IN-VITRO FERTILISATION (IVF) / INTRA-CYTOPLASMIC SPERM INJECTION (ICSI)
In-Vitro Fertilisation is a procedure where eggs are retrieved from the ovaries and placed in a petri dish to be fertilised by sperms in a laboratory. Intracytoplasmic Sperm Injection (ICSI) is an extension of the IVF technique in which a sperm is injected into the cytoplasm of the egg under high magnification in the laboratory to assist fertilisation and is especially suitable in couples where the husband has very low sperm count, motility or normal forms.
IVF and ICSI are the most effective methods of assisted reproduction technology to help women to conceive and have babies. Nowadays, IVF or ICSI can be offered as a primary treatment for infertility especially in older women whose ovarian reserve may be fast depleting or in couples whose conditions affecting their infertility may not be correctible by other simpler treatments. IVF/ICSI can also be offered as a secondary treatment for women who are usually younger and who have failed to conceive despite receiving appropriate corrective treatment. The IVF/ICSI cycles involve a series of steps and procedures which include ovarian stimulation with fertility medication (follicle stimulating hormone) to increase the number of eggs to be collected, the egg retrieval procedure, the In-vitro fertlisation or ICSI technique for the eggs, followed by embryo culture in the laboratory, embryo transfer into the uterine cavity, management of the luteal phase and finally ending with the bHCG test for pregnancy. Success rates for IVF/ICSI depend on several factors which include the experience of the doctor who is managing the ovarian stimulation protocol and doing the egg retrieval and embryo transfer procedures, the laboratory management of the eggs and embryos and most importantly on the quality of the eggs and embryos. In younger women in their 20’s with good quality and supply of eggs the per cycle pregnancy and take home baby rate can be 40 to 50 per cent whilst in women above 40 using their own eggs, the similar rates could be as low as 5 to 15 per cent per cycle.
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