Infertility remains one of the most significant clinical and psychosocial challenges of the twenty-first century, affecting approximately 15% of couples worldwide. As the biological understanding of reproductive health has deepened, the transition from intuitive attempts at conception to precision-based medical intervention has become the gold standard in the field.
IVF Treatment Istanbul, Turkey, has emerged as a preeminent global hub for this medical evolution, offering a synergy of high-tier clinical expertise, advanced laboratory infrastructure, and a robust framework for international patient care. At the heart of this ecosystem is the philosophy of comprehensive fertility testing—a diagnostic imperative that ensures treatment is not merely a reactive procedure but a targeted strategy based on the unique physiological profile of the couple.
This report provides an exhaustive analysis of the diagnostic landscape, the technological advancements in infertility, and the specialized methodology of Prof. Dr. Nilgün Turhan on fertility assessments in İstanbul.
Fertility is a shared journey between women and men, influenced by age, genetics, lifestyle, and overall health. When pregnancy does not occur naturally within a reasonable time, comprehensive fertility tests allow us to identify the underlying causes accurately and design a personalized treatment plan.
At IVF Treatment Istanbul, Prof. Dr. Nilgün Turhan approach fertility evaluation with a holistic, evidence‑based, and patient‑centered perspective.
The global rise in infertility is attributed to a multifaceted array of variables, including the societal trend toward delayed parenthood, environmental toxins, and a heightened awareness of underlying genetic conditions. Consequently, the traditional approach of waiting twelve months before seeking clinical advice is being replaced by a more proactive diagnostic workup, particularly for individuals over the age of thirty-five or those with known reproductive health conditions.
In IVF Treatment Istanbul, the diagnostic process is structured as a comprehensive "fertility check-up" that serves as the foundation for all subsequent interventions.
The rationale for comprehensive testing is rooted in the high incidence of "unexplained infertility," which often arises when standard evaluations fail to detect subtle hormonal imbalances or molecular defects in gametes. By employing a rigorous battery of tests, clinicians can transform "unexplained" cases into "diagnosed" ones, thereby selecting the most efficacious path—whether it be Intrauterine Insemination (IUI),In Vitro Fertilization (IVF),or specialized surgical intervention.
In a clinical landscape increasingly dominated by high-volume hospital networks, the personalized approach of Prof. Dr. Nilgün Turhan at ivftreatmentistanbul.com represents a critical differentiator. With over thirty years of experience in the field of In Vitro Fertilization and gynecological surgery, Dr. Turhan integrates her extensive academic background with a "tailor-made" treatment philosophy.
Prof. Dr. Nilgün Turhan’s clinical experience, which includes fellowships in Italy and leadership roles at major Turkish medical institutions, allows for the management of complex cases, such as "poor responders" or those with multiple previous IVF failures. The integration of laparoscopic and hysteroscopic surgery into the diagnostic workup ensures that structural impediments to implantation are addressed before the commencement of hormonal stimulation.
Comprehensive fertility testing refers to a structured set of medical, hormonal, genetic, and imaging investigations performed for both partners. These tests help us: to identify the cause of infertility, estimate reproductive potential, choose the most effective treatment option, avoid unnecessary treatments and time loss and early and accurate diagnosis is one of the most important predictors of fertility treatment success.
A successful pregnancy requires the harmonious synchronization of ovarian function, tubal patency, and uterine receptivity. The female diagnostic workup in Istanbul is designed to evaluate each of these components with high precision.
Ovarian reserve refers to the number and quality of remaining eggs in a woman’s ovaries. Unlike sperm production in men, women are born with a finite number of eggs, and this reserve naturally declines with age — both in quantity and genetic quality.
Ovarian reserve assessment helps us understand a woman’s reproductive potential and guides fertility planning and IVF treatment.
Ovarian reserve assessment provides critical information about expected response to ovarian stimulation, urgency of fertility treatment, probability of natural conception or IVF success, risk of poor ovarian response, and individualization of IVF protocols.
It is important to note that ovarian reserve does not predict the ability to conceive naturally in a given month, but it is highly predictive of IVF outcomes and treatment planning.
Ovarian reserve is evaluated using a combination of hormonal tests and ultrasound findings.
AMH is the most reliable and stable marker of ovarian reserve. It is secreted by small growing follicles in the ovaries. AMH can be measured on any day of the menstrual cycle and reflects the remaining pool of recruitable eggs.
Interpretation:
AMH helps predict how many eggs may be obtained during IVF stimulation but does not directly measure egg quality.
AFC is assessed by transvaginal ultrasound, usually at the beginning of the menstrual cycle. Counts small follicles (2–10 mm) in both ovaries. The small follicle numbers strongly correlate with ovarian reserve and helps tailor IVF medication doses. A low AFC suggests a reduced ovarian reserve, while a high AFC may be seen in conditions such as polycystic ovary syndrome (PCOS).
These blood tests are performed early in the menstrual cycle and include:
Elevated FSH or estradiol levels may indicate diminished ovarian reserve, even if cycles are regular.
This is a crucial distinction:
While egg quantity declines gradually, egg quality declines more sharply with age, especially after 35–38 years. A young woman may have a low ovarian reserve but good egg quality, while an older woman may have a normal reserve with reduced egg quality.
Ovarian reserve assessment is recommended for:
Ovarian reserve testing is not about labeling patients as fertile or infertile. It is a tool that allows us to choose the right timing, the right strategy, and the most realistic path toward a healthy pregnancy.
Ovulation means the release of an egg from the ovary. For a natural pregnancy to occur, ovulation must happen regularly and at the right time during the menstrual cycle.
Ovulation evaluation helps us understand whether ovulation is occurring, how regularly it happens, and whether the timing is optimal for conception.
Even if all other fertility tests are normal, pregnancy cannot occur without ovulation. Ovulation problems may cause difficulty getting pregnant, irregular menstrual cycles, missed fertile days and short or weak luteal phase. The good news is that ovulation problems are often treatable once properly diagnosed.
Ovulation is assessed using a combination of blood tests, cycle monitoring, and ultrasound.
Progesterone is a hormone released after ovulation. The progesterone levels are measured about 7 days after ovulation (usually day 21 in a 28-day cycle). It confirms whether ovulation has actually occurred and shows how strong the post-ovulation phase is.
What it tells us:
Tracking the menstrual cycle helps to identify cycle length and regularity, possible ovulation window and irregular or missed ovulation. This can include recording period dates, monitoring cycle length changes, using ovulation predictor kits (when appropriate). Regular cycles usually suggest ovulation, but blood tests and ultrasound are needed for confirmation.
Ultrasound allows us to directly observe ovulation. It monitors follicle growth in the ovaries, identifies the dominant follicle (egg-containing follicle) and confirms follicle rupture (ovulation). This method provides the most accurate information about ovulation timing and is especially useful for irregular cycles, fertility treatment planning and timed intercourse or IUI.
Ovulation testing is recommended if:
Ovulation problems are common and manageable. Many women who do not ovulate regularly conceive successfully once the issue is identified and treated.
At IVF Treatment Istanbul, ovulation evaluation is always personalized and explained clearly, so patients understand both the results and the next steps.
Ovulation evaluation is not just about tests — it is about understanding your cycle and working with your body to create the best chance for pregnancy.
Even with high-quality embryos, pregnancy cannot occur if the uterus is not receptive or if the fallopian tubes are obstructed. Istanbul clinics utilize state-of-the-art imaging to map the internal reproductive anatomy.
Transvaginal Ultrasound and Antral Follicle Count (AFC): This real-time imaging allows the specialist to count the follicles available for stimulation in a given month. It also identifies intramural fibroids, ovarian cysts, and endometriomas that may interfere with egg quality or pelvic health.
Hysterosalpingogram (HSG): This radiologic procedure involves the infusion of a contrast dye to visualize the interior of the fallopian tubes. Blocked tubes (hydrosalpinx) can be toxic to embryos, making this test a mandatory step before IVF.
Saline Infusion Sonography (SIS) / Sonohysterogram: By filling the uterine cavity with saline, clinicians can detect polyps or submucosal fibroids that act as mechanical barriers to implantation.
Hysteroscopy: Often used as both a diagnostic and therapeutic tool, hysteroscopy involves a thin fiber-optic camera inserted into the uterus. Prof. Dr. Nilgün Turhan utilizes this to correct uterine septums, adhesions (Asherman’s syndrome),and polyps with minimal downtime.
Hormonal balance is crucial for ovulation, implantation, and pregnancy continuation.
These tests are particularly important in cases of recurrent pregnancy loss or repeated IVF failure.
Contemporary research confirms that male factor issues are present in approximately 50% of infertility cases. Despite this, many international clinics still rely solely on volume and count. In Istanbul, the male evaluation is comprehensive, focusing on the functional and genetic integrity of the sperm.
A standard semen analysis evaluates the quantity, motility, and morphology of the sperm after a period of 2-5 days of abstinence.
| Metric | Definition | Clinical Threshold for Concern |
| Concentration | Number of sperm per mL of ejaculate. | Below 15 million/mL suggests sub-fertility. |
| Motility | The percentage of sperm that are moving effectively. | Below 40% total motility or 32% progressive motility. |
| Morphology | The percentage of sperm with normal physical structure. | Below 4% (Kruger’s strict criteria) indicates potential fertilization issues. |
While these metrics provide a baseline, they do not assess the DNA within the sperm. This is where the Sperm DNA Fragmentation Test becomes essential. High levels of DNA fragmentation—often caused by oxidative stress, smoking, or varicoceles—are a major cause of failed IVF cycles and recurrent miscarriage. For patients with high fragmentation, IVF Treatment Istanbul clinics often recommend Micro-TESE (Microscopic Testicular Sperm Extraction) or advanced selection techniques like IMSI to bypass damaged sperm and achieve fertilization.
These tests are especially valuable in unexplained infertility and repeated IVF failure.
Fertility treatment is not a one‑size‑fits‑all process. Comprehensive testing allows us to:
At IVF Treatment Istanbul, we combine advanced diagnostics with clinical experience to guide you safely and transparently through your fertility journey.
Fertility challenges can be emotionally overwhelming. My role is not only to diagnose and treat, but also to guide you with clarity, empathy, and scientific precision. Every couple deserves an individualized approach and honest medical guidance.
The journey to parenthood through assisted reproduction is a testament to the resilience of the human spirit and the brilliance of modern science. In Istanbul, this journey is safeguarded by a diagnostic framework that is as compassionate as it is comprehensive. By integrating thirty years of clinical wisdom from experts like Prof. Dr. Nilgün Turhan with the most advanced laboratory technologies ivftreatmentistanbul.com offers international patients a unique opportunity for success.
Comprehensive fertility testing is the silent hero of this process. It provides the clarity needed to navigate the complexities of reproductive health, ensuring that every injection, every ultrasound, and every embryo transfer is optimized for the best possible outcome. For couples facing the challenge of infertility, the combination of Istanbul’s medical excellence, ethical transparency, and economic accessibility provides more than just a medical procedure—it provides a realistic, evidence-based path to building a family.
IVF TREATMENT ISTANBULProf. Dr. Nilgün Turhan
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