For our second IVF attempt, we went to Lee Women’s Hospital in Taichung, Taiwan.
This hospital is fast becoming a popular option for Filipino couples looking for IVF treatment because of Lee Women’s Hospital’s high success rate, Taiwan is only a 3-hour flight from Manila, visa-free for 14 days, and the costs is comparable to IVF procedures in Philippines.
How much does IVF in Lee Womens Hospital cost?
We paid in total NTD117,650 (equivalent to PhP229,500 or USD3,800) for one cycle. Here is the breakdown of our expenses:
First Visit to Taiwan/Initial consultation (duration 3 days stay): NTD10,000 (doctor consultation, ultrasound, blood tests) plus NTD30,000 (medicines for stimulating follicles good for 8 days).
We informed the clinic on day 1 of my next menstrual cycle and was told to visit the clinic on day 8.
On our second visit to Taiwan (duration 30 days stay) our medical expenses were:
Day 8: NTD4,500 (ultrasound, blood tests and more medicines) plus NTD800 for semen analysis
Day 10: NTD6,000 (ultrasound, blood tests and more medicines)
Day 11: NTD5,000 (ultrasound, blood tests, urine test, and more medicines)
Egg Retrieval: ND30,000
Embryo Transfer: NTD60,000 (including fertilization by ICSI and laser assisted hatching)
Pregnancy Test: NTD1,350
Our Total Expenses: NTD117,650.
Please note that the above figures are based on our own experience only, for one cycle and using fresh transfer embryos.
The actual costs of treatment will depend on what tests your doctor will order and what kind of medicines you need. It may happen that follicles may not grow as rapidly as hoped, in which case your doctor may change or adjust the dosage of your medicines. Lee Hospital’s approach is to produce as many follicles and embryos as possible. Therefore, for older women able to produce only a few follicles each cycle, you may have to do a back to back retrieval, in which case your cost of medicines and egg retrieval will be multiplied as well (say total may go up NTD200,000 or USD6,500).
The clinic does not accept credit cards or debit cards so payment is a bit of a hassle. Payment is cash in NTD or USD, or USD telegraphic transfer only.
How about the accommodation costs? We stayed at Alice Hotel where they charged NTD30,000 for a 30-day stay. Taxis cost NTD85 flag down and to go most places will cost you only NTD160 (USD6) or less. Buses around Taichung are free for the first 10km provided you have an easycard. Food in mall foodcourts cost NTD150 per meal on average. Alice Hotel has stoves and a microwave so cooking your own meals is an option.
Including flights, accommodation costs and expenses, the grand total could rack up to P500,000 (USD9,500). Not cheap at all!
Visas (for Filipinos)
Taiwan allows Filipinos to visit visa-free for 14 days. If you need to stay longer, apply for a visa in Manila by going to the Taiwanese consulate. Visa when processed in Manila cost Php2,600.
Otherwise, to extend your stay in Taichung, you need to go to their Ministry of Foreign Affairs. The fee to extend the visa once you’re already in Taiwan cost NTD3,200, which is more expensive than when processed in your home country.
The visa requirements include documents to support why you need to visit Taiwan, birth and marriage certificates from PSA (NSO) and income and financial evidences such as bank statements.
Baby Dust to Every Hopeful Parents Out There!
IVF is expensive, invasive to your body and emotionally draining. Before going, arm yourself with as much knowledge as possible and prepare your wallet, and your heart for a roller-coaster ride of hope, disappointment, despair, frustration, and hopefully a happy pregnancy and a healthy baby at the end of it.
My husband and I have been trying to have a child for years. We have done everything, we have seens lots of doctors and taken lots of tests already and nobody still could say what is hindering us having a child. Its called unexplained infertility. Infertility is nothing to be ashamed of. Lots of couples experience it and its a medical condition, meaning its a disease, its not your fault, and its treatable. IVF is the last solution for couples who have been trying to have kids on their own but with no success.
IVF stands for in vitro fertilization. In vitro is Latin for “in glass”, it means outside of the human body. In IVF the fertilization, the meeting of the egg and sperm, is done in a laboratory. Its also called sometimes test tube babies, but actually the fertilization is not done in a test tube, but in a petri dish, and the baby is still grown inside the mother’s womb for nine months, not in a laboratory!
In the Philippines, there are several clinics that offer IVF. In Manila there are 4 clinics: Carmi at St Lukes Hospital, Kato Repro Biotechnology Center, CARE and ART Victory. There are also clinics in Cebu and Davao. We chose to go to Kato for our first IVF attempt as they are cheaper than Carmi. The IVF cycle at Kato takes place over two months. The first month is to collect eggs from the ovaries of the woman, and the second month is the transfer of embryos into the woman’s womb.
How much does IVF in Kato costs?
In total we paid P296,000 (USD5,800) for the costs of procedures at Kato. This is staggered over the 2-month period and payments are based on actual costs of procedures done during each clinic visit.
Here are the expenses that we incurred:
Initial consultation with a doctor (no tests done): P1,680.
After the initial consultation, we were told to text the clinic on day 1 of my next menstrual cycle, and to visit the clinic on day 2.
Here are the expenses for the first month:
Day 2 visit: P38,000 (ultrasounds, blood tests and medicines good for 8 days)
Husband Sperm Analysis: P5,000
Day 7 visit: P10,500 (ultrasound to check if the follicles are growing and more medicines)
Day 9 visit: P6,000 (ultrasound to check if the follicles are growing, blood tests and more medicines)
Day of retrieval cost: P62,160 (covers cost of operation to pick up the eggs) and P89,600 (fertilisation and freezing of 1 embryo)
Total of P212,940 for first month
In Kato they do not transfer embryos right after retrieval. They allow the body to rest after retrieval and for the medicines to wash out of the woman’s body first. They say that this allows for higher chance of success. In the meantime, they would freeze the embryo (baby) first.
We came back the next month for our transfer procedure. Here are our expenses on the second month:
Day 2: P6,000 (consultation, ultrasound, blood tests)
Day 10: P7,500 (ultrasound, blood tests, medicines)
Day 13: P3,800 (medicines and consultation)
Day of transfer: P60,416
Pregnancy test after 7 days: P5,000
Total of P82,716 for the second month
Not cheap at all! Payments were staggered over two months and the clinic accepts credit cards and debit cards, except for the P89,600 cost of fertisation which is payable in cash.
Do note that the above figures are based on our own experience only and the costs for patients depends on the tests that need to be done, and the dosages of the medicines. Sometimes it can happen that the follicles do not grow as fast as desired, so the clinic has to change or adjust the medicines. If you happen to produce more than 2 follicles/embryos that is good for you, but you need to pay for additional cost of freezing of embryos.
The above figures are based on Kato’s minimal stimulation IVF program. They have another, cheaper program, Natural IVF, where no medicines are used. In this program, the patients only pay for the costs of ultrasound, blood tests, doctors visit and egg retrieval. Natural Cycle IVF is for younger women who are still able to produce good quality eggs. It costs around P60,000 per cycle. After the transfer, and in the happy case of a successful pregnancy, there is an additional cost of P100,000 so total costs only about P160,000 (USD3,150).
Lee Womens Hospital in Taiwan is fast becoming a popular option for Filipino couples trying to conceive. My husband and I first heard of friends of friends who had a baby at Lee Womens Hospital in 2018. We considered going to Taiwan for our first IVF cycle but chose to stay in Makati and try Kato. For our second IVF attempt we decided to go to Taiwan.
The success rate at Lee Womens Hospital is quite high with their fb page claiming success rate of 80% in one cycle. Indeed when we visited the hospital, my husband and I met several Filipino couples in the hospital who either just got good news of a positive pregnancy test or already had a first baby at Lee Womens Hospital and were trying for their second already. Do take the success rate with a grain of salt because there are so many factors that can affect your own success rate such as the woman’s age and medical conditions. In addition when clinics quote success rate they usually mean a positive pregnancy test, not necessarily a live birth. Anyway suffice it to say that because of the success stories we heard we were encouraged to go for another IVF cycle.
We emailed Lee Womens Hospital and scheduled an appointment. They asked us to scan and send them copies of our passports, marriage certificate and a second ID. We were given choices of 4 doctors and we chose a lady doctor. Most Filipino couples that we met chose to go with the hospital founder, Dr Lee.
We flew from Manila to Taipei one hot and humid May morning in Manila and landed in Taiwan which was experiencing some gusts of winds and thunderstorms that time.
Lee Womens Hospital in Taichung
We met with the lady doctor and she asked us our medical history. I had blood tests done for hormone levels and a hysterescopy. My husband had a blood test and a semen analysis. All the tests were pretty standard. After speaking with the doctor and getting our results we decided to go with their IVF program. We bought the medicines needed for egg stimulation to bring to the Philippines back with us. For our initial visit, we spent 3 days in Taichung. We were asked to come back on the 7th day of my next menstrual cycle.
The medicines that our doctor prescribed were Letrozole, GonalF and Menopur. In Kato I also took Letrozole and GonalF, however I immediately noticed that the dosage for my medicines were much higher at Lee Womens Hospital than at Kato. At Kato I only injected myself once a day for 5 days. At Lee Hospital I injected myself twice a day for 10 days. So I thought to myself that this clinic is really aggressive which explains their higher success rate.
Once my next menstrual cycle started I informed the clinic and began taking the medicines and injecting myself with the follicle stimulating hormones. I went back to Taiwan on the eighth day for ultrasounds and blood tests. I was asked to come daily until eleventh day for blood tests (yes more pricking as if I didn’t have enough injections already) and ultrasounds to monitor the growth of my follicles. I had two big follicles and 2 medium sized follicles. On the evening of day eleventh I had a Pregnyl shot to trigger the maturation of the follicles. The follicles were harvested early morning on day 13th.
I arrived at the hospital very early on day 13th and went straight to the operating room waiting area. I put on the gown and hair net and an IV was put in my arm. I was also shaved down there. A nurse came to me and walked with me to the operating room. I noticed that all the nurses and anaesthesiologists were women. Arms and legs were put in restraints and anaesthesia was put in the IV and I went to sleep. I woke up and I was back in the waiting area already. I didn’t feel much discomfort after my egg retrieval. After I woke up from the anaesthesia I rested a bit and soon the IV was taken out and I was allowed to leave.
Because of my low ovarian reserve, we only got 3 eggs. Of the three eggs one egg was immature and not usable. The other two eggs were fertilised by ICSI. My doctor recommended that we freeze these embryos and we do another round of egg retrieval. She wanted me have as many eggs as possible as their clinic recommends 4 embryos are transferred each time for women in my age group (40s).
My husband and I talked about it and decided that we will go ahead with the transfer using my existing 2 eggs. So my transfer was arranged for day 16 of my cycle. Our embryos were 3 days old then.
On the day of the transfer we found out that both embryos have made it so far (day 3) and had good morphology. Hubby and I were so happy. An ultrasound was done to check my lining and one final blood test to confirm good hormone levels and all checked out good. We were proceeding with the transfer.
The transfer procedure at Lee hospital was the best part of our IVF cycle. I stayed at a private room (the staff called the rooms VIP rooms) and was given a 30-minute massage by the hospital masseuse to relax me before the transfer. Unlike in Kato, I did not have to leave the room to go to an operating room for the transfer. The doctor came in and wheeled in an ultrasound machine. The transfer itself was done in my room. The tube containing the embryos were inserted inside and the embryos released into the uterus. It was over in less 10 minutes. I was told to keep my hips up over a pillow and my knees raised for the first hour after. Legs were straightened on the second hour and I moved to either side for 30 minutes each after the second hour. All the while the hips were kept elevated. My transfer was at 10am and my husband and I stayed in the private room up to 5pm. It was quite cozy.
Cozy VIP room for transfer
After the transfer was the dreaded two week wait. It’s up to God now. Will the embryos stick? Will we finally be parents?
After the transfer, I was given aspirin, anti-rejection drugs, progesterone and estradiol tablets. I also had Pregnyl injections every 3 days. After the transfer it’s up to patients whether they want to go back to their home countries or have the pregnancy test in Taiwan.
These are the most frequently asked questions about Lee Womens Hospital.
1) How many visits do I need to make to the hospital?
You should schedule at least two-three visits. The first visit is for consultation. This usually lasts 3 days during which you meet the staff and your doctor. During this visit you may decide to buy the medications for follicle stimulation.
The second visit is for the actual treatment. You may begin your medications in your home country (as the clinic may direct you) and only visit the clinic on your 8th day. Follicle retrieval will be anytime between day 10 and day 14 usually. You may do a fresh transfer straight away or opt to freeze your eggs or embryo as you go through another round of follicle retrieval.
One thing to note about Lee Hospital is that they are all about increasing your chances to conceive. Therefore they encourage women to retrieve as many follicles as possible through multiple cycles. For women of advanced age and/or low egg count like myself this may mean that they have to take follicle stimulating hormones and undergo multiple retrievals in so many cycles to achieve a good number of follicles. This means of course more rounds of payments for the medicines and the retrieval procedures. The clinic fertilise all the follicles so I’ve encountered couples who were already pregnant but with 5, 10 or even more embryos still kept frozen. This can be problematic if you believe (like the Catholic Church does) that the embryo is a human life from the moment of fertilisation.
The treatment schedule will look like this (days stay in Taichung):
Consultation: 3 days
First cycle to retrieve: 7 days minimum (day 8 until retrieval on say day 14).
Second cycle to retrieve follicles and transfer: 14 days (day 8 up to day 14 for retrieval second time, then transfer on day 17 (3 day old embryo), and 3 days rest).
A lot of the couples I met in Taiwan are really committed and many of them stay in the country for months at a time. Couples may choose to stay in Taiwan for the pregnancy test (two weeks after transfer), up to when heart beat is present (further two weeks after the pregnancy test) and even beyond.
2) How much does it cost?
The short answer is it’s not cheap, NTD200,000 thereabouts.
The long answer is that it depends on your own medical conditions. The clinic does not really give an itemised breakdown of costs but here’s what I gathered based on my own expenses:
Initial consultation: NTD10,000
Medicines for follicle stimulation per cycle: NTD20,000. (You may need more or less medicines depending on your response to the follicle stimulating hormones)
Ultrasounds and blood tests: NTD5,000
Retrieval: NTD30,000 plus NTD10,000 for freezing
Transfer: NTD60,000
If you have to undergo 2 cycles of retrieval, total costs for one IVF procedure is NTD200,000
Costwise its very close to what Kato costs.
The clinic does not accept credit cards or debit cards so payment is a bit of a hassle. Payment is cash in NTD or USD, or USD telegraphic transfer.
How about the accommodation costs? Westayed at Alice Hotel where they charged NTD30,000 for a 30-day stay. Taxis cost NTD85 flag down and to go most places will cost you only NTD160 or less. Buses around Taichung are free for the first 10km provided you have the easycard. Food in mall foodcourts cost NTD150 per meal on average. Alice Hotel has stoves and a microwave so cooking your own meals is an option.
3) My impression of Lee Hospital and Taichung
I can not speak Chinese at all. Despite the language barrier, my husband and I did not have a difficult time in Taiwan. This is primarily because the Taiwanese are super friendly, polite and accommodating. Filipinos are an important clientele for the Lee Hospital and as such they have a team of coordinators specially for foreign patients. The coordinators will welcome you and translate the medications and usage for you. All the doctors at the clinic actually speak English but nevertheless the coordinators are also present when you meet with your doctor, and you can ask them to clarify in case you miss something. The nurses in the operating room waiting room have bad English but they are very friendly and will put you at ease. They are the ones who put the IV in your arm and also shave you, and they are all very considerate.
Waiting time at the clinic is not so bad. They have queue systems for everything: ultrasounds, blood tests, medicine education and doctor visits. It does get busy sometimes especially Monday morning appointments and you may have to wait more than 1 hour for ultrasounds, medicines education and doctor visits. Whenever you have to use injections, the coordinator and a nurse will brief you (medicine education) on the proper use and administration. There is a central ultrasound room and most ultrasounds are done by ultrasound technicians. However at critical times like just before retrieval and transfer, your own doctor may do your ultrasounds so that they can check out your eggs and uterus personally. For ladies used to ultrasounds in the Philippines, it may come as a shock that there are no separate dressing rooms or privacy curtains in the ultrasound rooms. You strip in front of the technician and only get a towel to cover yourself with during the procedure.
Our first IVF attempt was at Kato in the Philippines. The clinic is located within an office building, Enterprise Towers, in Makati. There are two well known IVF centers in Manila: Kato and Carmi which is at St Luke’s Hospital in BGC. We chose Kato as its the cheaper option of the two. It also has the added advantage of being a specialised fertility clinic located in an office tower so we won’t get exposed to diseases as we would inadvertently be in a hospital setting.
Kato’s principle is to use as little medicines as possible. They work with the woman’s natural body rhythm to ensure a gentler approach. They also discourage multiples (twins, triplets etc) as they only implant one embryo at a time and counsel couples to use up all the embryos they produce.
Kato has two IVF protocols: the natural cycle IVF where no follicle stimulating hormones are used and therefore the cheaper option (costs about P160,000) and the minimal stimulation IVF where follicle stimulating hormones are used and therefore more expensive (P300,000++). The natural cycle IVF is an option for younger women who still produce good quality follicles during their monthly menstrual cycles. We underwent the minimal stimulation IVF as I am older and need some help to produce follicles.
The most distinctive feature of Kato’s IVF procedure is that they retrieve follicles and transfer embryos in two separate cycles. They said that this allows the chemicals from the follicle stimulating hormones to wash out first out of the woman’s system before the embryo transfer. For example, the egg was taken during the January cycle. The follicle(s) are fertilised and are then frozen once the embryos reached the 5th day. The earliest the embryos will be transferred will be during the February cycle.
Kato has a team of three lady ob-gyn doctors who do the consultations with patients during the initial visit and during follicle monitoring. These ob-gyns also personally do the ultrasounds to monitor the growing follicles so you may ask them questions on how fast your follicles are growing. Notwithstanding that there are several doctors in the team, the medical director, Dr Mendiola, is the only one who does the egg retrieval and embryo transfer procedures.
If you are going to Kato, be on time for your appointment. The waiting time can be very bad, the longest I waited was 2 hours to have an ultrasound. However they are trying to be more efficient now by having patients come in hourly appointments. As soon as you exit the elevator, the security guard will check your name and appointment and give you a card to give to the front desk.
Kato has an in house laboratory for all the blood tests. During the follicle monitoring stage, you have to undergo ultrasounds and blood tests. Your doctor will wait for the results of the blood tests before she will see you. It takes about 1-2 hours for the results to come out. Each appointment usually takes 4 hours to complete. You pay as you go, that is you pay only for the medicines and tests that you undergo each visit. I noticed that compared to private laboratories like Premier, their laboratory charges were less expensive. Doctors consultation was also cheap at P560 only. Where you pay big time are for the medicines and for the cost of procedures.
The nurses and staff at Kato were all very sweet. They will tell you patiently how to use your medicines. Consultation time with the ob gyns tend to be quick but they will gladly answer any questions you may have. Their ultrasound rooms have curtains hanging from the ceilings for your privacy. They also have nice insulated bags for the medicines, these are in purple which were so feminine looking. If you are a bit shy, be prepared for a male doctor during follicle retrieval and embryo transfer, and that there would be male embryologists inside the operating room.
After our initial consultation at the clinic, we were told to contact them again once my next menstrual cycle started. We informed the clinic on my day 1 by text message. We visited the clinic on day 2 for blood tests and ultrasounds. After ultrasounds confirmed that there were growing follicles, one of the ob-gyn doctors prescribed me follicle stimulating hormones: oral medicines for 5 days (days 2-6 of my cycle) and GonalF injections for 3 days (days 4-6). I was told to come back to the clinic on day 7 for ultrasounds to check how well the follicles were growing.
I injected myself on the tummy with the GonalF injections every morning of days 4-6 of my cycle. GonalF was changed to Menogon on days 7-8, also tummy injections. GonalF injections were easier to use because they came in pre-filled “pens” and the needles were very fine so they didn’t hurt so much. Menogon was more complicated as I needed to mix two vials of powder with one vial of water using disposable syringes. GonalF however was also more expensive than Menogon.
I had to go to the clinic for ultrasounds on days 2, 7 and 9. Finally I had the trigger shot Ovidrel (also self injected) on the evening of day 9. I had 5 dominant follicles based on my ultrasound, the largest measured 21mm. The amount of medication was much lesser than what was used at Lee Hospital in Taiwan. I only had to use 1 GonalF pen of 300iu, 2 Menogon shots and the final trigger shot Ovidrel at Kato.
My follicles were retrieved on day 11. Kato refers to the procedure as OPU (Oocyte Pick Up). My husband and I were asked to arrive at the clinic 7am. Kato’s recovery room is partitioned into cubicles separated by curtains. I changed into the operating gown and cap, and laid down in a bed to wait for my turn. There were about 6 women scheduled for retrieval that morning. As I only had 5 follicles, I did not need to be sedated. Women who had substantial number of eggs had to be put under general anaesthesia. While I was in the recovery room, my husband went to the andrology lab to give his sperm.
The recovery room had pink wooly blankets but lights were overhead so I just laid there with my eyes closed. When my turn came, I was lead to the operating room by a nurse. Inside the operating room, I had to lie down with my legs up in stirrups. I was given a stress ball to hold and a nurse stayed by my side to tell me what was happening during the procedure. There were a couple of big TV monitors on the walls and I was able to see the ultrasound images of when the catheter was inserted and then the needles sucking in the follicles.
I felt a slight discomfort during the procedure as I felt the catheter piercing my ovaries. Two pieces of gauzes were put in and I went back to the recovery room to rest. After about 30 minutes of rest I was told to go to the restroom and pull out the gauzes. The nurse inspected them and as there were no excessive bleeding, I could go home. I was told that some spotting was to be expected after egg retrieval but to come back immediately in case of bleeding.
We found out later on that the clinic managed to retrieve only 2 mature follicles. These follicles were fertilised with my husband’s sperm via ICSI (Intracytoplasmic Sperm Injection). We had two embryos initially from the two follicles, but only 1 made it to day 5. The embryo was frozen and stored. The embryo transfer will only happen the next month.
Day 5 Blastocyst
Upon the start of my next cycle, we informed the clinic of our intention to transfer that month. I visited the clinic on day 2 for baseline blood hormones and ultrasound. As we were not retrieving follicles this month, I did not have to take follicle stimulating hormones. I did have to undergo ultrasounds on days 2, 10 and 13 to check how my uterine lining was growing. The doctors decided that my transfer should be on day 17 of my cycle. I was given a nasal spray to use on day 10.
On day 17, we were asked to come to the clinic by 8am. Before the transfer was confirmed I had to have one last ultrasound to check that my lining was thick enough and a blood test to make sure hormone levels were correct for embryo transfer. Thereafter, the embryo was thawed and underwent laser assisted hatching to prepare it for implantation.
Embryo transfers were done at the clinic after lunch. Similar to follicle retrieval, the embryo transfer was done in the operating room. The ladies change and wait in the recovery room and when it was my turn for transfer, a nurse came and lead me to the OR. They had strict procedures for identification and you will hear your name and birthday said several times in the operating room. I guess this is to make sure that there will be no switching of embryos. I was able to see the ultrasound images on the screen when they placed the embryo in my womb. Afterwards they also showed the microscope image of the catheter when they check that it was now empty. Sometimes the embryo might get stuck in the catheter and they have to put the catheter back into the womb. It was very heartwarming to see the embryo being implanted in my womb and I whispered a prayer and a “welcome baby” to my embryo. I was given an ultrasound picture and a sheet of paper summarising how many follicles I had, how many embryos were transferred and how thick was the uterine lining.
After the transfer, I had to get up and walk back to my bed in the recovery room. I rested for about 30 minutes and then a nurse came and told me it’s ok to go. I was prescribed progesterone pills and suppository, and estadiol pills. Pregnancy test was scheduled one week later.
One thing I appreciate at Kato was that they are able to tell you if there is a pregnancy or not after just 7 days through a blood test. They check if hcg levels are high. If hcg levels were elevated then its considered a positive pregnancy test.
It’s not easy to undergo IVF treatments. IVF is expensive, complicated and invasive. Most of the procedures involves the woman’s body and these procedures can be painful: she would need to inject herself with hormones. They are invasive: think numerous transvaginal ultrasounds and guess how they collect the follicles and transfer the embryos? yep with a catheter through the vagina, baby. Its time consuming: you need to make numerous trips to the clinic. In addition IVF is expensive and the chances of success are pretty slim. When you go for IVF be prepared to go on an emotional rollercoaster ride of hope and disappoint. It may take many cycles before you conceive. It’s also possible that even with IVF you will not be successful.
In case you don’t know yet, baby making, biologically speaking, may be divided into 3 phases: ovulation where the woman produces an egg from her ovaries, fertilisation where said egg is joined with a sperm and develops into an embryo, and implantation where the embryo gets implanted in the uterus and grows. The IVF process closely follows the natural cycle: basically produce an egg(s), take the egg(s) out of the woman, fertilise the egg (s) with sperm in a laboratory then put the embryo(s) back in the woman and hope for the best.
There are 5 basic steps to the IVF process.
1) First step is to stimulate the development and release of follicles from the woman’s ovaries. In this stage, the woman takes oral meds and injections to stimulate her ovaries to produce as many eggs as they can. If you decide to do IVF you will get familiar with medicines like GonalF, Puregon or Menopur which are follicle stimulating hormones. As the name suggests these medicines stimulates the development and release of follicles. Inside a follicle is an egg. Depending on the dosage and her responsiveness to these medicines, a woman could produce up to 10 or more eggs in one cycle. Younger women (under 30) are able to produce as many as 25 eggs while those in their 40s may struggle to produce even a single egg per cycle. The follicle stimulating hormones are usually taken daily from day 2 to day 12 of the woman’s cycle. Depending on the clinic’s protocol the woman may need to inject herself up to twice a day. She may need to visit the clinic on days 2, day 5, day 8, then daily afterwards for ultrasounds and blood tests. The development of the follicles is monitored by transvaginal ultrasounds to measure the size of the growing egg and blood tests (yes more pricking) for hormone levels.
2) The second step is to retrieve or harvest the eggs. Once the follicles are at least 18mm in size (as measured in an ultrasound), the woman gets her trigger shot. Within 36 hours of the trigger shot, the eggs are retrieved. The egg retrieval is usually done in an operating room. If there are numerous eggs the procedure may be done under general anaesthesia. Your legs are going to be strapped in stirrups and the doctor is going to puncture your ovaries with a needle and suck out the follicles. There is going to be some blood and maybe a little discomfort during and after retrieval.
3) Third step is fertilisation. The husband (or whoever male is your sperm provider) would have to masturbate in a clinical environment and ehem, collect the specimen for the IVF clinic’s handling. The sperm is put through a centerfuge and only those healthy ones are used. There are two ways to fertilise the eggs in the laboratory. The first one is by putting collected egg and sperms together in a Petri dish and one of the sperms get to be the lucky one to fertilise the egg. The second method is ICSI short for Intracytoplasmic Sperm Injection in which a single sperm (don’t ask me how this single sperm gets choosen) but this one lucky sperm is injected directly inside the egg thereby fertilising it, that is there is no need for the sperms to swim for the egg, a lucky one is shoved in the door. The embryo (egg and sperm together) is then grown in the laboratory for 2-5 days. The embryo may then be transferred to the uterus (fresh embryo transfer) or frozen for future use.
4) The fourth step is transferring the embryo into the woman’s uterus (womb). After fertilisation, the embryo grows form a single cell to become two, then four, then eight cells and so on. Within 2-5 days of retrieval, the embryo is transferred to the womb. Similar to the egg retrieval, transfer may be done in an operating room with the help of ultrasound. Blood tests will be done to check that hormone levels are good and ultrasounds will check that the uterus lining is ready before the transfer is confirmed. Injections of progesterone may also be given before and after transfer to support the uterus lining.
5) The fifth step is the dreaded wait between transfer and pregnancy test. Hormones supplements especially progesterone are taken to support the pregnancy. Within two weeks of transfer, blood tests can confirm whether there is a pregnancy or not.
Chances of pregnancy generally goes down with the woman’s age. Not every IVF procedure results in a pregnancy, and not every IVF pregnancy results in a live birth. Before deciding to do IVF, be sure to arm yourself with as much information as you can. It’s physically, emotionally and financially draining. There are many success stories and they are inspiring but it’s also important to be realistic with what IVF can do for you.
