Surg. Dr. Gurur POLAT, MD
Life begins with hope! The beginnings are fed with hope, the dreams grow, develop and become real. We are here to make your dreams real, put your “baby” desire through and share this enthusiasm with you.
In Vitro Fertilization (IVF)
In Vitro Fertilization
The fertilization is expected to occur spontaneously by putting the oocytes retrieved from the woman and the sperms retrieved from the man together. Contrary to what is believed, the fertilization process takes place in small plastic plates called dish, not inside the tube. These plates are kept in a device called an incubator, mimicking the mother’s uterus.
The temperature, humidity and carbon dioxide ratios are stable in these devices. In in vitro fertilization technique, one of the sperms floating around the oocyte is desired to penetrate the oocyte shell and fertilize the oocyte. After the first sperm enters, the oocyte does not allow any other sperm entry since it changes its shell structure.
The next day, fertilization control is done and the family is informed about how many oocytes are fertilized. Fertilization rates are more related to the capacity of the sperm rather than eggs. Since fertilization cannot occur if there is a motility, number or deformity disorder in the sperm, in vitro fertilization cannot be performed with this type of sperm. Microinjection procedure would be more appropriate.
What Is Infertility?
Infertility is inability to achieve pregnancy within 1 year, despite regular sexual intercourse without using any contraceptive method. The expression of regular here refers to an average of 2 intercourses per week. Reasons for not having intercourse such as military service, working in another city, vaginismus are not included in this period.
- 30-40% of infertility cases are due to male factors
- 30-40% are due to female factors
- 20-25% of couples have problems both in male and female.
- In 10-15% of couples, there is no finding to explain the infertility despite all researches. This group is called ‘unexplained infertility
First, 1 to 2 oocytes are grown with the help of oocyte-growing drugs. Pills or injections can be used for this purpose. Pills are more advantageous in terms of safety, injections are more advantageous in terms of thickening the uterine tissue.
When the oocytes grow mature enough, the egg cracking shot is administered and approximately 2 days later, sperm retrieved from the husband is irrigated, the good ones in terms of shape and mobility are selected and delivered to the top the uterus with the help of a catheter.
Both begin with oocyte growth treatment. It is tried to obtain about 5-10 oocytes from every woman by using egg-growing drugs. The number of oocyte is as important as the age of women in determining pregnancy chance.
Drugs used for this purpose are in the form of injection and are usually administered subcutaneously. It is usually initiated on the 2nd or 3rd day,although there are different drug schemes. 5-6 days later, 2nd control is performed. The sizes of oocytes are measured during this control. According to the situation, the drug dose adjustment is made. The next controls are every 2-3 days.
It is a technique initially developed for male infertility treatment. In cases where sperm does not have a normal fertilization characteristic, it is administered for the purpose of obtaining fertilization.
In cases of severe male infertility, other known treatment techniques, including in vitro fertilization method, are not able to achieve fertilization or achieve at very low rates.
Microinjection has revolutionized the infertility treatment and many couples, who have not been given a treatment chance previously, had a child thanks to this technique. In the microinjection technique, a single sperm is injected into the oocyte with the help of a micropipette.
By this means, even the weakly motile and deformed sperms are ensured to fertilize the oocyte. Because the fertilization process primarily occurs by sperm entry into the oocyte. While healthy sperms can do this on their own, the problematic sperms are helped thanks to microinjection procedure.
The expected action of the embryo is to progress, increasing the number of cells every day. Embryos, which initially develop slowly and then accelerate or initially develop rapidly and then decelerate, mean that they have lost the quality.
They should develop in a standard speed and continuously. Some embryos may completely stop their development (arrest) and may restart dividing 1 day and 2 days later. But these embryos also do not have the desired structure. At the same time, the cells in the embryo (blastomer) should be equal to each other and clear. Curly, cauliflower-like structures in the embryo impair the quality.