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Frequently Asked Questions
Find answers to your questions about IVF treatment and our fertility services on this page. If you can't find the answer you're looking for, don't hesitate to contact us.
The IVF Process
IVF treatment consists of four stages. These stages can be listed as follows: 1. Assessment of the couple, examination, diagnostic tests and determination of the treatment protocol: During the assessment of the couple, the patient's symptoms, medical history and family history are reviewed, and factors related to the cause of infertility are investigated. An ultrasound scan is performed to examine the structure of the reproductive organs, the uterus and the ovaries, and to identify any diseases or changes in neighbouring organs, investigating their relationship to infertility. If a problem is identified that hinders treatment or reduces the chances of success, steps are taken to resolve this issue first. During the ultrasound scan, an assessment of 'ovarian reserve' is carried out, which plays a significant role in selecting the treatment to be administered in the future and in determining the likelihood of treatment success. In addition, with a view to preparing for pregnancy, the presence of certain hormonal, metabolic and viral diseases that could adversely affect pregnancy, as well as the patient's immune status, is investigated. 2. Stimulation of the ovaries with medication: This constitutes the most important stage of the treatment. The treatment regimen to be administered during ovarian stimulation is determined based on the patient's age, the appearance of the ovaries on ultrasound, hormone test results, and, in patients who have previously undergone IVF, the response to treatment in the previous cycle. The physician's experience in determining this treatment directly influences the outcome. 3. Egg retrieval: Under anaesthesia, guided by transvaginal ultrasound, eggs are aspirated from the follicles containing the egg cells using a fine needle and removed from the body. 4. Embryo transfer: The best 1 or 2 embryos (fertilised eggs) are selected from those monitored in the laboratory and transferred into the uterus using a thin catheter. This procedure is similar to a routine examination and does not require anaesthesia.
The ideal time to start the egg stimulation process in IVF treatment is on the second or third day of the period. However, this is not an absolute requirement. Under certain specific conditions, ovarian stimulation medication can be started at any stage of the menstrual cycle.
Ovarian stimulation typically lasts approximately 8 to 14 days, although in some cases it may be shorter or longer. The growth of follicles that may contain eggs is monitored via ultrasound. Monitoring will require 4-5 visits to the IVF clinic during the course of treatment. In addition to ultrasound scans, hormone monitoring may also be carried out in some women. These hormones include oestrogen, progesterone and LH, and in some cases FSH. Once the follicles have reached the desired size, maturation injections (known as HCG or GnRH analogues) are administered to bring the eggs inside them to full maturity, and, barring certain special circumstances, the oocyte pick-up procedure is usually performed 34-38 hours later.
The oocyte pick-up (OPU) procedure is usually performed under local anaesthesia and takes approximately 15-30 minutes, depending on the number of follicles. If the ovarian response is limited and a small number of eggs are anticipated, the procedure may also be performed under local anaesthesia whilst the patient is awake. Following the procedure, you can return home after approximately 1-2 hours of observation and monitoring.
Once the oocyte pick-up has been completed, fertilisation with sperm takes place. The embryos are then monitored in the laboratory in special culture media for 3-5 days, or in some cases for 6-7 days. If there are any remaining high-quality embryos suitable for freezing after the transfer of those assessed in the laboratory and selected for transfer, these can be frozen and stored for transfer at a later date.
In Türkiye, the number of embryos that can be transferred is determined by regulations; for women under 35, it is limited to 1 embryo for the first 2 attempts, and for women over 35, it is limited to a maximum of 2 embryos. Under no circumstances is the transfer of more than two embryos permitted.
During the IVF treatment, ultrasound scans and blood tests are carried out during the egg stimulation phase to monitor egg development and adjust the dosage. On average, you will need to visit the hospital four or five times during the treatment process for these check-ups. As the time spent at the hospital during these check-ups is brief, they can be carried out without disrupting daily life or work routines.
Success Rates
The most up-to-date measure of success is the live birth rate of a single healthy baby per IVF cycle initiated. Multiple pregnancies are now considered high-risk, and transferring embryos one at a time wherever possible has become a global trend.
There are many variables that determine the chances of success in IVF, but the most important of these are the woman's age and ovarian reserve. In younger women with high ovarian reserve, the pregnancy rate (defined as the proportion of pregnancies resulting in live birth following the sequential transfer of all embryos obtained from a single egg retrieval) is higher. However, in women over the age of 40, this rate decreases, and by the age of 45, it drops to very low levels. Unfortunately, these results are not altered by supplements or 'rejuvenating' agents administered to the ovaries. AMH is one of the most reliable markers of ovarian reserve. Although a low AMH level does not necessarily mean pregnancy will or will not occur, it indicates that the number of oocytes picked up during the oocyte pick-up procedure will be low. Sperm quality is also a factor that directly affects embryo quality and the chances of pregnancy. In cases where there are very few sperm in the semen or where sperm must be retrieved from the testicles, embryo development is adversely affected.
Ovarian reserve is determined by an experienced physician performing a transvaginal ultrasound scan to assess the number of antral follicles present in the ovaries and their distribution. With advancing age, there will be a loss in the ovarian reserve; concurrently, there will be a reduction in ovarian volume and a decrease in the number of antral follicles. In addition to ultrasound, anti-Müllerian hormone (AMH) is the marker that best reflects ovarian reserve. Low AMH levels allow us to predict that the response from the ovaries during treatment will be poor, enabling us to tailor the treatment protocol accordingly.
In patients who have previously undergone unsuccessful IVF attempts, the most important factor determining the chances of success in the next treatment is the information regarding the ovarian response and embryo quality from the first treatment. When planning a new treatment, data from the previous treatment cycle is taken into account to plan how to obtain the healthiest and highest number of eggs from the ovaries. A history of low oocyte pick-up or poor-quality embryo development may be due to factors related to the patient, or it may be linked to the treatment protocol and medication doses used, as well as laboratory conditions. Other reasons for failure to achieve success include fibroids, polyps, blocked fallopian tubes, uterine malformations and intrauterine adhesions. Correcting these issues, where applicable, will increase the chances of pregnancy. Additional tests and assessments, such as investigations into coagulation disorders (congenital or acquired) and immune function, are not routinely recommended. The cause-and-effect relationship for both is unclear.
Various supportive medications, primarily the hormone progesterone, are used to support the embryo's implantation in the uterus following embryo transfer. The use of medications without scientific evidence (such as aspirin, blood thinners, agents that inhibit uterine contractions, immunosuppressive drugs, etc.) or strict bed rest will not increase the embryo's chances of implantation and will only cause unnecessary anxiety and expense.
Egg and Sperm Quality
Various vitamins, hormones and supplements aimed at improving egg quality have been used over the years, but none have been observed to make a clinically significant difference. Quitting smoking and losing excess weight may be beneficial. The most important factor determining egg quality is the woman's age. However, with optimal treatment, care should be taken to obtain the best and healthiest eggs from the ovaries.
Sperm quality is assessed based on three parameters: count, motility and morphological characteristics. Sperm morphology should not be considered as a separate parameter from sperm count and motility. There are certain specific structural abnormalities in sperm that can affect fertilisation and embryo development. In such cases of morphological abnormalities, sperm count and motility are also adversely affected. In such cases, specific solutions that support sperm motility and assist in the activation of the egg can be used to maintain fertilisation rates and prevent adverse effects on embryo development. It has also been demonstrated that microfluidic sperm separation methods may be beneficial. However, their superiority over conventional sperm sorting methods is debatable. Selecting sperm under high magnification (IMSI) is another method that can be used.
In vitro fertilisation, or conventional IVF, involves combining eggs retrieved from the woman with sperm retrieved from the man in a laboratory environment and transferring the embryo into the woman's uterus a certain time after fertilisation has taken place. Intracytoplasmic sperm injection (ICSI) or microinjection, on the other hand, refers to the procedure in which sperm obtained from the man is injected directly into the egg, followed by the embryo being transferred into the woman's uterus after a certain period following fertilisation. In both procedures, the primary aim is to bring the reproductive cells together in an external environment and achieve fertilisation. In the IVF method, sperm and eggs retrieved from the body are brought together in a special environment in the laboratory, and it is expected that fertilisation will occur naturally within a certain period of time. Sperm with insufficient motility and fertilisation capacity, or those that are few in number and severely malformed, cannot penetrate the egg on their own to achieve fertilisation. In such cases, fertilisation is achieved by injecting the sperm into the egg using a fine needle. This procedure is known as microinjection.
Embryo quality is assessed based on the rate of development, cell division characteristics observed during the three- to five-day monitoring period in the laboratory, and the morphological characteristics present at the blastocyst stage. A video recording of each embryo's five-day development within the incubator is examined to determine the time taken to reach specific developmental stages and the quality of these stages. This information is evaluated alongside the morphological characteristics the embryo has reached by day 5 (the structure of the inner cell mass and trophoectoderm cells, the width of the blastocyst cavity, the condition of the zona pellucida membrane surrounding the blastocyst, etc.) to determine embryo quality and select the embryo to be transferred.
Effects on the Female Body and the Emotional Process
Unless you change your lifestyle, the medication does not cause weight gain. Hormone levels rise temporarily. This produces effects similar to those experienced during the premenstrual phase. The body may retain some fluid, which is then relieved by menstrual bleeding. However, during this process, patients may become highly stressed due to the pressure to achieve the desired positive outcome. This, in turn, may negatively affect their eating habits.
In a significant proportion of treatments, the process begins in the early phase of the woman's menstrual cycle, and the follicular growth phase and oocyt pick-up stage are completed within that cycle. If a fresh embryo transfer is to be performed, the embryo transfer procedure is carried out a few days after the oocyte pick-up. In some cases, the retrieved eggs or embryos are frozen. In both cases, a missed period will occur if pregnancy is achieved; however, following egg freezing, the menstrual cycle will resume either during the expected period or within 7-14 days after the procedure.
As couples embark on this journey with a highly significant goal in mind, the emotional burden of the process, experiences from previous treatments, and socio-economic factors can lead to emotional fluctuations. Support from a partner, family and friends is of the utmost importance in minimising these fluctuations.
Every stage of IVF treatment, including ultrasound scans, injections, the egg retrieval process, embryo development stages and the transfer stage, can be a source of stress for the couples. Any stress that may arise during this process should be managed with the support of a partner, family and friends, and efforts should be made to control its negative impact on the process.
Medication Use and Monitoring
In treatments that often begin at the start of the menstrual cycle, or in some cases on any day of the cycle, injections are typically administered for an average of 8-14 days during the egg development phase. When a fresh or frozen embryo transfer is to be performed, progesterone is added to the existing injection treatment and is generally used until the first 8-10 weeks of pregnancy.
One of the most important aspects of IVF treatment is the correct determination of medication doses. The treatment protocol and medication dosage are determined based on the woman's age, weight, hormone test results (AMH), the number of follicles visible on ultrasound, and, if available, the response observed in previous treatments. A lower dose of medication may be required for a young woman with a good ovarian reserve, whilst a higher dose may be necessary for an older woman or one with a low ovarian reserve.
On the day treatment begins, the medications the woman will use are demonstrated by our nurse specialised in this area, who explains the procedure both verbally and in writing whilst administering the first dose. Generally, following this training, patients are able to administer their treatment comfortably in their own environment. However, some of our patients may choose to have their medication administered by visiting a healthcare facility nearby or by contacting the IVF unit where they are receiving treatment.
Embryo Freezing (Cryopreservation) and Genetic Screening
In theory, it can be said that embryos can be preserved indefinitely after the freezing process. However, according to the IVF Regulations, once five years have elapsed following the freezing process, the preservation period for embryos can be extended by submitting a written request to the Ministry of Health.
Embryos are frozen using solutions known as specially formulated media. Nowadays, following the widespread adoption of specially prepared solutions and a rapid freezing technique known as vitrification, embryos are safely preserved in liquid nitrogen tanks at -180°C. Whereas the likelihood of embryos being adversely affected by the 'slow freezing' technique was previously 20-30 percent, this rate is now below 1 percent with the vitrification technique. However, in some cases, it may be necessary to thaw and refreeze embryos. Studies indicate that pregnancy rates may decrease after more than two cycles of freezing and thawing.
As the aim of IVF treatment is to stimulate the growth of a large number of follicles, hormone levels in the blood are higher than during a natural menstrual cycle. It is currently a matter of debate whether this may lead to the uterine lining (endometrium) maturing earlier and, consequently, whether pregnancy rates may be slightly lower. The aim is to perform a fresh transfer provided that oestrogen and progesterone hormone levels do not exceed critical thresholds. No significant difference has been found between the success rates of fresh embryo transfer and frozen embryo transfer. Scientific research indicates that pregnancy rates are similar in both cases. Therefore, fresh embryo transfer may be preferred unless there is a medical condition requiring all of the patient's embryos to be frozen.
One of the most controversial aspects of IVF treatment is the genetic screening process. In some countries, PGT-A is directly recommended and performed for patients aged 35 and over. However, as the technology still has some grey areas (mosaic embryos) and due to the possibility that embryos capable of resulting in a healthy birth may not be transferred due to false positives, embryo genetic screening is important in the following scenarios: • Older patients • Patients with a history of multiple failed attempts • Patients with chromosomal abnormalities in either the woman or the man, where there is a high likelihood of these being passed on to the embryo • Inherited single-gene disorders • Patients with unexplained recurrent pregnancy loss
In order to carry out genetic screening, it is usually necessary to remove a few cells from the embryo, which is believed to represent the embryo, once it has reached the blastocyst stage. This procedure can be performed mechanically, using an acidic chemical, or with a laser. Nowadays, this procedure can only be performed very precisely using a laser. More importantly, the embryo is allowed to reach the blastocyst stage, and a sample is taken from the trophoectoderm cells, which will form the placenta, without touching the inner cell mass, which consists of the cells that will form the embryo. Therefore, there is a possibility of the embryo being damaged during the procedure, but this risk is negligible.
Cost and SGK Support
In IVF treatment, state funding can be obtained by producing an IVF report (signed by three people). To obtain this report, you must apply to centers authorised to issue such reports. Your physician must determine that IVF is necessary for the report to be issued. To obtain the report, one of the spouses must have at least 5 years of service with the Social Security Institution and a minimum of 900 days of contribution days, and the female partner must undergo a medical examination confirming she has no medical conditions preventing pregnancy. If deemed appropriate, an SGK report may then be issued.
Here, the couple's medical history and current condition regarding IVF treatment are significant. Following the physician's assessment, different methods to increase the chances of pregnancy or mandatory procedures to achieve pregnancy may be required. Services can be categorised as those related to laboratory and embryology, genetic and advanced diagnostic services, freezing and storage services, and services related to uterine preparation. These procedures include Embryo Glue, the microchip technique, IMSI, genetic embryo biopsy, and hysteroscopy/hysteroscopic polyp removal.
Post-Transfer Period
Embryo transfer corresponds to the time when, in a natural pregnancy, the embryo travels from the fallopian tube to the uterus. Just as there is no need for physical activity restrictions or bed rest in a natural pregnancy, there is no need for them after embryo transfer either. Research shows that bed rest following embryo transfer does not increase the chances of pregnancy. Similarly, there is no requirement to restrict sexual activity after the transfer. However, it is advisable to proceed with a plan as deemed appropriate by your physician. A blood test for pregnancy (hCG) should be carried out at least 10 days after embryo transfer. Tests carried out earlier may give a false-negative result, meaning that even if you are pregnant, the test may come back negative. Bleeding occurring the day before the pregnancy test does not necessarily mean you are not pregnant; it is advisable to continue taking your medication and contact your physician.
Diet and Lifestyle
Diet and weight management are always important for general health. When the body mass index rises to the obesity threshold, the chances of a live birth decrease. Attention should be paid to diet not only during IVF treatment but at all times; maintaining a healthy and balanced diet is beneficial. Healthy dietary recommendations are actually no different for women planning a pregnancy and those who are not; nor is there a specific IVF diet.
Alcohol and smoking are harmful to health in many ways. They should be avoided not only during IVF treatment or pregnancy, but at all times. Studies evaluating the impact of smoking and alcohol on the chances of achieving pregnancy generally show that they make conception more difficult, and that the effect is related to the dose and quantity consumed. The same negative effect has not been observed for caffeine. Unless you consume very large quantities (such as more than two cups of filter coffee, more than four cups of Turkish coffee or more than four espressos a day), there will be no adverse effects.
Dietary supplements, including vitamins, offer no additional benefits (or only very limited ones) for women who follow a balanced diet. As vitamin D is important for the bone development of new-born babies, it is assumed that it may also be beneficial during the prenatal period. However, it is very difficult to say that vitamin D directly increases the success of IVF. Based on current guidelines, there is no vitamin or dietary supplement other than folic acid that is routinely recommended.
Alternative Practices and Supportive Treatments
We all hope for every treatment to be successful, and we discuss every option we believe might improve your chances with you. Especially when there are conditions that negatively affect treatment success, such as advanced age or very low ovarian reserve, it is common, and often recommended, to seek hope in methods like 'alternative medicine' out of a sense of helplessness.
Although there are reasonable scientific theories behind some of these procedures, there is no miracle that has been proven by reliable clinical research. We do not actively recommend these treatments to you. Any treatments you are curious about should be discussed with your physician, and a joint decision should be made after weighing the potential benefits and risks.
Artificial Intelligence Applications
It is a fact that artificial intelligence technologies are developing rapidly and are making workflows more efficient in many fields. It is highly likely that it will find applications in IVF treatments, particularly in laboratory procedures. However, as of January 2026, there is no artificial intelligence application that delivers better results than experienced embryologists.
Artificial intelligence is increasingly being used in IVF laboratories for embryo selection. Time-lapse embryo monitoring systems and AI-based algorithms help identify the embryo with the highest implantation potential by analysing their division rates and developmental patterns. Although this technology is still in its developmental stage, it is difficult to state with certainty that it provides more objective and consistent results compared to standard evaluations.
Fertility Preservation
Yes — marital status alone is not a barrier to egg freezing; however, in Türkiye the procedure is subject to specific medical eligibility criteria. Conditions set out in the regulations are assessed, such as diminished ovarian reserve, a family history of early menopause, or certain treatments that may affect fertility.
The monitoring and egg retrieval stages of the egg freezing process are planned according to the individual's anatomy and medical situation. In people with no history of sexual intercourse, the examination and the method of the procedure can be individualised accordingly. The most appropriate approach is determined by the gynaecologist with privacy in mind. Depending on the patient's preference and circumstances, egg retrieval can be performed either vaginally or abdominally.
Egg cells can be stored indefinitely under laboratory conditions. Under the current regulations in Türkiye, reproductive cells such as eggs may be stored at a centre for a maximum of five years, and storage beyond that requires the permission of the Ministry of Health. If storage exceeds one year, the individual must also confirm annually that their consent still stands. As the regulations can change over time, current conditions should be confirmed with the centre.
The experience during the egg freezing process varies from person to person. Tenderness or bloating related to the injections may occur during ovarian stimulation. Sedation or anaesthesia options can be used for the egg retrieval procedure. Temporary cramping and tenderness may follow the procedure; a doctor should be consulted in the event of unexpected or severe symptoms.
If the sperm sample is produced by masturbation, the freezing procedure itself does not cause physical pain. However, if the sperm has to be obtained surgically — by TESE or micro-TESE, for example — anaesthesia may be used and temporary pain, tenderness or swelling may occur afterwards. The experience depends on the method used.
The number of sperm samples required varies from person to person. The semen analysis result, the total sperm count, the reason for freezing and the assisted reproduction method planned for the future can all influence the decision. A single sample may be sufficient for some people, while storing more than one may be considered in other situations. The plan is determined by laboratory and medical assessment.
Sperm cells can be stored indefinitely under laboratory conditions. Under the current regulations in Türkiye, sperm samples may be stored at a centre for a maximum of five years, and storage beyond that requires the permission of the Ministry of Health. If the storage period exceeds one year, an annual declaration that the individual's consent still stands is also required. Current conditions should be confirmed with the centre.
Yes. After thawing, frozen sperm is assessed for viability and suitability for use, and where appropriate it can be used in IVF or microinjection treatment.
Surgical Procedures
The duration of micro-TESE surgery varies from person to person. The structure of the testicular tissue, the search for areas that may contain sperm and the laboratory's concurrent assessment can all affect how long the procedure takes. Admission to hospital, preparation for anaesthesia and the post-procedure observation period should be considered separately from the operation itself.
After micro-TESE it is important to rest, to protect the wound area and to take any prescribed medication as advised by your doctor. Your doctor's advice should be awaited before returning to strenuous physical activity. If unexpected symptoms occur — increasing pain, fever, heavy bleeding or marked swelling — you should contact a healthcare provider.
If no sperm is found, the treatment process needs to be reassessed by the specialist team. Genetic and hormonal investigations, previous treatments and the couple's reproductive plan may be reviewed together. As the approach from that point on can differ for each patient, there is no single standard next step.
If suitable sperm is found during micro-TESE, it can be used in microinjection (the injection of a sperm into the egg) and pregnancy may be achieved. However, finding sperm alone is not a guarantee of pregnancy or a live birth. The outcome also depends on egg characteristics, embryo development, uterine factors, age and other clinical variables.
The pain or cramping felt during hysteroscopy can vary from person to person. Diagnostic or office hysteroscopy performed with fine instruments may cause more limited discomfort, while anaesthesia or sedation may be used for operative procedures. The extent of the procedure, the characteristics of the cervix and individual pain sensitivity are among the factors affecting the experience.
There is no single duration that applies to everyone. Diagnostic procedures take an average of 15–30 minutes and operative procedures 30–60 minutes. Operating times can differ depending on the extent of the procedure performed. Preparation for anaesthesia and post-procedure observation should also be considered separately from the hysteroscopy itself.
The use of anaesthesia in hysteroscopy can vary according to the type of procedure. Some office hysteroscopies performed with fine instruments can be carried out without anaesthesia or with local pain control, while sedation or general anaesthesia may be considered for operative procedures. As the level of pain and cramping felt can vary from person to person, it would not be accurate to state categorically that "hysteroscopy is painless".
The timing of a hysteroscopy is determined by factors such as the purpose of the procedure, the menstrual cycle and the possibility of pregnancy. In pre-menopausal women with regular periods, the first days after menstrual bleeding has finished are generally preferred for diagnostic hysteroscopy. The possibility of pregnancy must be excluded before the procedure. It can also be carried out at other points in the menstrual cycle, depending on what suits the doctor and the patient.
There is no single sleeping position that is required for everyone after a laparoscopy. Generally a comfortable position that does not increase pain or place undue pressure on the incision sites can be preferred. Avoiding sudden movements when getting out of bed may help. For more extensive operations, the surgeon's discharge advice should be followed.
The visibility of the skin incisions of 1 cm or less used in laparoscopic surgery generally decreases considerably within 1–4 months. The number of incisions, the size of the wound, skin type, genetic predisposition and the wound healing process can all affect the appearance of the scar.
Abdominal bloating after a laparoscopy is generally related to the gas used during the operation and to the healing of the tissues, and it decreases over time in most people. The duration can vary with the operation performed, but symptoms decrease considerably within the first 24 hours after surgery. If the swelling increases progressively, or is accompanied by severe pain, fever or persistent vomiting, the healthcare team should be contacted.
The duration of laparoscopic surgery varies with the extent of the procedure to be performed. A purely diagnostic assessment and surgery for endometriosis, fibroids, cysts or extensive adhesions are not completed in the same amount of time. Short diagnostic operations can be completed within 30–60 minutes, while extensive surgery can take considerably longer. Preparation for anaesthesia and the post-operative observation period should also be considered separately from the surgery itself.
Preimplantation Genetic Testing
The embryo biopsy performed for PGT is carried out under controlled conditions in experienced laboratories, but the risk of the procedure cannot be said to be entirely zero. The rate of embryo loss after the procedure is around 1%, and is lower in experienced laboratories. Removing a limited number of cells from the embryo, and the subsequent freezing and thawing stages, carry certain risks. The benefits and limitations of PGT should therefore be assessed for each patient individually.
The time taken for PGT results varies according to the type of test used and the working methods of the genetic laboratory. PGT-A and PGT-M, which may require family-specific preparation, do not necessarily take the same amount of time. PGT-A results are typically available within 7–14 days, while PGT-M results can take 2–4 weeks. The exact timing after the embryo biopsy should be confirmed by the performing laboratory before treatment.
No. An embryo found genetically suitable for transfer by PGT cannot be said to be certain to implant in the uterus. PGT only assesses the genetic or chromosomal characteristics that were tested. An embryo with a normal PGT result has a higher likelihood of implanting and resulting in a live birth, but embryo development, conditions within the uterus, age and other biological factors also affect the outcome of pregnancy and live birth.
During PGT, some tests may technically reveal information about the chromosomal sex of the embryo; however, in Türkiye sex selection may not be carried out for personal preference or for "family balancing". Cases with a medical indication — particularly where there is a risk of a sex-linked hereditary condition — are assessed separately.
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