IVF Malaysia | In Vitro Fertilization Treatment

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IVF in Kuala Lumpur, Malaysia

Fertility and childbearing is one of life’s wonders which keeps on giving. Though it is part of a natural process, many individuals and couples seeking fertility may not always be successful in conception. However, those fertility may benefit from medical advances which have come a long way in providing assistance in reproduction. In vitro fertilization (IVF) is a form of treatments and procedure. Several methods known as assisted reproductive technologies are implored but the most commonly performed process in Malaysia is In Vitro Fertilization (IVF). IVF is used by over 99% of individuals seeking assisted reproductive technologies. IVF’s goal is to emulate the process of fertilization artificially before implantation in the expectant mother. It is created to override or overcome infertility issues for those who cannot conceive naturally. IVF includes a method of stimulating the ovaries and retrieving the eggs (oocytes) from the ovaries for fertilization. Rather than in the body, IVF uses the oocytes retrieved and fertilize them in a laboratory hence (in-vitro). It is then returned to the uterine cavity. Candidates for IVF include but are not limited to : women suffering from polycystic ovary syndrome PCOS, damaged fallopian or ovarian tissue, pelvic adhesions, poor ovarian response to stimulation, male factor infertility or unexplained infertility in both genders. Regardless of the cause, IVF is the best option currently available for those who cannot achieve normal sperm transport or fertilization.

IVF picture mom & son

 

Who is a good candidate for IVF or not?

Parents are selected based on several complaints and medical issues that prevent them from achieving pregnancy. Some of them being as follows. Many women suffer from tubal insufficiency or tubal factor. That is, attached to their ovaries are two fallopian tubes on each side that are responsible for delivering the egg to the uterus for fertilization. However, sometimes these tubes may be blocked or damaged due to injury, surgeries or anatomical malformations. IVF helps benefit these patients by bypassing the natural method of ovulation and extracting them manually from the ovary itself. Other candidates are those with ovarian issues. Some may have a low ovarian reserve in which their egg count is too low for chances of achieving pregnancy. Others may be affected by ovarian failure in which their ovary isn’t properly maturing or able to perform due to diseases, radiation, past surgeries or birth malformations. Women may also be affected due to poor uterine patency, better known as uterine function and capacity. The fertilized embryo is housed in the uterus of the body and when it doesn’t have a proper capability, the embryo cannot be implanted and grow to birth. Sometimes the layers of the uterus may be damaged due to cysts, endometriosis, surgical or anatomical injury. These patients may also require a surrogate ( someone who gives birth to another patient’s fertilized embryo or donor). Lastly, infertility doesn’t affect women alone but also men. Male factor infertility is another major reason for the disruption of conception. This can be due to men having a low sperm count or anatomical dysfunctions that prevent the passage of sperm. Therefore IVF allows the fertilization to occur in the laboratory for a better chance of success.

Criteria
Medical IndicationsInfertility of all causes.
Age Criteria45 Years old or below.
Substance AbuseDo not currently abusing alcohol, narcotics or drugs.
Emotional HealthDo not have psychiatric disturbance.
Physical HealthNot being over weight.

The Process of IVF

The process of IVF involves carefully curated preparation before fertilization and ultimately pregnancy can occur. Evaluation and consultation by one’s OB GYN or fertility doctor is performed to determine a patient’s oocyte( egg) reserve. This is done through blood tests or ultrasonography. Ultrasound is a simple method of using sound waves to view an image inside the body. It is painless and most efficient to determine the anatomy of the female candidate. The amount of eggs remaining is recorded and assessed to see if they are fit for fertilization. If there is enough eggs or even few, the follicles holding the eggs must be stimulated for ovulation. Ovulation is the release of an individual egg in anticipation for pregnancy. For stimulating, multiple follicles have to be stimulated in the female prior to the egg retrieval. This is achieved through daily self injections of fertility stimulators. Injections are generally placed in lower abdomen or thigh for better concentration absorption. Follicle releasing hormone (FSH) is injected 1 to 3x daily to aid in oocyte maturation. Midway through the cycle, gonadotropin releasing hormone (GnRH) is also injected to prevent premature ovulation. After two weeks, human chorionic gonadotropin (hCG) is added to emulate ovulation and determine retrieval. Careful monitoring of maturation response is achieved with weekly checkups. Ultrasonography transvaginally is performed to visualize the process and blood work is drawn to measure estradiol levels, which usually are elevated.

Oocyte retrieval

The next process once ovulation has occurred is oocyte retrieval. The patient is put under anesthesia and the doctor will carefully insert an ultrasound guided hollow needle to harvest the oocytes through the lower abdomen and vaginal wall. The patient should expect to feel some level of discomfort and pain medications are generally provided. As this is occurring, the male partner or donor is asked to produce sample of sperm. It is collected in a vial or cup to be transferred for fertilization. The first method attempted is by incubating both the oocyte and the sperm to allow for a semi-natural insemination. If this doesn’t occur due to motility abnormalities, low sperm volume or viability, intracytoplasmic sperm injection (ICSI) is performed. A process in which a single sperm is directly injected into an egg. The oocyte is carefully held steady with a pipette and an injection needle containing the sperm penetrates the plasma of the egg allowing for sperm microinjection.

In Vitro Fertilisation

After IVF, the eggs are allowed to mature briefly in vitro. Fertilization is verified a day later by the presence of a pronuclei. Once verified, the embryos are inserted back into the female 3-5 days later. A long catheter is placed into the vagina, through the cervix and finally transferred into the uterus. The amount transferred may vary from one to several to develop the best chance of conception. If successful, implantation generally occurs 6-8 days after retrieval. For 2 weeks following the transfer, daily shots of the hormone progesterone are given to maintain implantation and the endometrial environment. Common side effects include mild pain, cramping, spotting or discomfort following the process.

IVF Summary

The entire process constitutes as one IVF cycle. The probability of a successful conception within one cycle depends on the quality and amount of embryos. Generally 45-50 % of primary cycles develop into gestation, some being multiple gestations to eventually give an IVF baby. IVF babies are solely conceived via IVF or fertility treatment based help. The ethics and termination behind multiple gestations may be discussed with the doctor and is still controversial to many. There is always a risk, about 15% for spontaneous abortions. Support from the partner, friends and staff is helpful when dealing with the process. Counseling and a positive mindset are encouraged as it is better to go through this together than alone. IVF provides an opportunity for families due to the marvels and advances we have today. With careful planning and consideration, fertility can be achieved for those who wish to.

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