Needle-based hormone stimulation is started with the beginning of the menstrual cycle in this stage. The reason for this is to stimulate the ovaries on the 2nd or 3rd day of the new menstrual period. These drugs are used to improve the development of multiple egg cells from the ovaries. This increases the likelihood of pregnancy. The duration of stimulation of the ovaries varies according to the patient. Usually this period ranges from 10-12 days. Egg growth is monitored every two or three days with the help of hormones and ultrasound.

After the egg cells reach a certain maturity and size, a final ovulation triggering needle, a hormonal needle that helps the oocytes to mature to what is called MII stage, is used. Egg collection is performed 34-36 hours after the needle is applied. It is crucial to apply this needle at the right time. Egg collection is carried out by transvaginal ultrasonography under sedation, called sedative anesthesia. The reason for this is to prevent the patient from feeling pain. The patient is taken on an empty stomach in the morning and this process takes about 20 to 30 minutes. None of the procedures during IVF treatment need long hospitalization and it takes usually not more than 2-3 hours.
 During this operation, the fluid in the follicles is aspirated. The eggs are collected by evaluating the presence of oocytes in the fluid. Eggs may not be found in the follicle fluid in the first procedure. In these cases, with the help of a special liquid, the follicle is washed off and the eggs in the follicle can be found. The number of eggs per patient can be between 10 and 12, and this number may be from 1 to 40. Very rarely, there is a possibility that no eggs may be collected. After this procedure, the patient is followed for 1 – 2 hours and can then go home. The next stage is the selection of the mature oocytes (MII) , the fertilization and the transfer of the good quality embryos inside of the uterus. 

After selecting the best and oocytes called MII oocytes obtained by the egg collection process, it is ensured that they are fertilized in the laboratory with the use of classical test IVF (in vitro fertilization)  or microinjection (ICSI) . The metdot for fertilization is usually chosen by looking at sperm cell number , motility and quality. In some cases, it may be more useful to use a microinjection (ICSI) method to increase the likelihood of fertilization.  In a specific culture medium, the fertilized eggs are monitored until they become transferable to the mother’s womb. One or two good and high quality embryo/s is/are selected and transferred into the uterus. 

Embryos are taken from the incubators and the transfer to uterine cavity  is called embryo transfer procedure. This stage is a procedure in which the patient will not feel pain that is why there is no need for  anesthesia. Mostly we prefer to transfer embryos  after 120 hours. This is the 5th day after the ovum pick-up and the embryo is in blastocyst stage which is the day when the enbryo implants to endometrium in natural pregnancies. The time of transfer is determined by the number and quality of embryos. Before transfer, the cervix is cleaned with special fluids. Transfer into the uterus: the thin catheter is applied through the mouth of the cervix and embryos are put inside the cavity in a small fluid droplet . Ultrasonography is used to see the exact point of transfer during the procedure. The bladder must be full for a good view at this time. 

During this time, you should take care of yourself and your baby, and avoid all the factors that can cause harm. You should avoid excessive movements and heavy work. It is especially important for you to pay attention to your nutrition and fluid intake.

You can see the outcome of the treatment with the pregnancy test done from blood 12 days after the embryo transfer. However, in some cases, the treatment end with a failures. Don’t upset yourself for that. This possibility does not present a danger in the first unsuccessful in vitro treatment. There are some reasons to investigate why there was a negaive pregnancy test. We actually  start the advanced investigation after two ineffective treatments.