By Paveena Kumar
Wouldn’t it be great if we could all get pregnant with candlelight and chocolate-dipped strawberries?
A survey conducted by I Love Children found that most couples in Singapore are not aware of fertility issues and most newlyweds want to have children within the first three years of marriage, but what if couples face a fertility obstacle?
In some cases, Assisted Conception Procedures (ACP) may be recommended by doctors. Some examples of ACP are In-Vitro Fertilisation (IVF) and Intrauterine Insemination (IUI).
What is the difference?
IVF treatment is a process that consists of five steps, (1) pre-cycle diagnostic testing, (2) stimulation of the ovaries to produce several eggs during one cycle, (3) retrieval of the eggs from each ovary, (4) fertilisation of the eggs in the laboratory via conventional fertilisation or intracytoplasmic sperm injection and then (5) transfer of the resulting embryos into the uterus.
IUI is a fertility treatment where sperm is inserted directly into a woman’s uterus during ovulation; decreasing the journey for the sperm to the egg. During ovulation, the woman produces one egg that is picked up by the end of the fallopian tube where it waits to meet the sperm. An IUI deposits higher concentrations of good quality sperm close to where the egg is waiting which increases the chances that the egg and sperm will unite.
According to Dr Ee Tat Xin, Associate Consultant, Department of Reproductive Medicine, KK Women’s and Children’s Hospital (KKH), “a typical IVF cycle involves an average of 8 to 12 days of ovarian stimulation”.
“Following that, eggs are collected and then inseminated with sperm. The embryos are then incubated for 2 to 5 days before being transferred back to the woman’s uterus. A pregnancy test is done 2 weeks after the transfer. In total, an IVF cycle will take about 4 to 6 weeks to complete. The IUI treatment also runs for around 2 to 3 weeks before the actual sperm insemination takes place and the pregnancy results will be known 2 weeks later,” says Dr Ee.
When’s the right time?
IUI is often the first treatment suggested to those who want to conceive as it’s less invasive. Recommendations for those who are 35 or over are often a little different as fertility reduces with age, therefore, your chances of conceiving via IUI might be too low, therefore, IVF may be recommended.
Dr Ee shared that IVF can be attempted if the woman has blocked fallopian tubes, endometriosis, subfertility, problems with ovulation, advanced age, or when the husband has a low sperm count.
“IUI may be attempted if there is mild reduction in sperm count or quality, unexplained subfertility or sexual dysfunction where there is difficulty with penetration,” says Dr Ee.
I Love Children was privileged to interview Grace, who went through both IUI and IVF to conceive baby Sophia in 2019.
After trying to conceive naturally for 2 years with no success, the couple decided to go through IUI. With a second failed IUI attempt in August 2018, Grace got a referral to KKH to try out IVF in late 2018. By February 2019, she had two good embryos transferred back into her uterus and 1 successfully implanted. Grace gave birth to baby Sophia on 1 October 2019. And guess what’s the icing on the cake? Grace is pregnant again with baby number two, also via IVF!
Grace’s Little Bundle of Joy – Sophia
Will it always be successful?
When we spoke to Dr Ee, he mentioned that the percentage of pregnancies per embryo transfer is around 35% to 40% and the live birth rate is about 25% to 30% for IVF treatments. As for IUI, the rate of conception with IUI is about 10% to 15%. But all this varies among couples.
He also advised that other factors such as the type of disorders present in each couple, the severity of these disorders, and the ability to correct them may also affect the outcome of fertility treatment.
“Past history of pregnancy and childbirth, or previous failed attempts with fertility treatments will also allow us to predict success rates for a couple. In order to increase success rates, it is best for couples to seek help early when needed as age and pre-existing conditions are few of the most important determining factors for fertility potential,” added Dr Ee.
You are not alone
To help couples better afford the cost of ACP treatment, couples may withdraw up to $6,000, $5,000, and $4,000 for the first, second, and third cycles respectively. Click here to find out more on MediSave For Assisted Conception Procedures.
In addition, eligible couples undergoing ACPs in public Assisted Reproduction (AR) centres can receive up to 75% co-funding from the Government. Click here for more details on Co-Funding For Assisted Conception Procedures.
It takes time
Couples who are intending to seek fertility treatment must be ready to accept the commitment and challenges that come with it. And it is important to have a strong support system. As Grace shared, her biggest challenge was the emotional journey.
“When we had our first failed IUI attempt, though it had cost us financially, the real deal was the emotional investment,” said Grace.
Couples need to remember that fertility treatments take time and they are no magic bullets that guarantee you a child. Most importantly, couples need to remember that infertility is not uncommon, and regardless of age, couples are encouraged to seek help sooner rather than later.
I Love Children would like to thank Dr Ee Tat Xin, Associate Consultant, Department of Reproductive Medicine at KK Women’s and Children’s Hospital (KKH), and Grace for their invaluable input towards this article.