In Vitro Fertilization (IVF) in Turkey

In vitro fertilization (IVF) is a complex of the procedures for infertility treatment when an egg is combined with sperm outside the body — in vitro.   

IVF has been used worldwide for almost 40 years. For many couples, this is the only way to have children. The procedure helps even in cases when natural conception is almost impossible.

In vitro fertilization in Turkey is the best option for patients with infertility. Indications for IVF are:

• tubal infertility because of the absence of fallopian tubes or their obstruction
• infertility associated with endometriosis
• endocrine diseases that lead to ovulation disorders
• hereditary diseases (hemophilia, etc.)
• male infertility 
• premature ovarian failure.

IVF is contraindicated for persons with:

• severe mental and physical diseases
• abnormalities of the reproductive organs
• benign uterine tumors 
• cancer.

Specialists perform in vitro fertilization in 8 steps:

1. infertility diagnosis
2. preparation for the procedure
3. ovulation stimulation
4. follicles puncture
5. egg fertilization
6. embryo cultivation
7. embryo transfer
8. pregnancy control and support.

In vitro fertilization including the infertility diagnosis and preparation for the procedure takes about 2 months. The duration of the IVF procedure itself depends on the protocol type and lasts 25-45 days. During this period, all steps are carried out from ovarian stimulation, fertilization, embryo transfer, to monitoring implantation and final confirmation of pregnancy.

Infertility is diagnosed when a woman cannot become pregnant for 1 year of regular sexual activity without the use of contraception. If a woman is more than 35 years old, this period is cut down to 6 months. In this case, it is necessary to consult a reproductive specialist.

There are a lot of factors that can cause infertility. Causes of infertility can be associated with health problems in both women and men. To define the exact cause of the disorder, the couple should undergo complete body examination and consult with a specialist.

IVF in Turkey is a complex and multi-step procedure that requires both physical and moral preparation. During the consultation, the doctor always recommends preparing the body for pregnancy — quitting all bad habits, controlling physical activity, and keeping a healthy eating plan.

To make sure the IVF procedure is possible, both a man and a woman must undergo examinations and pass tests.

Tests for men:

• semen analysis (spermogram)
• urethral smear
• smears infection test
• blood tests for HIV, hepatitis B, and C, syphilis.

Tests for women:

• consultation with an endocrinologist
• hysterosalpingogram (test of tubal patency)
• hysterolaparoscopy or laparoscopy
• coagulogram (blood clotting test)
• general urine analysis
• blood test for syphilis, HIV, hepatitis B and C
• blood test for hormones
• TORCH screen 
• Pap test
• scrape or brush cytology
• smears infection test
• consultation with a therapist
• chest X-ray
• ECG (electrocardiogram)
• Ultrasound of the mammary glands
• consultation with a gynecologist. 

The diagnostic plan is developed and modulated by a specialist. If necessary, the doctor may prescribe additional examinations.

Ovulation stimulation/induction (in vitro maturation — IVM) is the process of ovulation boosting by medication. To achieve the maturation of eggs number, the doctors prescribe daily injections of gonadotropins — hormones that lead to the maturation of several eggs at once in contrast with the common menstrual cycle when only one egg is maturated. 

The duration of this step depends on the type of induction protocol. The dose of stimulative drugs is selected by the doctor individually. Ovulation stimulation is carried out under the supervision of a specialist.

When the follicles grow to maturity, it is necessary to make a special injection to introduce a trigger for the final egg maturation. Follicle puncture and egg production are carried out in 34-38 hours after the trigger introduction. Only after this step, it is possible to obtain mature eggs.

The procedure is performed under general anesthesia and is monitored by ultrasound. The doctor uses a special needle to collect follicular fluid. After that, the embryologist selects eggs for further fertilization. The more eggs you get, the better result you can achieve.

The obtained eggs and sperm cells are placed in a special incubator where the temperature is 37°C and humidity is high. In these conditions the fertilization takes place.

In some cases, embryologists apply an intracytoplasmic sperm injection (ICSI). Using this technique, the embryologist selects the most qualitative spermatozoon and implants it into the egg cytoplasm. The procedure is performed if the quality of the ejaculate is low or the frozen eggs are used.

The day after fertilization in Turkey, the embryologist determines how many eggs are fertilized and monitors the development of the embryos for several days. In a few days after fertilization, the most qualitative embryo is transferred to the uterus. The transfer is carried out through the cervical canal using a catheter. The procedure is painless.

IVF in Turkey has several types and the specialist selects the procedure method depending on the infertility cause. The basic IVF technique is described above but it is often supplemented by additional technologies.

ICSI — involves the artificial introduction of sperm into the egg using a very thin needle. Usually, ICSI is used if the partner's sperm is motionless and are not able to fertilize the egg on their own. 

PICSI — a modification of the ICSI method when only mature sperm are selected. Before providing PICSI a special test is carried out.

IVM — involves the removal of immature eggs. They mature in vitro, in laboratory conditions. It allows patients to avoid hormonal stimulation. It is also used if stimulation does not give a result.

Assisted hatching — a technology that facilitates the implantation of an embryo into the uterus. The embryo is surrounded by a thin coverage, which is destroyed before the implantation. Hatching is the artificial destruction of this coverage.

According to statistics of Dunya IVF Clinic, the success index of in vitro fertilization is:

• 56% — in women of 20-29 years old
• 51% — in women aged 30-34
• 45% — in patients of 35-39 years old
• 14% — in women over 40.

Healthcare is the key development sector of the Turkish government. The Turkish authorities are convinced that care for the citizens' health should be an absolute priority of state policy and spend about 77 billion liras for healthcare annually.

As a result, 28,000 medical facilities provide excellent medical care in the country. About 50 centers have certificate of JCI (Joint Commission International), the international improver of healthcare quality and safety across the globe. The index of certificates obtained is the largest. To compare, Israel has 20 JCI-accredited facilities, and Germany — only 10 clinics of this type.

Turkey is also a well-known country globally due to high-skilled doctors that undergo internships in American and European institutions. Patients from Saudi Arabia, Qatar, Kuwait, the UAE, Jordan, and Lebanon prefer treatment in Turkey to other places.

Highly developed medical centers and first-rate therapeutic services at affordable prices attract people from all over the world. Over 1 mln international patients travel to Turkey annually. So Turkey is among Top 10 countries with the most developed medical tourism sector.

Turkey is a top destination for medical tourists because of low-costs. You may save up to 50% on services compared to European countries or the USA due to the average local citizens' income and general price policy within the country.

In Turkey, hotels of different price ranges and service levels are presented. The level of Turkish hotels is comparable to hotels in Tunisia, Morocco or Egypt. Most tourists choose 4 and 5 star hotels with all-inclusive meals. Such hotels have everything for a comfortable stay: varied food, a large well-groomed territory, animation for children and adults. Some hotels have their own water park, which guests can use for free. Budget travelers can afford to book an economical 3-star hotel with half board or no meals at all.

The main advantage of Turkish resorts is the long beach season. On the Mediterranean coast, it starts in April and lasts until November. In the resorts of the Aegean Sea — from May to October. The most comfortable time for swimming is from mid-June to the end of October. A large influx of tourists is in July-August, when the air temperature is +38°C, and the water warms up to +27°C.

In 2020, the Republic of Turkey has visa-free agreements with 89 states. Some foreigners are exempted from obtaining entry visas, others are required to receive an electronic visa (e-Visa), and still others must apply for a visa at Turkish missions abroad.

What states need a visa for treatment in Turkey and what countries can cross the border free and easy read here.

Visas for travel to Turkey require a number of documents. The necessary papers can be submitted 90 days before the planned departure. Lists of documents includes:

• ID card
• confirmation of online registration and filling out the questionnaire
• certificate of income and availability of funds ($50 per day per person)
• insurance policy for a stay in Turkey (original and copy)
• 2 photos (5x6)
• visa receipt
• booking of flight and hotel
• medical opinion about the need for treatment.