Executive Plan for Couples coming from abroad to Istanbul for Assisted Conception Needs

1. Executive Plan forCouplescomingfromabroadtoIstanbulforAssistedConceptionNeeds

2. Better IVF therapy with lower cost @ Istanbul 2200$ without med.s Offer fertility care for EU citizens Offer fertility care for Turkish community living in EU Our mission: Treatments which are Effective, With high quality, Patient friendly, Simple Safe Why would you prefer us?

3. Via my e-mail tevfik@yoldemir.com Via Skype dr_yoldemir How do you communicate with us from abroad?

4. Via our certified Travels Agent www.fhs.com.tr E-mail :hakan@fhs.com.tr Skype : hakan1122 msn messenger : hakankirhan@hotmail.com How can you afford your trip and make reservations ?How do we host our guests ?

5. Communications YOU Dr Tevfik Yoldemir Travels Agent Embryolog Scientist Coordinator Nurse

6. ONE IVF CYCLE COST $ 2200 Medication cost is extra Following medications are used • Recombinant FSH Group • Human Menopausal Gonodotropins • Highly purified Human Urinary FSH • Antagonist and agonist medications

7. WHY TRAVEL TO TURKEY FOR IVF ? • Dr Yoldemir practices assisted reproductive technologies for over 10 years. • You will be treated by internationally experienced Dr Yoldemir who had practiced assisted conception techniques in the United States and Australia. • You will save on enormous financial expenses compared with Western Europe and North America. • You will receive high quality medical service in a very modern clinic • In Turkey, we are allowed to transfer max 2 embryos. • You will allow the stress associated with IVF to be melted by a vacation-like environment, in a beautiful city.

8. MALE Two or three sperm counts one month apart are ordered and evaluated. WHO (World Health Organization) and Krugers` criteria is used to analyze the sperm parameters. If the sperm count is abnormal, hormonal tests and ultrasound of the testes is performed. This way, hormonal and vascular problems may be detected. In male infertility however, medical and surgical therapies are getting less and less popular due to high failure rates. Therefore for male infertility, currently artificial insemination or IVF/ICSI is recommended, depending on sperm count results. HOW DO WE APROACH THE INFERTILE COUPLE ?

9. WOMEN We order FSH, LH, E2, PRL, and TSH hormon levels on the third day of the period. If these are normal, ovulations are monitored with ultrasound. If there is an ovulation problem it is treated by oral medications or hormonal injections, monitored by ultrasound. If the ovulation is normal, then Hysterosalpingography ( X-ray of the uterus and tubes) is performed to rule out the tubal blockage. If there is a problem with the tubes, laparoscopic correction is tried in certain cases. However, in recent years due to highly successful IVF/ICSI results, tubal surgery is performed less often HOW DO WE APROACH THE INFERTILE COUPLE ?

10. 1. Stimulation of the eggs with drugs: Fertility medications are used to stimulate ovarian production and there is an attempt to obtain multiple eggs to increase the patient's chance of getting pregnant by fertilizing numerous eggs for embryo development. At this stage, the eggs developing in the ovaries are monitored with ultrasound and hormone testing and retrieved before they are released. 2. Retrieval of the eggs: The eggs are retrieved by inserting a special aspiration needle guided by ultrasound into the vagina.  The patient is given light anesthesia. Once retrieved the eggs are placed in special receptacles in a laboratory environment. Special methods are used to fertilize the eggs with sperm taken that same day from the from the woman's husband. Summary of IVF –1

11. 3. Fertilization of the eggs and embryo development: The eggs are fertilized in the laboratory with sperm using the microinjection method. Then the embryo is allowed to develop for a period of time, after which the highest grade embryos are chosen for placement in the mother's womb. 4. Transfer of the embryo to the mother's womb: The chosen embryos are transferred to the mother's womb with a special catheter, after which one must wait and see if they attach to the womb and pregnancy develops. Summary of IVF -2

12. 5. Luteal follow-up: In order to assist pregnancy development, the patient will be given medications containing progesterone after the embryo transfer. Ultrasound and hormone tests will be administered once a week. Whether or not pregnancy has occurred will be determined by testing for the bHCG hormone in the blood on the 12th day after the embryo transfer. Summary of IVF -3

13. How do you communicate with the patients and how does pre IVF treatment start ? • We believe that the most important part of an infertility treatment is the communication between the patient and the doctor • For this reason, we will call you or reply you via tevfik@yoldemir.com as fast as we can. We also offer patients interviews with Dr Yoldemir at Skype. • First, we receive the application of the patient. If there is anything missing, we advise the patient • We will work closely with patient`s local gynecologist in order to understand the medical situation more clearly • If we decide to accept you as a patient, your medication shhet will be e-mailed to your doctor • The flight will be scheduled according to the treatment • plan and the patient will be in Istanbul as planned.

14. How long will You stay in Istanbul ? • The stay is approximately 7-10 nights. • Treatment starts in accordance with your primary care physician • Ovarias will be stimulated for the first 4-5 days at your homeland and then you will followed by Dr Yoldemir • Egg retrieval scheduled at the appropiate time for mature egg harvesting and will be under IV anesthesia. • At the time of the egg retrieval process, sperm will be taken from the partner and ICSI will be performed • After 3 days of embryo development, Embryo Transfer ET will be done with ultrasonographic guidance • The next day or the day after, couple may return back to home country

15. What will happen after the treatment ? • We will continue our contact when you return back to your country (via e-mail or msn messenger) • After 12 days of Embryo Transfer , pregnancy test will be performed. If the result is positive, we will be in contact with both you and your gynecologist on a regular basis and advise if needed. • If the result is negative, we will discuss the possible reasons and try to determine what we can do more for you.