In-Vitro Fertilization (IVF)

In-vitro fertilization (IVF),

colloquially known as “test-tube baby”, is a form of assisted reproduction whereby the woman’s egg is fertilized by the man’s sperm in the laboratory. After fertilization, the resulting embryo is transferred to the woman’s womb.

While in theory IVF is not a complicated process, the couple has to be both physically and psychologically prepared as they are put through a strict regime to maximize the chances of successful fertilization and conception.

To begin the process of IVF, the woman will need to have daily injections to stimulate the eggs in her ovaries to grow. She will also need to undergo regular ultrasound scans and blood tests to monitor the growth of the eggs. When the eggs are matured and ‘ripe for picking’, they are retrieved from the woman’s body using a fine needle under ultrasound scan guidance. The eggs are then fertilized by the husband’s sperms. Successful fertilization will result in embryos. The embryos are in turn monitored for at least two days. Two, sometimes three under certain conditions, healthiest embryos are then transferred to the womb.

While IVF would seem to be an attractive proposition to many, IVF is definitely not a panacea to address all subfertility woes. It may not be suitable for some couples. Not only the medical indications for starting IVF must be valid, the couple must be both physically and emotionally strong enough to see each other through the journey with its attendant vicissitudes. Every stage of IVF is filled with anxiety for the couple. Depending on the outcome at every step, the hopes and mood of the couple may either be lifted high or plummet low, not unlike a psychological roller-coaster ride.

As the eggs are being stimulated, every single egg that is growing is a source of hope for the couple. However, not all eggs that grow in the ovaries will turn out to be matured eggs of good quality. Hence, the first dampener for the couple may be to learn that the number of usable mature eggs after retrieval may not correlate with the number of eggs being tracked on the scans.

Secondly, not all eggs that are fertilized will grow and develop into embryos. So the second reality check comes when the couple is told that the number of good embryos may be less than the number of eggs fertilized. The day the good embryos are eventually transferred into the womb is when the couple will likely be at the peak of mixed feelings. Having an embryo in the womb is the first step that the woman comes close to being pregnant even as the couple will pray very hard that the embryo will implant and grow. A positive result for pregnancy two weeks after the transfer of embryo in the womb will be the news the couple is hoping to hear.

Carrying twins is actually a high risk pregnancy that has many associated risks and complications. As the human body is more suited for the growth and development of one baby at a time, the main problem with conceiving twins is premature delivery. Premature delivery is defined as delivery before 37 weeks of pregnancy. On the average, twin pregnancies last 36 weeks before the mother goes into spontaneous labour.


This article was contributed to Tab A Doctor by By Dr Chee Jing Jye.