The drive to have a family is a very strong natural urge in most individuals or couples, and its due to this that IVF treatments will continue to be an avenue for those in need of it, even in the face of many unanswered questions. When considering this as an avenue to explore or go down, one should know the answers of at least some of the main questions regarding IVF procedures and centers. Here are some examples..
1. What is the real success rate for IVF ?
Centres usually declare their success rates to be between 40 and 60 % per standard trial. However, in most circumstances what can influence or determine your success as an individual is you yourself. Each individual couple's chance of success depends on a number of varying factors such as age, cause of infertility and lifestyle etc. In general, for women in age groups below 35 years, each IVF trial has a success of 50 %. This significantly decreases over the age of 40 years, and for women at and over the age of 45 years, the chance is below 5% (with some exceptions).
It must be remembered however, that 'chance' always plays an important role in success. Our experience over the years has shown that for the vast majority of those who resisted and continued forging their way forward without losing their hope or confidence usually ended up with the joy of being hande d their babies at the end. Having said that, and regarding persistence, it's worth noting that if a couple or individual do not obtain success after three attempts in the same centre, then perhaps it's best attempting treatment at other centers. This is less to do with the failure of original centre, but more to do with enabling the couple or individual to make a psychological change.
2. Is IVF really expensive as they demand ?
Success certainly comes first, but the financial burden on the patient is often so great that many couples feel that they can only afford one cycle and therefore face the added stress of trying to maximize their one and only chance to conceive in that cycle, or get pregnant on the first try.
If you look at IVF prices in developed countries, it ranges between $10,000- $15,000 in US and 4500-5000GBP in UK per cycle. Besides, these prices do not cover the drug expenses and most centres charge the techniques ICSI, AHA, blastocyst culture etc. additionally. I recommend evaluating experienced centres with at least 50 cycles per month and over, to compare costs and make your selection then. On the other hand, countries like Turkey has affordable prices with high success rates. Expenses can be minimised to one-third of the high costs mentioned above and combining your medical treatment with a vacation in these countries is quite possible.
3. Is it harmful for my health ?
Every patient who is considering using IVF probably asks herself this question before she starts treatment. IVF treatment has been practiced for more than 30 years all over the world. Remember that more than four million IVF babies have been born since the earliest IVF successes in 1978. Lots of investigations have been carried out on the fact that IVF is a safe procedure when performed carefully. Today, as treatment is carried out by an experienced physician in a experienced centre, hardly a serious problem arise. Of course, as in any attempt to treat, unexpected problems and complications may occur in the rate of 1-2 %. These problems can be solved by a very large extent on careful observation and experience. The most common problem is the collection of fluid in the abdomen, bloating, excessive arousal table presenting the findings of the need for hospitalization called hyperstimulation syndrome and is about 1-2 % in experienced centres. Myths like IVF causes cancer are not at all true or based on medical findings .
4. You cannot change the age and capacity of your ovaries.
Every woman is most fertile between the ages of 20 and 30. Fertility starts to decline significantly from the age of 35. The decline in number of eggs with age is an important issue in IVF. However, egg quality and fertilization rates are also reduced from 35 years of age. There are several tests to help you to comment on that. AMH blood test (AMH) is a marker for ovarian reserve and provide information on the number of eggs to be obtained but not about the quality of the eggs. It is an indirect way of evaluating how well the ovaries are working.
Nature behaves differently in different individuals. So whilst on one hand one woman may have a wealth of ovarian capacity, another woman may unfairly suffer from the onset of menopause at an early age. The same situation is also true for men. Some may have hundreds of millions of sperm in their counts whilst some others may have very low or even none existent sperm in their counts. Unfortunately based on such a genetic characteristics, there is no specific treatment can be done. Remember that, you cannot produce new eggs and sperms, but in vitro fertilization treatment uses what exists. Perhaps this fact is subject to change with the development of stem cell therapies in the near future. We hope that this process will not take too long.
5. There is also physical and emotional cost of IVF treatment.
The majority of couples describe the IVF experience as financialy, physically and emotionally demanding. Physical side effects can include headaches, insomnia, bloating, fatigue and emotional fluctuations. Many also find the IVF experience stressful as they go through the painful process of waiting for the result. Reputable clinics offer specially trained psychological counselling services to help people through the emotionally challenging aspects of IVF. Of course, not every couple is requiring this services. In this regard, note that you are entitled to receive support and be ready for some amount of stress.
6. There is no guarantee.
Approximately four million children have been born worldwide as a result of in vitro fertilization treatments. It is a highly efficient technology to have a baby when the other treatment modalities are failed. According to statistics, around 85% of pregnancy rate reached after 3 attempts. However, with a good-quality embryo transfer in the best conditions, pregnancy rate is 50-55% per trial. In addition, miscarriage may occur in up to 10-15% in the age of 35. For a young lady trying IVF, take-home baby rate of a single embryo transfer in the optimum conditions for each trial is about 40 % . When much higher figures in the first interview is given to you, you should think about reliability of that centre.
IVF is a highly effective treatment in overcoming many causes of infertility such as low-sperm count, blocked fallopian tubes and PCOS. However, there are no guarantees. In fact, it is known that half of the people who try IVF will not be successful for each trial.
7. When should I give up?
In theory, as long as eggs from woman and the sperm from the man can be obtained and the transfer performed, the couple has a chance of pregnancy. However, if female age is close to 45, with three or more failed attempts, only poor quality embryos hardly obtained despite high-doses of drugs, and you start to get in trouble financially, sit down with your partner and think again.
Should you go on trying even your doctor say so ?
Doctors may be reluctant to stop treatment because they don’t want to accept “failure” on their part as a care-provider or they may feel that part of their job is to remain eternally hopeful and optimistic for you. The bottom line is that this is your and your partners decision.
During the program, to get an appropriate response from the drugs, untimely and irregular effects (e.g. ovulation) of the hormones that your body secretes, have to be blocked. Generally, the drugs which would suppress the hormones are started on the 2nd or 21st day of the menstruation. These drugs are applied subcutaneously (under skin) once a day.
Vaginal ultrasound examinations are performed. Because it provides more detailed information compared to the abdominal ultrasound and saves you from discomfort because full bladder is not necessary. Follicles are liquid-filled sacs which are seen as dark colored, oval shapes under ultrasound and are thought to have oocyte inside. As the lubricant gel used is water-based, it does not have any side effects and does not stain your clothing. 
Hormone levels are traced by obtaining blood samples on certain days before beginning to use ovary stimulants. You will be informed in advance for such examinations.
When the follicle number and size, hormone level and the endometrium reaches the desired level, human corionic gonodotropin (hCG), is injected intramusculary to mature the eggs to trigger ovulation. 36 to 40 hours following the hCG injection, ovulation occurs. In IVF procedure, eggs are retrieved by emptying the follicles prior ovulation. As timing is very important, you have to pay maximum attention to follow the given information about hCG injection. On the hCG injection day, you will be explained and given a form explaining how you should get your injection done at a specific hour after 8 pm.
On the day of oocyte pick-up, please come to the hospital in the morning with your spouse, with empty stomach (avoid eating, drinking and smoking 6 hours before oocyte pick-up).
Not every retrieved egg yield to an embryo. Embryo transfer might be canceled if fertilization failure or inadequate embryo formation occurs. For this reason, you should call us the next day of retrieval and get information about the fertilization. In the following days, appropriately developed embryos will be transferred to the uterus. As this procedure is done as a normal vaginal examination, there is no need for anesthesia. We recommend that you have a light breakfast before you come to the center. Previously decided number of embryos will be transferred into the uterus with a plastic catheter in gynecological examination position. This procedure has to be done with full bladder. You can be discharged following this process, after a short rest. Again your IVF doctor will give you information about ET and the days following it. We recommend a home rest the same day but the following day you can go back to your routine life style.
Pregnancy test will be performed on the 12th day following the ET by detecting beta-hCG hormone level in blood. A pregnancy can also occur despite the bleeding.