Gülseren Kuyumcuoğlu, Health Tourism Officer of Istanbul IVF and Women's Health Center, gives answers to the questions that patients from abroad who will come to Turkey for IVF treatment.
You work as the health tourism officer of the center. How long have you been in this position? What kind of services do you offer to couples who come to Turkey for IVF treatment?
WE TRY NOT TO LEAVE COUPLESWHO APPLY FOR IVF ALONE 24/7
"I have been working at Istanbul IVF and Women's Health Center for 7 years and I have been in this position as a health tourism officer. I continue my duty to inform patients from abroad who want support from us on issues related to women's and reproductive health in detail about the processes before they come here, and to be with them at all times during the treatment phase when they arrive. We try not to leave them alone 24/7 in this special situation. Because patients coming from abroad have uneasiness and emotions about being treated in another country. In this process, we support them as a department where they can ask their questions and get information about the process."
GREAT INCREASE IN THE NUMBER OF PATIENTS APPLYING FOR IN VITRO FERTILIZATION
"We often hear Turkey's name in health tourism in the world. Turkey is in a very good place especially in IVF treatment. According to your observations, is there an increase in the number of patients applying for IVF treatment from abroad?"
Yes, there is a noticeable increase. Turkey has made a name for itself all over the world with its health facilities that apply advanced technology in the health sector. In addition, it has become one of the leading countries in reliable and easily accessible treatment. IVF treatment has been practiced worldwide for more than 40 years. Due to Turkey's rapid application of developing technologies in the field of in vitro fertilization treatment and successful results, there has been a 100 percent increase in patients applying to us for in vitro fertilization treatment in health tourism.
THERE ARE PATIENTS COMING EVEN FROM AFRICAN COUNTRIES FOR IVF TREATMENT
So, which countries receive the most applications for IVF treatment?
"We receive applications from many countries of the world. We have patients from Balkan countries, Iraq, Syria and the Middle East, European countries. There are even patients from very small countries in Africa."
CONFIDENCE IN IN VITRO FERTILIZATION WITH ELECTRONIC TESTIMONY
When IVF patients abroad contact you and your team before coming for treatment, what are they most curious about? Which questions do they want to get answers to about IVF treatment in Turkey?
"Before coming from abroad, patients most often ask us about the cost and whether there is a reliable center. IVF treatment is not a treatment for a few days. Therefore, the IVF process itself is also an important question for them. We aim to ensure that patients have confidence with a method we call electronic witnessing. The fact that they are treated with a method where they verify their identities as men and women at every stage of IVF treatment gives us priority in their choice of centers."
“WILL THE EMBRYOS BE MIXED?” WITH ELECTRONIC WITNESSING NO MORE WORRIES!
What is the electronic witnessing you mentioned? Is it a measure to prevent embryos or frozen eggs from being mixed up?
"Couples have concerns about issues such as ‘Will our embryos be mixed?’ 'Will other embryos be transferred? Thanks to this security system that we provide to patients from the beginning, couples can continue their treatment more safely at every stage by checking their own identity information."
This is one of the most curious and perhaps one of the most anxious issues for couples undergoing IVF treatment not only in Turkey but in every country in the world. Can you tell us what kind of a security system it is?
"When the patient applies for treatment, they are given a special number when their identity information is taken. The treatment process starts with this patient-specific ID number. These are then transferred to the chip. This chip is on the patient's wrist. During the treatment process, the patient verifies that he/she is the person being treated by scanning that chip and viewing it together with his/her identity. In this way, patients can easily continue their treatment. These chips are used in the egg collection process, and these chips are also placed in the sample container to be given by the man. The most important feature is that this chip, which is on the woman's wrist, verifies the identity of the woman with an audible warning when the procedure is started. When the procedure starts, the system with the chip is reflected on the screen. The patient sees and verifies her identity there. The same chip is also in the sample container provided by the patient. These chips are checked and scanned repeatedly by several people and the procedure continues.
We are one of the first centers in Turkey to use the electronic witnessing system. With this electronic witnessing system, the suspicious view of IVF treatment is very low, at least in our patients. We can even say that it does not exist. Most of our patients continue their treatments safely in our center because they see their identities on the screen. They no longer have questions like “Does the embryo transferred or the sperm sample belong to someone else?” in their minds.
PERSONALIZED TREATMENT IN IVF
At the beginning of our conversation, you emphasized some of the questions that people who are thinking of coming to IVF treatment ask you at the first stage. First of all, you said they ask about the price. Let's assume that a couple from Greece came to Turkey. What are the patients most curious about their treatment process? What kind of support do they need?
"They mostly ask questions about the treatment process. How long will it take? Is there any risk I can take during the treatment process? Is there anything that can happen to me? When will the results of the tests be available? In our center, treatments are planned individually after the doctor's examination. In other words, not a standard treatment for every patient who walks through the door, but the most appropriate treatment for the patient's condition is planned after the examination and test results.
After the examination and test results, the physician's treatment recommendation and the process are clearly explained to the patient. IVF treatment is normally a process of about 20 days. However, this varies according to the patient's condition. In the first 10-12 days, egg follow-ups are performed together with examinations. The next stage is egg collection. After egg collection, the process is completed by transferring the fertilized eggs in the laboratory environment after 3 or 5 days. As I said, this is not the same for every patient. When the patient arrives, if the indications are clear, if the problems related to the inability to conceive are clear, the treatment plan and process created accordingly are transferred to the patient. What can be different? Egg collection and transfer may not be performed in the same month for every patient. Some patients may require pre-treatment. Treatment can be planned according to the patient's condition and then proceed to IVF. Treatments that need to be done in cases such as low egg reserve of the patient, uterine problems may prolong this process. In patients with low egg reserve, it may not be enough to collect eggs once. It may be predicted that the egg formed will not increase the chance of pregnancy in terms of quality and in this case, extra egg collection may be recommended. All of this can lead to the transfer of an embryo that will increase the patient's chances of pregnancy. But of course, in such cases, the process can take more than 20 days. It may even take several months.
The fact that the treatment takes several months does not mean that the patient should completely cut all ties with her home country and live here. If the patient finds a doctor in his/her home country, if he/she can send us the results of his/her tests and examination results on the same day, he/she can continue the follow-up part of the treatment in his/her home country. He can come here only for procedures. This allows the patient to do their work there without interruption."
TRANSLATION SERVICE FOR IVF PATIENTS IN THEIR OWN LANGUAGE
Turkey aims to be a leader in health tourism. Since many patients from various countries come to Istanbul and your center for IVF treatment, one of the things they need the most must be interpreting services. What kind of support do you provide in this regard?
"In the health tourism department of our center, we have staff who speak English, Arabic and Russian. If needed in another language, we support the patient with daily interpreters and support their treatment."
“IT WOULD BE GOOD FOR COUPLES TO COME TOGETHER IN THE FIRST APPLICATION”
Well, one of the points I would like to ask is, should couples come together for the first examination, for the first interview? I mean, is it necessary for husband and wife to come together?
"Not necessarily, but it is useful for both the man and the woman to be evaluated at the same time during the first visit in order to determine the underlying cause and treatment. Because there are some tests that need to be done for both men and women. Therefore, it is preferable for men and women to come to the first examination at the same time."
So when is the ideal time to apply for IVF treatment?
"If the couple is under the age of 35 and pregnancy has not been achieved despite one year of unprotected intercourse, it is recommended to consult a physician. For women over 35, this period is 6 months. If a woman over 35 years of age cannot get pregnant despite unprotected intercourse, she should definitely see a physician specialized in reproductive health."
WHAT IS PERMITTED AND WHAT IS NOT PERMITTED REGARDING IVF IN TURKEY ACCORDING TO THE LAW?
There are legal regulations regarding IVF. I would like to ask a question to inform those watching us from abroad, especially Greece. What does the legislation in Turkey permit and not permit in IVF treatment?
“According to the legislation on IVF treatment, the couple must have an official marriage certificate. Foreign couples who provide a marriage certificate can undergo any IVF treatment here.”.
So, can people coming from abroad freeze eggs or sperm in Turkey? What is the legislation on this?
“Unfortunately, we cannot perform egg freezing procedures on foreign patients. A committee report is required to donate eggs. Since this report is issued by university hospitals or training and research hospitals, eggs cannot be frozen for foreign patients.”
IVF PLANNING FOR A WOMAN WITH IRREGULAR PERIODS.
We have actually exceeded our chat time, but since we are a YouTube channel, we can continue a little longer. It is extremely important for a woman to have regular periods. When planning IVF, either at the first consultation or later, how do you approach a woman who does not have regular periods?
“We absolutely need to know the reason why the patient cannot have regular periods. When a patient first applies to us from abroad, we tell them to see their doctor there. There are two important hormone tests whose results we ask them to send to us along with the examination results. These give us a rough idea of the patient's condition. This determines what kind of treatment will be given. If the patient wishes, they can come and start treatment. Sometimes, the doctor needs to prescribe medication to help patients menstruate.
ISTANBUL: A HUB FOR HEALTH TOURISM AND IVF TREATMENT
We can describe Istanbul as Turkey's centre of attraction in terms of health. Istanbul is a very important city in terms of tourism. While IVF patients from abroad are here for treatment for a certain period of time, do they also want to visit Istanbul's historical and tourist sites or the surrounding provinces? What kind of requests do you receive most often?
“There are many places in Istanbul, and especially in Taksim where our centre is located, that patients can see, visit, and shop. Patients can spend their time here both enjoying themselves and undergoing their treatment. Istanbul's historical fabric is already known worldwide. When they come, they are very pleased to visit places such as mosques, palaces, or bazaars.”