In Vitro Fertilization (IVF) And Intracytoplasmic Sperm Injection (ICSI)

WHAT IS IVF and ICSI?

IVF is a technique for infertility treatment where an egg is fertilised by sperm outside of the body, in vitro. The resulting embryos will then be transferred to the uterus with the intention to establish a successful pregnancy. The process is undertaken by couples struggling to conceive or single women wishing to have a baby through sperm donation.

ICSI is a technique used to enable fertilization, in which a single sperm is injected into the centre of an egg.

WHO NEEDS IVF/ICSI?

1. Blocked fallopian tubes


2. Moderate/severe endometriosis


3. Severe abnormalities in semen analysis (sperm count, motility or morphology)

4. Azoopsermia (no sperm found in ejaculation)


5. Unexplained infertility


6. Failure to conceive by other treatments, including intrauterine insemination (IUI)

7. Advanced age (for female partner)

8. Egg donation due to premature ovarian insufficiency or diminished ovarian reserve

WHAT ARE THE RISKS ASSOCIATED WITH IVF/ICSI TREATMENT?

During the treatment, the following risks might occur:

•  Ovarian poor response, cycle cancellation 10-15% 


•  Ovarian Hyperstimulation Syndrome (OHSS) 5-10% 


•  Severe OHSS 0.1% 


•  Premature ovulation 1% 


•  No egg collected 1% 


•  Abdominal internal bleeding 0.2% 


•  No fertilization, no embryo 1-5% 


•  OHSS during pregnancy 5-10% 


•  Multiple pregnancy 15-20% 


•  Miscarriage 20-25% 


•  Ectopic pregnancy 3% 


•  Preterm labor 20% 


•  Bladder bleeding 0.2% 


•  Pelvic inflammatory disease (PID) 0.1% 


•  Congenital defects 1-2% 


TREATMENT PROCEDURE

• Ovarian stimulation will be started within the first 3 days of your cycle

• During ovarian stimulation, you will have injections every day for 2 – 4 weeks 


• Ultrasound scanning and blood test will be done to monitor the ovarian response. 


• When follicles reach the optimal size, you will be prescribed the last injection at a specific time (usually at night). 36 hours after this last injection, egg collection will be performed. 


• On the day of egg collection, your husband will collect the sperm by masturbation. 


• Fertilization will be performed either by conventional in vitro fertilization (conventional IVF) or Intra-cytoplasmic sperm injection (ICSI). 


• Embryos will be transferred into the uterus 2 – 5 days later. 


• Number of transferred embryos will be discussed with you by your doctor. The remaining embryos, whose quality is good enough, will be frozen for future use. 


• After embryo transfer, you should continue using the medication as prescribed. 


• Pregnancy test (blood test) will be performed 2 weeks after embryo transfer. 


• In egg donation cycle, the donor will follow the same procedure mentioned above until the day of egg collection. For the recipient, endometrium preparation will be done for embryo transfer.

• The pregnancy rate of IVF/ICSI is about 40-70%. This successful rate might be affected by your age, indications for IVF/ICSI, embryo quality as well as previous treatment history.