Not being able to get the desired result from In Vitro Fertilization, which is a serious financial and moral burden, is truly a devastation. However, it should not be forgotten that second, third or more There are countless couples who have reached a happy ending as a result of trials...
The important thing is to try again and again, without losing hope, after a detailed evaluation and research, and correcting any issue that has been overlooked. In fact, theoretically, there are a lot of research and examinations that can be done before each trial, but trying to do all this research, especially before the first trial, is not recommended and often unnecessary, as it will result in a serious increase in costs. For example, evaluating the inside of the uterus with hysteroscopy may of course be beneficial, but attempting to perform hysteroscopy before each in vitro fertilization attempt will increase the cost of in vitro fertilization and will not give a meaningful result in most cases. However, hysteroscopy is absolutely necessary after unsuccessful attempts and will sometimes reveal an overlooked problem.
Here are frequently asked questions about in vitro fertilization failure:
In what cases can IVF treatment be canceled?
1.The response of the ovaries may be inadequate and if it is thought that you will not benefit from the treatment, your doctor may interrupt your treatment and cancel the procedure. As we mentioned before, the most important factors in determining which regimen to start and the drug dose for the patient are blood hormone levels, the appearance of the ovaries on ultrasonography, and the ovarian reserve, which varies depending on the patient's age. However, patients may not always respond as expected. Therefore, in patients with insufficient egg development, the treatment can be canceled and a new treatment can be started, or in some patients who do not respond at all, the treatment can be stopped completely.
2. Although there are developed follicles in the ovaries, eggs may not be obtained from them on the day of egg collection. This is usually due to untimely hatching of eggs before egg collection. This undesirable condition can generally be seen in older women with decreased ovarian reserve. Very rarely, there may be no eggs in the follicles (empty follicle syndrome). This condition is seen in less than 1% of patients.
3. The resulting eggs may not be fertilized. This situation is extremely rare in the era of microinjection applications. However, in 2–5% of patients, fertilization may not occur due to abnormal eggs or sperm.
4. None of the fertilized eggs may divide. This condition is also very rare and is generally observed in the presence of small numbers and poor quality eggs.
5. Sperm may not be found during surgery in azoospermic men. In such a case, the treatment is canceled just before egg collection.
6. A normal embryo may not be found in cases where PGD is performed. In such a case, embryo transfer is not performed.
7. Even if the embryo is healthy in the embryos where PGD and HLA analysis is performed, if no HLA compatible embryo is found, transfer is not made.
How many times can IVF be repeated?
There is no limit on the number of in vitro fertilization treatments. As long as the ovarian capacity and the man's sperm status allow, that is, as long as a healthy embryo can be developed and transferred, as many attempts can be made as desired. Three or four applications are possible in a year. However, more than four applications are generally not recommended in the same year. If a suitable number of healthy embryos are obtained in the first attempts, these embryos can be frozen and stored for use in later experiments. In this way, the woman's use of medication is limited and the cost of treatments is reduced.
Is it necessary to change medications after an unsuccessful in vitro fertilization attempt?
There are certain drug combinations in in vitro fertilization applications. These combinations are created after extensive research. After evaluating the patient, we choose the appropriate drug protocol based on the results we obtain. During the treatment, we closely monitor the patient's blood hormone levels and ultrasound and make necessary dosage adjustments. However, if the treatment does not result as desired, we review the available information. We evaluate how the patient responded to the drug protocol chosen during the previous treatment. For example, the patient may have responded to medications faster or slower than expected. We can review such information and make changes to the drug protocols in the next trial. However, this does not mean that every unsuccessful treatment occurs because of the drug protocol. There are many other reasons that affect success.
Laser is said to increase the success of in vitro fertilization. When is this used?
Embryos (fertilized eggs) need to attach to the inner lining of the uterus in order to be nourished and develop. If the membrane surrounding the embryo is thicker than necessary, attachment to the uterus cannot occur and pregnancy will not occur. In order to make it easier for the embryo to attach to the uterine wall, this membrane can be thinned by various processes or a small hole can be created in part of it. This process, which was done using some chemicals and enzymes in the past years, can now be done with a laser system. Laser is used in people who have not been able to achieve pregnancy through in vitro fertilization before and in women aged 35 and over. It is also applied to embryos that will be biopsied for genetic diagnosis, embryos obtained after freezing-thawing, cases in which pregnancy did not occur despite obtaining good quality embryos in previous attempts, and cases with borderline or high FSH hormone levels. The method of thinning the membrane of the embryo with laser in our center in all transfers is implemented.
What is the method of Blastocyst transfer on the fifth day?
Blastocyst is the name given to the embryo that has reached the fifth day after fertilization. The generally accepted practice in in vitro fertilization treatment is to place the embryos in the mother's uterus on the third day after fertilization. Transferring embryos at the blastocyst stage has some important advantages. For example, embryos that have reached this stage are more likely to attach to the uterus. Because the ability of these embryos to survive until the fifth day is higher than others. In other words, they are embryos that can take the lead in the marathon, whose viability has been proven, and whose chromosomes are more normal. Normally, two embryos that have reached the blastocyst stage are selected and placed in the uterus. The remaining embryos can be frozen and stored using the rapid freezing technique. Frozen embryos can be thawed and given when there is no pregnancy or when the patient wants to become a mother again in the future.
Does pre-pregnancy genetic diagnosis increase treatment success?
Yes. It is a useful method, especially in cases where we need to choose from embryos. In some cases, we examine the embryos in terms of genetics and chromosomes before placing them in the mother's womb. This method, which we call preimplantation genetic diagnosis (PGT), is applied to a cell taken by biopsy after the embryos reach eight cells. Thus, the embryos with the least risk are selected and healthy embryos are transferred to the expectant mother. This method; It is applied to those with recurrent miscarriages, those of advanced age, those with repeated unsuccessful in vitro fertilization attempts, cases of severe male infertility, and those at risk of genetic diseases such as Mediterranean anemia.
In case of failure, will artificial womb application work?
Especially in cases with poor and slow embryo development, Artificial Womb application (Co Culture or Co Culture in Turkish) can be performed with the belief that this problem can be corrected by changing the environmental conditions. Co-Culture that is, embryos in conditions closest to their natural environment; In other words, for more detailed information about this method used to nourish the intrauterine environment until transfer, please Click here.
Is vitamin application beneficial to the expectant mother to prevent miscarriages as a result of the in vitro fertilization method?
In in vitro fertilization treatment, expectant mothers are recommended to take vitamins before treatment. It is especially recommended to use multi-vitamins with antioxidant effects and folic acid, which protects against diseases affecting the nervous system that may occur in the baby. The use of vitamins is a supportive treatment. However, using vitamins alone cannot prevent miscarriage.
Does stress affect the success of treatment?
An infertility diagnosis can create stress for couples. Many couples feel hopelessness, inadequacy, guilt, and failure. Additionally, treatment can be stressful for couples. Lack of information, especially regarding treatment-related procedures, can make couples tense and distressed. It is beneficial for the treatment team to prepare the couples, to reveal and discuss factors that the couples have not taken into account. Psychologist and psychiatrist support can be obtained when necessary. Recent research shows that stress alone is not a cause of infertility or a factor that causes treatment failure. However, we know that treatment carried out in a peaceful environment also increases the patient's compliance with the treatment. Don't postpone motherhood too long...
Does advanced age prevent pregnancy?
Women over 35 should act quickly. After the age of 40, the chance of pregnancy decreases dramatically, even with in vitro fertilization treatment. As in Western societies, the increasing participation of women in the workforce in our country leads to postponement of pregnancy. This increases the need for in vitro fertilization treatment. However, the chance of pregnancy decreases significantly with in vitro fertilization treatment at older ages.
Why can't older women with regular menstrual periods become mothers?
There are two important factors in in vitro fertilization treatment. The first is the eggs, the second is the fertilized eggs, that is, the uterus where the embryos will attach. Advanced age negatively affects both the number and quality of eggs.
What are the success rates of in vitro fertilization treatment?
In a good IVF center, the pregnancy rate under the age of 40 is 50-55 percent and above. However, this rate can decrease to 25 percent over the age of 40. Pregnancy rates should be directly proportional to the number of embryos transferred.
What is the ideal age for pregnancy?
Between 25–35 years old. It is best to try to have a child within the ideal age limits for the health of both the mother and the baby. Metabolic problems due to advanced age, factors affecting fertility, and approaching menopause are very important obstacles to becoming a mother.
What are the developments in infertility treatment?
The most important problem, especially in older women, is the limited egg reserve. In the near future, egg and sperm cells will be obtained from somatic cells through stem cells. Egg freezing can currently be applied, although not with high success.
As a last word, I would like to repeat the sentence I said at the beginning.
It should not be forgotten that second, third or more There are countless couples who have reached a happy ending as a result of trials... The important thing is to ensure that if there is an issue that has been overlooked, it is corrected after a detailed evaluation and research, without losing hope. again and again is to try. It should not be forgotten that the chance of pregnancy reaches 85%, especially in the first 3 attempts.
To get detailed information about in vitro fertilization treatment, in vitro fertilization prices and our in vitro fertilization center, please Click here.