IVF (In Vitro Fertilization) – The Best Guide

Northern Cyprus is one of the world’s leading providers of IVF treatments, offering excellent fertility clinics with excellent specialists. Infertility treatment is a long and sensitive journey that touches on the most sensitive parts of life. Project Healthcare is proud to share the journey of becoming a family with IVF patients.
We pay attention to the diversity of each family’s story alongside respecting their privacy first and foremost. We believe in the importance and value of our families and serve them in accordance with all the legal and ethical values of the Turkish Republic of Northern Cyprus.

project-healthcare-ivf
project-healthcare-ivf-1

At the same time, the Institute for Embryology meets European standards and works with centers with the best technology. The experimental results from our experienced embryologists are very flattering. We work with the Center, which has the largest donor portfolio in Northern Cyprus and provide prompt service to patients without a waiting list. We also take pride in bringing you closer to the beauty and freshness of Cyprus through treatments. You are free to use a well-thought-out package to allow you to spend the treatment process in a secluded comfort with air, nature and local beauty.

What is In vitro fertilization (IVF)?

In vitro fertilization (IVF) methods, which have long been preferred by couples and women who are unable to give birth, are now one of the most common treatment techniques. The basis of this technique, used for women who do not yet have children due to various factors, is based on placing embryos created in a laboratory environment according to advanced techniques in the mother’s womb. The individually planned treatment process is carried out by a team of experts. The technique involves many processes from preparation to patient treatment, such as  ovarian stimulation, sperm capacitation, laboratory examination, Intracytoplasmic Sperm Injection (ICSI), and embryo transfer.

In which cases is IVF recommended?

Situations that require In Vitro Fertilization for men and women can be listed as follows;

Female related factors;

Male related factor;

Closed fallopian tubes or tubes previously tied or damaged,
Immunological infertility or unexplained infertility,
A viscidity condition that will prevent the ovum developing in the ovaries from being stuck to fallopian tubes,
Inability to get pregnant despite drug treatment for ovulation,
Occurrence of the endometrium layer outside the uterus, on the intestines, around the tubes or in the ovaries (also known as Endometriosis)
In cases such as decreased fertility in women due to age, in vitro fertilization treatment is applied.
Studies have shown that the lack of sperm cells in men is the reason for in vitro fertilization,
In vitro fertilization treatment is used for unexplained infertility or immunological infertility in both men and women,
Sperm deficiency in semen, known as azoospermia,
Male oligospermia
Presence of amorphous sperm (weak sperm morphology)
In vitro fertilization is also used when sperm motility is poor.

When is IVF treatment recommended?

IVF treatment is used for women who cannot become pregnant for some reason. In vitro fertilization treatment in Cyprus has many benefits for families and mothers who want to have children. This is a treatment that can be used by many women who are trying to become pregnant in old age, especially families who are trying to become pregnant. IVF treatment is one of the most preferred methods of pregnancy today. The country has become Europe’s leading center for in vitro fertilization treatment, especially due to the high-tech equipment used in the Turkish Republic of Northern Cyprus and the management of the process by a team of experts. The conception rate is very high thanks to the diagnostic and laboratory procedures performed in the clinical setting and the individually designed in vitro fertilization treatment plan.

project-healthcare-ivf-2

What is mini IVF?

The Mini IVF application is an in vitro fertilization treatment that does not use high doses of drugs or daily needles. This method, also known as simplified IVF treatment, produces fewer eggs but higher quality eggs. At the final stage of the Mini IVF method, which uses standard IVF and ICSI techniques, embryos are transplanted into the patient.

The main goal of mini IVF treatment is to obtain high quality eggs. One healthy egg can be  enough to have a baby. Therefore, it is an advantageous technique in avoiding situations such as discontinuing treatment or being unable to take the patient to treatment.

Mini IVF Treatment

is the preferred treatment for all women:

Who is young and can produce many eggs,
May have low ovarian reserve and is at an older age
Decreased egg cell development due to drug use
Whoes ovaries are overstimulated due to polycystic ovary syndrome (overstimulation syndrome).

The main medications used in mini IVF treatment begin on the third day of menstruation. Once the egg has reached a certain size, another low-dose drug may be used.

Why is IVF treatment done?

In vitro fertilization is a treatment used for couples and women who have been unable to have a baby due to a variety of factors. It is recommended for many couples who have not responded to fertility treatment and have been unable to become pregnant despite an active sexual life of over a year.

How to get prepared for IVF treatment?

project-healthcare-ivf-3

One of the most important factors in the treatment preparation process is that both couples should have accepted the treatment. In particular, the information about the procedure should be detailed and descriptive. Patients should be informed of many aspects such as the tests required for treatment, success rate, failure rate, and so on. A Mediterranean diet is recommended before treatment to maintain the health and well-being of the mother. If there is a weight problem, starting treatment when the ideal weight is reached  your ideal weight. The dose of the drug used should be at normal levels. Complications can occur during treatment.

The main complications that may occur during IVF treatment are:

1) Ectopic pregnancy: A condition that develops when a fertilized egg attaches to a place other than the uterus. In this type of situation, also known as an ectopic pregnancy, life-threatening bleeding can occur if the growing tissue is not treated.
2) Early pregnancy complications: The most common early pregnancy complication is sudden bleeding.
3) Miscarriage: IVF treatment is not a high risk procedure for miscarriage. It is a treatment with the same level of risk as women who become pregnant naturally.
4) Multiple pregnancies: Transplanting multiple embryos into the uterus increases the risk of multiple pregnancies by in vitro fertilization. This type of condition can lead to risks such as preeclampsia, preeclampsia, gestational diabetes, and bleeding.
5) Fetal and neonatal complications: The risk of congenital anomalies applies not only to women who become pregnant with IVF, but also to women who become naturally pregnant.

IVF treatment does not carry the risk of treatment-specific complications. It carries the same risks as complications that women who conceives naturally may face.

How does the IVF treatment progress?

After completing the preoperative procedures required for IVF treatment, the first step is ovarian stimulation. The purpose of ovarian stimulation is to induce pregnancy. To increase the success rate during the pregnancy process, the number of oocytes (eggs) in healthy women is expected to be one or more. In this way, it is more likely to get pregnant with high quality eggs. Ovarian stimulation uses blood tests, vaginal ultrasonography, and medical methods to achieve this number suitable for pregnancy. The average treatment period is 8 to 12 days.

If the treatment is not done with a donated egg in the egg collection process, a cracking needle is applied.  The process start time is 36 hours. This procedure, performed under general anesthesia, uses a fine-tipped needle to remove the mature egg. The average operation time is 10-15 minutes. Semen samples are requested from the male on the same day of the procedure. To improve sperm quality, the male should not masturbate 3 days before sampling. In some cases, it may be necessary to dissolve and prepare sperm samples previously obtained from a male partner, if possible. The same procedure applies to donor sperm samples.

Laboratory vaccination stage is the stage wherein the morphology and movement of the spermatozoa concentration and whether or not to use for classical IVF or ICSI application are determined after the tests. There is 24-hour waiting duration after the eggs taken from the ovaries are located withinside the embryo culture medium together with the sperm with out losing any time. The fertilization rate and the number  of pronuclear stage embryos are determined for incubating eggs after vaccination. Cells of two pronuclei representing chromosomes are an indication of a successful fertilization in eggs. Necessary environmental condtitions must be supplied for the healthful development of the obtained embryos (moisture balance, temperature, gas concentration etc.) and contact with with the embryos must be minimal.

project-healthcare-ivf-4

At the end of the 72 hours, experienced embryologists provided information on the embryo quality (with 6-8 cells), the number of eggs, blastocyst transplantation stages favorable for culturing embryos, and the patient’s compatibility for the transfer. After activation of the embryonic genome from the 6-8 cell stage, attempts are made to identify healthy embryos with extended culture.

Within 5 days, experts will determine if all embryos are at normal and healthy developmental levels with respect to chromosomes. At this step, Preimplantation Genetic Diagnosis (PGD) is recommended to guide the process in a healthy way. PGT is a biopsy high-quality embryo cell collection method that fertilizes 4-5 days after the collection of eggs developed in vitro fertilization and laboratory environment testing for genetic testing purposes.

Both Partners are informed of the advantages and disadvantages of treatment throughout the process. The process is done in consultation with parents so that they can make a healthy decisions about the type of treatment which will be applied.

The embryo biopsy stage is the stage of removing one or more cells from an embryo. At this stage, experienced embryologists can diagnose and determine the genetic status of cells sent to the laboratory, distinguishing between healthy and diseased embryos.

ICSI (Intracytoplasmic Sperm Injection) is the placement of a spermatozoid into the mature egg. This method, which specifically allows infertile men, who can not become a father because of lack of sperm, is frequently preferred today. ICSI is a valid practice in fertilizing the egg cell and developing an embryo in any case there may be a problem in sperm form or motility. Similarly, it’s preferred for cases wherein there may be no sperm this is known as azoospermia.

In practice, both testicular tissues are accessed through an incision made on the surface of the scrotum where the testicles are located. After examination under a microscope, a suitable area for fertility is determined. Micro tissue pieces collected from this region contain live sperm cells. Sperm cells are injected into the egg using the ICSI method. This method, called micro TESE, has a high success rate.

project-healthcare-ivf-5
project-healthcare-ivf-6

Embryo transfer takes place within 2-5 days, which is known as the highest level of treatment. The goal at this stage is to transfer the embryos taken from the laboratory to the mother’s womb. After the application, catheter the embryo transfer into the uterus is monitored by abdominal ultrasound. This step is necessary to ensure that the droplets containing the embryo are in place. The application is convenient and painless. It takes place without anesthesia or sedative.

Not all healthy embryos obtained after embryo transfer can be transferred to the uterus at one time. Embryos obtained as a result of this situation which is subject to medical and legal restrictions  can be frozen and stored with the consent of the couple. The storage and freezing costs required by the patient is one year. After one year, healthy embryos can be stored in the next year under current conditions at a reasonable processing fee.

Conclusions about the outcome of treatment are possible within 1012 days after embryo transfer. Follow-up on urine results is very important at this stage. For some patients, the test can be repeated after 48 hours.

Pre-operation process

The preoperative process involves a detailed analytical process to diagnose and identify the cause of infertility and determine treatment options. After referencing a medical biography to diagnose male infertility, a semen sample analysis called a semeniogram is required. Based on the results obtained, a urologist will evaluate the urology department.

Women have procedures such as gynaecological and endometrical cavity examintaion and transvaginal ultrasonography which makes it possible to evaluate egg reserves. After extensive examinations such as menstrual cycle analysis and detection of changes in the fallopian tubes, sexual health is also assessed as needed. The IVF process begins when the couple is psychologically and biologically ready for IVF treatment.

Post-operation process

For the pregnancy to continue for 8-10 weeks, women must have a sufficient amount of progesterone hormone in their body. If there isn’t, it means that there is no pregnancy. If the test is positive, 2 weeks later vaginal ultrasonography is performed. In this step, it is even possible to monitor the baby’s heartbeat. During the first 3 months after the embryo transfer stage, drug use should be under the control of a physician. Stopping taking of many drugs at an early stage, especially those containing progesterone hormone, may cause a miscarriage risk.

It is important to rest on the same day of the embryo transfer. After the procedure, spending a few hours in the clinic and resting is recommended for the future mother.

It is not recommended for the mother to do heavy exercises after the treatment, but there is no harm in changing her daily life habits. (Short walks, daily chores, etc.) She should consume healthy foods in her diet, avoid excessive salt consumption, alcohol intake and drinks with high caffeine content. She should prefer foods rich in fibre, grains and protein and create a healthy nutrition program. In this process, it is also possible to create a common list of nutrition with the right foods by consulting the relevant doctor. There are also supplements that can be given to some patients to use in this process

What is the success rate in IVF?

There are many criteria that affect the success of IVF treatment. It is possible to talk about many clinical factors such as the equipment and infrastructure of the centre where the treatment will be made, the experience of the doctor staff, embryologists, the techniques used in the treatment, the adequacy of the laboratory environment.

At the same time, it should not be forgotten that the most important criteria affecting the success rate of treatment are the age of the woman getting prepared to pregnancy, fertility history and egg quality.

The main criteria that negatively affect the chance of success in the first trial phase of the treatment process; being overweight, problems with the immune system, hydrosalpinx in the tubes, intrauterine problems, decreased ovarian reserve, frequency of smoking and alcohol use.

Every couple who wants to have a child with IVF may have vital habits that need to be changed before the application process starts, or in the presence of any infection/disease, it may be requested to perform treatment attempts to solve the problem in the first place. In the first stage of treatment, the aim is; is to eliminate all factors that will adversely affect the process.

Other factors that will affect the success of IVF are the psychological support of the mother and father to each other. In addition to being physically prepared for the process, it is very important for the mother to be ready for the treatment and to feel comfortable and calm mentally. In particular, activities that will reduce stress, nature walks, and methods such as meditation will help her relax.

For the success of the treatment, It is recommended that both mother and father eat the right foods. In particular, for men eating protein and carbohydrate-containing foods is an element that increases sperm quality. Regular water consumption should not be neglected, and attention should be paid to a diet rich in fruits, vegetables and protein. Mediterranean diet type foods (almonds, hazelnuts, whole wheat flour, roasted vegetables, mackerel, rye, etc.) is recommended for many candidates in this process.

For the success of the treatment, It is recommended that both mother and father eat the right foods. In particular, for men eating protein and carbohydrate-containing foods is an element that increases sperm quality. Regular water consumption should not be neglected, and attention should be paid to a diet rich in fruits, vegetables and protein. Mediterranean diet type foods (almonds, hazelnuts, whole wheat flour, roasted vegetables, mackerel, rye, etc.) is recommended for many candidates in this process.

project-healthcare-ivf-mediternian-diet

What should be considered in IVF treatment?

It is recommended that the mother pay attention to her nutritional routine before starting the treatment process.
She must inform her physician if there is a problem about the drugs she is having and her genital health.
Alcohol and smoking should be quitted.
It is not recommended for father candidates to be in very hot environments at least 3 months before. Hot weather negatively affects sperm quality and sperm production.
Again, as in women, the drugs used in men before the treatment should be reported to the physician, and if there is any inflammation of the genital organs, they should be treated.
For a healthy treatment process, stress should be avoided.

Is IVF treatment legal?

IVF treatment within the borders of Cyprus is a legal practice. It is not possible to carry out any procedure that is not in accordance with the law in the clinic.

Is twin pregnancy possible in IVF treatment?

The probability of twin pregnancy in IVF treatment is 10% on average. In natural pregnancies, this rate is 1%. There is a 1% chance of giving birth to identical twins (in case of single embryo delivery). However, it is possible to say that usually a single pregnancy situation is encountered.

Single embryo transfer? Double embryo transfer?

Double embryo transfer in IVF treatment can result in twin pregnancy. In such a case, some complications may occur for maternal and infant health. The important thing in treatment is to give birth to a healthy baby rather than the number of embryos obtained. The probability of getting pregnant in a single embryo transfer is also very high.

What is the average number of embryos for IVF?

The number of embryos needed to start IVF treatment is 1. The restrictions on embryo transfer, which is valid in many countries, is not valid in Northern Cyprus. Therefore, it is possible to transfer more than one embryo.

The laws of the Turkish Republic of Northern Cyprus regarding IVF

The most important reasons why Northern Cyprus is a popular location for IVF and the laws regarding IVF can be listed as follows;

Embryos obtained after embryo transfer can be frozen and stored after the approval of the couples.
In 2002, surrogacy was legalized in the Turkish Republic of Northern Cyprus.
In many European countries, IVF treatment is not applied to patients over the age of 40. In Northern Cyprus, patients over the age of 40 can also be treated for IVF.
Again, sperm donation, egg donation and gender selection that are illegal in many countries of the world are legal in Northern Cyprus.
Marriage is not required for treatment.
While there are restrictions on the number of embryo transfers in some countries, there is no similar restriction in Northern Cyprus. There is a restriction on the number of embryos to be transferred in Turkey in 2020.
The opportunity to have children is offered to couples by donating sperm with certified sperm banks that have the necessary security measures abroad.