successfully treated. Pregnancy will proceed more healthily for both the expectant mother and the baby.

Doctor’s check-ups performed at certain intervals by an Obstetrics and Gynecology Specialist during pregnancy are called antenatal, or prenatal, examinations. Even if she has no complaints, it is extremely important for the expectant mother to visit her doctor at regular intervals, both for her own health and for the health of her developing baby. Most expectant mothers go through a healthy pregnancy period without experiencing any problems and have a healthy baby after a completely normal birth. Our purpose is not to intervene in a pregnancy that is progressing without problems, but to detect a possible problem at an early stage and try to resolve it before it reaches an irreversible stage.

Many events that were previously attributed to “bad luck” or “fate,” such as maternal and infant deaths, or giving birth to a disabled or stillborn baby, have now become largely controllable. An expectant mother who does not consult a specialist physician at all during pregnancy because she has no complaints will most likely also have a healthy pregnancy and a healthy baby. However, there are many medical conditions that may show no symptoms throughout pregnancy or may appear after a long waiting period. There are many diseases that can be treated easily when diagnosed early. In the later stages, what can be done for these diseases is limited, and situations that endanger the health of the expectant mother and/or the baby may occur. There are many examples of pregnancies progressing in an unhealthy way despite causing no complaints. Especially during pregnancy, some bacteria in the urinary tract can multiply silently without causing any symptoms. Detecting this condition with a simple urine test is very important. This allows precautions to be taken before serious infections develop. Untreated urinary tract infections may create risks for the expectant mother such as fever, kidney inflammation (nephritis), and kidney failure, and for the baby such as premature birth and growth restriction. Terminating unhealthy pregnancies becomes more physically and emotionally difficult for the expectant mother as pregnancy progresses.

If there is no sperm in a man’s semen sample (azoospermia), microinjection cannot be performed directly. Although sperm cannot be ejaculated in men with this condition, there is a possibility that sperm may be found inside the testicular tissue or in the ducts that carry sperm. After urological examination and various tests, in patients who are considered likely to have sperm in the testicular tissue or ducts, microinjection can be successfully performed using sperm obtained from the testes or ducts. TESE (Testicular Sperm Extraction) is the process of finding sperm in the testes in men whose semen sample contains no sperm and who also do not have obstruction in the ducts. This procedure may also be performed in cases where all sperm in the semen sample are immotile (total immotility), with the hope of finding motile or a higher proportion of live sperm. In couples who will undergo TESE, the man is first taken into surgery on the day the eggs will be collected from the woman or one day before. Under local or general anesthesia, tissue samples taken from the testes by the doctor are sent to the laboratory to investigate whether they contain sperm. Tissue samples continue to be taken until sperm are found or until it is concluded that there are no sperm (multiple biopsy). If sperm are found, the woman’s eggs are collected and the microinjection procedure is performed. If no sperm are found, the woman’s eggs are not collected and the treatment steps are stopped. In cases where there is a risk of ovarian hyperstimulation syndrome (OHSS), even if sperm are not found during TESE, egg retrieval may be performed to protect the patient’s partner. In some patients, this procedure can be performed without the need for surgery, with the help of a thin needle, and sperm can be obtained (TESA or TEFNA). Alternatively, a biopsy may be performed on the man before the woman is prepared for the procedure, and the sample taken is sent both for pathological examination and to the embryology laboratory to investigate whether sperm are present. If sperm are observed in this sample, the tissue is frozen and stored. After this stage, the woman begins treatment, and on the day the eggs are collected or one day before, the frozen tissue is thawed and ICSI is performed with the sperm found. This provides the chance to make more than one attempt with a single intervention, and if there are no sperm, the woman is not exposed to unnecessary treatment and stress. The only and most important disadvantage of this practice is that in cases with a limited number of sperm, sperm may not be found during the thawing process. In recent years, the micro-TESE method has been developed to increase the chance of finding sperm in the testes of azoospermic men. This method can be summarized as opening the testes and examining the tubules where sperm are produced under an operating microscope. This practice is successfully used in our center in collaboration with a urology specialist. MESA (Microsurgical Epididymal Sperm Aspiration) is the procedure of obtaining sperm from the ducts of men under local or general anesthesia by microsurgical method (MESA) or directly through the skin with a needle (PESA) in cases where there is no sperm in the semen due to blockage of the sperm-carrying ducts, either congenital or caused later by various diseases, trauma, or surgeries (obstructive azoospermia). The obtained sperm are then injected into the eggs obtained from the woman by the microinjection procedure. At Irenbe IVF Center, all these procedures are performed by specialist doctors experienced in these fields. You do not need to stay at our center for these procedures, and if no problem occurs, you can rest for a while after the procedure and then go home. If pregnancy is not achieved as a result of the procedure performed, procedures such as TESE or MESA can be repeated.

Fibroids are masses containing irregular uterine muscle tissue. Almost all of them are benign in nature, but in 1 out of 1000 cases, they may become malignant. Especially types that are closer than 0.5 cm to the inner lining of the uterus (endometrium) and create pressure should be removed. Likewise, removal is preferred for fibroids larger than 4–5 cm, as they may disrupt blood flow.

It definitely has a negative effect. It has harmful effects on both egg and sperm quality.

Despite close and careful follow-up, the ovaries may be overstimulated (OHSS). Multiple pregnancies may occur. Inevitably, metal needles are used during the egg retrieval procedure. This creates a potential risk of injury to the bladder, intestines, uterus, fallopian tubes, or blood vessels. A simple problem may occur, or internal bleeding and/or infection that may require hospitalization may develop. This risk is less than 1/1000. Intra-abdominal adhesions and/or technical reasons may prevent egg retrieval from the ovaries. Before the egg retrieval procedure, this procedure may not be performed due to spontaneous ovulation. No eggs may be obtained from the aspiration of egg cysts, or all of the eggs obtained may not be mature. This may prevent embryo formation. The collected eggs may not be normal. The semen sample may be of very poor quality and may have characteristics that make it unusable for the procedure. The eggs may not fertilize. The fertilized eggs may not divide and form embryos. The embryos may not develop normally. If the embryos do not develop or are not viable, the transfer procedure may not be performed after discussing the situation with the couple. Placing the embryo into the uterus may be technically difficult or impossible. This undesirable situation is usually caused by structural/anatomical abnormalities. Some or none of the transferred embryos may attach to the uterine wall. Not every embryo that attaches to the uterus, meaning implants, may always develop normally and reach birth. Medical device failures, infection, human errors, or unforeseen factors may lead to the loss of or damage to eggs, sperm samples, or embryos.

Quit smoking. Many studies suggest that smoking reduces pregnancy rates. If you cannot quit completely, even reducing the number of cigarettes, especially in the period after embryo transfer, may have a positive effect. It would also be appropriate for the male partner to quit smoking in the same way, preferably starting a few months before the procedure. Do not use medication without consultation. The only medications you may take without consulting IVF doctors are painkillers containing “acetaminophen” (paracetamol), such as Parol, Tamol, etc. Other medications may also be taken, but some of them are dangerous; therefore, do not use medication without the knowledge of the IVF team. Nonsteroidal anti-inflammatory drugs, such as those containing salicylic acid, naproxen sodium, or indomethacin, must definitely not be used during the IVF cycle. Do not consume alcohol. Men and women should not consume more than two glasses of alcohol per day before the egg retrieval procedure. After embryo transfer, the female partner should avoid all alcoholic beverages. Do not take hot baths or use saunas. High temperature has been shown to have a negative effect on sperm motility and on the embryo in the uterus. Men should avoid high temperatures starting at least 90 days before the egg retrieval procedure, and women should avoid high temperatures after embryo transfer.

If, as a result of the examinations, it is decided to proceed with IVF or microinjection procedures, some additional tests such as Complete Blood Count, Blood Group, Hepatitis, AIDS, Rubella, etc. will also be required. After discussing the couple’s problems, a detailed physical examination is performed in every respect. Keep in mind that not giving accurate information to the doctor due to feelings of embarrassment may lead to many unnecessary procedures and financial burden. As a result of the evaluation and according to the identified cause, after the most suitable treatment method for you is determined, a detailed explanation about this treatment method will be provided to you, and your treatment will begin at the appropriate time.

A healthy couple has a 20% chance of conceiving in one month. With each application of assisted reproductive techniques, this chance can increase up to 50%. However, despite these encouraging results, no IVF program can guarantee a successful pregnancy and childbirth, even with multiple attempts. Many factors affect success. These are not limited only to the patient’s age, the cause of infertility, and the experience and skill of the IVF team. Today, more than twenty years after the birth of the first IVF baby, “assisted reproductive techniques” have made significant progress. This has had a positive impact on pregnancy rates and live birth rates. It is believed that babies born as a result of IVF do not differ from babies conceived naturally in terms of congenital abnormalities, genetic abnormalities, intelligence problems, etc. However, multiple pregnancies may result in premature birth. Problems related to this may be observed more frequently in IVF pregnancies. While IVF pregnancies generally result in healthy births, they may also result in miscarriage or stillbirth at rates similar to pregnancies conceived naturally. The risk of ectopic pregnancy also exists for IVF pregnancies. In transfers involving more than one embryo, an ectopic pregnancy may occur together with an embryo implanted in the uterus. This is called a “heterotopic pregnancy.” In this case, it is possible to treat the ectopic pregnancy while preserving the pregnancy inside the uterus.

Insemination treatment is a method that dates back many years. The partner’s sperm is washed with a special saline solution and centrifuged; then, with different collection methods, motile sperm are separated from dead tissue, cells, and discharge. In this way, mostly motile and good-quality sperm are delivered directly into the uterus with the help of a thin catheter. While this procedure can also be performed with normal sperm parameters, the total number of progressively motile sperm, sperm morphology, the female partner’s age, and smoking are parameters directly related to success. Insemination treatment is not recommended for more than 3–4 attempts, because after the 4th attempt, it is rare for new attempts to result in pregnancy. Insemination treatment is not performed in patients whose both tubes are blocked. In cases where one tube is open, determining the condition with laparoscopy is important. Although the chance is lower in patients with one blocked tube, pregnancy is still possible.

Ectopic pregnancy and molar pregnancy cases may show no symptoms in the early period. However, in both conditions, treatment success is very high with early diagnosis. A simple examination and ultrasound evaluation performed during this period are sufficient to diagnose an abnormally progressing pregnancy and take precautions. Disabilities that would make survival after birth absolutely impossible, such as anencephaly, meaning the baby’s brain tissue does not develop, can be diagnosed with an ultrasound examination performed in the early stages, and this pregnancy can be terminated without putting the expectant mother at risk. If this examination is not performed, the pregnancy may continue until the end despite the baby having a severe disability. Starting ultrasound screenings from the early period is important in this sense. With first trimester ultrasound screening and the double screening test, the risk of chromosomal diseases is investigated. In suspicious cases, prenatal diagnosis serves expectant mothers as a new field of science whose boundaries are gradually expanding.

Egg retrieval is not a very painful procedure and can even be performed without using any medication. However, today it is carried out with minimal discomfort by using sedative and pain-relieving medications administered intravenously. In addition, patients are put to sleep by an anesthesiologist.

Almost all egg retrieval procedures are performed with the help of ultrasound through the vaginal route, called transvaginal ultrasonography. Other access methods are laparoscopy or transabdominal ultrasonography. In the transvaginal method, the ovaries are visualized with an ultrasound probe placed in the vagina. Through a needle advanced toward the ovary by passing through the vaginal wall, the fluid inside the follicles is aspirated. The egg that comes with this fluid is found under a microscope and collected. This procedure usually takes less than 30 minutes. GnRH analogues are used to prevent the follicles from rupturing earlier than expected. However, rarely, they may fail to do so; the follicles may rupture before the egg retrieval procedure, and the eggs may scatter into the abdominal cavity. This event is called spontaneous ovulation. In this case, the procedure is cancelled. It is performed using intravenous general anesthetic medications, which are a type of general anesthesia. The patient is in a complete sleep state and is unaware of what is happening around her. In this type of anesthesia, placing a tube into the airway to provide breathing, called intubation, is generally not necessary. This procedure is performed by an anesthesiologist.

A woman’s menstrual pattern contains important clues about ovulation. Irregular or abnormal ovulation is detected in 25% of all infertile women. Basal body temperature tracking is a simple and inexpensive method for determining whether ovulation occurs. The progesterone hormone secreted after ovulation prepares the inner lining of the uterus for the implantation of a fertilized egg 12–16 days before menstruation. For basal body temperature tracking, the woman measures her body temperature orally every day after waking up, before getting out of bed, and records it according to the menstrual day. Normally, due to the progesterone hormone secreted after ovulation, body temperature rises by about 1 degree during a period that corresponds to the middle of the menstrual cycle. However, if ovulation does not occur, there is no temperature change. Since this tracking can be affected by many factors that influence body temperature, such as a cold, it is not definitive. Your doctor may ask you to use special urine test strips that detect “luteinizing hormone” (LH), which stimulates ovulation and is excreted in the urine after being secreted, in order to monitor ovulation. Endometrial biopsies taken from the inner surface of the uterus 1–3 days before the expected menstruation are helpful in determining whether ovulation has occurred. Biopsy procedures can also evaluate whether the progesterone hormone is secreted sufficiently. However, today this has been replaced by measuring the blood level of progesterone hormone, which indicates the presence of ovulation. Ultrasonographic follow-ups and measuring blood progesterone hormone levels between the 19th and 24th days in women who menstruate every 28 days help confirm the presence of ovulation. With ovulation medications, ovulation can be achieved in approximately 80% of women. If there is no other cause, more than half of couples may become pregnant during the first six ovulation treatment cycles.

A gynecological examination is performed on special examination tables designed for this purpose. Before starting the examination, it is useful to empty the bladder. In addition to the gynecological examination, we also recommend performing a breast examination. During the gynecological examination, any abnormalities are noted. Then, the speculum examination is performed, which allows the inside of the vagina to be observed. With this instrument, the vaginal walls can be separated from each other. A warm and lubricated speculum is advanced into the vagina, and during this process, the vaginal walls, vaginal discharge, and, if discharge is present, its characteristics are observed. Afterwards, the speculum reaches the cervix at the upper part of the vagina. The cervix is evaluated. Cervical ectropion, erosion, cervical discharge, and cervical cancer can be detected with this examination. At this stage, a sample is taken from the cervix for a test called a smear test. No pain is felt at any stage of these procedures. The width and flexibility of the vagina are evaluated, as well as whether there is any herniation of the bladder toward the vagina, called cystocele, or of the intestines, called rectocele. This herniation and uterine prolapse are also observed during straining. Ultrasound evaluation has a very important place in gynecological examination. With gynecological ultrasound, the lower abdominal organs, especially the uterus and ovaries, are evaluated in detail. With ultrasound, the structure, position, and size of the uterus, tumors originating from the uterus, and fibroids can be detected; at the same time, the inner lining of the uterus, called the endometrium, is also evaluated and necessary information is obtained. Similarly, both ovaries are also identified by ultrasound. The structure of the ovaries, their egg development capacity, ovarian cysts, and tumors are detected by ultrasound.

It is a screening test performed to detect precancerous changes in the cervix. It is recommended to be performed once a year in women over the age of 18 who have started an active sexual life. For those with viral infections such as HSV or HPV, and for those who have previously been diagnosed with low- or high-grade cervical lesions (CIN), it is recommended to be performed every 6 months.

The most suitable period is the week after menstruation ends. There should be no sexual intercourse for 2–3 days before the test, and vaginal suppositories or creams should not have been used. Vaginal douching should also not have been performed. In addition, a smear is not taken in cases of vaginal bleeding or intense vaginal infection with heavy discharge, as these may affect the result. During menopause, the smear test should not be neglected along with annual mammography and bone density measurement. Although it is more appropriate to perform it before pregnancy if possible, we definitely recommend it at the beginning of pregnancy if a smear has not been taken before. This is because, unfortunately, the most common genital cancer during pregnancy is cervical cancer. Contrary to common belief, a smear test taken during pregnancy has no harm to either the baby or the mother.

One of the most important factors in IVF treatments is laboratory conditions, and they play a very critical role in the success of the treatment. Achieving maximum efficiency from the laboratory is primarily possible through a well-planned and organized laboratory, advanced technological equipment, experienced embryologists, meticulous work, and the establishment of a serious quality control system. Since the factors that determine success are always hidden in the details, it is essential that the working environment and devices are checked regularly and frequently, and that any problems are resolved immediately.

In IVF treatment, the number of embryos to be transferred varies between 1 and 2. When determining the number of embryos, the woman’s age, the quality of the embryos, and previous IVF attempts are taken into consideration. According to the relevant regulation in Türkiye, in women under the age of 35, 1 embryo may be transferred in the first two IVF treatments, and a maximum of 2 embryos may be transferred afterward. In women aged 35 and over, a maximum of 2 embryos may be transferred regardless of previous IVF attempts.

Before deciding on which day embryo transfer will be performed, the embryology team and doctors should definitely make the decision together by considering the patient profile. When deciding on embryo transfer, certain main factors should be taken into account. First of all, each patient should be evaluated individually. The reason for choosing IVF treatment, the results of any previous attempts, the woman’s age, embryo development characteristics, whether PGT (preimplantation genetic testing) will be performed, the number of eggs obtained and embryos developed, and the daily development of the embryo are evaluated, and then the day of transfer is decided. Embryo transfer can be performed on days 2, 3, 4, 5, and 6, with the earliest being the 2nd day and the latest being the 6th day.

These embryos, which are not transferred but have a high chance of pregnancy and show good-quality development, can be frozen and used at a later date. Frozen embryos can be stored for up to five years, provided that written consent is obtained from the couple. In this way, with a simpler method, the financial and medical burdens that a new IVF treatment would bring to the couple can be reduced.

In order to identify the better embryo during embryo selection, it is an embryo that is monitored in the laboratory until the fifth day and has a higher pregnancy potential. The zygote, meaning the fertilized egg formed by the fertilization of the egg and sperm cell, begins to divide, multiply, and develop. This occurs in the same way in both natural pregnancies and fertilization achieved through IVF. After fertilization, the egg divides and becomes a group of 2-cell, 4-cell, and 8-cell cells. On the second and third days, it is a cell mass consisting of 4–8 cells and containing no cavity. By the 5th day after fertilization, it becomes a structure surrounded by cells and containing a cavity inside; this form is called a blastocyst. In pregnancies that occur naturally, the blastocyst is the form the embryo takes just before attaching to the uterine wall.

First of all, in order for embryo freezing/thawing treatments to be used effectively, the center providing treatment services must offer a very good cryopreservation service. However, many factors, from technological infrastructure to the experience of embryologists, can affect achieving the desired success from the result. Along with advanced technological infrastructure, the quality and selection of the embryos to be frozen are very important in the first stage. Afterwards, the method to be used during freezing and the experience of the embryologists come into play. Due to these factors, although many IVF centers offer embryo freezing and thawing services, there are significant differences between their success rates in treatment. In a good and high-quality IVF center, the number of patients who are given the chance of embryo freezing is high. However, one of the even more important points is that the chance of pregnancy obtained with frozen and thawed embryos is at least as high as treatments performed with fresh embryos, and may even be higher because the treatment is carried out in a more natural uterine environment.

With technological possibilities, changes are also occurring today in the patient profile for whom embryo freezing is recommended. In the past, this method was recommended for couples who had a certain number and quality of embryos, but today it can also be recommended for couples who have a single good-quality embryo. The important point is that the embryo’s level of development and quality are suitable. The embryo freezing option is an effective solution not only for couples who have remaining embryos after treatment, but also in cases where treatment needs to be stopped or postponed. For example, in Ovarian Hyperstimulation Syndrome (OHSS), which occurs when the woman’s ovaries respond excessively to the hormones and medications used during treatment, all developing embryos can be frozen and stored at early developmental stages. Thus, as soon as the patient’s clinical condition returns to normal, the embryos are thawed and transferred, allowing high pregnancy rates to be achieved. Some clinics also use embryo freezing in cases where high doses of hormones/medications are used for egg development and, for this reason, the capacity of the uterine lining to allow embryo implantation is thought to decrease, or when structures that may prevent embryo implantation are observed in the uterus during treatment, such as fibroids or polyps. In this case, all embryos are frozen, and after the problems/obstacles are eliminated and the uterus reaches a healthier and more natural environment, the embryos are thawed and transferred. With this method, it may also be possible to achieve high pregnancy rates. Another approach in which embryo freezing is beneficial is for couples whose embryos are planned to undergo genetic diagnosis. In couples with a high risk of genetic disorders but from whom a limited number of eggs and embryos can be obtained during treatment, developing embryos can be frozen. After multiple egg development and embryo creation procedures, the embryos accumulated through freezing are taken together to the genetic examination stage. In this way, the cost of genetic testing can also be significantly reduced.

Just like embryos, eggs can also be frozen and stored, then thawed later to create embryos, and this is successfully practiced today. Eggs retrieved and successfully stored at younger ages almost stop time for expectant mothers who wish to have a baby in later years, and despite the passing years, the age of the egg remains as healthy as it was when first retrieved from the patient. In our country, the medical conditions under which women can apply to freeze their eggs, or oocytes, are regulated by the Ministry of Health. With a regulation published on September 30, 2014, unmarried women who have reduced ovarian reserve, have not yet given birth, or have a family history of early menopause may freeze and store their eggs. If this condition is documented with a medical board report consisting of three specialist physicians, the eggs can be frozen. In addition, oocytes can be frozen before treatments that damage oocyte cells, such as chemotherapy and radiotherapy, or before surgeries that may lead to loss of reproductive function, such as removal of the ovaries. Egg freezing is performed in our center with the vitrification method, just as with embryos. With improvements in the solutions and protocols used for this purpose, results similar to fresh attempts are now being obtained. Frozen oocytes can be stored for a maximum of 5 years within the limitations of the relevant regulation. However, it has also been stated that this period may be extended if an extension request is submitted to the Ministry of Health by petition.

Until recently, only certain chromosomes could be examined, but today, with the genetic screening method, all chromosomes can be examined in detail. Comprehensive chromosome analysis is a method performed before embryos are transferred to the uterus in IVF applications, allowing embryos to be examined not only for selected specific chromosomes by the FISH method, but for all existing chromosomes, meaning 24 different chromosomes. Does an embryo found normal in terms of all examined chromosomes always result in pregnancy? The risk of pregnancy not occurring due to chromosomal abnormality, or the loss of an established pregnancy in the early stages, is a situation that can occur at any age. However, this risk increases significantly, especially in couples where the woman’s age is over 35. Therefore, selecting normal embryos through genetic screening significantly reduces this risk. On the other hand, obtaining a genetically normal embryo alone is not sufficient for pregnancy to occur. Healthy uterine tissue is also an essential criterion for pregnancy to occur.

The PGT service provided in many clinics today is performed using a technique called “Fluorescent In Situ Hybridization” (FISH), and with this technique, embryos are generally examined only in terms of selected chromosomes, such as 5, 7, or 9 chromosomes. Since the chromosomes to be examined include genetic disorders that may result in live birth or chromosome problems that are observed at high rates in early miscarriages, 60–80% of chromosomal abnormalities that may occur in the embryo can be detected in PGT applications where 9 chromosomes are screened. However, since the remaining 20–40% of chromosomal abnormalities cannot be detected with this technique, a disorder in these unexamined chromosomes may underlie the failure of an embryo that has been examined for 9 chromosomes and found “normal” to result in pregnancy. With comprehensive chromosome screening, all chromosome regions can be seen in detail. Therefore, transferring an embryo that is normal in terms of the 24 different chromosomes examined may also increase pregnancy rates.

Our IVF laboratory follows all innovations in its field and puts them into practice in order to provide patients with world-class service and to achieve a reliable and continuously increasing success rate. For this purpose, the Continuous Embryo Monitoring System has started to be used in our IVF Laboratory. The embryo monitoring system allows your embryo to develop without being exposed too much to the external environment. The embryo monitoring system helps us increase pregnancy rates by showing the embryo with a high potential to attach inside the uterus according to the embryo’s division rate. With the systems used today, the embryo is taken out of devices called incubators on certain days and at certain times for control, which causes the embryo to be exposed to the external environment more than necessary. The quality of an embryo that is exposed too much to the external environment and its potential to attach inside the uterus decrease. With the embryo monitoring system, this risk is completely eliminated, and the embryo is monitored on the screen without being removed from the incubator. Thanks to the embryo monitoring system, you can instantly monitor the development of your embryos, and if you wish, you can also witness this magnificent journey of your embryo.

It is quite simple to perform and does not cause pain. During a normal gynecological examination, cells shed from the cervix are collected with the help of a brush, spread onto a thin glass slide, and fixed. They are then examined under a microscope by a pathologist and reported. The ThinPrep method, in which the brush is placed directly into an alcohol-containing container without fixing it onto a glass slide, has reduced the false-negative rate, meaning saying there is no disease when disease is actually present, to around 4%. With this method, the types of HPV virus, which has been shown to cause cervical cancer, can also be identified.