The Hope of Joy for Parents through IVF

In vitro fertilisation or widely known by the abbreviation IVF, is a procedure involving the manual union of the egg and sperm externally, in vitro (in glass). This procedure has gradually become the common alternative for infertile couples and the resulting offspring popularly nicknamed as “test tube babies”. Parenthood talks to Dr. S. Selva, as he shared further on IVF success rates, the process, and the procedure at Mahkota Medical Centre (MMC), Melaka.

Parenthood: What causes of infertility can IVF treat?

Dr. S. Selva: In vitro fertilization (IVF) can treat every type of infertility. The only cause of infertility that it cannot help is when the man does not produce any sperm or the woman cannot produce any eggs at all. If such is the case, sperm donors and egg donors are necessary.

Parenthood: What can couples expect from IVF?

Dr. S. Selva: IVF is a technique whereby a woman’s ovaries are induced using injectable hormones to produce many eggs. These eggs are collected and fertilized using her husband’s sperm. The resulting embryo is then transferred into the womb (uterine cavity). The process is quite tedious. The woman will need to undergo daily injections for the duration of 10 days to about 20 days. She will need to be seen in the clinic on several occasions to undergo transvaginal ultrasounds and blood tests. On the day of the egg collection, she will need to be in the hospital for several hours. Usually egg collection is done under sedation. On the same day, the husband will need to give a semen sample. After the egg collection, she returns home. She will need to take some medication orally and/ or transvaginally after the egg collection. Usually three days after the egg collection the embryos will be transferred into the uterine cavity. Embryo transfer is a simple procedure that will not require any anaesthesia. After the embryo transfer, she will need to continue taking some medication. Two weeks later a blood test will be done to see whether she is pregnant.

Parenthood: What are the success rates for IVF in Mahkota Medical Centre (MMC)?

Dr. S. Selva: Success rates in MMC are about 50 to 70 per cent. The younger the patient, the better the success.

Parenthood: Are there other issues with IVF to consider?

Dr. S. Selva: The most important thing to know is that not all couples who have difficulty in conceiving must undergo IVF. At our centre, we assess all couples and decide as to which is the cheapest way to assist a couple to conceive. We perform advanced laparoscopic surgery using 3D laparoscopy and many women successfully conceive after simple treatment and/or laparoscopic surgery. We do not push everyone to undergo IVF. However, some women especially when their age is in the forties are better off doing IVF than trying conservative treatments.

Parenthood: What are the IVF packages offered by your centre and what makes you different from others?

Dr. S. Selva: Our IVF package is about RM15, 000 and ICSI package is about RM 17,000. The difference in our centre is that we have a strong reproductive surgery unit and so by performing excellent surgery especially in endometriosis, many patients conceive spontaneously. We also have a good laboratory and so we do very diligent hormone monitoring to enable us to decide precisely what the dosage of drugs to give a patient and when to schedule oocyte recovery. Many standalone IVF centres do not enjoy this benefit because they have to send their blood tests to independent labs. Our in-house laboratory can give us results in two hours.

Parenthood: How soon after an IVF can a pregnancy test be performed?

Dr. S. Selva: Pregnancy tests are done two weeks after embryo transfer.

Parenthood: How long of a wait is recommended between a failed IVF cycle and trying again?

Dr. S. Selva: When a couple fails in her IVF, there are several things that need to be considered. The most important issue is the emotional and mental states of the couple. Most couples will be depressed after a failed IVF cycle and it takes about three months for them to stabilize their emotional state. The second issue is that the clinician and the laboratory will need to study the couple’s IVF cycle to see what else can be done to improve their pregnancy chances in the subsequent cycle. Sometimes this may require some behavioural and life style modifications. An overweight lady will be better off losing some weight. Some women may benefit from taking certain vitamins for one to two months before embarking on a second IVF cycle. As such usually a second IVF cycle should be started about three months after the failed IVF cycle.