309 330
FERTILITY & PREGNANCY
309
January14
For would-be parents who are struggling
to conceive because of fer tility
problems, DR KELLY LOI answers our
questions on IVF, or in-vitro fertilisation.
Dr Kelly Loi
Who should consider IVF?
Because it is a fairly complex and
stressful process with some risks
involved, IVF is usually recommended
only if simpler fertility treatment
procedures have not worked. These
simpler treatment procedures include
ovulation induction with the help of
fertility drugs, as well as intra-uterine
insemination where sperm is placed
directly into the womb by artificial
means.
For some couples, however, IVF may
be recommended earlier. This might
happen in the case of severe male factor
infertility due to abnormal sperm count
or quality; or gynaecological conditions
such as endometriosis, or disease or
obstruction of the fallopian tubes. In
endometriosis, tissue similar to the lining
of the womb is deposited
outside
the
womb, leading to painful periods and
ovarian cysts.
Pregnancy success rates fall
markedly after 40, so a woman who
is approaching that age may also be
recommended to try IVF earlier.
How do you decide whether to
recommend IVF to a couple?
I perform a thorough assessment. For
the man, a sperm analysis is needed.
For the woman, investigations include:
•
an
ultrasound evaluation
of the
uterus and ovaries
•
blood tests
to assess her hormonal
profile and ovarian reserve
•
a test of
tubal patency
(absence of
obstruction in the Fallopian tubes),
either by means of an X-ray and dye
test called a
hysterosalpingogram
,
or during a diagnostic
laparoscopy
,
wh i ch en t a i l s su rge r y unde r
anaesthetic.
Dr Kelly Loi
Health & Fertility Centre
for Women
390 Orchard Road,
#18-06 Paragon Medical
Suites
6235 5066
healthfertility.com.sg#1
What does IVF entail?
A typical cycle starts from Day 2 or Day
3 of the menstrual cycle. Daily injections
are given for 10 to 12 days to stimulate
the growth of the eggs. During this
stimulation phase, ultrasound scans
are done to monitor the growth of the
eggs. Once the eggs have reached a
good size and are ready for harvesting,
they are retrieved through the vagina
using a vaginal probe. As this procedure
is performed under sedation, there is
minimal discomfort. After four to five
days, the best embryos are selected for
transfer back into the uterus.
What is the success rate of IVF?
Pregnancy rates range from 30 to 40
percent, depending on age; success
rates fall with increasing age.
What does it cost?
Generally speaking, around $12,000
to $15,000.
What is your message for couples
who are struggling to become
pregnant?
Investigations and treatment take time,
so seek consultation early.