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
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
Impaired Sperm Production
Premature Ovarian Failure
Preservation of Fertility
Previous Tubal Ligation or Vasectomy
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
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
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:
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
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
Some women may experience these common side effects after undergoing an IVF cycle:
Mild cramping or bloating
What is the Success Rate of IVF?
The success rate of IVF is determined by several factors such as:
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!
38 Irrawaddy Road #10-63
Mount Elizabeth Novena Specialist Centre