Heather Guidone: Dr. Oktem can you tell us what is the typical endometriosis infertility experience in your demographic?
Mesut Oktem, MD: Well, thank you very much, first of all. I see a lot of endometriosis cases in our clinic, about 30 percent of infertile woman have endometriosis. It is a huge number for us. It is very important because they are very hard cases for us to treat them, especially for infertility. They are coming to us with dysmenorrhea, chronic pelvic pain and infertility especially. They have wanted a long time to conceive a pregnant but they did not.
Heather Guidone: You have the same problem we have here in the United States with delay in diagnosis then.
Mesut Oktem, MD: Yes. These patients always go to a lot of doctors and could not find the real diagnosis. So when they come to us after evaluation if we decide, yes, it is a case of endometriosis then we have to think about how we can treat infertility. We do the tubal pregnancy and what is the ovarian reserve and it is important also the symptomatology of the woman.
Heather Guidone: How old are your IVF patients on average and your endo and infertility patients on average?
Mesut Oktem, MD: About 30 years old.
Heather Guidone: About the same in the United States.
Mesut Oktem, MD: They have some endometriomas and the ovarian reserves are much reduced in these patients.
Heather Guidone: Multiple surgeries, of course.
Mesut Oktem, MD: Yes, and they had multiple surgeries previously. If we decide to perform IVF it is very hard for us because the oocytes number that we will collect will decrease. The chance of the pregnancy will decrease also. It is important to diagnose early.
Heather Guidone: Here in the United States we find a lot of challenges and a lot of barriers, particularly, not only with the surgical aspect of course, and the care and treatment, but with respect to the IVF and the fertility issues and aspects of endometriosis. I wonder if we could talk just briefly, if you could share your perspective how it is different or perhaps similar from here in the United States where we have a lot of issues with fertility coverage and access to care. How is it handled in Turkey? For example, when you have got an endometriosis case that is an infertile patient, how do you handle that?
Mesut Oktem, MD: The cases will need surgery. The government will pay all surgery costs for the patients.
Heather Guidone: The government pays – wow!
Mesut Oktem, MD: For IVF the government will only pay two times.
Heather Guidone: Only! Only two times.
Mesut Oktem, MD: Yes, after two times the patient has to pay by herself because it is a lot of money and the government will not pay for the third or the other IVF cycles, but for surgery there is no limitation in Turkey.
Heather Guidone: Absolutely amazing. Very interesting. Well thank you so much for being with us and we are so glad that you are here and we want to thank you for sharing your time and your thoughts with us, thanks so much!
