Frequently Asked Questions

• Is pregnancy via assisted reproduction treatment risky after 40 years of age?

  Sociological studies demonstrate that age of pregnancy is on the rise in the normal population. Postponing marriage at a later age, the increase of women in the paid workforce, and the prioritization of career plans cause increasingly more pregnancies to at later ages. Scientific studies show that especially some medical problems are experienced more commonly in pregnant women older than 40 years old.

  According to Turkish Statistical Institute; the average age of mothers, who gave birth in 2001 was 26.7 years while it was 28.9 in 2019. The average age of mothers, who had their first birth in 2019, was 26.4 years.

• What are the problems experienced by pregnant women older than 40 years old?
  • High blood pressure during pregnancy
  • Diabetes during pregnancy (gestational diabetes)
  • Low birth weight baby
  • Increased risk of pregnancy loss

  Therefore, close monitoring of pregnant women older than 40 years for these risks is necessary whether pregnancy occurred naturally or via assisted reproduction treatment. 
   

• When to Consider Assisted Reproduction Treatment?

  If candidate mothers under the age of 35 cannot achieve pregnancy despite unprotected sexual intercourse for a year, the couple should apply to a fertility specialist obstetrician and gynecologist. If the candidate mother over the age of 35 cannot achieve pregnancy for six months despite unprotected sexual intercourse, the couple should be evaluated at the assisted reproduction treatment center.

• Can women who have no menstrual periods become pregnant?

  Unfortunately, women with absolute absence of menstrual periods have no chance of becoming pregnant. Assisted reproduction treatment starts on the second to third days of the menstrual bleeding. Menstrual bleeding is essential to establish pregnancy via assisted reproductive techniques.

  Provided that medications induce menstruation, there is a chance with assisted reproduction treatment when ovarian stimulating hormones do not work or menstrual cycles are absent. In women with a low egg reserve leading to premature menopause, it is impossible to achieve pregnancy by using the patient's own eggs.

• What type of lifestyle changes should we adopt when we receive assisted reproduction treatment?

  We should avoid smoking and alcohol use. We should not engage in strenuous exercises especially after the embryo transfer. You must take your medications regularly.

• How is the egg retrieval procedure performed?

  Collection of the eggs is performed under anesthesia because the procedure induces pain. The egg retrieval procedure takes almost ten to fifteen minutes. During the procedure, the eggs in the follicle fluids are harvested from the ovaries. Later, the follicular fluid is examined by embryologists in the laboratory under a microscope and eggs are taken into special culture solutions.

• How is embryo transfer performed?

  Embryo transfer is a painless procedure; therefore, no anesthesia is required. The embryo is taken into a fine plastic catheter; then, it is placed into the uterus under ultrasound guidance.

• Can I go swimming after egg retrieval or embryo transfer?

  Yes, you can swim 48 hours after the procedure. 

• Can I travel by car or plane after the embryo transfer?

  Yes, you can travel by car or plane.

• Will I need to abstain from sexual intercourse after egg retrieval or embryo transfer?

  It will be prudent not to have sexual intercourse after the egg retrieval procedure.

• Can I dye my hair while receiving treatment?

  No.

• How can you prepare to return work?

  You can return to work one day after the transfer provided that your job does not require physical effort.

• How many embryos can be transferred at a time?

  A single embryo is transferred in the first and second treatment cycles until the age of 35. Two embryos are transferred to other patients.

• Are there any differences in success rates between the frozen and fresh embryo transfer?

  The rates of establishing clinical pregnancy are not different between the frozen and fresh embryo transfer.

• Can cancer treatment or surgery cause infertility? How can reproductive health be maintained?

  Some chemotherapy drugs act on reproductive health unfavorably by destroying sperms and egg cells. Therefore, male patients diagnosed with cancer can keep their chances of becoming a father by having their sperms frozen before starting treatment. The idea of freezing and storing the ovarian tissue before cancer treatment aims to place such tissue into the body of the patient when she becomes cancer-free. However, freezing and transplanting the frozen ovarian tissue back to the body remains experimental. 

• When can pregnancy be diagnosed?

  A pregnancy test to be performed 12 days after the embryo transfer shows whether pregnancy has been established.

• What happens to extra embryos?

  Good quality embryos left over after the embryo transfer can be frozen to be used in future treatment cycles if you wish.

• How many cycles can establishing a test-tube pregnancy be attempted?

  If patients are not impetuous, pregnancy can be established after four treatment cycles at a cumulative rate of 90%. The treatment success will be less likely after the sixth attempt.

• Will I need to stay at hospital after the transfer?

  It will be adequate if you rest at home. Being an inpatient does not increase the chance of becoming pregnant.

• What are the success rates of assisted reproduction treatment?

  Pregnancy rates per embryo transfer are around 50% on average. This rate increases to 60% in young patients but it goes down to 15% in patients over 40 years old.

• What are the factors acting on treatment success in assisted reproduction treatment?

  A critical factor affecting the success of assisted reproduction treatment is maternal age. The chances of success reduce over the age of 35. The factors acting on treatment success include causes of infertility, the long period of infertility, whether it is both male and female infertility, and the quality of the embryo.

• What are the drawbacks of consanguineous marriages? Can assisted reproduction treatment be a solution?

  Consanguineous marriage is referred to a marital union between a male and female with the blood bond. Considering the degree of closeness, the most disadvantageous consanguineous marriages occur between two first-degree cousins; who are the children of aunts and uncles. Marriages between grandchildren of siblings and marriages between second-degree cousins pose a lower risk of genetic disease transmission compared to marriages between two first-degree cousins.

  Hereditary diseases that occur as a result of consanguineous marriages are usually metabolic diseases; which are quite numerous. Screening all types of metabolic diseases is not possible in any country around the globe today. However; if a hereditary disease in the family is known or if the couple has already a child with such a disease, these diseases are screened in the embryos obtained by in vitro fertilization. After such screening, only healthy embryos are transferred.

• What should you bring with you?

  In order to start your treatment as soon as possible, we kindly ask you to bring the following documents to your first visit.

  • Any surgery report or note
  • Sperm analysis (all test results if you have more than one) 
  • Hormone tests of the female spouse
  • Medical reports from previous treatments 
  • Radiological imaging tests of the uterus
  • Chromosome analysis
  • Medical reports about other diseases
• Are there any differences in treatment success rates between the microinjection method and the classical in vitro fertilization (IVF) method?

  The rates of establishing clinical pregnancy are not different between these two methods.