In-Vitro Fertilisation (IVF) uses laboratory techniques to bring the egg and sperm together outside a woman’s body and involves several treatment stages. First the woman has to undergo hormonal injections to increase the quantity of her eggs. Then ultrasound scans and blood tests are done to assess the growth and maturity of the eggs. Once the eggs are ready, they’re retrieved with the help of a vaginal ultrasound while the woman is under anaesthesia and are fertilized with the sperm to form embryos before being transferred back into the woman’s womb several days later.
IVF is usually recommended if simpler fertility treatments were unsuccessful. Simpler procedures include ovulation induction with the help of fertility drugs and intra-uterine insemination where sperm is placed directly into the womb artifi cially.
However, IVF may be recommended earlier if the couple’s condition is more challenging. These include severe male factor infertility due to abnormal sperm count or quality or gynaecological conditions such as disease or obstruction of the fallopian tubes, and endometriosis when tissue similar to the lining of the womb is deposited outside the womb, leading to painful periods and ovarian cysts. IVF may be recommended earlier if the woman is over 40 years of age as pregnancy success rates fall markedly after that age.
During a conventional IVF procedure, processed sperm and eggs are left together in a culture dish, allowing the natural process of sperm selection and fertilization to take place. However, sometimes sperm may fail to penetrate the egg on its own. In such a case, intracytoplasmic sperm injection (ICSI) is used to directly inject the sperm into the egg. Occasionally, men with very low sperm count are sent for genetic testing. In the event a genetic condition is found, they may be encouraged to take genetic counselling before their partner does IVF.
Dr Kelly Loi Consultant Obstetrician & Gynaecologist