Thomson Fertility Centre: Assisted conception, IVF, Singapore, international

Preliminary evaluation and Clomiphene
The first step if there is no pregnancy after the recommended time limits is to see your gynaecologist. Some preliminary tests will be done which will include blood tests, ultrasound scans and a sperm analysis.

He will probably give you a course of fertility tablets called Clomiphene. This will ensure that you ovulate. If a pregnancy does not occur within 6 months, then further continuation of Clomiphene is unlikely to result in a pregnancy.

Checking the tubes
We would normally consider checking the fallopian tubes next. The preferred way is through an operation called a laparoscopy. This involves inserting a small telescope into the abdomen through the navel.

This has the advantage of checking if the internal organs are normal and healthy, whether the tubes are blocked and if the ovaries are close to the ‘mouth’ of the tube.

Super-Ovulation and Artificial Insemination
Super-Ovulation and Artificial Insemination (SO-AI) is the second step in treatment. This involves daily hormones injections to ‘give a boost’ to your natural hormones. This has the aim of inducing the growth of up to 3 eggs.

At the time of ovulation, your husband’s prepared sperm will be put into your womb in a simple and painless procedure. We do not recommend pursuing this method if there is no pregnancy after 4 cycles of treatment.

In - Vitro Fertilisation
In Vitro Fertilisation (IVF) or more commonly called the ‘test tube baby programme’ is the next step of treatment if SO-AI fails. It is the preferred step if the fallopian tubes are blocked or when there is insufficient sperm for SO-AI.

It basically involves extracting eggs from the body and mixing it with sperm in the laboratory. Three fertilised eggs, now called embryos, are replaced in the womb.

Diagram

The complexity of IVF lies in ensuring that the egg development occurs at the correct speed, and to determine when they reach maturity. This is because immature eggs do not fertilise.

IVF at most centres require the combined and frequent use of ultrasound scans and blood tests to determine when the eggs are mature. In these centres, one can expect an average of up to 70 injections over a 4 week period, and about 15 visits to the clinic. During these visits, blood tests are usually done to measure hormone levels. A period of hospitalisation may be required after the eggs are retrieved.

SIMPLIFIED IVF @Thomson does away with almost all the blood tests. The number of injections are reduced to a minimum - on average 15 injections over one month are required in comparison to 70 injections in other IVF centres. This allows the number of visits to be reduced to about 8. Hospitalisation is rarely required. All these can be achieved with no reduction in safety and pregnancy.