{"id":7689,"date":"2010-03-12T05:39:44","date_gmt":"2010-03-12T04:39:44","guid":{"rendered":"https:\/\/www.kinderwunschteam.berlin\/diagnostik-therapie\/tedavi-einstieg-therapie-alt\/ivf-in-vitro-fertilisation\/konventionelle-ivf\/"},"modified":"2020-09-04T00:01:19","modified_gmt":"2020-09-03T22:01:19","slug":"konventionelle-ivf","status":"publish","type":"page","link":"https:\/\/kwt.meiio.net\/tr\/uzun-omur\/tuep-bebek-ve-kisirlik\/tedavi\/ivf\/konventionelle-ivf","title":{"rendered":"Konvansiyonel IVF"},"content":{"rendered":"<h2>Konvansiyonel IVF (in vitro fertilizasyon\/klasik t\u00fcp bebek i\u015flemi)\u2019de izlenecek yol<\/h2>\n<h3>1. \u0130la\u00e7l\u0131 \u00f6n tedavi<\/h3>\n<p>Konvansiyonel IVF\u2019de, ila\u00e7l\u0131 bir \u00f6n tedavi ile, yumurta h\u00fccrelerinin say\u0131s\u0131n\u0131n nispeten artt\u0131r\u0131lmas\u0131 sa\u011flan\u0131r. Normalde bu i\u015flem i\u00e7in deri alt\u0131na g\u00fcnde 150 \u2013 225 I.E. FSH (Gonal-F veya Puregon) ya da FSH\/LH kar\u0131\u015f\u0131m\u0131 (Menogon) enjekte edilir. Erken ov\u00fclasyonun olmas\u0131n\u0131 \u00f6nlemek i\u00e7in\u00a0<a href=\"https:\/\/kwt.meiio.net\/spektrum\/kinderwunsch\/therapie-des-unerfuellten-kinderwunsches\/ivf-in-vitro-fertilisation\">uyarma protokol\u00fcne ba\u011fl\u0131 olarak<\/a>, ek olarak farkl\u0131 ila\u00e7lara da gereksinim duyulur (Synarela Spray, Zoladex, Enantone, Dekapeptyl).<\/p>\n<figure id=\"attachment_7462\" aria-describedby=\"caption-attachment-7462\" style=\"width: 800px\" class=\"wp-caption alignnone\"><img decoding=\"async\" class=\"size-full wp-image-7462\" src=\"https:\/\/kwt.meiio.net\/wp-content\/uploads\/ba-b-_dp_026.jpg\" alt=\"A\u015f\u0131lama stim\u00fclasyonu hastan\u0131n kendisi taraf\u0131ndan yap\u0131labilir ve bu tip stim\u00fclasyonun s\u00fcresi yakla\u015f\u0131k 10 g\u00fcn kadard\u0131r.\" width=\"800\" height=\"534\" srcset=\"https:\/\/kwt.meiio.net\/wp-content\/uploads\/ba-b-_dp_026.jpg 800w, https:\/\/kwt.meiio.net\/wp-content\/uploads\/ba-b-_dp_026-300x200.jpg 300w, https:\/\/kwt.meiio.net\/wp-content\/uploads\/ba-b-_dp_026-768x513.jpg 768w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption id=\"caption-attachment-7462\" class=\"wp-caption-text\">A\u015f\u0131lama stim\u00fclasyonu hastan\u0131n kendisi taraf\u0131ndan yap\u0131labilir ve bu tip stim\u00fclasyonun s\u00fcresi yakla\u015f\u0131k 10 g\u00fcn kadard\u0131r.<\/figcaption><\/figure>\n<p>Yeterince folik\u00fcl (yumurta kesesi) b\u00fcy\u00fcd\u00fckten sonra, yumurta h\u00fccresinin olgunla\u015fma faz\u0131n\u0131 tamamlayabilmesi i\u00e7in bayan hastaya \u201cov\u00fclasyon a\u015f\u0131s\u0131\u201c (Brevactid, Pregnesin, Ovitrelle) verilir. Bu a\u015famadan itibaren yumurta h\u00fccreleri elde edilebilir.<\/p>\n<h3>2. Yumurta h\u00fccrelerinin al\u0131nmas\u0131<\/h3>\n<p>Ultrason denetiminde vajinal folik\u00fcl ponksiyonu, normalde HCG i\u011fnesi vurulduktan 32 ila 36 saat sonra, k\u0131sa s\u00fcreli anesteziyle yap\u0131l\u0131r.<\/p>\n<p>Bu i\u015flemde, ultrason ba\u015fl\u0131\u011f\u0131ndaki bir k\u0131lavuz kolunun i\u00e7inde bulunan bir ponksiyon i\u011fnesi vajinaya sokulur. Yumurtal\u0131k sadece birka\u00e7 milimetre uza\u011f\u0131ndad\u0131r. \u0130\u011fne, vajina duvar\u0131ndan ge\u00e7erek direkt ayr\u0131k folik\u00fcllere var\u0131ncaya kadar bat\u0131r\u0131l\u0131r. S\u0131v\u0131 aspire edilir ve i\u00e7inde yumurta h\u00fccresinin olup olmad\u0131\u011f\u0131n\u0131 \u00f6\u011frenebilmek \u00fczere s\u0131v\u0131 hemen biyologlara g\u00f6nderilir.<\/p>\n<figure id=\"attachment_7455\" aria-describedby=\"caption-attachment-7455\" style=\"width: 800px\" class=\"wp-caption alignnone\"><img decoding=\"async\" class=\"size-full wp-image-7455\" src=\"https:\/\/kwt.meiio.net\/wp-content\/uploads\/oocyte-b-400.jpg\" alt=\"Gran\u00fcloza h\u00fccreleri olarak bilinen ''k\u00fcm\u00fcl\u00fcs bulutlar\u0131ndaki'' yumurta h\u00fccreleri\" width=\"800\" height=\"678\" srcset=\"https:\/\/kwt.meiio.net\/wp-content\/uploads\/oocyte-b-400.jpg 800w, https:\/\/kwt.meiio.net\/wp-content\/uploads\/oocyte-b-400-300x254.jpg 300w, https:\/\/kwt.meiio.net\/wp-content\/uploads\/oocyte-b-400-768x651.jpg 768w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption id=\"caption-attachment-7455\" class=\"wp-caption-text\">Gran\u00fcloza h\u00fccreleri olarak bilinen &#8221;k\u00fcm\u00fcl\u00fcs bulutlar\u0131ndaki&#8221; yumurta h\u00fccreleri<\/figcaption><\/figure>\n<h3>3. D\u00f6llenme<\/h3>\n<p>Yumurta h\u00fccreleri, laboratuvarda besin \u00e7\u00f6zeltisine koyulur ve yakla\u015f\u0131k 50-100,00 tane \u00e7ok aktif spermle \u00f6rt\u00fcl\u00fcr. \u00c7anaklar, geceden ink\u00fcbat\u00f6re ink\u00fcbe olmaya (k\u00fclt\u00fcr geli\u015ftirmesi i\u00e7in) b\u0131rak\u0131l\u0131r.<\/p>\n<p>19-21 saat sonra, ka\u00e7 adet yumurta h\u00fccresinin \u00e7ekirdek \u00f6ncesi faza (PN faz\u0131 \u2013 pron\u00fckleus faza) ula\u015ft\u0131\u011f\u0131 saptand\u0131ktan sonra, PN faz\u0131 h\u00fccrelerinden (en az\u0131ndan Almanya\u2019da) hangilerinin (en fazla 3 olmak suretiyle) d\u00f6llenme i\u015fleminde kullan\u0131laca\u011f\u0131 se\u00e7ilmelidir. Her pron\u00fckleusta yumurta h\u00fccrelerinden ve spermlerden gelen kromozomlar bulunur.<\/p>\n<figure id=\"attachment_7460\" aria-describedby=\"caption-attachment-7460\" style=\"width: 800px\" class=\"wp-caption alignnone\"><img decoding=\"async\" class=\"size-full wp-image-7460\" src=\"https:\/\/kwt.meiio.net\/wp-content\/uploads\/med-dp_010-col-warmgrau.jpg\" alt=\"Bir 2 PN h\u00fccresi (prokaryot - h\u00fccre \u00e7ekirde\u011fi)\" width=\"800\" height=\"602\" srcset=\"https:\/\/kwt.meiio.net\/wp-content\/uploads\/med-dp_010-col-warmgrau.jpg 800w, https:\/\/kwt.meiio.net\/wp-content\/uploads\/med-dp_010-col-warmgrau-300x226.jpg 300w, https:\/\/kwt.meiio.net\/wp-content\/uploads\/med-dp_010-col-warmgrau-768x578.jpg 768w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption id=\"caption-attachment-7460\" class=\"wp-caption-text\">Bir 2 PN h\u00fccresi (prokaryot &#8211; h\u00fccre \u00e7ekirde\u011fi)<\/figcaption><\/figure>\n<p>Sperm verildikten sonraki 2. veya 3. g\u00fcnde, bir veya birden \u00e7ok embriyo geli\u015fti\u011finde, emriyo veya embriyolar rahim bo\u015flu\u011funa transfer edilir. Bir veya birden fazla blastokist olu\u015ftuysa, 5. g\u00fcnde de transfer yap\u0131labilir ve bu uygulamada mant\u0131kl\u0131d\u0131r.<\/p>\n<figure id=\"attachment_7459\" aria-describedby=\"caption-attachment-7459\" style=\"width: 800px\" class=\"wp-caption alignnone\"><img decoding=\"async\" class=\"size-full wp-image-7459\" src=\"https:\/\/kwt.meiio.net\/wp-content\/uploads\/med-dp_011-col-warmgrau.jpg\" alt=\"\u0130kinci g\u00fcnde embriyonun 2 h\u00fccre faz\u0131nda olmas\u0131 beklenir\" width=\"800\" height=\"602\" srcset=\"https:\/\/kwt.meiio.net\/wp-content\/uploads\/med-dp_011-col-warmgrau.jpg 800w, https:\/\/kwt.meiio.net\/wp-content\/uploads\/med-dp_011-col-warmgrau-300x226.jpg 300w, https:\/\/kwt.meiio.net\/wp-content\/uploads\/med-dp_011-col-warmgrau-768x578.jpg 768w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption id=\"caption-attachment-7459\" class=\"wp-caption-text\">\u0130kinci g\u00fcnde embriyonun 2 h\u00fccre faz\u0131nda olmas\u0131 beklenir<\/figcaption><\/figure>\n<figure id=\"attachment_7458\" aria-describedby=\"caption-attachment-7458\" style=\"width: 800px\" class=\"wp-caption alignnone\"><img decoding=\"async\" class=\"wp-image-7458 size-full\" src=\"https:\/\/kwt.meiio.net\/wp-content\/uploads\/med-dp_012-col-warmgrau.jpg\" alt=\"\u00dc\u00e7\u00fcnc\u00fc g\u00fcnde en az 4 h\u00fccrenin olu\u015fmas\u0131 beklenir\" width=\"800\" height=\"602\" srcset=\"https:\/\/kwt.meiio.net\/wp-content\/uploads\/med-dp_012-col-warmgrau.jpg 800w, https:\/\/kwt.meiio.net\/wp-content\/uploads\/med-dp_012-col-warmgrau-300x226.jpg 300w, https:\/\/kwt.meiio.net\/wp-content\/uploads\/med-dp_012-col-warmgrau-768x578.jpg 768w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption id=\"caption-attachment-7458\" class=\"wp-caption-text\">\u00dc\u00e7\u00fcnc\u00fc g\u00fcnde en az 4 h\u00fccrenin olu\u015fmas\u0131 beklenir<\/figcaption><\/figure>\n<figure id=\"attachment_7457\" aria-describedby=\"caption-attachment-7457\" style=\"width: 800px\" class=\"wp-caption alignnone\"><img decoding=\"async\" class=\"wp-image-7457 size-full\" src=\"https:\/\/kwt.meiio.net\/wp-content\/uploads\/med-dp_013-col-warmgrau.jpg\" alt=\"\u00dc\u00e7\u00fcnc\u00fc g\u00fcnde 8-h\u00fccreli embriyodan y\u00fcksek kalitede bir embriyo olu\u015fur.\" width=\"800\" height=\"576\" srcset=\"https:\/\/kwt.meiio.net\/wp-content\/uploads\/med-dp_013-col-warmgrau.jpg 800w, https:\/\/kwt.meiio.net\/wp-content\/uploads\/med-dp_013-col-warmgrau-300x216.jpg 300w, https:\/\/kwt.meiio.net\/wp-content\/uploads\/med-dp_013-col-warmgrau-768x553.jpg 768w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption id=\"caption-attachment-7457\" class=\"wp-caption-text\">\u00dc\u00e7\u00fcnc\u00fc g\u00fcnde 8-h\u00fccreli embriyodan y\u00fcksek kalitede bir embriyo olu\u015fur.<\/figcaption><\/figure>\n<p>Di\u011fer bilgiler,\u00a0<a href=\"https:\/\/kwt.meiio.net\/spektrum\/kinderwunsch\/therapie-des-unerfuellten-kinderwunsches\/blastozystenkultur\">Blastokist transferi<\/a>\u00a0b\u00f6l\u00fcm\u00fcm\u00fczdedir.<\/p>\n<h3>4. Embriyo transferi<\/h3>\n<p>Sperm al\u0131nmas\u0131n\u0131n 2., 3. veya 5. g\u00fcn\u00fcnde, embriyo transferi yap\u0131l\u0131r. Gerekti\u011finde ultrason g\u00f6zetiminde yap\u0131lacak bu transfer s\u0131ras\u0131nda, hastan\u0131n can\u0131n\u0131 yakmadan bir kateter rahim bo\u015flu\u011funa sokulur. Embriyo veya embriyolar, buraya dikkatle b\u0131rak\u0131l\u0131rlar.<\/p>\n<p>Bu transferin haz\u0131rlanmas\u0131 a\u015famas\u0131nda, kad\u0131n, rahim rahim kaslar\u0131n\u0131 gev\u015feten ila\u00e7lar kullanabilir. \u0130zleyen 14 g\u00fcn, kad\u0131na progesteron (sar\u0131 cisim hormonu: Crinone\u00ae jeli, Utrogest\u00ae) verilerek, kad\u0131n\u0131n mukoza oran\u0131n\u0131n embriyonun implantasyonu (rahim i\u00e7ine ekilmesi) i\u00e7in optimum olmas\u0131 sa\u011flan\u0131r.<\/p>\n<figure id=\"attachment_7461\" aria-describedby=\"caption-attachment-7461\" style=\"width: 525px\" class=\"wp-caption alignnone\"><img decoding=\"async\" class=\"size-large wp-image-7461\" src=\"https:\/\/kwt.meiio.net\/wp-content\/uploads\/\/ba-b-_dp_011-764x1024.jpg\" alt=\"Embriyo transferi (ET) i\u00e7in, embriyo, stereoskopik mikroskopla ET kateterine \u00e7ekilir.\" width=\"525\" height=\"704\" srcset=\"https:\/\/kwt.meiio.net\/wp-content\/uploads\/ba-b-_dp_011-764x1024.jpg 764w, https:\/\/kwt.meiio.net\/wp-content\/uploads\/ba-b-_dp_011-224x300.jpg 224w, https:\/\/kwt.meiio.net\/wp-content\/uploads\/ba-b-_dp_011-768x1029.jpg 768w, https:\/\/kwt.meiio.net\/wp-content\/uploads\/ba-b-_dp_011.jpg 800w\" sizes=\"(max-width: 525px) 100vw, 525px\" \/><figcaption id=\"caption-attachment-7461\" class=\"wp-caption-text\">Embriyo transferi (ET) i\u00e7in, embriyo, stereoskopik mikroskopla ET kateterine \u00e7ekilir.<\/figcaption><\/figure>\n<figure id=\"attachment_7456\" aria-describedby=\"caption-attachment-7456\" style=\"width: 800px\" class=\"wp-caption alignnone\"><img decoding=\"async\" class=\"size-full wp-image-7456\" src=\"https:\/\/kwt.meiio.net\/wp-content\/uploads\/slide_15.jpg\" alt=\"Embriyo transferinin \u015fematik g\u00f6sterimi\" width=\"800\" height=\"546\" srcset=\"https:\/\/kwt.meiio.net\/wp-content\/uploads\/slide_15.jpg 800w, https:\/\/kwt.meiio.net\/wp-content\/uploads\/slide_15-300x205.jpg 300w, https:\/\/kwt.meiio.net\/wp-content\/uploads\/slide_15-768x524.jpg 768w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption id=\"caption-attachment-7456\" class=\"wp-caption-text\">Embriyo transferinin \u015fematik g\u00f6sterimi<\/figcaption><\/figure>\n<p>Embriyo transferinden sonraki s\u00fcrede heyecanlanmaman\u0131z ve \u00e7ok fazla hareket etmemeniz gerekir. Ayn\u0131 \u015fekilde, kan dola\u015f\u0131m\u0131n\u0131z\u0131 artt\u0131ran sportif aktivitelerden ka\u00e7\u0131nman\u0131z ve s\u0131cakl\u0131\u011f\u0131 y\u00fcksek olan ortamlarda (sauna, s\u0131cak su banyolar\u0131) bulunmaman\u0131z gerekmektedir. Bunun d\u0131\u015f\u0131nda, \u00f6zel bir tavsiyemiz yok. Hatta cinsel ili\u015fki bile pozitif etki eder.<\/p>\n<p>D\u00f6llenmeden 12 ila 14 g\u00fcn sonra idrar ve kan al\u0131narak yap\u0131lan testler sonucunda, kad\u0131n\u0131n gebe kal\u0131p kalmad\u0131\u011f\u0131 belirlenir.<\/p>\n<p>Bu y\u00f6ntemin bir avantaj\u0131, bu y\u00f6ntemde geriye, genelde \u201cyeterli say\u0131da\u201c (k\u0131smen) d\u00f6llenmi\u015f yumurta h\u00fccrelerinin kalmas\u0131d\u0131r. Bunlar da sonraki \u201e<a href=\"https:\/\/kwt.meiio.net\/spektrum\/kinderwunsch\/therapie-des-unerfuellten-kinderwunsches\/kryokonservierung\">donma sikluslar\u0131nda<\/a>\u201c kullan\u0131labilir. Yine de daha yeni ara\u015ft\u0131rmalar, elde edilen folik\u00fcl (yumurta keseci\u011fi) say\u0131s\u0131 az oldu\u011funda, \u201ciyi\u201c yumurta h\u00fccrelerinin daha y\u00fcksek y\u00fczdede \u00e7\u0131kt\u0131\u011f\u0131n\u0131 g\u00f6stermi\u015ftir. Bu, (konvansiyonel olarak yap\u0131lan IVF\u2019de) dondurulmu\u015f h\u00fccrelerde geli\u015febilir h\u00fccrelere daha az s\u0131kl\u0131kla rastland\u0131\u011f\u0131 anlam\u0131na gelmektedir.<\/p>\n<h2><strong>IVF\u2019nin riskleri\/komplikasyonlar\u0131:<\/strong><\/h2>\n<ul>\n<li>OHSS (Over hiperstim\u00fclasyon sendromu)<\/li>\n<li>Organ yaralanmas\u0131<\/li>\n<li>\u00c7oklu gebelik<\/li>\n<li>D\u0131\u015f gebelik (ektopik gebelik)<\/li>\n<\/ul>\n<p><a href=\"https:\/\/kwt.meiio.net\/spektrum\/kinderwunsch\/therapie-des-unerfuellten-kinderwunsches\/ivf-in-vitro-fertilisation\/nc-ivf\">NC-IVF<\/a>\u00a0ve\u00a0<a href=\"https:\/\/kwt.meiio.net\/spektrum\/kinderwunsch\/therapie-des-unerfuellten-kinderwunsches\/ivf-in-vitro-fertilisation\/mini-ivf\">Mini-IVF<\/a>\u201a de, OHSS olmaz.<\/p>\n<h4>OHSS (Over\u00a0Hiper\u00a0Stim\u00fclasyon\u00a0Sendromu) Yumurtal\u0131\u011f\u0131n \u00e7ok fazla uyar\u0131lmas\u0131<\/h4>\n<p>\u0130n-vitro fertilizasyon (t\u00fcp bebek) ve intra sitoplazmik sperm enjeksiyonu (mikroenjeksiyon) \u00e7er\u00e7evesinde yap\u0131lan \u00f6n tedavide oldu\u011fu gibi yumurtal\u0131\u011f\u0131n hormonla her uyar\u0131lmas\u0131, yumurtal\u0131\u011f\u0131n a\u015f\u0131r\u0131 uyar\u0131lmas\u0131 riski ta\u015f\u0131r. Uyar\u0131 dozu ne kadar artt\u0131r\u0131l\u0131rsa, a\u015f\u0131r\u0131 uyarma riski de o kadar y\u00fcksek olur. \u00d6zellikle, PCO (Polikistik over) sendromlu kad\u0131nlar\u0131n uyar\u0131lmas\u0131nda bu risk daha fazlad\u0131r.<\/p>\n<p>IVF\u2019de over hiperstim\u00fclasyonunda, birden \u00e7ok yumurta h\u00fccresi olgunla\u015ft\u0131r\u0131larak, embriyo transferi i\u00e7in yeterli say\u0131da embriyonun al\u0131nmas\u0131 \u015fans\u0131 artt\u0131r\u0131l\u0131r. Normalde g\u00fcn i\u00e7in se\u00e7ilen standart 150-225 I.E. dozundaki FSH ile 10-15 folik\u00fcl\u00fcn b\u00fcy\u00fct\u00fclmesi ama\u00e7lan\u0131r. Ama \u00f6zellikle ilk stim\u00fclasyonun yap\u0131ld\u0131\u011f\u0131 siklusta, kad\u0131n\u0131n ald\u0131\u011f\u0131 hormonlara kar\u015f\u0131 nas\u0131l bir reaksiyon verece\u011fi hakk\u0131nda bir \u00f6ng\u00f6r\u00fcm\u00fcz bulunmamaktad\u0131r. Kad\u0131n hormonlara olumsuz bir tepki verdi\u011fi takdirde, bu durum OHSS ile sonu\u00e7lanabilir. OHSS\u2019de, genelde 20-25 folik\u00fcl b\u00fcy\u00fcr. Bu folik\u00fcller, sadece b\u00fcy\u00fckl\u00fckleri oran\u0131nda bas\u0131n\u00e7 yaparlar. Sadece, olgun bir folik\u00fcl\u00fcn \u00e7ap\u0131n\u0131n 2 cm. oldu\u011funu g\u00f6z\u00fcn\u00fcz\u00fcn \u00f6n\u00fcne getirirseniz bunu daha iyi anlayabilirsiniz. Ba\u015fka bir problem de, folik\u00fcl\u00fcn \u00f6strojen salg\u0131lamas\u0131yla ortaya \u00e7\u0131kar. Kan seviyesi ne kadar fazla olursa, damar duvarlar\u0131nda o kadar b\u00fcy\u00fck bir de\u011fi\u015fme olur ve bu, nispeten a\u015f\u0131r\u0131 s\u0131v\u0131 ak\u0131\u015f\u0131na (kan b\u00f6lgesinden, mide b\u00f6lgesine) neden olur. Bu ak\u0131\u015f\u0131n sonucunda, v\u00fccut, bas\u0131n\u00e7tan rahats\u0131zl\u0131k duyar. Bu biriken s\u0131v\u0131 (assit) o kadar a\u015f\u0131r\u0131 olur ki, ki\u015fi kendini hasta hissetmeye ba\u015flar ve damar i\u00e7erisindeki kan\u0131n yo\u011funlu\u011fu artt\u0131\u011f\u0131ndan tromboz riski do\u011far. Toplanan s\u0131v\u0131 berlirgin bir bi\u00e7imde artt\u0131\u011f\u0131nda, semptomlar\u0131n h\u0131zl\u0131 bir \u015fekilde d\u00fczeltilmesi i\u00e7in s\u0131v\u0131 transvajinal (folik\u00fcl ponksiyonunda oldu\u011fu gibi vajinadan) veya perk\u00fctan (ciltten) yollardan \u00e7ekilerek al\u0131n\u0131r. Ne yaz\u0131k ki, damar duvarlar\u0131 ge\u00e7irgenli\u011fini korumaya devam etti\u011fi i\u00e7in, bu i\u015flemin genellikle birka\u00e7 g\u00fcn boyunca defalarca tekrarlanmas\u0131 gerekir.<\/p>\n<p>A\u011f\u0131r vakalarda, yo\u011fun bir t\u0131bbi destek al\u0131nmas\u0131 gerekebilir.<\/p>\n<h4>Folik\u00fcl ponksiyonu- Yumurta h\u00fccresinin al\u0131nmas\u0131<\/h4>\n<p>Folik\u00fcl ponksiyonu, transvajinal ultrason alt\u0131nda, anesteziyle veya anestezissiz olarak yap\u0131l\u0131r. Lokal anestezi yap\u0131lmas\u0131 da m\u00fcmk\u00fcnd\u00fcr, ama bu zahmetsiz bir i\u015flem de\u011fildir.<\/p>\n<p>Ponksiyonda, ultrason probuna sokulan k\u0131lavuz \u00e7ubu\u011fun i\u00e7erisinden uzun bir i\u011fne sokulur. \u0130\u011fnenin hareketi monit\u00f6rden izlenir ve vajina duvar\u0131ndan (2-3 mm), s\u0131v\u0131s\u0131nda yumurta h\u00fccreleri bulunan folik\u00fcle direkt sokulur. Yumurtal\u0131k yanl\u0131\u015f yerle\u015fmi\u015fse ya da ba\u015fka tip bir teknik problem oldu\u011funda, barsa\u011f\u0131n, kan damarlar\u0131n\u0131n veya mesanenin yaralanmas\u0131 ihtimali vard\u0131r.<\/p>\n<p>\u0130\u015flemler vajinadan girilerek yap\u0131ld\u0131\u011f\u0131 i\u00e7in, lokal bir dezenfeksiyon sa\u011flanm\u0131\u015f olsa bile, temel bir enfeksiyon riski do\u011far.<\/p>\n<figure id=\"attachment_7473\" aria-describedby=\"caption-attachment-7473\" style=\"width: 800px\" class=\"wp-caption alignnone\"><img decoding=\"async\" class=\"size-full wp-image-7473\" src=\"https:\/\/kwt.meiio.net\/wp-content\/uploads\/slide_12-2.jpg\" alt=\"Vajinal ponksiyonun \u015fematik anlat\u0131m\u0131\" width=\"800\" height=\"546\" srcset=\"https:\/\/kwt.meiio.net\/wp-content\/uploads\/slide_12-2.jpg 800w, https:\/\/kwt.meiio.net\/wp-content\/uploads\/slide_12-2-300x205.jpg 300w, https:\/\/kwt.meiio.net\/wp-content\/uploads\/slide_12-2-768x524.jpg 768w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption id=\"caption-attachment-7473\" class=\"wp-caption-text\">Vajinal ponksiyonun \u015fematik anlat\u0131m\u0131<\/figcaption><\/figure>\n<h4>\u00c7oklu gebelik riski<\/h4>\n<p>Almanya\u2019da gebelik y\u00fczdelerinin % 30\u2019u ila 35\u2019inin ba\u015far\u0131yla sa\u011flanabilmesi i\u00e7in, ortalama en az 2 embriyo transferinin yap\u0131lmas\u0131 gerekir. \u00c7oklu gebeliklerin Almanya\u2019daki y\u00fczde oran\u0131 yakla\u015f\u0131k olarak % 20-25\u2019lerdedir, \u00fc\u00e7\u00fcz gebeliklerin oran\u0131 % 4\u2019lere \u00e7\u0131kmaktad\u0131r. Gebelik komplikasyonlar\u0131n\u0131 artt\u0131rmak problemlidir.-Erken do\u011fum ve bunun sonucu ortaya \u00e7\u0131kan problemler.<\/p>\n<p>Y\u0131llard\u0131r istemeden olu\u015fan \u00e7oklu gebelik, \u00fcreme t\u0131bb\u0131nda bir hata olarak g\u00f6r\u00fclmektedir. Bu riski azaltman\u0131n farkl\u0131 yollar\u0131 vard\u0131r. Ama, bu yollar\u0131n b\u00fcy\u00fck bir k\u0131sm\u0131 Almanya\u2019da yasakt\u0131r. \u00c7ok daha liberal yasalarla y\u00f6netilen \u00fclkelerde, bu tip hamilelik y\u00fczdeleri sadece bir tane \u201cy\u00fcksek kaliteli\u201c embriyonun transferinden sonra elde edilmektedir.<\/p>\n<p>SET (single embryo transfer) yasalar liberalse ve IVF laboratuvar\u0131n\u0131n bu konuda becerisi varsa, \u00e7oklu gebeli\u011fi \u00f6nlemek i\u00e7in optimal bir y\u00f6ntemdir.<\/p>\n<h4>EU Ektopik gebelik (d\u0131\u015f gebelik)<\/h4>\n<p>Embriyolar, birka\u00e7 g\u00fcn boyunca, rahim bo\u015flu\u011funda oradan oraya hareket etti\u011fi i\u00e7in, IVF de d\u0131\u015f gebelikle sonu\u00e7lanabilir (kas kas\u0131lmalar\u0131na ba\u011fl\u0131 olarak). Yani t\u00fcm embriyolar\u0131n % 4 kadar\u0131, fallop t\u00fcp\u00fcne kadar gidip orada kal\u0131p komplikasyonlu d\u0131\u015f gebeli\u011fe yol a\u00e7abilirler. Bu tan\u0131 konulduktan sonraki herhangi bir zamanda medikal veya cerrahi olarak tedavi edilebilir. Hastalar sadece erken te\u015fhisle hayati tehlikesi olan komplikasyonlardan korunabilir.<\/p>\n<p>\u2014 \u015eematik anlat\u0131mlar: \u00a9 Professor Herrero, Barcelona<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Konvansiyonel IVF (in vitro fertilizasyon\/klasik t\u00fcp bebek i\u015flemi)\u2019de izlenecek yol 1. \u0130la\u00e7l\u0131 \u00f6n tedavi Konvansiyonel IVF\u2019de, ila\u00e7l\u0131 bir \u00f6n tedavi [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":7690,"parent":7684,"menu_order":1,"comment_status":"closed","ping_status":"closed","template":"page-siblingnavi.php","meta":{"footnotes":""},"class_list":["post-7689","page","type-page","status-publish","has-post-thumbnail","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Konvansiyonel IVF &#8226; Kinderwunschteam Berlin<\/title>\n<meta name=\"description\" content=\"Konvansiyonel IVF (in vitro fertilizasyon\/klasik t\u00fcp bebek i\u015flemi)\u2019de izlenecek yol 1. \u0130la\u00e7l\u0131 \u00f6n tedavi Konvansiyonel IVF\u2019de, ila\u00e7l\u0131 bir \u00f6n tedavi ile,\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"tr_TR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Konvansiyonel IVF &#8226; 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