Your IVF journey may feel confusing, especially for couples who are seeking
IVF treatment in Singapore for the first time. But it does not have to be like this.
To ease your struggles and allow you to have a clearer view of what you can expect, we consolidated the entire IVF treatment journey and some Frequently Asked Questions (FAQs) below.
What is IVF?
A couple will first have to visit an IVF specialist clinic to determine if IVF is suitable for them.
IVF is used to treat a range of fertility and conception problems. It involves fusing the egg and sperm together in an external laboratory setting, followed by selecting the highest quality embryos and transferring them back into the woman's uterus.
Who can have IVF?
IVF is recommended for couples who are unable to get pregnant despite actively trying for at least a year, or 6 months for women aged 35 and older.
In Singapore, all women below 45 years old can undergo 10 IVF cycles (round of treatments), up from 5 cycles previously allowed for women over 40 years old.
The IVF Journey
Each IVF cycle involves several different steps that will help you increase the chances of becoming pregnant. The entire IVF process, from first injection to embryo transfer and pregnancy test, lasts for about 4 to 6 weeks.
Step 1: Suppressing the Natural Menstrual Cycle
Medication is given to suppress the body's natural menstrual cycle, which makes the next stage of treatment more effective.
This medication is in the form of an injection or a nasal spray, which needs to be administered daily over the next 2 weeks. You'll be taught how to administer the injections yourself.
Step 2: Ovarian Stimulation
You will take a fertility hormone called follicle stimulating hormone (FSH), which is another daily injection you give yourself, usually for about 10 to 12 days.
The injections increase the number of eggs your ovaries produce so more eggs can be collected and fertilised.
The egg growth and uterine lining development is monitored via ultrasound. About 34 to 38 hours before your eggs are collected, you'll have a final hormone injection to help your eggs mature.
Step 3: Egg Retrieval
Your eggs will be retrieved through an ultrasound-guided procedure, where you are under anaesthesia. A thin needle is inserted through the vaginal wall into the ovaries. The eggs are removed from each ovary under gentle suction.
Step 4 (for men): Sperm Collection
You'll be asked to produce a fresh sperm sample. The sperm are washed at a high speed so the healthiest and most active sperm can be selected.
Step 5: Fertilisation of Eggs
A sperm specimen is acquired and prepared for insemination.
The most active sperms are mixed with the egg in a dish, which is known as IVF. They are placed in an incubator and checked to see if they are fertilised after 18 hours.
Eggs that have been successfully fertilised (embryos) will be grown in the laboratory incubator for 2 to 5 days. The best embryos are chosen for transfer.
Alternatively, your gynae may recommend that one single sperm is directly injected into the egg, which is known as Intracytoplasmic Sperm Injection (ICSI). ICSI is carried out if
Previous IVF treatments have low fertilisation rates
- Sperm collected is sub-optimal
- Only a few eggs are available
Step 6: Embryo Transfer to the Womb
You'll be given hormone tablets to prepare the lining of the womb to receive the embryo. This is usually given either an injection, a gel, or as a pessary placed inside the vagina.
The best embryo(s) is/are selected for embryo transfer. The embryo transferred into the womb, in a simple procedure that does not require anaesthesia.
The number of embryos that will be transferred depends on the woman's age, embryo quality and IVF cycle.
Single embryo transfer
- Women under 37 years old in their first and second IVF cycle with top-quality embryos available
- Women aged 37 to 39 years old in their first and second IVF cycle with top-quality embryos available
Double embryo transfer
- Women under 37 years old in their first and second IVF cycle with no top-quality embryos
- Women aged 40 and above
Step 7: The Two Week Wait
Two weeks after your embryo transfer, you will take a pregnancy test to determine the result of the IVF treatment. An average couple undergo 2 to 3 cycles before a successful pregnancy occurs.
Once you are pregnant via IVF, the pregnancy is no different from a natural pregnancy.
Step 8: Freezing Embryos for Future Pregnancies
With IVF or ICSI treatment, you may have leftover good quality embryos which weren't used in your current treatment. In case the current treatment does not work or you want to have another child, you can freeze them to use in future.
The IVF process is a long, physically and mentally draining journey that can sometimes last for years. The couple must be prepared to expect painful injections, surging hormones, and unsuccessful IVF treatments.
During the period, the couple may find it useful to speak to a counsellor or to contact online forums like Trying to Conceive (TTF) community, with first-hand experience on the IVF journey in Singapore.
Most importantly, your partner ought to be there in every possible way so that you don't feel like you're on your own. Ensure that there is open communication between each other so your partner can be involved and support you every step along the way.
You can choose to go to a public hospital, private hospital or medical institution.
The total average cost of an IVF cycle in a public hospital is $10,000 to $15,000 while it costs $13,000 to $20,000 in the private sector. You can get up to 75% of the costs co-funded by the government.
Singaporean or PR couples can also make use of their Medisave to pay for IVF in any public or private centres, as shown below.
- 1st IVF cycle: $6,000
- 2nd IVF cycle: $5,000
- 3rd & subsequent cycles: $4,000
Do note there is a lifetime Medisave withdrawal limit of $15,000 per patient for all artificial reproductive technology, including IVF.
IVF Risks
1. Medication side effects
Many women will have some reaction to the medications used during IVF.
These include hot flushes, feeling irritable or depressed, headaches, and restlessness. The side effects are generally mild.
Seek medical attention if you experience persistent or worrying side effects during treatment.
2. Multiple births
This might be possible if more than one embryo is placed in the womb.
3. Ovarian hyperstimulation syndrome (OHSS)
This is a rare complication of IVF. This occurs when too many eggs develop in the ovaries, which become very large and painful. Seek medical attention if your symptoms include
- Abdominal pain and swelling
- Shortness of breath
- Nausea and possibly vomiting
- Reduction in urine output
Consult an IVF Specialist in Singapore
1 in 8 couples struggle with infertility. Know that you're not alone and we'll be there with you every step of your way. Seng's OG Practice is an IVF service clinic that provides professional, compassionate and comprehensive care to help you fulfil your dream of building a family. Contact us now at 6472 7988 to schedule an appointment.