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In-Vitro Fertilisation (IVF)

What is IVF?

In-vitro fertilisation (IVF) is a form of assisted reproductive technology (ART) that is used to help couples struggling with infertility to conceive. IVF treatment is a complex and incredible procedure that combines medicine and surgery to fertilise an egg with a sperm (both carefully selected to be of the highest possible quality) outside of the body. The fertilised egg, known as an embryo, can be frozen for later use or immediately implanted into a woman’s uterus.

What is the Step-by-Step Process of IVF?

An IVF cycle consists of several stages, as follows:

  • Stage 1: Ovarian Stimulation

    The IVF process includes the extraction of multiple eggs from a woman’s body. As women are only capable of producing one egg per menstrual cycle, a specialist skilled in IVF will train the woman to administer daily injections of Follicle Stimulating Hormones (FSH) in order to stimulate her ovaries to produce multiple eggs at a time.

  • Stage 2: Ovarian Follicle Monitoring

    IVF surgeons will conduct regular blood testing and ultrasound to monitor the ovaries and measure hormone levels and follicle development. With this, the timing of egg collection can be accurately determined. Following which, human Chorionic Gonadotropin (hCG) injections will be used to trigger the final stage of egg maturation. The egg retrieval will then take place approximately 34 to 36 hours following the hCG injection.

  • Stage 3: Oocyte/Egg Retrieval

    In general, eggs or oocytes are ready for collection and fertilisation when they reach a size of 17–18mm. The egg retrieval procedure is usually performed under general anaesthesia. A thin needle guided via a transvaginal scan will be used to retrieve the eggs from the follicles.

  • Stage 4: Fertilisation of Egg with Sperm

    Upon collection of a fresh sperm sample from the man (or a frozen sample, if using a sperm bank), it will be processed and examined in an IVF clinic laboratory. An embryologist will determine the best quality sperm, and introduce it to the selected egg. An embryo will then develop, if the fertilization was successful.

  • Stage 5: Embryo Transfer

    Embryos of good quality can be frozen for future use or immediately transferred into the woman’s uterus, in the hopes that it will implant onto the uterine lining and result in pregnancy.

Am I Suitable for IVF?

In general, the IVF procedure is offered if either the man or woman has been diagnosed with certain medical conditions that contribute to infertility (e.g. blocked fallopian tube, low ovarian reserve, endometriosis, low sperm count/quality, unexplained infertility). Most IVF doctors will usually only recommend IVF after other treatments have proved unsuccessful.

How Do I Prepare for IVF?

When preparing for IVF, you may have to take into consideration the following:

  • Emotional Support – IVF is a couple's journey, despite most procedures being performed on the woman. The husband plays a vital role in supporting his wife, as the hormonal medications, self-injections and the uncertainty of the whole process can often take their toll. Couples should also take time to mentally prepare themselves, as there is a relatively high likelihood of it not being successful on one’s first try.
  • Lifestyle Modifications – Prior to starting IVF, it is key to make one’s body as healthy as it can be. You may be recommended to follow a healthy diet and refrain from drinking and smoking. Stress reduction and letting your IVF doctor know about existing medications you are taking are also important.

What is the Success Rate of IVF Treatment?

Age is the primary factor affecting the success rate of IVF. It is estimated that among women aged 35 to 39, the percentage of live births stands at close to 40%; as for women in their 40s, the percentage of live birth falls to the single digits. This is because older women have fewer eggs, less healthy eggs, as well as a higher risk of developing medical issues that can impact fertility (e.g. uterine fibroids).

How Many IVF Cycles Do People Usually Need?

Generally speaking, anywhere between 3 to 6 cycles can result in a successful birth. Of course, there are couples who require more, or even less, than the average.

Dr Michael Wong

Medical Director & Senior Consultant Urologist
FAMS (Urology), FICS (USA), FRCS (Edinburgh),
M Med (Surgery), MBBS (S’pore)

Dr Michael Wong is a Senior Consultant Urologist who is internationally recognized for his surgical expertise and academic contribution to the field of Urology, in particular the subspecialized field of minimally invasive Endourology.

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