- Stimulation of the ovaries with drugs (stimulation and follow-up)
- Sperm sampling from the male and selection of good quality sperm by IMSI
- Collecting the eggs
- Fertilization of eggs in the laboratory environment and development of the resulting embryos
- Placing the formed embryos back to the expectant mother (embryo transfer)
VF Stages (long protocol)
To summarize micro-injection therapy:
- The development of many follicles in the ovaries is ensured by making the woman use some drugs (stimulation and follow-up). The doctor decides which type of stimulation will be applied [Antagonist, Long] according to the patient's hormone values, age and medical history information.
- Ultrasound and blood tests (E2, LH) are performed on the woman regularly while she is using the drugs. Thus, the growth of the follicles is followed. The diameters of the follicles are measured during ultrasound follow-ups. HCG is administered when 2-3 follicles over 18-20 mm develop in the ovaries. Egg collection is then performed approximately 35-36 hours after the hCG injection.
- Ovum pick-up procedure is performed under local anesthesia or short-term general anesthesia. Under ultrasound control, a needle is inserted into the follicles in the ovaries and the fluid in each follicle is drained this way. The aim is to obtain 1 egg from each follicle.
- In the laboratory, eggs in the follicle fluid are searched and found. The number of eggs varies from patient to patient.
- On the same day, the patient's wife gives sperm by masturbation. Then sperm washing and preparation procedures are carried out. If a man has Azoospermia (absence of sperm in the ejaculate), sperm is obtained directly from the testis or epididymis by PESA/MESA/TESE/TESA/M.TESE methods. If these procedures are done beforehand, sperm or testicular tissue can be freezed and stored. Pre-frozen sperm or testicular tissue is prepared for ICSI by thawing on the day of egg collection.
- Sperm selection is very important. The best quality sperm selection is made with the IMSI method. The selected sperms are drawn into the microinjection needle after immobilization. A needle containing a single spermatozoa is inserted into the egg. After the sperm is released into the cytoplasm of the egg, the needle is removed.
After the ICSI process is completed, the eggs are placed in special devices called incubators. The special liquids in the culture solution media contain the substances required for the nutrition and growth of the embryos. Incubators are very sensitive devices that mimic the mother's uterus, whose internal environment keeps the heat, humidity and gas concentrations necessary for the normal division and growth of embryos at a certain level. There is highly purified and filtered air in the incubator.
- The best quality embryos, which are kept in the incubator for 2-6 days until the embryo transfer day, are transferred back to the uterus of the expectant mother.
- If there are embryos of good quality that can be freezed and stored, they can be freezed and stored using the most advanced method of vitrification.
- The risk of miscarriage is reduced by the use of medication (luteal support) after the transfer.
- On the 15th day after the ovum pick-up (OPU) procedure, the Beta HCG value in the blood is checked to control whether the pregnancy has occurred or not.
- If pregnancy has occurred, 15 days after the Beta HCG test, pouch formation is checked on ultrasound. Then 7-10 days after that day, fetal heart rate (FH) is checked. The patient, who has passed all these stages, is now taken to routine pregnancy follow-up.