Have you been trying to get pregnant for quite sometime now and only end up in frustration when it doesn’t happen to you as naturally as it does to the next door neighbour who is going to have her 5th child? You are not alone. There are 1 out of 10 couples who share your story. Statistics increase to ⅓ couples especially if the woman trying to conceive is above the age of 35.
Here is some essential information to answer your lingering questions on IVF (In Vitro Fertilisation) before embarking on the IVF journey.
What causes infertility?
It takes two to tango. Hence the reason infertility doesn’t lie alone as a woman's burden.
There are two types of infertility:
- Primary: Women who have never gotten pregnant before, after one year of unprotected sex without any contraceptives.
- Secondary: Women who have had a child/children previously, but at the moment are unable to conceive despite of trying for the duration of a year.
- Sperm production: 90% of the cases are where men suffer from low sperm counts, low quality of sperms or both.
- Blockage of tubes: Often men experience the blockage of tubes for sperm transportation.
- Anatomical problem: Some men experience varicocele vein, an enlarged testicular vein.
- Hormone imbalance: The production of sperm highly depends on the hormonal stability of a man.
- Age: Women above 35 years have the higher tendency of leaning towards hormonal problems.
- Blocked fallopian tube: Makes it hard for the sperm to meet the egg (ovum).
- Physical problems: Fibroid, polyps, adenomyosis.
- Hormonal imbalance
- Sometimes everything might be okay but it might still be hard to get pregnant.
When should I consider IVF treatment?
Infertility: when you are unable to conceive after having regular unprotected sex for a year. If you are a woman above the age of 35, you should consider consulting a doctor after trying for 6 months as the pregnancy rate declines as you age.
What are the IVF procedures I would go through?
IVF is conducted by extracting the ovum from the woman’s body and fertilising them in a laboratory with the sperm of her partner. The formed embryo (usually takes form within 2 to 6 days) is then transferred into the uterus. The procedures are as follows:
- Evaluation test for both partners.
- Ovaries are stimulated.
- Ovum development is monitored.
- Ovum is extracted.
- Sperm preparation is done.
- Transferring of the embryo into the uterus.
- Pregnancy test and scan.
Duration of procedure:
30 mins (ovum extraction).
Preparation before procedure:
You are required to fast before the procedure.
Sedation is given.
Outpatient, 2-3 hours stay after procedure.
30 mins to an hour after procedure. Driving and exercise are not allowed for the next 48 hours.
What are the evaluation tests conducted?
Evaluation tests are conducted before the actual IVF treatments. Treatments begin as soon as the analysis results are out.
Hemoglobin, RBC, PCV, MCV, MCH, MCHC, RDW, blood group
|2. Rapid Plasma Reagin/Venereal Disease Research Lab (RPR/ VDRL) :
HIV 1&2 Antibody (Ab)/Antigen (Ag), Hepatitis B, Ab Hepatitis B Ag, Hepatitis C Ab, Hepatitis C Ag
|3. Semen Analysis:
Total count/ml, motile count/ml, progesterone %, normal morphology (shape) %, count after washing
|4. Baseline Reproductive Hormone (between day 2-6 of cycle)
Follicle Stimulating Hormone (FSH), Estradiol (E2), Luteinizing Hormone (LH), Progesterone (P4), Thyroid Function Test (TFT), prolactin
|5. Pelvic Examination and Ultrasound||NO||YES|
|6. Menstrual Cycle Pattern||NO||YES|
|7. Medical History:
Drug allergy, previous surgeries, illness
Will I experience any side effects?
Most women are able to resume their normal routine lifestyle the following day itself. However, there are a select few that experience minor side effects such as passing small amount of fluid (maybe clear/blood tinged) after the procedure, mild cramping, constipation, mild bloating and breast tenderness. Your doctor should be contacted if you experience heavy vaginal bleeding, pelvic pain or blood in urine and fever (38°C and above).
The fertility medications that you would be consuming also might cause a few side effects such as headache, mood swings, abdominal pain, hot flashes, abdominal bloating and very rarely, Ovarian Hyper-Stimulation Syndrome (OHSS).
If you are experiencing nausea/vomiting, decreased urinary frequency, shortness of breath, light-headedness, severe stomach ache and bloating or if you have gained 10 pounds within 3-5 days of the treatment, you are most likely feeling the symptoms of OHSS.
What are the success rates am I looking at with IVF treatment?
|62.10%||Less than 30 years old|
|58.30 %||31 to 34 years old|
|42.20%||35 to 39 years old|
|21.70%||Above 40 years old|
My friend’s IVF treatment failed. I am skeptical if I should try. Will mine fail too?
Some couples experience trouble in conceiving within the first cycle of their IVF treatment and require to go through a 2nd or 3rd IVF cycle. These are among the reasons why and how it can be treated:
- Endometrium: Estrogen helps to build up the endometrial wall to prepare it for implantation of the embryo. If endometrium growth is poor, exogenous estrogen will be given.
- Embryo implantation: There might be a chromosomal/genetic abnormality. This can be detected early by Preimplantation Genetic Diagnosis (PGD)
- Hormones: Most common hormonal problem is luteal deficiency which can be corrected by oral, injection or vaginal route by exogenous hormone.
- Antibodies: Certain women have antibodies that attacks the embryo as a foreign body and this results in the failure of implantation.
- Stress: Relax!
- Diet and lifestyle: Overweight — studies shows that BMI more than 25 increases the risk of failure of implantation. Smoking and consumption of alcohol also increases the risk.
How much will I be spending on my IVF treatment?
I took the liberty upon myself out of the curiosity to find out the cost of IVF treatment centers in Asia including Malaysia, Indonesia, Singapore, Thailand, Philippines, Vietnam and Japan.
Approximately you would be spending 3000 USD to 4500 USD per IVF treatment. The price for IVF Treatment and Preimplantation Genetic Screening would cost at a range of 6500 USD to 7300 USD. This cost would vary if you require a 2nd or 3rd cycle of treatment. Its relatively cheaper as compared to the 1st cycle as they would have had already stored and freezed your ovum.
Apart from IVF, what other options do I have?
If IVF isn’t your cup of tea, the technology in the medical world doesn’t end here. You have a wide array of choices to consider.
- Artificial Insemination, also known as Intrauterine Insemination (IUI).
- Intracytoplasmic Sperm Injection (ICSI).
- Donor egg/embryo.
- Gamete Intrafallopian Transfer (GIFT).
- Zygote Intrafallopian Transfer.