Frequently Asked Questions - about Fertility Treatment
- Abstinence before semen analysis: For Semen Analysis, you will need to ejaculate 3-5 days before the appointment date and abstain until semen sample is produced on the date of appointment.
- No sperm? In such instances, we would examine your partner and run some blood and genetic tests. Where possible, we could attempt to retrieve sperm directly from his testicles. This sperm would then be used to fertilise your eggs, collected from an IVF cycle.
- Fast before AMH? No, you are not required to fast prior to the AMH blood test.
- Choosing Treatment? This decision depends on the length of time you’ve been trying, your age, your ovarian reserve, the cause of your infertility, your partner’s semen analysis, and naturally, your preference. Together, we’ll help you plan a regime that best suits your needs.
- Do injections hurt? These injections are given with a small needle, guided under your skin, therefore, the pain is almost negligible.
- Exercise? Yes, by all means. However, moderate to light exercises are preferable instead of high impact work-outs during this period.
- Hair dye? Most modern hair dyes are safe to be used during fertility treatment and in pregnancy. However, as a precaution, do remember to mention your potential pregnancy to your stylist.
- Traditional herbs and medicines? We would generally recommend that you stop those herbs or traditional modalities that might potentially have an adverse effect on your fertility treatment and outcome. If in doubt, it might be best to refrain until after completion of your fertility treatment.
- Acupuncture? Yes; acupuncture is not known to have any negative impact on fertility treatment.
- Time off work? No, on the contrary, you can continue with your normal daily schedule and activities. The only day you will need to be off work is on the day of your egg collection in an IVF cycle. However, this being a day-care procedure, means you get to go back home to rest a few hours after the egg collection. We would normally also give you a few days off work after your embryo transfer, but you can opt to go back to work sooner, should you choose to, with no negative impact to your treatment outcome whatsoever.
- Bed rest? No, you are advised to continue your daily activities as usual. Bed rest has been shown to add no benefit in any fertility treatment cycle.
IUI or IVF? Both are treatments offered for infertility. Intrauterine insemination (IUI) uses milder ovarian stimulation medication to create a smaller number of eggs in your ovaries. For the fertilisation process, sperm is introduced directly into your womb via a thin catheter. The sperm will then have to find the egg and fertilise it for pregnancy to happen.
In-vitro fertilisation (IVF) utilises oral or injectable fertility medication for ovarian stimulation, with the aim of collecting more eggs, which are then fertilised with your partner’s sperm in our laboratory. One of these successfully fertilised eggs, now called an embryo, is then transferred into your womb for implantation and pregnancy to occur. IVF offers significantly higher pregnancy success rates.
- Risk of cancer? Rest assured, studies have so far not indicated any direct association between cancer and fertility treatment.
- How long will IVF take? Once you have decided on your treatment, you can generally commence IVF with the onset of your next menstrual cycle. From this date, it typically takes approximately 10-12 days before your eggs are collected. Your embryo/s will be replaced into your womb 2 to 5 days after the egg collection. A pregnancy test will be scheduled 2 weeks after the egg collection.
- How many clinic visits? In a typical cycle, you will be seen at the beginning of your menstruation to commence on injectable fertility hormones. Subsequently, 2 to 3 visits will be scheduled for the purpose of monitoring your response to the medication, via ultrasound scans and hormonal blood tests. Following that, your 4th and 5th visits will be for egg collection and replacement of your embryos, respectively. Lastly, your 6th visit will be for you pregnancy test.
- Extra embryos? These embryos would be cryo-preserved (embryo freezing) for your future use.
- Good graded embryos not used? We now have a frozen embryo transfer following a ‘freeze all’ policy, where the best embryos has not been transferred yet and are frozen using the quick freeze method called vitrification.
- Is egg collection painful? An anaesthetist will be on-hand to administer sedatives, hence your egg retrieval procedure should be painless.
- What is PGT? Pre-implantation genetic testing is an option for couples attempting IVF. As its name suggests, an embryo’s genetic material is tested for normality before it’s returned to its mother’s womb for implantation. PGS offers an added measure of increasing the chance of a healthy pregnancy for couples undergoing IVF. The largest cause of IVF failure and miscarriages is due to chromosomally abnormal embryos, and PGS can help detect these.
- Will I use all my eggs? No, because each IVF cycle stimulates eggs from a pre-specified finite number of eggs meant only for that particular cycle; and these are from the batch of eggs that would have been discarded anyway, in a natural non-IVF cycle, since the body only selects 1 egg to grow per menstrual cycle. Hence, in an IVF cycle, we attempt to collect more eggs from this monthly pool which otherwise are destined to be discarded by the body.
- Complications? In modern fertility practices, treatment is generally safe. Therefore, we very rarely encounter problems or complications; namely:
- Ovarian hyperstimulation syndrome
- Bleeding or infection during egg retrieval
- Twins or triplet pregnancies
- Anaesthetic risks
- How many IUI cycles? Studies indicate that pregnancy rates begin to fall after the 3rd or 4th failed IUI cycles. Therefore, you might want to consider other treatment options at this point, unless there is a strong justification to attempt further IUI cycles. This will naturally also be based upon your specific preferences.