Women’s Health and IVF Specialist, Op. Dr. Ufuk Yılmaz: We talked to the expert on infertility, a topic that closely concerns almost every family nowadays, and the related issue of IVF. Op. Dr. Ufuk Yılmaz shared important information with our readers.
What is IVF? Who is it applied to?
IVF or In Vitro Fertilization is the process of fertilizing eggs retrieved from a woman and sperm obtained from a man in a laboratory environment, and then placing the fertilized embryos into the woman’s uterus after a certain period. It is successfully applied in many centers in our country according to world standards.
What does Infertility mean?
Simply put, infertility is the condition where a couple cannot achieve pregnancy despite having unprotected and regular sexual intercourse for a year. The term infertility comes from “infertile,” while the ability to conceive is referred to as “fertility,” and the event of fertilization, which is the beginning of pregnancy, is synonymous with “conception”
Does a woman’s age affect the chances of pregnancy?
Yes, it does. As a woman’s age advances, the chances of pregnancy decrease. The time it takes to achieve pregnancy through regular sexual intercourse increases as a woman gets older. While a 25-year-old woman generally becomes pregnant within 2-3 months, for women over the age of 35, this period can extend beyond 6 months.
Does age affect men’s reproductive health?
Partially. Men can experience a decrease in sperm count and quality after the age of 60. However, unlike women, men remain fertile throughout their entire lives.
Is infertility caused by common reasons?
Infertility in couples can be attributed to issues in either the man, the woman, or both. In infertile couples, the problem is due to male factors in 40%, female factors in 40%, and both partners together in 20% of cases.
Has infertility become more common nowadays?
Yes, it has become more common due to increased age at marriage and the tendency of married couples to delay having children. Additionally, the rise in infections can lead to tube blockages, resulting in infertility.
Can stress cause infertility?
Yes, stress can generally be a consequence of infertility. However, severe stress can also lead to ovulation problems and a decrease in sexual intercourse frequency.
What are the chances of couples undergoing infertility treatment to get pregnant?
This depends on the couple’s specific infertility problem and its severity. Some causes can be easily treated, while others may require more advanced techniques and time. Infertility treatments require both financial and emotional patience.
Do women who use birth control pills have difficulty getting pregnant later on?
Birth control pills do not cause infertility. However, after discontinuing these pills, it may take a few months for pregnancy to occur. This effect is more pronounced in older women, but it is temporary.
How long should couples wait before seeking a gynecologist’s advice due to infertility?
Healthy couples have a 20% chance of getting pregnant each month. More than half of the couples achieve pregnancy within 6 months of trying. If you have been having regular sexual intercourse without using any birth control method for 12 months and have not achieved pregnancy, you should see a doctor as soon as possible.
Are there any couples who shouldn’t wait this long?
If couples suspect any problem, for example, if the female partner has very irregular or absent periods, a history of infection, or severe pain during menstruation and intercourse, or if the male partner has an undescended testicle, a history of testicular surgery, or testicular injury, they should see a doctor immediately.
Should couples visit the gynecologist together?
It is recommended that couples visit the gynecologist together for the first appointment, as the problem of not being able to conceive can be due to either the woman, the man, or both partners.
Is a gynecological examination necessary?
Yes. Physical and pelvic examinations are essential steps in infertility investigations. The woman’s gynecological examination involves ultrasonographic examination, sampling from the cervix for pathological examination, and taking samples for microbiological investigations. In the case of the male partner, a testicular examination is performed by a urologist, and if necessary, ultrasound examination can be requested. What percentage of infertile couples can be treated? In ancient times, there was not much hope for an infertile couple. However, with today’s technology and medications, correct diagnosis and treatment enable about 85% of couples to have children.
How is In Vitro Fertilization (IVF) and Microinjection (ICSI) applied?
IVF (In Vitro Fertilization Method): About 50 thousand sperm are placed next to each egg. Fertilization is expected to occur when a sperm enters the egg on its own. The fertilized egg cells divide and develop into embryos. The embryos are monitored daily and are allowed to grow under laboratory conditions for 2-3 days. IVF is usually the preferred treatment for couples who cannot conceive due to tube blockages.
ICSI (Microinjection Method):
After the eggs are collected, the surrounding cells are removed by the embryologist. With the help of special and extremely thin tools, but visible under a microscope, the egg is held, and a sperm is injected into it. Like in IVF, the division of the egg is expected one day later. ICSI is a suitable method for male partners with low sperm count or weak motility and female partners with reduced egg reserves.
I don’t know how to apply the injection drugs used in IVF; what should I do?
We prefer that you or your partner administer the injections. Learning how to apply the medications, which are generally administered as subcutaneous injections, can be achieved in a short time. Even if you don’t want to do it yourself, knowing how it is done is important for controlling the people who will administer the injections. The medications you will use for IVF treatment will be explained to you in detail.
How long does the Egg Retrieval procedure (OPU) take?
The duration of the OPU procedure depends on the number of follicles in the ovaries. On average, it can take between 15 to 30 minutes. We recommend allocating a minimum of 3 hours for this procedure, considering the preparations before the procedure and the rest period after the procedure.
Is the Egg Retrieval procedure painful?
The OPU (Egg Retrieval) procedure can be a moderately painful procedure even without the use of any medication. However, today, it is performed with minimal discomfort thanks to sedatives and pain-relieving medications administered through intravenous access. Additionally, patients who wish to sleep throughout the procedure are anesthetized by an anesthesiologist.
How will I feel after the Egg Retrieval procedure?
You may feel drowsy due to the effects of the anesthetic drugs. There might also be some discomfort in the abdomen. If you feel well enough, you can return to your normal activities the next day.
Does each follicle seen during the Egg Retrieval procedure contain an egg?
No. However, sometimes, if there are too many follicles, it may not be possible to count them accurately. In such cases, more eggs can be retrieved than what was seen on the ultrasound. However, unfortunately, in cases where only a few follicles are visible on ultrasound, no eggs may be obtained.
Is fertilization achieved in every egg collected during the IVF procedure?
The average fertilization rate is about 65%. Some couples may achieve a higher rate of fertilization, while very rarely, no fertilization may occur.
When are embryos frozen?
Embryos can be frozen on any day determined appropriate by the IVF team, from the day of fertilization until the sixth day.
How long can frozen embryos be stored?
Nobody knows the exact answer to this question. However, the laws in our country limit this period to three years. We know that successful storage is possible even after this period and for much longer.
Will all remaining embryos after Embryo Transfer be frozen?
Not all embryos show the desired development. For freezing, all of them should have proper development and appearance. If you have previously frozen embryos, you will be informed during the transfer procedure.
When can I start normal activities?
You can resume your normal activities two days after the transfer. If your job is very stressful and exhausting, we recommend discussing this with your doctor.
When can we have sexual intercourse after Embryo Transfer?
You should avoid having sexual intercourse until you get the result of the pregnancy test.
How long should I rest after the transfer?
You can lie down in a comfortable position in bed or sit in a chair. Except for bathroom breaks and similar situations, resting for one or two days is sufficient.
HOW CAN YOU INCREASE THE SUCCESS OF YOUR IVF PROCEDURE?
Do not take any medications without consulting your doctor. The only medications you can take without consulting IVF doctors are pain relievers containing acetaminophen. Quit smoking. Several studies suggest that smoking reduces pregnancy rates. If you can’t quit entirely, reducing the number of cigarettes, especially after the embryo transfer, can have a positive effect. Avoid alcohol. Both men and women undergoing IVF treatment should not consume more than two glasses of alcohol per day before egg retrieval (OPU). The female partner should avoid all alcoholic beverages after the embryo transfer (ET). Avoid hot baths and saunas. High temperatures have been shown to have a negative effect on sperm motility and embryos in the uterus. Men should avoid high temperatures at least 90 days before egg retrieval, and women should avoid high temperatures after embryo transfer.
Source: Karadeniz’de Sonnokta
