Most people have heard of IVF, or In Vitro Fertilization, as a popular treatment for infertility, and whether the cause of infertility is due to genetics or pre-existing medical conditions, IVF uses modern technologies to help couples become pregnant despite these hurdles. Couples looking to conceive but are unable to do so on their own should learn more about assisted reproductive technologies (ART) like IVF. At Beyond IVF, we believe in the importance of providing evidence-based information to our clients so families can make the best decisions for themselves.
What is IVF (In-vitro Fertilization)
In vitro fertilization (“in glass“), or what we know as IVF, involves collecting eggs and sperm and fertilizing the eggs with the sperm in a laboratory to create embryos that will hopefully develop, after five days, into blastocysts. These blastocysts are then transferred back into the uterus to implant and grow into a fetus.
IVF and ICSI: What is the difference?
ICSI, which stands for Intracytoplasmic Sperm Injection, differs from IVF in only one step, and that is how the egg is fertilized by the sperm. With IVF, sperm is placed in a petri dish with the egg and sperm will naturally find its way into the egg to fertilize it. Utilizing ICSI, a single, well-formed sperm is selected and injected directly into the egg to increase the chances of fertilization and, ultimately, pregnancy.
** Therefore, currently, ICSI is a more popular treatment option for infertility than IVF.
Who can have IVF?
Who are the best candidates for IVF?
- Women over the age of 35
- Women with blocked or narrowed fallopian tubes
- Women experiencing abnormal ovulation
- Women with endometriosis
- Women with severe pelvic adhesions
- Women with genetic conditions
- Men with low sperm motility or low sperm count
- People suffering from unexplained infertility
IVF Success Rates
The success of IVF/ICSI depends on:
- Response to ovarian stimulation
- Health of the embryos
- Age of the female partner (when over the age of 40, the chances of producing healthy embryos that can survive long enough for transfer are lower than for those under 40)
- Health of the female partner, such as ovarian function
The causes of IVF treatment failure
The risks of IVF/ICSI include:
- Miscarriage
- Stress
- Twin pregnancy
- Premature birth
- Complications associated with egg collection
The IVF Process (Step-by-step)
IVF Procedure
The IVF and ICSI procedures have six main steps as follows:
- Doctor consultation
The doctor will explain the procedure, preparation and set up the treatment plan (be sure to schedule your consultation on day 1 or 2 of your period). Blood tests will be performed to test your current fertility hormone levels, which will give our doctor an indication of how much ovarian stimulation medication needs to be prescribed.
- Ovarian stimulation
The doctor will check your hormone levels and carry out an ultrasound to start. You will receive your first ovarian stimulation injection on the second or third day of your cycle, which will continue daily for the next 10-12 days. The doctor will then schedule regular ultrasounds and blood tests to monitor the growth of your eggs and check your hormone levels during this period.
- Egg and sperm collection
Once the eggs have grown to the desired size, the doctor will perform an ovum pick-up (or OPU), to extract the eggs individually from the ovaries. The procedure is done under sedation and a needle is inserted through the vagina into the ovaries to collect the eggs. This procedure usually takes 20-30 minutes, depending on how many mature eggs need to be collected. During this period, sperm also needs to be collected to be used in the fertilization process in the laboratory shortly after.
- Embryo development
Embryos are kept in the laboratory until they become six- to eight-cell embryos (by day 3) and then on to strong blastocysts (by day 5-6).
- Embryo transfer
Once ready, the doctor and patients will select an embryo to be transferred into the uterus. This is an out-patient procedure and does not require general anesthesia.
- Pregnancy test
The doctor will schedule blood tests every three days after embryo transfer to check hormone levels. Pregnancy can be tested for 14 days after the transfer.
The Preparation before IVF Treatment
Preparing for IVF
For the female partner
- A physical examination to be used for treatment planning; this should be done on the second or third day of your cycle.
- Assessment of your ovaries by checking estrogen levels and using ultrasound in the first few days of your cycle to see how well your ovaries are responding to stimulation.
- Blood tests to check hormone levels and an ultrasound in the first days of your period to assess if your ovaries are functioning effectively.
- Examination of your uterus either with ultrasound or through hysteroscopy to determine the best method for fertilization.
- Avoid caffeine if possible.
- Avoid alcohol and cigarettes for at least three months before treatment starts.
- Please let the doctor know if you have any pre-existing medical conditions and please bring all medications you are taking when you see your doctor.
- Be sure to get adequate rest.
For the male partner
- Avoid ejaculating five to seven days before seeing the doctor.
- Avoid alcohol and cigarettes for at least three months before treatment starts.
- Exercise regularly, but not too much and not too little.
- Avoid wearing tight underwear.
- Avoid soaking in hot water and using the sauna for extended periods.
- Avoid stress; try to stay relaxed.
- Be sure to get adequate rest.
Care after IVF Treatment
Taking Care of Yourself After IVF
- After embryo transfer you will need to rest at the clinic for two hours for monitoring.
- You can resume normal activities as you are comfortable doing so.
- Avoid strenuous exercise.
- Avoid lifting heavy objects.
- Try to eat foods that are gentle on your stomach.
- If you have a fever, you can take fever reduction medication.
- Avoid sexual intercourse and vaginal douching.
- Try to stay relaxed; stress affects your hormones. Looking for ways to stay distracted.
- If you experience any abnormal symptoms, such as abdominal pain, vaginal bleeding, or excessive vaginal discharge, please contact the doctor immediately.
Pros and Cons of IVF Treatment
Pros of IVF
Advantages of IVF/ICSI
- The assisted reproduction technique with the highest success rate.
- It can treat a variety of infertility-related problems.
- No surgery is required.
- It can be done even after a tubal ligation.
- It can be done even with low sperm motility.
- Genetic testing (next-generation sequencing, or NGS) of the embryo can be done before it is transferred.
Cons of IVF
Disadvantages of IVF/ICSI
- IVF/ICSI costs significantly more than IUI.
- It has a more complicated process requiring multiple steps.
- The procedure lasts many days.
- Some patients may experience side effects from egg collection, such as abdominal discomfort.
Risks and Complications
Potential risks & side-effects
- Swollen ovaries due to too much ovarian stimulation
- Ectopic pregnancy, where the fertilized egg implants in the fallopian tube instead of the uterus, which may cause life-threatening bleeding, if left untreated
- Increased stress levels as IVF process and the associated medications can affect both the body and mind
- Side effects from the medication, which can cause headaches, restlessness, hot flashes and mood swings
- Risk of premature birth and low birth weight
- Risk of complications during the egg collection process, such as infection, bleeding
- Potential chance of getting pregnant with twins (if more than one embryo is transferred), which can potentially result in premature births and low birth weight
IVF Package Costs
IVF is an expensive procedure, but it is a worthwhile investment when you are experiencing infertility and would like children of your own. The starting cost of IVF is 200,000 baht and can go up to 500,000 baht per cycle, depending on the facility, leading people to wonder: why is IVF/ICSI so much more expensive than intrauterine insemination (IUI)?
IVF is an involved process that is made up of several important steps: ovarian stimulation, preventing ovulation, triggering egg maturation, ultrasounds, egg and sperm collection costs, and the ICSI procedure itself—all of these have their own expenses.
At Beyond IVF we are pleased to offer a promotion price of 300,000 baht for one cycle of ICSI, which covers almost the entirety of the ICSI process.
IVF Treatment at Beyond IVF Bangkok
With the rising popularity of assisted reproductive technologies like IVF and ICSI in those over 30 or those experiencing infertility, there are endless options of small and big clinics and hospitals that offer treatment options for infertility. But choosing the right place to help you start your family shouldn’t be solely a financial decision. Consider safety, professionalism, and the skills of specialist doctors—all important components of this journey.
At Beyond IVF, our doctor is a highly trained and experienced fertility expert, with credentials and expertise on top of being a renowned obstetrician and gynecologist who graduated from Ramathibodi University. Furthermore, our clinic prides itself on its high standards for cleanliness and safety. Our team is knowledgeable and professional, and we utilize leading edge technologies comparative to the largest international hospitals.
Please contact us for our promotion prices for IVF and ICSI and we offer a 0% interest installment plan!
FAQs about IVF Treatment
Is it possible to have IVF treatment after vasectomy?
Whether your fallopian tubes are tied or clipped, ICSI or IVF are both possibilities and don’t require the tubal ligation to be reversed. The fallopian tubes are not necessary in these procedures. Furthermore, your chances of success are not affected by tubal ligation.
Can IVF decide a child’s gender?
In Thailand it is illegal to choose your child’s gender, but chromosomal testing of embryos before transfer will reveal an embryo’s gender. Chromosomal testing not only reveals abnormalities or indicates health of the embryo, but also reveals if the embryo has XX (female) chromosomes or XY (male) chromosomes. However, our doctor will always recommend that you choose to transfer the healthiest embryos first.
How are IVF and ICSI different from GIFT (gamete intrafallopian transfer)?
In the past GIFT was a well-known treatment option for infertility. It involves making three small incisions in a woman’s abdomen to insert a camera and tools to place sperm as close to the egg as possible to encourage fertilization. The success rate of GIFT was only 20% and one of its biggest disadvantages was that is required three surgical incisions! If one procedure failed, it would have to be repeated.
GIFT is almost never done anymore and IVF/ICSI are the preferred ARTs for infertility. These procedures have higher success rates and require no surgery. They also allow the embryo to develop outside the body until it can be transferred into the uterus. IVF/ICSI is a significant investment because it requires a modern laboratory that meets international standards, and this is expensive to create.
What is genetic testing of the embryo and why is it done?
Next-generation sequencing (NGS) looks at all 23 pairs of chromosomes in the embryo to check for any abnormalities. Most families experiencing infertility and undergoing IVF/ICSI are often older and thus are at higher risk for chromosomal abnormalities like Down syndrome, cleft palate, hypothyroidism, etc. Genetic testing of embryos before they are transferred into the uterus is an option to prevent complications and increase the chances of a successful and healthy pregnancy. NGS is recommended when the woman is over 35, if the woman has experience two or more miscarriages, and if there is family history of chromosomal abnormalities.
Can IVF/ICSI lead to a twin pregnancy?
A twin pregnancy is considered high risk, so it is not recommended to have more than one fetus during pregnancy. However, in some cases, the doctor my recommend the transfer of two embryos at the same time. This decision is based on many factors, one of which is the quality of the embryos. If the embryos are not of good quality, the doctor may recommend transferring two with the hopes that one might be healthy enough to implant, essentially doubling the chances of pregnancy. If both embryos implant, it could develop into a twin pregnancy. This will then be closely monitored by the doctor.
Final Thoughts
IVF increases the chances of a successful pregnancy to 60-70%. IVF is an ideal choice for those with medical or reproductive problems that make natural conception impossible. Whether you are experiencing problems getting pregnant or suspect that you might have a difficult time getting pregnant, we recommend that you see a doctor for a thorough examination and the appropriate treatment planning tailored to you to ensure your best chance of growing your family.
For a complimentary consultation to prepare for pregnancy or discuss infertility, please contact us on Line @beyondivf