5 things you may not know about IVF

You yearn to cuddle your own baby, but before your start your IVF journey, know what you’re in for…

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One in seven couples in Singapore suffer from infertility. So, assisted reproductive technology offers hope to infertile couples. There are two types ― IVF (where the sperm and egg meet without any intervention in a petri dish) and intracytoplasmic sperm injection (or ICSI, an extension of IVF, in which the sperm is injected directly into the egg).

When Louise Brown, the world’s first “test-tube baby” was born via in-vitro fertilisation (IVF) on July 28, 1978, in the UK, there was controversy and fear that medicine was trying to “play God”. Nearly 40 years later, this medical phenom has improved, plus it’s more widely accepted within society.

To date, more than five million children have been conceived by assisted reproductive technology, notes Dr Pascal Gagneux, an evolutionary biologist and associate professor of pathology and comparative medicine in the US.

Indeed, mum of two, Maimunah Nasir, 35, will always be grateful that she has IVF to thank for blessing her with baby number two, who is now 3. She had her first child, a boy, now 10, soon after marriage and then tried to conceive her second child naturally for the next six years. However, her husband had some fertility issues. Maimunah says, “I’m so glad I live in a time that medicine has advanced so far that allowed me to have my daughter.”

Still, not everyone ― including the couples about to embark on their IFV journey ― know what this arduous procedure entails. Here are five lesser-known truths about IVF…

1) Expect plenty of tests, needles and doctor’s visits 

First, you have to undergo various blood tests and scans to confirm that you’re infertile. In particular, hysterosalpingography (HSG) is an ultrasound where they inject dye into your fallopian tubes to check if they’re blocked. Some women have described it as “eye-wateringly painful” and “totally unexpected”.

Once you start on the stimulation phase (stims) you’ll need to inject yourself twice a day with hCG (human chorionic gonadotropin) hormones to stimulate your ovaries to boost egg production. Carried out after your last menstrual cycle, this can last 10 to 12 days. “I had to see my doctor every morning during my stims cycle, so that he could run tests and determine if everything was going according to plan,” Maimunah recalls. 

To date, more than five million children have been conceived by assisted reproductive technology.

Next is egg-retrieval day, which takes place 36 to 38 hours after your last hCG jab. “The patient will be under sedation…with the help of an ultrasound, a vaginal probe is attached to the needle inserted into the vaginal walls, and into the ovary and follicle for egg retrieval,” explains Dr Yeong Cheng Toh, an IVF specialist at Virtus Fertility Centre.

A positive pregnancy doesn’t mean you can breathe easily just yet, by the way. All the hormones you took to suppress ovulation initially and manipulate your body for IVF will leave your body confused. It doesn’t know when to produce its own hormones to support your pregnancy. So, your fragile little embryo needs to be nurtured in the first few weeks of pregnancy with progesterone supplements.

Since you’ll receive this through suppositories or weekly injections at your doctor’s office, this can go for up to week 15, until your body has created the placenta. “IVF definitely isn’t for the faint-hearted or anyone who’s scared of needles, I’ll tell you that!” adds Maimunah.

2) It’s going to wreak havoc on your body 

Before you can even start on stims, you’re required to take go through a two-week downregulation "long Lupron” protocol. During this time, you’ll be given drugs to stop the egg from being released and to prep your body for ovary stimulation later on. The Lupron is injected under the skin in your thigh or abdomen area, which can cause a whole host of side-effects including migraines, mood swings and early menopausal symptoms like hot flashes.

Dr Yeong quickly says that some clinics now offer the short protocol where just one injection will reach the same desired effects in half an hour and with less side-effects. “However, women with conditions such as endometriosis aren’t eligible for the short protocol,” he adds.

You are also at risk of Ovarian Hyperstimulation Syndrome (OHSS) when you’re going through the stims cycle. As the name suggests, this occurs when the hormones boosting your egg production go on overdrive and hyper-, or over-stimulate the number of eggs produced. Mild cases of OHSS can occur in about 10 to 20 per cent of cycles and symptoms include intermittent lower abdominal pain, nausea, vomiting and bloatedness. In severe cases, it can result in dizziness and shortness of breath.