Frequently Asked Questions

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.

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.

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.

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.

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.

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.

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.

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 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.

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.

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.