In vitro fertilization (IVF) is one of the most frequently researched assisted reproductive methods for couples in Izmir who want to have children. This process is not a single procedure: it progresses through successive stages such as initial evaluation, ovarian stimulation, egg retrieval, fertilization, embryo development, and embryo transfer.
Medically known as in vitro fertilization (IVF), it is a treatment method that aims to obtain an embryo by bringing egg and sperm cells together in a laboratory environment. When suitable conditions are met, the resulting embryo is transferred into the uterus.
Although the stages of IVF treatment are described with the same headings for every couple, the treatment plan varies from person to person. The woman's age, ovarian reserve, sperm analysis, intrauterine evaluation, cause of infertility, and previous treatment history are considered together. Therefore, the process should not be considered a standard procedure; it should be evaluated as a medical roadmap planned specifically for each individual.
In natural pregnancy, the egg and sperm mostly meet in the fallopian tube, the fertilized egg reaches the uterus, and attaches to the inner lining of the uterus. IVF moves the fertilization step of this process into a laboratory environment.
According to patient resources from the American Society for Reproductive Medicine (ASRM), the IVF process is summarized in four main steps: ovarian stimulation, egg retrieval, fertilization in the laboratory, and transfer of the resulting embryos into the uterus. Before these four steps, an evaluation phase performed before starting treatment is added; embryo culture and follow-up after transfer are also part of the process.
Which medication protocol will be chosen, whether fertilization will be performed using the conventional method or microinjection, and on which day the embryo will be transferred are determined according to the individual’s clinical condition.
If you are looking for an IVF doctor in Izmir, you can schedule an evaluation appointment with Assoc. Prof. Dr. Funda Göde to learn how the process may progress according to your clinical condition.
IVF does not begin directly with medication. The first step is to evaluate the couple’s situation as a whole. In current clinical practice resources, this evaluation includes medical history, ovarian reserve assessment, evaluation of the uterine cavity, and sperm analysis.
Ovarian reserve is evaluated through methods such as FSH and estradiol tests performed on the third day of menstruation, AMH, or antral follicle count. These tests show only the quantitative reserve of the ovaries; they do not provide direct information about egg quality (qualitative). The most important determinant of egg quality is the woman’s age.
Uterine imaging can reveal conditions such as polyps, fibroids, adhesions, or septum that may affect implantation. On the male side, sperm analysis guides the selection of the fertilization method.
ASRM’s committee opinion on ovarian reserve tests emphasizes that tests such as AMH and antral follicle count provide information about egg quantity and response to stimulation; however, they do not independently indicate egg quality or pregnancy potential.
In the natural cycle, the ovaries usually release a single mature egg. In IVF, the goal is to obtain more than one mature egg in a single cycle. Therefore, the ovaries are stimulated with medications.
During this process, oral pills or injectable hormone medications are used to ensure that your eggs grow in a healthy way. Preventive injections are also used to prevent the eggs from rupturing earlier than planned, meaning unintended ovulation.
All these stages are closely monitored through ultrasound examinations and blood tests. During this 8–14 day period, the patient usually needs to visit the clinic approximately 3 to 5 times for transvaginal ultrasound and blood monitoring.
When your eggs reach the desired level of maturity, the final maturation injection, commonly known as the “trigger shot”, is administered shortly before the egg retrieval procedure.
This stage requires frequent monitoring, and the dosage is individualized according to general guidelines and the physician’s experience. The number of eggs obtained varies from person to person; although current sources report a range of approximately 10–20 eggs in stimulated cycles, this number differs depending on age and ovarian reserve. When the response is very low or very high, monitoring may alter the course of the cycle.
Egg development may not reach the targeted level in every patient starting treatment. Due to insufficient ovarian response or, conversely, the risk of excessive stimulation, the treatment may be cancelled at this stage.
The trigger shot stimulates the final maturation of the eggs and determines the timing of the retrieval procedure. Mature eggs are collected approximately 34–36 hours after hCG administration.
The procedure is generally performed under mild anesthesia. Using vaginal ultrasound guidance, follicular fluid is aspirated with a thin needle. The ratio of the number of collected eggs to the number of visualized follicles is called the egg retrieval rate; in stimulated cycles, this rate is expected to be approximately 80–95% of follicles. Significant deviations from expectations may be evaluated in terms of the stimulation protocol or retrieval technique.
Although egg retrieval is a minimally invasive surgical procedure, rare risks include vaginal wall bleeding, intra-abdominal bleeding, and the risk of pelvic infection, especially in patients with a history of endometriomas (chocolate cysts).
The collected eggs are fertilized with sperm in the laboratory. There are two main methods. In conventional IVF, prepared sperm and the egg are placed together in the same environment, and fertilization occurs through the sperm’s natural ability. In microinjection, also known as ICSI, a single sperm is directly injected into the egg.
So which one should be preferred? According to ASRM’s 2026 ICSI committee opinion, there is no evidence that ICSI increases pregnancy and live birth rates when there is no significant male factor. Therefore, microinjection is mainly considered for significant male factor infertility and selected special situations.
Whether fertilization has occurred cannot be determined immediately. Eggs are examined under a microscope approximately 16–17 hours after fertilization and evaluated for pronuclei and polar bodies. Embryo division is monitored over the following days.
Despite all laboratory preparations, the process may not always result in fertilization. In rare cases, total fertilization failure, where none of the eggs are fertilized, may also occur as one of the possible clinical risks.
Fertilized eggs continue developing in the laboratory and provide different information each day. The embryologist monitors development under a microscope and evaluates the number of cells, similarity of the cells, fragmentation rate, and appearance at the blastocyst stage. This is called morphological evaluation; how a high-quality embryo is identified is a separate topic.
An embryo can be transferred either at the cleavage stage 3 days after fertilization or at the blastocyst stage 5 days after fertilization. Blastocyst culture is not a treatment that improves embryo quality; rather, it is a laboratory selection method used to choose the embryo with the highest potential for implantation.
This also explains why a blastocyst is not expected directly in every patient. In selected cases, preimplantation genetic testing (PGT) may be applied to embryos at this stage; however, it is not a routine step for every patient.
Embryo transfer is the relatively short but decisive stage of the process. The embryo is placed into the uterus through the cervix using a thin catheter; it is generally positioned approximately 1–2 centimeters below the uterine fundus. Mild cramping during the procedure or a small amount of spotting afterward may occur.
The number of embryos to be transferred is an important decision. In Turkey, the number of embryos to be transferred is determined by regulations. According to ESHRE recommendations, single embryo transfer is recommended in most cases, and transferring more than two embryos should be avoided. The decision is made according to embryo quality and developmental stage, the woman’s age, ovarian response, and treatment history. The main purpose of single embryo transfer is to reduce the possibility of multiple pregnancy, which carries higher risks for both the mother and baby.
To support embryo implantation and continuation of pregnancy, progesterone supplementation is usually started on the day of egg retrieval or embryo transfer. At the end of the determined period, pregnancy is evaluated through a blood test (beta hCG).
If good-quality embryos remain after the transfer, they can be frozen for future use. Future attempts using frozen embryos may be less invasive because they do not require repeated ovarian stimulation and egg retrieval. This waiting period can be emotionally challenging for many couples; receiving support is an important part of the process that should not be overlooked.
IVF is generally considered safe; however, like every medical procedure, it may involve certain risks.
The most well-known risk of ovarian stimulation is ovarian hyperstimulation syndrome (OHSS); current sources report that severe OHSS occurs in approximately 0.2–1% of stimulated cycles. Temporary pain related to egg retrieval, rare infections, or effects on nearby organs are other possible risks.
Single embryo transfer reduces the risk of multiple pregnancy; however, it does not eliminate it completely. After a single embryo implants in the uterus, it may rarely split into two and result in identical twins. Nevertheless, reducing the risk of multiple pregnancy compared to transferring more than one embryo is one of the most important reasons for preferring single embryo transfer. Multiple pregnancy is associated with risks such as premature birth, low birth weight, high blood pressure during pregnancy, gestational diabetes, and the need for neonatal intensive care.
Warning: If you experience rapid weight gain, sudden abdominal swelling and tightness that makes breathing difficult, severe groin pain, shortness of breath, or a significant decrease in urine output, this may be a sign of OHSS. It is critically important to contact your doctor without delay or reach the nearest emergency department.
No, the stages of IVF treatment and the supportive methods that may be applied within the treatment process can vary specifically for each couple. The stimulation protocol, fertilization method, transfer day, and number of embryos to be transferred are determined by considering age, ovarian reserve, sperm findings, uterine evaluation, and the couple’s clinical history together. Therefore, “IVF stages” are not a fixed prescription but a personalized roadmap.
The stages of IVF treatment do not progress in the same way for every couple. The treatment plan is created individually according to age, ovarian reserve, sperm findings, uterine evaluation, and the couple’s clinical history. To get information about how the process may be planned according to your situation, you can contact Assoc. Prof. Dr. Funda Göde, an IVF specialist working in Izmir.
For couples applying for IVF treatment in Izmir, planning begins with the initial evaluation. Age, ovarian reserve, sperm analysis, uterine evaluation, and previous treatment history are reviewed together. This information determines how stages such as ovarian stimulation, egg retrieval timing, fertilization method, and embryo transfer will proceed.
Some patients require closer ultrasound and blood test monitoring, while in some patients medication doses may be adjusted according to ovarian response. Whether the embryo will be transferred on day three or day five, the number of embryos to be transferred, and the need for microinjection are also decided according to the clinical situation.
For this reason, when choosing an IVF specialist in Izmir, attention should be paid not only to the center where the treatment will be performed but also to the clarity of the evaluation process, physician follow-up, coordination with the embryology laboratory, and ensuring that the patient is clearly informed throughout the process. IVF treatment stages can be explained under standard headings; however, good planning requires applying these steps with the correct rationale for each couple.
Kaynakça
American Society for Reproductive Medicine. In Vitro Fertilization Treatment Journey. ReproductiveFacts.org.
American Society for Reproductive Medicine Practice Committee. Intracytoplasmic sperm injection for nonmale factor indications: a committee opinion. Fertility and Sterility; 2026.
The ESHRE Good Practice in the IVF Lab Working Group, Arroyo G, Barrie A, Coticchio G, et al. ESHRE Recommendations on Good Practice in the IVF Laboratory. Grimbergen: European Society of Human Reproduction and Embryology; 2026.
American Society for Reproductive Medicine Practice Committee. Testing and interpreting measures of ovarian reserve: a committee opinion. Fertility and Sterility. 2020;114(6):1151–1157.
Following pre-treatment evaluation, the process progresses through four main steps: ovarian stimulation, egg retrieval, fertilization in the laboratory, and embryo transfer. Embryo culture and post-transfer follow-up are also part of this process.
The eggs are collected using a thin needle under vaginal ultrasound guidance, usually under light anesthesia. The procedure is scheduled approximately 34-36 hours after the trigger injection.
There is no single right answer. Blastocyst transfer may offer a higher live birth rate per cycle, but fewer embryos may remain for transfer as embryos that do not develop in culture may be eliminated. The decision is made based on embryo development and clinical presentation.
No. There is no evidence that ICSI increases pregnancy and live birth rates in cases where male factor infertility is not significant. Microinjection is more often considered in cases of significant male factor infertility and in selected, specific situations.
No. While completing the steps correctly is promising, it doesn't guarantee a pregnancy. The outcome varies depending on age, egg and sperm characteristics, the embryo's genetic makeup, uterine conditions, and the transfer process.
Note: This content is for general informational purposes only and does not replace diagnosis or treatment. A physician evaluation is required for personal diagnosis and treatment planning.
