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Ask Dr Paul Tseng: In Vitro Fertilisation (IVF)

Posted on 27 Jul 2018
Ask Dr Paul Tseng: In Vitro Fertilisation (IVF)  undefined

Dr Tseng is an experienced fertility specialist, obstetrician and gynaecologist who is well known for his holistic approach to fertility treatment recognising the importance of assisted reproductive technology coupled with traditional complementary therapies to achieve the best results for patients. 

Dr Paul answered questions from readers on:

How is IVF performed in Singapore, and what should one know before going for IVF in Singapore?

There are different protocols that are used for different types of patients. It is best you attend the Counselling sessions that are held by the IVF Centres to understand more about how they conduct their programs, as each fertility specialist has his/her own preferences.

I think many patients have different concerns and misinformation about what IVF entails. Some think its very painful, some think it is very time consuming and others are concerned about the cost of the procedure.

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How much is the cost of IVF treatment in Singapore, and what affects the cost of IVF treatment?

Costs differ between IVF centres but a ballpark figure of $10,000 -15,000 per cycle would be an estimate. 

The variance is because of Professional fee differences, laboratory fees and amount of drugs used. You will have to request this from the centres that you are interested to have your IVF done in.

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How do I optimize my chances of IVF success, and what are the success rates of IVF treatment in Singapore?

I personally believe that the success of IVF is directly dependent on the health of the Woman and her husband.

Eating well, as in eating nutrient rich foods helps to ensure proper cell function at every level. Minimising toxic chemicals, quitting smoking and not consuming contaminated foods and drinks helps reduce cell damage.

I also believe that complementary Medicine such as those offered by TCM and acupuncture contribute positively to a successful outcome.

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How does age affect IVF treatment and success rates?

Age has a direct correlation to the quality of the eggs in a woman. The older the woman, particularly above 35 years, the higher the chance of the eggs losing their quality.

The quality of the eggs also dictate the quality of the embryo, and hence the success in achieving a healthy pregnancy.

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Should I unblock my fallopian tube before IVF?

We used to resort to surgery to unblock damaged and obstructed tubes. This was a time when IVF was in its infancy and results unpredictable. The situation has since changed for the better.

IVF results are much better and the discomfort much less than undergoing surgery to unblock a tube.

It is also now not recommended as first line treatment as the damaged tube would most likely have many areas of damage and blockages that it would be very difficult to retain a healthy portion of the tube-hence the reason you have had 2 ectopic pregnancies.

READ MORE >

How long does it take to become pregnant after starting IVF?

Hopefully, two weeks after your Embryo transfer. This would depend on whether it was a fresh transfer or Frozen embryo transfer. A fresh transfer is one where the transfer is done on the same cycle as the egg retrieval.

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How painful is IVF, and what can be done to reduce the pain?

The only painful part of the whole IVF process is the Oocyte retrieval and this is very often done under a light General Aneaesthetic.

The daily injections of the stimulant are very often bearable-like an “ant-bite”.

What are the main reasons for the failure of IVF in Singapore?

This is not necessarily a true statement. It all depends on the reason for the Infertility. The success in achieving a pregnancy can be as high as 40-50% if it is purely due to blocked or damaged tubes, but the quality of the eggs and sperm are good and there is no abnormality to the uterus.
 
However, in many instances, this is not the case. There are a combination of adverse factors that influence and dictate the success rates.
 

How will I know if implantation has failed during the IVF cycle?

It is not unusual to have some episodes of vaginal spotting when using the progestogen(Crinone) inserts. They can dry the vaginal skin and cause superficial abrasions which bleed when the pessary is inserted.
 
In addition, some centres also use low-dose aspirin as a supplementary drug to enhance blood flow to the endometrium. These have the effect of thinning the blood and cause minor bleeds which seem to be worse then they actually are.
 

What are the latest developments to decrease IVF failure?

Like I have mentioned in a previous answer on IVF failure in Singapore, you need to try and identify the cause of the failures. The most difficult to rectify is the poor quality Oocyte.
 
There are experimental techniques like transplanting the nuclear material to a healthy donor cytoplasm before fertilisation. All still very experimental, but promising techniques. They have not been approved for clinical use yet.
 

What are the risks of IVF to the mother in the short and long term?

I am happy to say IVF in this day and age carries very few risks to the women undergoing such treatment. The most dreaded was the Hyperstimulation Syndrome where the number of eggs retrieved was in the region of above 30.

The present protocols are safer and reduce dramatically the incidence of these complications.

READ MORE > 

What are the health risks for an IVF child compared to a naturally conceived child?

Many large scale studies have been conducted and so far the consensus is that there is no difference in health between naturally conceived babies and IVF babies.

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Is IVF or IUI the best treatment for infertility?

If the tubes are blocked or damaged, there is no point in doing IUI. If the sperm count is so low, again there is no point in doing an IUI.

It may be a point in doing an IUI as an interim procedure before embarking on IVF.

Although it does not carry the same success rates as IVF, it is much less of a discomfort and definitely a much cheaper procedure.


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