“Every infertility case is like a puzzle for me.”

A visit to Doctor’s Bağış office in ACIBABEM Altunizade Hospital – where he leads the Assisted Reproduction Department – is an unique experience. Hundreds of babies pictured in photographs sent by graceful parents from all over the world are an impressive testimony of his work and dedication. In the following material, Professor Tayfun Bağış talks about the success rate at the IVF Fertility Center that he coordinates, about God’s role in reproductive medicine as he felt it so many times and about the love and care for an infertility laboratory that he compares to… “a child”.

Professor Bağış, is it difficult for a couple to go through infertility procedures – especially IVF? In terms of emotions, phsycology.

Prof. Dr. Tayfun Bağış: Our very first aim should be not to harm the couples. So, please notice that I did not say to help the couples, but not to harm them - this is very important. Many people come here with great expectations, but we are not Gods and they should not see us as such. No, this is a procedure and it has limited success. And you have to try maybe two times, three times, four times and still you may not have a baby. A lot of people come here in their mid forties - 43, 44 years old - and they say yes, my age is 44, but it’s just a number I feel more younger, my real age is way smaller. Sorry, but your body does not take your feelings into consideration. For example, no matter how young you still feel, your ovarian reserve – your eggs, your follicles – can be depleted, exhausted. We know this for a fact from the results that we have seen all these years. Infertility can be a burden and the emotional problems related to it are a very intimate feeling, they experience it, they are very sad, it obviously harms couples. And for that reason we have to talk very openly before starting any treatment about the results, people should understand the success rates and they should understand the procedure. Many of them think they will come to Turkey, they will become pregnant and they will return home happy. This is not a scenario I encourage, on the contrary. Facts, statistics and risks should be discussed very franky from the beginning. The approach based on the belief that I will give the money, then take home a baby is very harmful.

You have mentioned the success rates. What are these figures at ACIBADEM?

Prof. Dr. Tayfun Bağış: We have a graphic inside our Assisted Reproduction Department, we are putting a black line, and a red line, and the red line is at 45%. But you know that success is different in age groups. For example, for women younger than 35 years old they have nearly 70% pregnancy rate. If they are younger than 30, you can have 80% pregnancy rate, but 15-20% of them are going to have a miscarriage. We usually say that if you are younger than 35 years old, you have 50% chance to have a baby. This is basic. If you don't have any problem in your ovarian reserve, you are going to have a baby. But as age progresses, the success rate drops. Each week and each month we are taking notes for the pregnancy rates and we are observing the statistics. If the number drops below 45, then I have red cards in my hand. Checking everything all the time is very important. Now, in 2016, the pregnancy rates in United States was 42% in all age groups. Our bottom line, as I have said, is 45. If we are going below 45, I start asking myself what's happening in the laboratory? I believe that, in my life, the laboratory is like a child. You have to spend time with it, and you have to like it, pamper it, take care of it, know it by heart. Sometimes it becomes hungry, sometimes emotional, I don't want to do that, just like a kid. It’s a fascinating relationship.

The progress of reproductive medicine is obvious, has the pregnancies number increased in the last years?

Prof. Dr. Tayfun Bağış: Yes, it has, but we cannot say that during 5 years time it has increased a lot, because there are some limitations, you cannot go furthermore. For example, we cannot do anything for menopause patients. If there is no sperm in the test result, also we cannot do anything. Now the stem cells research doesn't work properly, we weren't able to make sperm out of the stem cells. So, many patients enter menopause very early, we cannot do anything. We cannot produce new cells. Maybe in the future we will be able do this, also - producing sperm or eggs.

Do you see couples after 40-45 years with still good quality for eggs and sperm?

Prof. Dr. Tayfun Bağış: After 45 I don't take patients. Because I don't feel comfortable. I would feel like a liar if I would tell these people that they have chance. No, women above 45 years does not have a chance, it is very very very low. I am not saying that no one can become pregnant after 45, but to use IVF is this situation is wrong. Yes, you can become pregnant naturally after 45. But IVF doesn't increase this chance.

What do you think makes you different from other IVF world renowned specialists?

Prof. Dr. Tayfun Bağış: I give time to the couples that seek my help. I try to understand what's happening, not to hurry things. Every case is different for me. It's like a puzzle. What is problem, what can I do, what can I change? It’s like I'm making a project. And if, at the end of it, I'm going to be successful, I will feel very good. You have to like this job. If you can resolve something, if your plan is going to work, everything is going to be good. So planning is an important part of this job. You have to give the right decision, you have to give this decision time to be obvious and certain.

Can you share with us a case that has impressed you during your career?

Prof. Dr. Tayfun Bağış: I remember a patient. It was very dramatic for me, it was a Turkish couple in Adana, other patients referred them to me, they were workers, very very poor. There was a very low number of eggs and sperm, and in the end of the treatment there was only one embryo. And it was a very bad embryo. So I told them let's not make the embryo transfer, take some money back and then put a little bit more, and I'm going to make one more IVF procedure, ok? I tried to give a little bit more money because they were very poor. So they refused, they did not had any other money to cover another procedure in the future and they have asked to transfer the embryo. And she became pregnant. It was amazing, really amazing. With one embryo in bad condition that I was going to trash she became pregnant. That is the moment when I have said that God made it, everything is being done by God. We have lots of situations when we put la very very good quality embryo, and the woman cannot become pregnant. And I had this case when I have put a morphological bad embryo, and got a pregnancy. Something is affecting it. So, many years, million doctors, works in implantation we cannot resolve it. There is something more in this, after we have done everything technologically, scientifically, humanly possible, at the end there is something more affecting that decides if the pregnancy happens or not. And now we cannot resolve this. Maybe in the near future we are going to, but now we have limitations.

It is pretty difficult to count all the babies from the photographs in your department – how many infertility procedures did you perform?

Prof. Dr. Tayfun Bağış: Around 15.000 IVF cycles. Nearly let's say half are pregnancies that I have also followed as a doctor and then helped deliver the babies. I did work for a while at a maternal hospital and I do remember there were nearly 22,000 deliveries per year, a huge number. I delivered nearly 22 patients in one day. It was like a factory. Generally for IVF patients I'm doing caesarian section. It's not mandatory, it is my option.

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