What is IVF (In Vitro Fertilisation)?
IVF (In Vitro Fertilisation) refers to the assisted reproduction technique (ART) in which the process of fertilization occurs outside of the body. The mature eggs extracted from the ovaries are manually combined with a retrieved sperm in a laboratory dish. Then, when a healthy embryo (fertilised egg) develops, it is cultured for a few days before it is implanted in the uterus.
Why is IVF (In Vitro Fertilisation) used?
IVF is frequently used to treat fertility problems. However, it is usually a reserved treatment when other fertility methods like fertility drugs and artificial insemination did not work. On the other hand, IVF is recommended as a primary option if you or your partner has certain health or genetic conditions like the following:
- Absent, Blocked or Damaged Fallopian Tube
- Genetic Disorder
- Impaired Sperm Production
- Ovulation Disorders
- Premature Ovarian Failure
- Preservation of Fertility
- Previous Tubal Ligation or Vasectomy
- Uterine Fibroids
- Unexplained Infertility
What Steps are involved in IVF (In Vitro Fertilisation)?
In Vitro Fertilisation requires a preliminary health assessment to determine the fertility potential of both parties. This is also done to make sure that possible conflicting medical problems are discovered and treated before beginning an IVF cycle, so that any negative impact of the procedure will be prevented.
Once both parties are proven ready for an IVF cycle, here are the steps that they need to follow:
Step 1: Stimulation of Ovulation
Oral or injectable hormonal medication is used to stimulate ovulation or egg production. The medication causes the ovary to produce multiple eggs, instead of a single egg every month. Multiple eggs are needed as some might not develop or fertilise after the retrieval process. The IVF doctor will closely work with you in order to identify which suitable medication to prescribe and when to take them.
One to two weeks of ovarian induction is normally needed before harvesting the mature eggs. The following procedures will be performed to know if the eggs are ready for retrieval:
- Vaginal ultrasound - an imaging test of the ovaries used to observe the growth of a follicle (fluid-filled ovarian sacs where eggs mature).
- Blood tests – used to measure the estrogen levels or the hormonal response to ovarian stimulation medications.
Step 2: Extraction of the Egg
The most common method of egg extraction is the transvaginal ultrasound aspiration. This process involves an ultrasound probe that locates the follicles and a fine needle attached to a suction device that extracts the mature eggs. The patient will be sedated during the egg extraction and pain medications will be given after the procedure to lessen any possible discomfort. The procedure usually last from 20 minutes up to an hour, depending on the accessibility of the ovaries and the number of mature follicles.
If transvaginal ultrasound aspiration is not applicable, laparoscopy is an alternative. It is the creation of a small incision near the navel and a laparoscope that guides the needle is inserted. The retrieved eggs are placed in a culture medium and are incubated.
Step 3: Retrieval of the Sperm
On the same day of egg extraction, a fresh sperm sample will be obtained through a testicular sperm aspiration. It is when the sperm is directly retrieved from the testicle through a small surgical procedure. A frozen sample is opted when fresh is unobtainable or when the sperm comes from a donor.
Step 4: Fertilisation
There are two possible methods that can be used for the fertilisation process:
- IUI (Intrauterine Insemination) – the mature eggs and sperm will be combined, immediately after the retrieval. It will be stored in a laboratory dish to assist with the fertilisation, and will be incubated overnight.
- ICSI (Intracytoplasmic sperm injection) - it is when a single healthy sperm is inserted directly into every mature egg in order to attain fertilisation. This method is commonly used if there is a lesser chance of fertilisation due to low sperm number/quality or when prior IVF cycles failed.
The eggs will be thoroughly observed to make sure that the embryo is developing and cell division is occurring.
Step 5: Transferring the Embryo
The embryos are usually transferred into the uterus 3 to 5 days after the fertilisation procedure. The procedure involves a catheter (a long, fine, and flexible tube) that is inserted into the uterus and a syringe to transfer the developed embryo. It is usually painless, but mild cramping is sometimes experienced. It may be performed under mild sedative.
The embryo will implant in the lining of the uterus normally around 6 to 10 days after the egg retrieval, if the transfer is successful. In most cases, women can resume to normal activities, but rigorous actions should still be avoided after the embryo transfer.
What are the common side effects of IVF (In Vitro Fertilisation)?
Some women may experience these common side effects after undergoing an IVF cycle:
- Breast tenderness
- Hot flashes
- Mild cramping or bloating
- Mood Swings
What is the Success Rate of IVF?
The success rate of IVF is determined by several factors such as:
- Reproductive history
- Maternal age
- Cause of infertility
- Other Lifestyle Factors
Aside from these factors, seeking help from an infertility expert may also contribute to the success of an IVF procedure.
If you are looking for a certified IVF specialist in Singapore, Dr Jonathan Wee Yeow Sherng is an experienced obstetrician and gynaecologist who is trained in reproduction medicine and IVF. Together with Dr Irene Chua, they are well-known for their interest & expertise in minimally invasive surgery. Contact us at 6339-7333 to schedule an appointment!