Understand IVF follow up care, emotional support, and monitoring throughout the fertility journey.

Learn about In Vitro Fertilization Lifestyle and Prevention strategies, including an ideal fertility diet, stress management, and how to prevent infertility risks. 

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Walking With You Until the End

The embryo transfer is the medical climax of an IVF cycle, but for the patient, it is just the beginning of the most emotionally challenging chapter: the wait. At Liv Hospital, our philosophy is simple: You are not a patient only when you are in the building. Whether you are waiting for your pregnancy test in a hotel room in Istanbul or back home in London or Berlin, our “Continuum of Care” ensures you never feel abandoned.

Our IVF Follow-up and Support program is designed to guide you through the critical weeks after treatment. We interpret the numbers, manage the medications, celebrate the victories, and—if necessary—investigate the setbacks to build a stronger plan for the future.

The "Two Week Wait": Managing Anxiety and Physiology

The 10 to 14 days between embryo transfer and the pregnancy test are notoriously difficult. This period is medically known as the Luteal Phase.

1. Medical Support: The Progesterone Lifeline

During an IVF cycle, we remove the cells (granulosa) that normally make progesterone during the egg retrieval. Therefore, your body cannot support a pregnancy on its own yet.

  • The Rule: You must take Exogenous Progesterone (vaginal suppositories, injections, or gel) religiously.
  • The Warning: Do not stop this medication even if you have spotting or feel “PMS symptoms.” Progesterone mimics pre-menstrual symptoms (bloating, breast tenderness), which can be confusing. Only a blood test can confirm if it worked.

2. Psychological Support: The “Liv Line”

Anxiety releases cortisol, which isn’t helpful for implantation.

  • Remote Monitoring: You will have a dedicated WhatsApp line or patient coordinator. If you feel a cramp on Day 5 and panic, we are there to reassure you that cramping is often a sign of implantation, not failure.
  • Symptom Check: We guide you on what is normal (light spotting, mild cramping) versus what needs attention (heavy bleeding, severe pain).

The Verdict: Interpreting the Beta-hCG Test

Home urine tests are convenient, but they are often inaccurate in the early days of IVF. We require a Quantitative Beta-hCG Blood Test 12 days after a Day 3 transfer (or 10 days after a Blastocyst transfer).

Understanding the Numbers

  • < 5 mIU/mL (Negative): Implantation did not occur. We will ask you to stop medications and wait for your period (which usually arrives in 3–5 days).
  • 5 – 25 mIU/mL (Borderline/Chemical Pregnancy): Implantation happened, but the embryo may not be growing. We repeat the test in 2 days.
  • > 50 mIU/mL (Positive): Congratulations! You are officially pregnant.

The “Doubling Rule”

A single positive number isn’t enough. We need to see the Beta-hCG level double every 48 hours.

  • Example: If your first test is 100, the second test (2 days later) should be around 200. This exponential rise confirms that the pregnancy is viable and growing in the uterus, ruling out an ectopic pregnancy.

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Prof. MD. Tahsin Yakut Prof. MD. Tahsin Yakut IVF (In Vitro Fertilization)
Group 346 LIV Hospital

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Early Pregnancy Monitoring (Weeks 4–10)

An IVF pregnancy is precious. We monitor it more closely than a natural pregnancy.

1. The Viability Scan (Week 6–7)

About 2 weeks after your positive test, you will have your first ultrasound.

  • What we look for: We confirm the Gestational Sac is inside the uterus (not the tube) and look for the Yolk Sac (the baby’s first lunchbox).
  • The Heartbeat: This is the milestone. Seeing the fetal heart flicker (usually 100+ beats per minute) drops the risk of miscarriage dramatically (to less than 5–10%).

2. The “Graduation” (Week 10–12)

By week 10, the placenta takes over hormone production.

  • Weaning Off: We will give you a schedule to slowly reduce your progesterone and estrogen support. Do not stop “cold turkey.”
  • Handover: We prepare a detailed medical file for your local OB/GYN, explaining your IVF journey, medications, and due date. You are now a “normal” pregnant woman!

The "Post-Cycle Review"

Despite our best technology, not every cycle leads to a baby. A negative result is heartbreaking, but it is also data. At Liv Hospital, a failed cycle is not the end; it is a diagnostic tool.

We schedule a “Review Consultation” to ask:

  1. Was it the Embryo? If we didn’t do PGT-A, the embryo likely had a chromosomal error. If we did do PGT-A and it failed, we look at the uterus.
  2. Was it the Lining? Did the endometrium fail to thicken (>7mm)? Was there fluid?
  3. Was it the Timing? Some women have a displaced “Window of Implantation.”

The Action Plan:

  • Frozen Embryo Transfer (FET): If you have frozen blastocysts, we can try again immediately with a different protocol (e.g., Natural Cycle vs. Medicated Cycle). Success rates for FET are often higher than fresh cycles because the body is rested.
  • Further Testing: We may recommend ERA, Hysteroscopy, or Immunology testing before the next attempt.
IVF

Advanced Investigations for Recurrent Failure

IVF

If you have had 3+ good quality embryos fail to implant, this is Recurrent Implantation Failure (RIF). We dig deeper.

1. ERA Test (Endometrial Receptivity Analysis)

About 20% of RIF patients have a displaced window. Their uterus is ready on Day 6, not Day 5.

  • The Solution: We take a biopsy of the lining in a “mock cycle.” The genetic analysis tells us exactly how many hours of progesterone you need. We then time the next transfer to the specific hour.

2. Thrombophilia Panel (Clotting Disorders)

Tiny micro-clots can form behind the placenta, cutting off blood supply.

  • The Solution: If you test positive for Factor V Leiden or MTHFR mutations, we add blood thinners (Low Molecular Weight Heparin) and Baby Aspirin to your next protocol.

3. Immunology Testing (Killer Cells)

Rarely, the mother’s immune system may attack the embryo.

  • The Solution: We may use Intralipid Infusions or corticosteroids (Prednisone) to suppress the immune response and allow implantation.

International Patient Logistics

Most patients fly home 1–2 days after the embryo transfer.

  • Medication Supply: We ensure you have enough Progesterone and Estrogen to last you until your pregnancy test (or 12 weeks of pregnancy). It is often cheaper to buy these in Turkey.
  • Fit to Fly: We provide a medical letter stating you have had a “minor gynecological procedure” (to protect privacy) and are fit to travel.
  • Local Coordination: We can communicate directly with your local gynecologist or fertility clinic to arrange your blood tests and scans, so you don’t have to fly back to Istanbul just for a check-up.

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With patients from across the globe, we bring over three decades of medical

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FREQUENTLY ASKED QUESTIONS

Is bleeding after transfer normal?

Yes. About 20–30% of women experience “Implantation Bleeding” or spotting during the first trimester. It is usually brown or light pink. If it is bright red and fills a pad, call us. Never stop your medications because of bleeding. It might just be a hematoma, and the baby is fine.

It is a very early miscarriage where the embryo implants briefly (giving a low positive hCG) but stops growing before a sac is seen on ultrasound. It is usually due to genetic abnormalities in the embryo. It is emotionally painful, but medically it is a good sign—it proves you can get pregnant and implantation can occur.

If you have frozen embryos, you can start a Frozen Transfer (FET) cycle immediately with your next period. If you need a fresh egg retrieval, we usually recommend waiting 1–2 months to let your ovaries recover from the stimulation.

We generally advise Pelvic Rest (no sex) until the pregnancy test or the first ultrasound. Orgasms cause uterine contractions, and while unlikely to dislodge an embryo, we want to minimize any risk or guilt if the cycle fails.

Take it as soon as you remember. If it is almost time for the next dose, take it anyway (progesterone is hard to overdose on, but dangerous to underdose). Let your coordinator know so we can adjust the timing if necessary.

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