Fertility treatment helps but is no miracle cure

A woman stands a 35 per cent chance of getting pregnant if she completes her in-vitro fertilisation (IVF) cycle and has her embryos transferred to her womb.

In contrast, a fertile couple has around a 20 per cent chance of getting pregnant in a month, said Associate Professor Yong Tze Tein, senior consultant at the Department of Obstetrics and Gynaecology, Singapore General Hospital.

Indeed, assisted reproductive technologies or ART can help some couples to conceive, but success is dependent on various factors, such as the woman's age.

Here are some things to note:

IT CANNOT REVERSE THE EFFECTS OF AGEING

Many people mistakenly believe medical technology can help them conceive when they are older.

The success rate of fertility treatments decreases with the woman's age. "This is because as the age increases, both the quality and quantity of eggs in a woman's ovaries decrease," said Dr Loh Seong Feei, medical director of Thomson Fertility Centre.

"In addition, gynaecological conditions, for example, ovarian cysts, endometriosis and fibroids, become more common with age."

A woman over 40 has around a 10 per cent chance of conceiving in each cycle, said Dr Lim Min Yu, consultant at the Clinic for Human Reproduction, National University Hospital Women's Centre.

Infertility is when one is unable to conceive within a year of having regular, unprotected sexual intercourse (two to three times a week), he said.

"If a couple has been trying for this length of time, or if the woman is above 35 and hasn't conceived within six months, they should consider seeing a doctor for investigations," he said.

"Not everyone will require IVF, but investigations should be offered at this stage, to determine who would benefit from fertility treatment."

IT TAKES EFFORT

Patients have to adhere to the treatment regime and not miss their course of hormone injections to encourage the ovaries to produce more eggs than usual, as it can affect the outcome.

For example, towards the end of egg stimulation, there is one injection to mature the egg before the egg is retrieved, said Prof Yong.

"Sometimes, patients forget about this, which may result in low or zero egg retrieval."

For some patients, lifestyle changes have to be made before treatment can begin.

"Some couples may have existing illnesses or are overweight, and their conditions would need to be optimised before they can be offered fertility treatment," said Dr Sadhana Nadarajah, director of KKIVF Centre, KK Women's and Children's Hospital.

IT CAN BE EMOTIONALLY TAXING

Emotional stability and positive mindfulness can have a positive impact on fertility treatment.

When couples go through IVF and other fertility treatments, they are also undertaking an emotional journey, which can involve anxiety about the outcome or disappointment with previous unsuccessful experiences, said Virtus Fertility Centre director Roland Chieng.

Indeed, the couple's relationship should be stable enough to withstand the stress of fertility treatments, said Dr Sadhana.

Even if the treatment succeeds, there is still the possibility of a miscarriage or ectopic pregnancy.

Couples can turn to fertility counselling, if needed.

IVF IS NOT THE ONLY FERTILITY TREATMENT

A couple's chance of pregnancy will depend on the cause of their infertility, which could include male infertility issues, such as an abnormal quantity or quality of sperm.

Finding and treating the root cause of infertility can frequently yield pregnancies without couples resorting to IVF , said Dr Loh.

Other available treatments include artificial insemination, reproductive surgery, such as the removal of fibroids which distort the womb and affect implantation, and correcting tubal blockage.

Stress can affect the mood and frequency of sexual intercourse, as well as ovulation, said Dr Loh.

If no causes can be found and everything is normal, then taking a break to de-stress before trying again may work, he said.

Joyce Teo

A version of this article appeared in the print edition of The Straits Times on March 22, 2016, with the headline 'Fertility treatment helps but is no miracle cure'. Print Edition | Subscribe