Our fertility specialists will provide you with the highest quality fertility care for your IVF cycle. Medicana IVF Center IVF treatments encompass the following steps:
Your Initial Consultation
You will meet with one of our physicians, at which time we will review your medical history and establish your unique IVF treatment plan.
Pretreatment testing will include blood work to determine hormone levels, blood tests , a semen analysis (if applicable), and a uterine assessment. In order to have the optimal outcome with your IVF treatment, we review your medical history and the results of your pretreatment testing before we finalize a protocol that is tailored for you.
IVF Coordinator Consultation
you will meet with one of our IVF coordinators to review your protocol and plan your calendar.
Controlled Ovarian Hyperstimulation
An IVF cycle begins with ovarian stimulation and ultrasound monitoring. A baseline pelvic ultrasound will ensure a healthy starting point before initiating medication for the stimulation and assessment of egg production. You will take hormone injections to recruit multiple eggs from your ovaries. During this time, follicular development and hormone levels will be monitored for appropriate growth for several days. Once your follicles have reached the ideal size, you will be ready for egg retrieval.
Ultrasound-guided, transvaginal egg retrieval is a procedure in which a long, thin needle is passed through the vaginal wall into the ovary. The physician aspirates the follicles from each ovary and the follicular fluid is collected in test tubes, where the embryologist carefully searches for the eggs. The eggs are cleaned, counted, and placed in an incubator. Later that day, the eggs are fertilized with sperm either by standard insemination or Intracytoplasmic sperm injection(ICSI). Injuries during this procedure are extremely rare. Structures near the ovaries, such as the bladder, bowel, or blood vessels, could possibly be injured and require further surgery. Limited bleeding from the ovaries may occur, but the need for transfusion is extremely rare. Infections following transvaginal egg retrieval are also possible, but are rare.
Embryo Culture and Assessment
During IVF, your embryos are cultured for up to six days in a temperature-controlled incubator. Each day the embryos are evaluated for quality and development. This information is shared with the doctors to help determine the appropriate day for embryo transfer, which is typically performed on day three or day five of embryo culture or day six in the case of PGS/PGD. Our embryologists will call you each day to update you on the embryo quality and to answer any questions you may have.
Embryo Transfer or Blastocyst Transfer
Embryos are typically transferred back to the uterus on day three, when the embryo is at a multicell stage, or day five or six, when the embryo is at a blastocyst stage. This simple procedure usually requires no anesthesia. Your doctor and embryologist will discuss the number of embryos to transfer that will provide you the highest probability of success and the lowest probability of high-order multiple births. You will be given ample time to discuss your embryos and decide on the number of embryos to transfer. You also will receive pictures of your embryos being transferred. You will relax in the room for a short period of time once the embryo transfer is complete. The transfer itself may cause mild irritation to the cervix or uterus.
We will schedule your pregnancy test 10-12 days after your transfer. When your first pregnancy test is positive, a repeat value will be obtained approximately 48 to 96 hours later. To confirm the positive pregnancy test, we will schedule an obstetrical ultrasound two weeks following the second pregnancy test. At this visit we will be confirming the implantation of embryo(s) and fetal heart motion.
We require a series of tests for fertility assessment / fitness for pregnancy as well as infectious disease screening. Each and every test that we order serves a different purpose and each one of these tests will have an implication for your treatment.
For assessment of fertility, we ask each female patient to have the following testing done on day 2 or day 3 of their menstrual cycle: FSH, LH, Estradiol, Prolactin, TSH and AMH hormone tests. The AMH test is independent from your menstrual cycle and can be done at any time, but our patients find it easier to have all the tests done on the same day during their visit to their doctor. It will also be important to have a base line pelvic ultrasound scan during this visit for antral follicle count in the ovaries and to check that there are no major visible problems in the uterus that can interfere with a successful pregnancy.
The male patient is required to have a semen analysis done. Especially if he has not had a child in the near past, it will be important to observe sperm parameters such as count/volume/motility/morphology/pH level and round cell count. In some cases, a small infection in sperm can compromise the whole process, therefore, it is important to be prepared for possible precautions that we may need to take.
The validity of infectious disease testing is six (6) months. As long as patients have their testing done within the 6 month period prior to their treatment time, we do not require a repeat test. However, if patients do not have current test results, then we will administer these tests here at our practice prior to handling any samples.
Only the test results from reputable clinics and hospitals will be accepted, and original test results will need to be presented at the time of your first visit. Photocopies and scanned email attachments are only accepted as temporary proof of testing until we see the originals.
The infectious disease tests required by our practice are as follows:
For female patient: Anti-HIV, Anti-HCV, HbsAg, VDRL, Rubella IgG, CMV IgG, and Toxoplasmosis IgG
For male patient: Anti-HIV, Anti-HCV, HbsAg, VDRL.
The chances of success will depend on a number of factors. These include your age, your hormone levels and general level of fertility as well as your husband’s semen characteristics and other factors like the equipment used, doctors’ experience and choice of medication. So it is really misleading to quote a success statistics in general or based on just your age. However, the age based statistics we publish on our website more or less provide an idea of what you will be looking at. However, your individual hormone profile and your ovarian reserves are the most important determinant of how likely you are to achieve success. Patients up till mid-30s usually have a very good chance of getting pregnant on the first attempt as long as they have an ovarian reserve and a hormone profile in line with their age. Above the age of 35, the level of fertility declines and the chances of success start to diminish. In some cases, when we are able to obtain
a good count and quality of eggs, we end up having multiple embryos and if there are more embryos than required for the given transfer cycle, we are able to preserve the ones that will not be used in the current cycle. This gives you a chance to use these preserved embryos at a future date without having to go through the entire treatment again. Should your current cycle fail, the preserved embryos will give you a chance to have another go. In the case your current cycle is successful, the preserved embryos will give you a chance to have a sibling for your child in the future.
Ask the couples who have benefitted from the attractive IVF treatment packages in Turkey. The global marketplace has allowed clients to get good deals at low prices, regardless of geography. In the UK, IVF depends largely on local trust policies, and the NHS recommends eligible couples receive up to three cycles only.
Meanwhile, couples from countries like Lebanon, other parts of the Middle East Romania, Bulgaria, Azerbaijan, other East European countries, and North Africa may find that some cultural similarities of Turkey provide peace of mind when they too, are looking for cheap IVF treatment packages. Besides low cost of IVF in Istanbul Turkey, choosing to get treated there will give intending parents from the aforementioned regions a chance to truncate their travel expenses and time.
Fortunately, In Vitro Turkey has done all the homework in networking with the leading IVF centers and in making known discount IVF packages in Istanbul, Turkey to interested parties on the Internet. The beauty of the web is that it enlightens infertile couples with awareness of low-cost IVF, and possibly allows them to keep hefty amounts of funds from leaving the wallet over this emotional medical need.
People may usually get amazed at the amount they can save when undergoing IVF treatment in Turkey. A Turkey IVF package cost can be considerably less than private IVF treatments offered in Western countries, and this is after including travel, accommodation and miscellaneous costs. Prohibitive cost is the major reason couples put off IVF services. And it turns out that discount IVF packages can generally provide the cost-saving benefit, convincing infertile partners to come in numbers, through the years, to IVF hospitals in Istanbul Turkey.
Need for Cheap IVF Treatment Packages
According to the European Society of Human Reproduction and Embryology (ESHRE), one in six couples worldwide experienced infertility problems in 2010.
The HFEA and the Human Reproduction Journal respectively report that the number of fertility treatments such as IVF, have been increasing in demand in the UK and US.
Although assisted reproductive treatments are in demand, not all couples seeking such aid can afford costly IVF services.
IVF treatment packages in Turkey provide an alternative to infertile couples seeking affordable IVF treatments that do not compromise on medical quality and expertise.
Who Should Consider IVF Treatment Packages in Istanbul, Turkey?
If you have been recommended for IVF treatment by a gynecologist and would like to find a lower cost option.
ICSI (Intracytoplasmic Sperm Injection) is beneficial for all couples, however it is significant for those where fertilizatıon may be difficult, even when IVF procedures are used.
For example, couples dealing with male infertility factors such as — low sperm count, poor motility or movement of the sperm, poor sperm quality, trapped spermatozoa or if the sperm lacks the ability to penetrate the egg membrane.
At Medicana IVF, the ICSI (Intracytoplasmic Sperm Injection) procedure is carried out as standard as part of all our IVF treatmentsto ensure fertilization.
ICSI Treatment Process
Step 1 Sperm Retrieval
The male partner is asked to provide a sperm sample by masturbation in a quiet, private room. In cases of azoospermia, the sperm is retrieved either from the epididymis from the testes (TESE).
Step 2 Sperm Preparation
Following careful sperm preparation, the best quality spermatozoon is chosen for injection into the oocyte (egg).An electronic micromanipulator connected with an inverted microscope is used for this method.
Step 3 Fertilization
The oocyte is immobilized and with the use of an ICSI micropipette the spermatozoon is injected within the cytoplasm of the oocyte through the zona pellucida (membrane surrounding the egg). Once the ICSI micropipette is removed and the spermatozoon successfully placed within the egg, the zona pellucida seals back and the egg closes resuming its original shape.
The fertilized oocytes are observed to determine normal division and growth until the day of embryo transfer.
For more information regarding any of the programs at Medicana IVF Center, please feel free to contact us.
PGD is a technique used throughout IVF-ET, wherever embryos square measure tested for malady genes and solely healthy embryos square measure transferred into a female internal reproductive organ.
PGD – however may be a diagnosing created ?
Embryos square measure obtained by combining eggs and sperm cell within the laboratory. From every embryo, one or 2 blastomeres are removed and tested. If the embryo is judged to be freed from the disorder, are transferred to the cavum.
What square measure the indications for PGD ?
Indications for PGD square measure –
Advanced maternal age ( > thirty nine years)
Repeated IVF/ICSI –ET failure cycles
Unexplained physiological condition
Known genetic causes.
What does PGD/PGS involve?
All couples requesting PGD must first undergo an IVF cycle to stimulate the ovaries to produce a number of eggs. These eggs are collected and fertilised using the male partner’s sperm. The resulting embryos are cultured in the laboratory. Embryo biopsy can be performed either on Day 3 or Day 5 after egg collection. Embryos that have developed to at least 5-6 cells are suitable for biopsy. A hole is drilled in the outer shell of the embryo using laser and 1 or 2 cells are removed for genetic analysis. This procedure which is done at the 3rd day gives us the chance of having fresh transfer on the 4th or 5th day. The embryos are kept in culture while the testing of the biopsied cells proceeds. Genetic test results are usually obtained within 24 hours of embryo biopsy. Our embryologists will discuss the PGD results with the couple at the completion of testing. When available, one or two unaffected embryos can be transferred on Day 4 or Day 5. When a number of embryos are identified as being genetically suitable for transfer, morphological criteria are used to determine the best embryo/s for transfer. Surplus unaffected embryos will be grown in culture to Day 5 or Day 6. If they reach an appropriate stage of development (ie: form a good quality blastocyst) they will be frozen. These embryos may be used in a subsequent IVF cycle if the couple do not achieve a pregnancy with the fresh embryo/s. Embryos that are affected or have a chromosome abnormality are discarded.
However, For the last two years, we prefer performing PGS (Preimplantation Genetic Screening ) procedures ( not targeting a specific disease ) at the 5th day instead of the 3rd day. We wait until the 5th day after the egg collection to choose the best ones and make the embryo biopsy from the trophectoderm cells instead of the embryo itself. So, the risk of damaging the embryo becomes virtually zero ( which was estimated to be around 5 % with the Day 3 biopsy) and also the number of the embryos to be screened decreases causing a lower cost. We use NG-CGH (Next Generation Comparative Genomic Hybridization ) technology to check all ( 24 pair ) the chromosomes of the embryos for screening purposes such as advanced maternal age or repeated implantation failures.
A debatable disadvantage about this procedure ( Day 5 biopsy ) is that we should freeze the embryos since the results will be available in 24 to 36 hours which can be too late for the fresh transfer. The only problem is that couples come to our centre again in two or three months for only a few days for the transfer of the healthy embryos found. Besides, our statistics shows that the pregnancy rates are exactly the same as the fresh ones. Furthermore, some recent studies reveals that transferring the frozen embryos may give even higher implantation rates since ovarian stimulation with high dosage of hormones may impair the endometrial receptivity. It is very easy to have frozen embryo transfer. Otherwise, transfer is cancelled. But we think that this is much better than realising the baby is not healthy during the pregnancy with a probable miscarriage..
Assisted hatching may be a scientific technique utilized in In Vitro Fertilisation (IVF) that will improve the implantation of embryos into a woman’s female internal reproductive organ lining by making an opening through that the embryonic cells will hatch out. physiological condition cannot occur unless the embryo hatches.
Just before embryo implantation, the developing embryo should “hatch” out of its outer shell (zona pellucida). Some embryos appear to possess a thicker shell that will decrease their ability to hatch, and thus scale back the chance that they’ll implant. this could result to the age of the girl or different, unknown reasons.
The unfertilized egg (oocyte) is enclosed by the zona membrane. The zona ensures that just one spermatozoon enters and fertilises the egg. once fertilisation, the embryo begins to cleave into a two-cell, then a four-cell and then on. it’s at this early cleavage stage that motor-assisted hatching is performed on embryos.
It has been shown that ladies older than thirty seven years older have a bent to supply oocytes with a tougher and/or thicker zona than younger ladies. constant applies to women with a high level of follicle Stimulating secretion (FSH).
The problem of a tougher zona is that the embryo might not hatch and therefore not attach to the woman’s uterus. Hatching of the embryo is critical to attain physiological condition. it’s been reportable that up to seventy fifth of traditional embryos could ne’er hatch. Laboratory procedures concerned in IVF could raise the hardening of the bodily structure, because the embryo isn’t frequently exposed to the enzymes gift within the natural atmosphere of the fallopian tubes.
There is conjointly proof to recommend that the method of cooling and thawing embryos could cause the bodily structure to harden, and exploitation assisted hatching is helpful.