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IVF: in vitro fertilization

Infertility refers to an inability to reproduce by natural means after 12-24 months even though there is no use of contraception. There are many causes of infertility and they can be in either men or women or even in both of them. The common causes of male infertility are low sperm count, diseases, stress etc. while those of female infertility are caused by abnormalities of reproductive system including hormones, fallopian tubes, or uterus. There are unexplained causes as well. One of well-known assisted reproductive technologies used to treat infertility is in vitro fertilization (IVF).

 

In vitro fertilization (IVF) or test-tube baby is a process that the eggs are fertilized by prepared sperms outside the body. Eggs are retrieved from the women’s ovaries and then fertilized by sperms in the laboratory. Later, the embryos will be transferred in the women’s uterus, increasing a chance of a successful pregnancy. The difference between IVF and GIFT or gamete intrafallopian transfer is that GIFT places eggs and sperms in the fallopian tubes and wait for natural fertilization. If the process is successful, the fertilized egg then reaches the uterus and implants itself there, resulting in the pregnancy.

 

The IVF success rate has been greatly improved and gained more and more popularity. Also, after the egg retrieval, patients need only a few hours to rest before they can go back home.

 

IVF Procedure

1. Male and female patients come to have a health check-up at the hospital to see if they are physically fit for IVF. Women need to come 2 days before their period. For men, if they are ready and in a good physical condition, they may be asked to collect semen samples for sperm preparation for the fertilization of the eggs. Abstinence for 48 hours is required prior to collection. 

 

2. On the first day of their period, women have to see the doctor to check the ovarian reserve. They will take folic acid supplement and hormones will be injected daily for 9-12 days depending on each woman’s condition to stimulate the ovaries to develop mature eggs. Patients will have to come and see the doctor in every 3 days to check the egg quantity and quality. The hormones injected may be adjusted according to each person. On the final appointment before the egg retrieval, the doctor will check their respiratory system to see if it is safe for patients to undergo anesthesia. During these times, abstinence is required and women need to stop doing exercises and having massage. They should eat kiwi, pineapple and 3 egg whites to increase hormones.

 

3. Patients will be put under light anesthesia to have the egg retrieval, which will later be fertilized by prepared sperm. On the previous night, patients will have an injection at 9 p.m. and they will not be allowed to consume any food or drink after midnight. After the egg retrieval, patients need only a 2-3-hour rest before they can go back home and let the body adjust before having the embryos transferred into the uterus.

 

4. The fertilization of the eggs in the laboratory will be closely monitored in the following 2-3 days to determine the growth and development and see if and how many of them can become embryos. The doctor will check 23 pairs of chromosomes to determine the gender and the overall conditions of the embryos. 

 

5. Patients need to have a body check-up before having the embryo transferred into the uterus and waiting for the pregnancy. After the transfer, progesterone hormone will be injected for 3-5 days. A pregnancy test will be done 2 weeks later.

 

IVF Risks

1. During the egg retrieval, there may be bleeding, infection or failure to obtain eggs. 

2. There may be side effects from fertility drugs such as hot flushes, headaches, nausea or even ovarian hyperstimulation.

3. A multiple pregnancy, caused by more than one embryo transferred into the uterus, may increase the risk of having a premature baby or a baby with a low birth weight.

4. An increased risk of ectopic pregnancy

5. The IVF baby may have a higher risk to be born with a birth defect, though it is not common.

 

  Price & Package    400,000-600,000 THB including body check-ups, fertility drugs and hormones injection, egg retrieval, sperm preparation, fertilizations of the eggs in the laboratory, test of 23 pairs of chromosomes and embryo transfer into the uterus

 

Schedule for IVF in Thailand   (an example from a patient who has her period on 2015/8/22)

 

  2015/8/19      Arrival at Thailand
  2015/8/20   See the doctor and have a body check-up at the hospital
  2015/8/21-2015/8/23     Take fertility drugs and have hormone injections (should be around the same time everyday)
  2015/8/24      Have a blood test and take fertility drugs and have hormone injections
  2015/8/25-2015/8/26     Take fertility drugs and have hormone injections (should be around the same time everyday)
  2015/8/27     Have a blood test and take fertility drugs and have hormone injections
  2015/8/28-2015/8/29      Have drug injections to stimulate the ovary and prevent premature ovulation
  2015/8/30    Have a blood test and check the respiratory system and have drug injections to stimulate the ovary and prevent premature ovulation
  2015/8/31    Have a drug injection at 9 p.m. and stop consuming any food or drink after midnight
  2015/9/1       Have the egg retrieval to have a fertilization of the eggs by prepared sperm in the laboratory (Patient rests 2-3 hours in the hospital before going home)
  2015/9/2-2015/9/3     Check the growth and development of embryos
 2015/9/4   Check 23 pairs of chromosomes to determine the gender and overall conditionsor have the embryos frozen for the future use. Embryo in the good  condition will betransferred into the uterus 
  2015/9/5         Check patient’s condition before transfer the embryo into the uterus
  2015/9/6-2015/9/10  

   Inject progesterone hormone to increase the chance of pregnancy

 

(Go back home to take some rest before coming back for a pregnancy test 2 weeks later)

 

Period of stay in Thailand

13-15 days for patients who stay until the day of the egg retrieval

an interpreter is needed for 6 days, 1 day at the airport on arrival date and 5 days when seeing the doctor

 

22-25 days for patients who stay until the last process

an interpreter is needed for 7 days, 1 day at the airport on arrival date and 6 days when seeing the doctor

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