IVF literally means that fertilisation of the woman’s egg happens outside the human body, as compared to natural conception where the sperm fertilises the eggs in a woman’s womb.
Since the sperm and egg meet outside the body, the IVF process will consist of steps taken to retrieve the egg from the woman and the sperm from the man before the sperm and egg meet in a test-tube for fertilisation to happen. Here’s what a couple goes through during the IVF process:
Step 1: Egg Stimulation
The ovaries are first stimulated using an injection with hormones to produce many eggs at once. The injections can be administered by the patient at home, and starts from Day 2 of the menstrual cycle. It takes 10-12 days from the first injection to the time the eggs are retrieved.
Step 2: Assess Egg Maturation
On Day 8/9 of the cycle, the gynaecologist then performs a simple ultrasound scan to check on the maturity of the stimulated eggs.
Step 3: Egg Retrieval
Once a mature egg is observed, it will be extracted from the woman in a day surgery procedure within the IVF centre. This procedure is done under anaesthesia. From the first injection to the retrieval of eggs, the duration is approximately between 10- 12 days.
Step 4: Fertilisation with Sperm
The collected eggs and sperms are fertilised in an IVF laboratory by an embryologist on the day of the egg retrieval. Eggs that have been successfully fertilised are known as embryos. These embryos are then grown for 3 to 5 days, during which the abnormal or unhealthy ones are weeded out. An embryoscope may be used to create a time-lapse video over these 5 days to monitor the development of the embryos in the IVF laboratory.
Step 5: Freezing of Embryos
Embryos that are determined to be optimal are then frozen, before being transferred back into the woman’s womb 1-2 months later. The woman will need to take hormone tablets daily before the transfer is performed.
Step 6: Transfer of Embryos
The embryo will be transferred back into the woman’s womb in a simple procedure that is done in the IVF centre. This transfer process will take around 20-30 min and does not require anaesthesia.
Step 7: Check if IVF is Successful
2 weeks after the transfer of the embryo into the woman’s womb, a pregnancy test (blood test) will be done to check if the woman has successfully conceived.
The success rates of IVF range between 50-60%. In recent years, freezing the embryos before putting them back into the woman’s body has been found to increase success rates of IVF. The underlying theory is that embryos that have survived the freezing process are more resilient and therefore have a higher chance of resulting in pregnancy. Transferring frozen embryos is now commonly practised by many IVF clinicians.
Not more than 3-4 IVF cycles are required, in fact, on average, most couples get pregnant in less than 3 cycles.
As mentioned earlier, each IVF cycle includes the retrieval of eggs for fertilisation. Depending on your age, one IVF cycle typically produces multiple embryos, good enough for 2-3 transfers. If the first transfer of embryo is unsuccessful, the remaining embryos can be used for subsequent transfer(s) without having to repeat the IVF cycle. This definitely helps make things easier for the woman.
With each repeated IVF cycle, the challenge to get pregnant increases. However, if IVF fails persistently, the gynaecologist will need to conduct further assessment to determine the causes. Other times, there could also be instances of early miscarriage, which could be due to a variety of factors.
There is a specialized group of male and female gynaes in Singapore, who are IVF-accredited, that can perform IVF for you. These gynaecologists have gone through rigorous training and are mandated to perform a stipulated number of IVF procedures under supervision before they are accredited as IVF clinicians.
However, the fertility journey does not start with In-vitro Fertilisation (IVF). These fertility specialists will conduct a detailed fertility assessment to determine the causes of infertility before recommending the most suitable fertility treatment option unique to your condition. Always keep an open mind and most importantly, seek help early to maximize your chances at pregnancy.