In vitro fertilisation (IVF) has become a sought-after infertility treatment, with approximately 12 million IVF babies born globally since 1978. IVF involves manually combining eggs and sperm in a laboratory dish where fertilisation occurs. For many Singaporean couples struggling with infertility, IVF provides hope when other less invasive options have failed.
The IVF process consists of several important steps that span approximately four to six weeks:
- Ovarian stimulation
- Egg retrieval
- Fertilisation
- Embryo culture
- Embryo transfer into the uterus
If the implantation is successful and pregnancy happens, it would imply that IVF is really helpful to those challenged with blocked fallopian tubes, ovulation disorders like polycystic ovarian syndrome (PCOS), endometriosis, unexplained infertility, and more.
Read throughout the article to gain useful insights into this process, and so that you would know what to ask or discuss with a recommended gynae or women’s clinic in Singapore.
When is IVF Used?
The following are the medical reasons why IVF may be recommended to you.
- Blocked or damaged fallopian tubes
Hormonal issues or pelvic infections like pelvic inflammatory disease (PID) may cause the fallopian tubes to become blocked or scarred. Since the eggs need to travel down the tubes to reach the uterus, damaged tubes make natural conception difficult. - Ovulation disorders
Conditions like polycystic ovarian syndrome (PCOS) prevent regular ovulation. As a result, it limits the number of mature eggs available to be fertilised. - Endometriosis
Cells similar to those lining the uterus grow elsewhere in the body. It often impacts infertility. IVF bypasses the anatomical issues caused by endometriosis. - Low sperm count or motility
Issues on the male partner’s side, including low sperm, abnormal shape, and limited mobility, can all be overcome with IVF. - Unexplained infertility
When no cause is found to explain a couple’s infertility, IVF essentially takes conception into what we call an optimal lab environment. - Other reasons
Aside from medical infertility, IVF is also an option for same-sex couples, single parents by choice, and those wishing to screen for genetic diseases pre-implantation. IVF is also sometimes used for fertility preservation before undergoing cancer treatment.
Compared to intrauterine insemination (IUI), IVF has higher success rates because fertilisation happens outside the body and embryos can be selected for optimal viability. IVF also demands greater medical intervention and costs.
Preparing for an IVF Cycle
IVF demands extensive pre-cycle testing and preparation to improve outcomes. Make sure to follow these steps if you are finalised to have an IVF after consulting a recommended gynae or women’s clinic in Singapore.
Fertility assessments
Thorough medical exams evaluate factors influencing fertility, like hormone levels, ovarian reserve, uterine health, and semen quality. Genetic screening may also be advised.
Imaging and diagnostic tests
These exams check for structural issues that you might have. It includes blockages or fibroids that may affect conception. Tests like HSGs, MRIs, ultrasounds, and laparoscopies help to customise treatment plans.
Medical instruction
IVF nurses will give instructions on the proper administration of injections needed for ovarian stimulation and to support hormones through embryo transfer.
Lifestyle modifications
If you want best and want to increase the success rate, modify your lifestyle before the procedure.
- Quit smoking
- Maintain a healthy BMI
- Eliminate alcohol intake
- Reduce caffeine
- Minimise stress levels
- Take supplements like folic acid
Understanding costs
Significant costs are incurred for medications, ultrasounds, blood tests, egg retrieval, and lab work. Eligible couples can offset some expenses through insurance and government co-funding programs in Singapore.
Adhering to these healthy lifestyle changes would mean full commitment to bettering your chances of conceiving. Ready yourself medically and emotionally so that the process becomes more manageable.
The IVF Process Step-by-Step
Protocols may vary, but here is what a standard IVF cycle may include:
- Ovarian stimulation (8-14 days) – fertility medications that you take by injection or nasal spray stimulate your ovaries to develop multiple mature eggs per cycle. Follicular development is tracked through frequent monitoring.
- Trigger shot – hCG injection is administered when a threshold number of follicles reaches approximately 18 mm, which triggers final egg maturation. The timing of egg retrieval is based on this.
- Egg retrieval – Eggs are collected from ovarian follicles using an aspiration needle guided by ultrasound. A mild anaesthesia may be administered to provide relief from pain. This outpatient procedure takes about 30 minutes.
- Fertilisation – Eggs and sperm are combined via conventional insemination or ICSI (direct injection into eggs), then incubated under optimised conditions. The normal fertilisation rate is about 70 per cent.
- Embryo culture (five to six days) – successfully fertilised eggs become embryos and are regularly monitored for correct division and development to the blastocyst stage for optimal viability.
- Embryo transfer – one or more embryos are placed inside the uterus via a thin catheter that goes through the cervix. Some embryos may also be frozen for future conception attempts.
- Pregnancy test – around 9 to 14 days post transfer, a blood test measures hCG levels to detect if embryo implantation is successful and pregnancy occurred. Subsequent ultrasounds will confirm the progression of the pregnancy.
Those undergoing IVF should expect frequent appointments, injections, ultrasounds, and blood tests through the various phases, spanning one full menstrual cycle. Thus, it is best to communicate regularly and clearly with your recommended gynae or women’s clinic in Singapore.
Considerations and Decisions in IVF
Making informed choices influences treatment success and health risk management. Make sure to only come up with a sound judgment by taking into consideration the following factors.
- Number of embryos transferred > Transferring multiple embryos boosts pregnancy odds but also increases the chance of high-risk multiple pregnancies. Age and history help determine a safe number to transfer/freeze.
- Genetic testing > Some embryos may be screened for chromosomal abnormalities or specific genetic diseases before transfer or freezing to prioritise viable ones.
- Donor gametes > Using donated eggs or sperm increases success rates in some IVF cases with infertility due to maternal age, poor egg/sperm quality, or recurrent failure.
- Gestational carriers > A gestational carrier’s uterus hosts the embryo when a woman is unable to carry a pregnancy herself. Same case with an absent uterus.
- Fertility preservation > If you are having treatments, say cancer therapy, you may bank eggs/embryos via IVF before starting. The reason for this is that your therapy may have side effects on your fertility.
Discuss all these options honestly with your gynae or a recommended women’s clinic in Singapore for the best chance of success and also to minimise avoidable risks like multiples. It is in your best interest to consider all these possibilities in advance for more empowered decision-making.
Risks and Limitations of IVF
If you are considering IVF to conceive, you should be aware of the risks and limitations that accompany it.
Medical risks
- Ovarian Hyperstimulation Syndrome (OHSS) – a rare complication from fertility medication overresponse
- Multiple pregnancy – carrying twins or triplets+ has higher maternal/foetal complications
- Ectopic pregnancy – embryo implants outside the uterus, nonviable
- Miscarriage – similar rate as natural conception
- Birth defects – slight increase in risk, but more data is needed
Emotional factors
- Stress, depression, or anxiety – counselling should be leveraged
- Treatment failure – inability to retrieve eggs or create viable embryos for transfer
Limitations
- Advanced maternal age – success rates decline significantly, especially > 40 years
- Cost – full IVF cycles average 11,000 SGD, but it all depends on your selected treatment
- Restrictions in Singapore – sex selection procedures are forbidden in Singapore
You become empowered when you are enlightened on all the aspects of IVF and ready to enter treatment fully equipped with this knowledge. Discuss all your concerns with a recommended gynae or women’s clinic in Singapore for the safest, most positive pathway ahead.
Improve Your Chances of IVF Success
IVF technology helps overcome fertility barriers, but certain lifestyle factors also influence outcomes.
- Success rates declined steadily > 35 years old, rapidly > 40. Using younger donor eggs improves the odds.
- Smoking, alcohol use, and obesity lower IVF success.
- Daily folic acid intake reduces the risk of foetal neural tube defects. Antioxidants may also help.
- On average, one to three IVF cycles are needed for success. Less than half achieve pregnancy on the first IVF cycle.
Research also shows attending counselling builds coping skills to persist through multiple cycles and emotionally challenging diagnoses. Make sure to consider this option to overcome these challenges.
Leverage all the available resources you can find to become empowered as prospective parents. Increase the odds of bringing home a healthy baby by doing your best to stay on top of your health and mind.
After Your IVF Cycle and Embryo Transfer
The days after embryo transfer can stir up mixed emotions. So here is what to expect physically and the recommended next steps.
Normal symptoms
- Bloating and mild cramping
- Breast tenderness
- Constipation
- Spotting
Ongoing medications
- Progesterone supplements thicken the uterine lining to support early embryo implantation and development. Crucial to continue as prescribed by your gynae or a recommended women’s clinic in Singapore.
Follow-up care
Approximately 9 to 14 days post transfer: blood test checks pregnancy hormone hCG levels. Ultrasounds later confirm.
If pregnant: Referred to an obstetrician for prenatal care and monitoring. Early scans rule out ectopic pregnancy.
If not pregnant: Your gynae or women’s clinic will discuss options – either use frozen embryos, adjust protocol and retry IVF, or consider gestational carrier. Give your body and mind one menstrual cycle break at a minimum.
Your Gynae or a Recommended Women’s Clinic in Singapore Knows Best
Communicating openly with your IVF team offers the best path forward, even when news is disappointing. Their guidance, combined with the self-care tips discussed above, paves the road towards successful outcomes.
Need a women’s clinic immediately? Contact us for an appointment or if you need answers to your inquiries.
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