Doctor Consultation;
After you decide to attend the IVF program, your doctor will examine you and will finish all the processes necessary to start the program. During the examination, the ovaries, the uterus, the length of uterus and cervix will be observed. Also, tests such as hormone levels, hysterosalphingogram (HSG), spermiogram and serology will be completed. All of these tests are done in one menstrual cycle. After this meeting, the patient has to start taking folic acid. Folic acid is found protective against abnormalities of the bone structure and complications in the nervous system of the baby, when used in a regular basis before the pregnancy and during the first 3 months.
Meeting With The IVF Coordinator
The IVF coordinator will first check and make sure that your file is completed. Also he/she will give you information about general course of the program such as the arrival time and the place for ultrasound and blood analysis, use of the drugs, phone number you can reach anytime and financial issues. Before this meeting, please note all the questions you might have. In our experience, most of the questions which are not written can be forgotten during the meeting
The second part of the meeting is the description of the drugs and their doses, start of the medication and control dates. All of this information is given in written forms. Please feel free to ask anything. Any mistake you make in the usage of your medication would harm you financially and more importantly would cause loss of your precious time.
STARTING THE PROCEDURES;
Supression Of The Hormones
During the program, to get an appropriate response from the drugs, untimely and irregular effects (e.g. ovulation) of the hormones that your body secretes, have to be blocked. Generally, the drugs which would suppress the hormones are started on the 2nd or 21st day of the menstruation.
Induction Of The Ovaries
When the hormone levels reach the desired level, hMG (LH + FSH) or pure FSH are used are injected intramusculary or subcutaneously. Injections have to be done everyday at the same time. Additionally, the numbers of follicles are evaluated by ultrasound. The time of follicle development varies from 1 to 3 weeks depending on the response of the ovaries.
Ultrasound Follow-Up
HCG Injection
When the follicle number and size, hormone level and the endometrium reaches the desired level, human corionic gonodotropin (hCG), is injected intramusculary to mature the eggs to trigger ovulation. 36 to 40 hours following the hCG injection, ovulation occurs. In IVF procedure, eggs are retrieved by emptying the follicles prior ovulation. As timing is very important, you have to pay maximum attention to follow the given information about hCG injection. On the hCG injection day, you will be explained and given a form explaining how you should get your injection done at a specific hour after 8 pm
Egg Retrieval-Oocyte Pick Up
On the day of oocyte pick-up, please come to the hospital in the morning with your spouse, with empty stomach (avoid eating, drinking and smoking 6 hours before oocyte pick-up).
First, a sperm sample will be taken from your husband (in certain cases if necessary, sperms will be extracted from testicles with operation). Oocyte pick-up will be performed in the operating room under sterile conditions. During this procedure, you will be given mild anesthesia for a painless and comfortable operation. The egg retrieval is done with a needle guided by vaginal ultrasound and an aspiration system. During and following anesthesia, pain complaints are rare. The same day, you will be discharged from the hospital after the doctor visit and information will be given about the egg number and the following processes. Usually the whole procedure takes 1-2 hours but we recommend that you spare your whole day to the IVF and do not make any other plans for that day. Rarely, no eggs can be retrieved from the follicles. The most common reason for that is not getting your hCG injection in the right time or right manner.
Progesteron Aplicaton
Embryo Transfer
As this procedure is done as a normal vaginal examination, there is no need for anesthesia. We recommend that you have a light breakfast before you come to the center. Previously decided number of embryos will be transferred into the uterus with a plastic catheter in gynecological examination position. This procedure has to be done with full bladder. You can be discharged following this process, after a short rest. Again your IVF doctor will give you information about ET and the days following it. We recommend a home rest the same day but the following day you can go back to your routine life style.
Pregnancy Test
Pregnancy test will be performed on the 12th day following the ET by detecting beta-hCG hormone level in blood.
