Case Study 7
Premature menopause, donor eggs, IVF-ICSI

Mr and Mrs F were happily married but delayed parenthood because of their careers. When it was time to have a child, Mrs F realized that she did not have her menstruation for a long time. The doctor diagnosed her as having premature menopause syndrome. She was only 25 years old.

Mrs F was devasted. She felt inferior when she saw other pregnant women. She became depressed initially but her family’s support soon made her search for help. She rang up all the IVF centres in Singapore and found out that she can still bear children if donor eggs are used. This involves assisted reproduction techniques to inseminate donor eggs with his husband’s sperm and placing the resulting embryos in her womb. However, none of the IVF centres could provide an egg donor immediately given the constraints of time and restriction imposed by the Ministry of Health in Singapore.

The couple’s family advertised for egg donors in Indonesia and finally found one. The egg donor was prepared by an Indonesian doctor working in conjunction with Dr Cheng Li Chang at Thomson Fertility Centre. The egg donor started hormone injection daily for 6 days to stimulate her ovaries and thereafter to another injection of Cetrotide so that the eggs will not be released prematurely. Four days later, her follicles grew to the size appropriate for egg collection. A final injection was administered to ripen her eggs and 10 eggs were extracted.

Two days later, the eggs were inseminated by Mr F’s sperm by ICSI (intracytoplasmic sperm injection). Seven of the 10 eggs were fertilised and frozen. This was necessary so that the egg donor could be tested for HIV 6 months later as the window period for sero-conversion of AIDS is 6 months.

Six months later, four of the frozen embryos were thawed. Three were replaced and Mrs F gave birth to a lovely daughter 9 months later. The 3 remaining embryos were stored and Mrs F still has another chance of conceiving.