As you contemplate starting a family, in vitro fertilization or IVF may be an option if you face infertility issues. IVF fertility is a complex process that helps with fertilization, allowing you to get pregnant when other methods have failed. The decision to pursue IVF is a big one with many factors to consider before moving forward. The good news is IVF has high success rates for helping infertile couples conceive. This guide provides an overview of everything you need to know about IVF, from how the procedure works to what you can expect during treatment. You’ll learn about the eligibility criteria, costs, risks, and benefits to determine if IVF is the right path for you and your partner to build your family. With the right information and medical support, IVF can make the impossible dream of having a baby come true.
What Is IVF and How Does It Work
In vitro fertilization (IVF) is an assisted reproductive technology in which eggs are retrieved from a woman’s ovaries and fertilized by sperm in a lab. The resulting embryos are then transferred to the woman’s uterus. IVF allows couples to conceive a child when other methods have not been successful.
The IVF process begins with fertility drugs to stimulate the ovaries to produce multiple eggs. Once mature, the eggs are retrieved through a minor surgical procedure. The eggs are then fertilized in a lab using the sperm. If fertilization is successful, the resulting embryos develop for 3 to 5 days before being transferred to the uterus.
- IVF may be recommended if:
- A woman’s fallopian tubes are blocked or damaged
- A man has a low sperm count or sperm motility issues
- Infertility is unexplained
- Other treatments like fertility drugs or IUI have not worked
The IVF procedure has several steps:
- Ovarian stimulation: Fertility medications are used to stimulate the ovaries to produce multiple eggs. This typically takes 10-14 days.
- Egg retrieval: The eggs are removed from the ovaries under sedation. This procedure takes about 30 minutes and is usually done as an outpatient procedure.
- Fertilization: The eggs are combined with sperm in a lab for fertilization. This step is done the same day as the egg retrieval. Intracytoplasmic sperm injection (ICSI) may be used if there are issues with the sperm.
- Embryo development: Any resulting embryos are monitored for 3 to 5 days as they develop.
- Embryo transfer: One or more embryos are placed in the uterus using a thin catheter. This step usually takes only a few minutes and requires no sedation.
- Pregnancy test: About 2 weeks after the embryo transfer, a blood test is done to check if pregnancy was achieved. An ultrasound a few weeks later confirms the pregnancy and checks for a heartbeat.
The average IVF cycle takes 4 to 6 weeks and pregnancy success rates depend on a variety of factors like age and infertility diagnosis. IVF does come with risks like multiple births, ectopic pregnancy, and ovarian hyperstimulation syndrome. However, with recent advances, IVF has become a very successful treatment for infertility.
Who Should Consider IVF?
IVF is an option for a variety of individuals and couples facing fertility issues. The process may be suitable if:
- You have been diagnosed with infertility due to problems like blocked or damaged fallopian tubes, ovulation disorders, or endometriosis. IVF allows for the eggs to be retrieved and fertilized outside the body before being transferred to the uterus.
- Your partner has a low sperm count or sperm motility issues. With IVF, only a single sperm is needed to fertilize an egg.
- You have a medical condition that makes pregnancy dangerous or impossible, such as a genetic disorder. IVF allows for preimplantation genetic testing to screen for certain genetic diseases.
- You are in a same-sex relationship or single and wish to have a child. IVF provides an opportunity to have a biological child using donor sperm or eggs.
- You are of advanced maternal age, typically over 35 years old. As women age, the quality and quantity of eggs decrease, making natural pregnancy less likely. IVF maximizes the chances of getting pregnant with the eggs you have left.
- You have had multiple miscarriages. Some causes of repeat pregnancy loss, such as genetic or hormonal issues, can potentially be diagnosed and treated with IVF. IVF also allows for the transfer of a single, genetically tested embryo to lower the risks.
- You wish to preserve fertility before undergoing medical treatment like chemotherapy. IVF can be used to freeze eggs, sperm, or fertilized embryos for future use.
In summary, IVF can help many different patients become parents when other options are not possible or have failed. However, it is an intensive and expensive procedure, so you should only consider it after consulting with a fertility specialist about your specific situation.
Key Factors to Consider Before Pursuing IVF
Financial Considerations
Before pursuing IVF, you must evaluate if the treatment is financially feasible for your situation. IVF is an expensive procedure, typically costing between $12,000 to $15,000 per cycle in Singapore. While government co-funding and subsidies can help offset costs, you will still likely face substantial out-of-pocket expenses. Consider if you have insurance coverage for fertility treatments and whether you can pay for multiple cycles, as success is not guaranteed on the first try. Discuss payment plans and financing options with your fertility clinic.
Time Commitment
Understand that IVF requires a serious time commitment, especially for the female partner. You will need to commit to multiple doctors appointments, ultrasounds, blood tests, daily injections or pills, and surgical procedures. The process typically takes 2 to 3 months per cycle and may require time off work. Consider how pursuing IVF will impact your work, family, and personal obligations. Having a strong support system in place will help reduce stress during an already emotionally taxing experience.
Physical and Emotional Challenges
In Vitro Fertilization can be physically demanding and emotionally difficult for both partners. The female partner will experience discomfort from ovarian stimulation, egg retrieval surgery, and potential side effects like bloating or mood changes. Both partners may feel distressed from the uncertainty, anxiety over the outcome, and financial strain. Speaking with a counselor or joining a support group can help you develop coping strategies to navigate challenges. Discuss all risks and side effects with your doctor before starting treatment.
While IVF provides hope for those struggling with infertility, it is not an easy process. Weigh all key factors carefully with your partner and doctor to determine if you are physically, emotionally, and financially ready to pursue this advanced fertility treatment. With realistic expectations and support in place, IVF can be a viable option for growing your family when natural conception is not possible.
Alternatives to IVF: IUI, ICSI
Intrauterine Insemination (IUI)
Intrauterine insemination (IUI) is a simpler procedure than IVF. It involves injecting specially washed sperm into a woman’s uterus when she is ovulating to increase the chances of pregnancy. IUI is often tried before moving on to IVF and may be attempted a few times first.
- IUI can be effective for certain kinds of infertility, such as issues with cervical mucus, unexplained infertility, or male factor infertility like low sperm count or decreased sperm mobility.
- The basic steps in IUI include:
- Ovulation stimulation using fertility drugs to produce multiple eggs.
- Monitoring via ultrasound and blood tests to detect ovulation.
- Inseminating washed sperm into the uterus using a catheter.
- Taking a pregnancy test to check if conception occurred.
- IUI is less invasive, expensive, and intensive than IVF. However, success rates tend to be lower. On average, the success rate of IUI is 10-20% per cycle depending on factors like a woman’s age and infertility diagnosis.
Intracytoplasmic Sperm Injection (ICSI)
Intracytoplasmic sperm injection (ICSI) is an assisted reproductive technique used in conjunction with IVF. It involves injecting a single sperm directly into an egg to fertilize it and then transferring the resulting embryo into the uterus. ICSI is used when there are concerns about the quality or number of sperm.
- ICSI can be used to treat male factor infertility, such as low sperm count, poor sperm motility, or high abnormal sperm count.
- The basic steps in ICSI include:
- Egg retrieval from the ovaries.
- Sperm collection from the male partner.
- Selecting a high-quality sperm and injecting it into an egg using a microinjection pipette.
- Transferring any resulting embryos into the uterus.
- Taking a pregnancy test to check if conception occurred.
- ICSI provides an opportunity for fertilization and pregnancy even with severe male infertility. Success rates tend to be slightly higher than with traditional IVF. The live birth rate per ICSI cycle is around 30-40% depending on factors like a woman’s age. However, ICSI does come with a slightly higher risk of genetic abnormalities in offspring.
How Much Does IVF Cost in Singapore?
The cost of IVF treatment can vary significantly between clinics and countries. In Singapore, the total cost of a standard IVF cycle typically ranges from $10,000 to $20,000. The exact amount depends on several factors:
Treatment Type
The specific IVF procedure used affects the overall cost. Conventional IVF tends to be the most affordable option, while more complex treatments like ICSI or egg/embryo freezing can increase the total fees.
Medications
Fertility drugs make up a major portion of the total IVF cost, from $3,000 to $5,000 per cycle. More intensive medication protocols will be on the higher end of this range.
Additional Services
Additional services like fertility testing, egg retrieval, embryo storage, and embryo transfer also contribute to the overall IVF cost in Singapore. These procedures range from $2,000 to $8,000 or more.
Clinic and Doctor
Fees for the IVF clinic, specialists, anesthesiologist, and lab tests can vary significantly based on the facility and physicians. Reputable clinics and doctors with high success rates often charge higher rates.
Number of Cycles
Most patients require more than one IVF cycle to achieve a successful pregnancy. While the fees for the initial consultation and testing are usually only charged once, the costs for medications, egg retrieval, embryo transfer, and storage are incurred with each new cycle.
Insurance Coverage
In Singapore, most insurance plans do not cover IVF or other infertility treatments. However, some private insurers do offer optional infertility coverage or discounts for IVF services at selected clinics. Check with your insurance provider regarding your policy details and options.
The total cost of IVF in Singapore can seem daunting. However, many clinics offer financing options and payment plans to make treatment more affordable. Discuss the fees in detail with your doctor to determine the most suitable and cost-effective treatment plan based on your unique situation.
How Effective Is IVF? Success Rates and Live Birth Rates
Success Rates
The success rates of IVF refer to the percentage of IVF cycles that result in a successful pregnancy and live birth. According to the latest report by the Society for Assisted Reproductive Technology (SART), the average live birth rate for IVF cycles in the U.S. using a patient’s own eggs was 50.2% for women under 35, 38.6% for women ages 35 to 37, 27.8% for women ages 38 to 40, and 13.6% for women ages 41 to 42.
- These rates have been gradually improving over the years due to advancements in IVF procedures, fertility medications to stimulate the ovaries, and cultivation of embryos.
- Success rates depend on several factors, including a woman’s age, infertility diagnosis, reproductive history, lifestyle factors like smoking, and the number and quality of embryos transferred.
- The more embryos transferred, the higher the success rates, but also the higher the chances of multiple births. Most clinics now transfer 1-2 embryos to minimize the risks of multiple pregnancies while maintaining good success rates.
Live Birth Rates
Live birth rates refer to the percentage of IVF cycles that result in at least one live born baby. This is a more meaningful measure of IVF success than just clinical pregnancy rates. According to SART, the live birth rate per transfer of 1 fresh embryo from non-donor eggs was:
- 1% for women under 35
- 1% for women 35-37
- 26% for women 38-40
- 2% for women 41-42
These rates vary between clinics based on factors like physician experience, clinic protocols, and patient population. When evaluating success rates between clinics, consider their live birth rates of singleton and multiple births separately to get a complete picture.
While IVF offers hope, there is no guarantee of success. However, by choosing an experienced fertility clinic and physician, following their recommendations on number of embryos to transfer based on your unique situation, and making positive lifestyle changes, you can maximize your chances of having a healthy baby.
What Are the IVF Process and Procedure?
The IVF Process
The in vitro fertilization (IVF) process involves several steps to accomplish a pregnancy. Before beginning IVF, you will undergo an evaluation to determine if you are a good candidate. The basic IVF procedure includes:
1. Ovarian Stimulation
You will receive fertility drugs to stimulate your ovaries to produce multiple eggs. This is done through daily injections for around 10-14 days. Ultrasounds and blood tests are used to monitor egg development and hormone levels.
2. Egg Retrieval
Once the eggs are mature, egg retrieval is performed using an ultrasound-guided needle inserted into the ovaries to remove the eggs. This minor surgical procedure is done under sedation.
3. Fertilization
The eggs are combined with sperm in a laboratory dish. If fertilization occurs, the resulting embryos continue to develop for 3 to 5 days. Only high-quality embryos are selected for transfer into the uterus.
4. Embryo Transfer
The selected embryos are loaded into a thin catheter and transferred into your uterus through the cervix. This painless procedure does not require anesthesia. You can return home shortly after.
5. Pregnancy Test
About two weeks after the embryo transfer, a pregnancy test is done to determine if implantation was successful. If positive, an ultrasound confirms the presence and development of an embryo. Additional blood tests and ultrasounds are required to monitor the pregnancy.
IVF offers hope to those struggling with infertility. However, it is not an easy process and does come with risks. It requires time, patience, and can be expensive. But for many, the reward of a healthy baby makes all the challenges worthwhile. By understanding each step in the IVF process, you can prepare yourself physically and emotionally for this fertility treatment.
FET and Different Methods
Frozen Embryo Transfer (FET)
Frozen embryo transfer (FET) involves transferring frozen embryos into the uterus. This is a common procedure, especially for patients who have extra embryos left over from a previous IVF cycle. FET has several advantages:
- It enables patients to have multiple chances at pregnancy from a single egg retrieval. The embryos can remain frozen for many years.
- It avoids the need for another egg retrieval procedure. This reduces cost, physical discomfort, and time.
- It provides flexibility in treatment planning. Patients can choose to have an FET immediately after an IVF cycle or delay it for months or years.
There are two main methods for performing an FET:
- Natural cycle FET: The FET is timed to coincide with your natural menstrual cycle. No fertility medications are used. This avoids the side effects of medications but timing the transfer can be tricky.
- Medicated cycle FET: Fertility medications are used to prepare the uterine lining and control the timing of ovulation. This provides more control over the cycle but does require taking medications. Common medications for a medicated FET include:
- Estrogen (estradiol) to thicken the endometrium
- Progesterone to prepare the endometrium for implantation
- Gonadotropins (FSH) to stimulate follicle growth
The FET procedure is less invasive than a fresh embryo transfer. The frozen embryos are thawed and transferred into the uterus using a catheter. Pregnancy rates for FET tend to be slightly lower than with a fresh transfer but still quite good, around 40-60% for most patients. FET gives many patients an additional chance at success with IVF.
An FET cycle typically costs between $3,000 to $5,000 in addition to the initial IVF cycle fees. The exact fees will depend on your clinic and whether a natural or medicated cycle is used. Many insurance plans cover FET, especially if they covered the initial IVF cycle.
Egg Freezing IVF: Common Questions About the Process Answered
Once you have undergone an IVF cycle and had embryos created, egg freezing allows you to preserve your eggs or embryos for future use. This process gives you more flexibility and control over your fertility and family planning. Before proceeding with egg freezing, it is important to understand the details and implications.
What is egg freezing?
Egg freezing, or oocyte cryopreservation, involves extracting and preserving a woman’s eggs. The eggs are harvested, then vitrified, a flash freezing process that uses liquid nitrogen to freeze the eggs very rapidly. When a woman is ready to use the eggs, they are warmed and fertilized with sperm. The resulting embryos are then transferred to the uterus.
Who should consider egg freezing?
- Women who want to delay childbearing in order to pursue education, career, or other life goals.
- Women at risk of infertility due to medical treatments like chemotherapy.
- Women with a family history of premature menopause.
- Couples not ready for children but wanting to preserve the woman’s fertility.
What does the process involve?
- Ovarian stimulation and egg retrieval: Medications are used to stimulate the ovaries to produce multiple eggs. The eggs are then retrieved through a minor surgical procedure.
- Freezing: The eggs are flash frozen and stored in liquid nitrogen at -196°C. They can remain frozen for many years.
- Thawing and fertilization: When ready to use, the eggs are thawed and fertilized using ICSI. Normal fertilization rates for frozen eggs are around 70-80%.
- Embryo transfer: Viable embryos are transferred to the uterus in the hopes of achieving a successful pregnancy.
What are the success rates?
Success rates can vary but generally, the chance of a live birth from frozen eggs is around 30-50% per embryo transfer. Egg freezing is still a relatively new technology, so success rates may improve over time. The age of the woman at the time of egg retrieval and the number of eggs frozen can also affect success rates.
Egg freezing gives women more reproductive freedom and flexibility. However, it is an invasive and expensive process, and does not guarantee a future pregnancy. For the best chance of success, women should consider egg freezing before age 35 when egg quality and quantity start to decline. By understanding the details, you can make an informed choice about whether egg freezing is right for you.
Conclusion
That covers the essential information you need to know about IVF in Singapore. While the IVF process can be complex and emotionally taxing, many families have found success through perseverance and the expertise of reputable IVF clinics. Do your research, understand the key factors that influence success rates, discuss treatment options with your doctor, and go into the process with realistic expectations about outcomes and timelines. IVF is not an easy journey, but for those struggling with infertility, it can be a life-changing opportunity to build a family. If you have weighed the pros and cons carefully and decided IVF is the right choice for you, stay hopeful – with treatment, support, and a bit of luck, your dream of becoming parents just may come true.
Anna Haotanto is the Founder of Zora Health and a passionate advocate for women’s empowerment. Anna’s personal experiences with egg-freezing, PCOS and the challenges of fertility have fueled her mission to provide high-quality information, financing, and support to help women and couples navigate their fertility journeys with confidence. She is also recognised for her achievements in finance, entrepreneurship, and women’s empowerment, and has been featured in various media outlets. You can also follow her on Linkedin or Instagram.
