It’s almost every woman’s dream to be blessed with a child but sometimes, this little dream is shattered when they find they cannot conceive.
Today however, assisted insemination techniques offer a window of possibility for the previously inconceivable. At Prince Court Medical Centre, medical knowledge and technology goes hand-in-hand with the experience and warmth of professional personal care to give some possibility of hope and a smile to the faces of couples who previously had none.
IVF or In Vitro Fertilization is a method of assisted insemination in which the human sperm and egg are fertilized outside the human body. In Vitro is Greek for ‘outside’. Normally a pregnancy occurs after intercourse when the man ejaculates the sperm in the vagina which then swims up the fallopian tube, and fertilizes the eggs in the tube inside the body. The embryos will form and travel down into the uterus to be implanted there.
With IVF, the doctors insert a needle into the woman’s body to gather the eggs in clusters of 10-50 eggs. They are then fertilized with the man’s sperm and incubated for about 3-5 days before being re-inserted into the woman’s body.
Reasons for IVF
It is often for couples where one or both partners suffer from infertility. Infertility can be generally defined as where a couple is unable to conceive naturally after 12 months of unprotected sexual intercourse. The reasons can be manifold. Three major subgroups have been identified:
- Men – One major factor suspected is that due to the stress of everyday living and the contamination of food and the environment, there is a greater risk of male sperms being abnormal. This is becoming an increasing problem, accounting for a third of all infertility cases or 30%.
- Women – The next factor could be due to issues concerning the woman’s reproductive health. A past infection could have led to blocked fallopian tubes, preventing the sperm and egg from meeting. A woman may have the female condition called endometriosis that can lead to damaged eggs and tubes. She may also have polycystic ovarian syndrome – in which the woman does not ovulate well. These are just some of the known causes of female infertility.
- Unknown – The final third is unexplained. Sometimes, even after all the conventional tests are done and both the male and female partners are healthy – and in all reasonableness should have no difficulty doing so, they are still unable to conceive.
Why choose Prince Court?
Since the inauguration of Prince Court Medical Centre in 2009, we have gained an enviable reputation as a center of excellence in IVF treatment. Back then success rates for women below 37 years who opted for IVF was 48% and for women above 37 years of age it was 43%. In 2012 those numbers have increased: for women below 37 years it is 53% and for those above 37 years it’s now 48%; an impressive leap in only 3 years.
Purpose built lab and state of the art facilities
At Prince Court Medical Centre, the Obstetric & Gynaecology Department has its very own purpose built IVF lab which was specifically designed to meet and reflect high standards in assisted insemination development and advancement.
The highly trained medical professionals and specialists provide quality care and services with a human touch. Experienced doctors with decades of experience between them ensure that anxious prospective mothers and their partners are in the best of hands. Under their stewardship, Prince Court has become one of the leading IVF centers in the country.
To ensure the health and viability of both mother and child, measures are in place to detect any abnormalities during the pregnancy. Three main types of fetal testing are provided:
- During the first trimester to minimize the risk of miscarriage the mother will have ultrasound scans done at every visit to monitor the developing baby’s condition.
- Then at about 11-14 weeks at the end of the first trimester there is what’s called the first trimester screening test, for Down’s syndrome – the commonest human chromosomal disorder known. It is a condition that occurs more often in pregnancies of older women who are 35 years old or above.
- The third test is a detailed scan of the baby from the top of its head all the way down to its toes to check for any physical malformations.
Both the sperm and the egg are frail and fragile. Especially so for the female egg which is extremely friable, even compared to the sperm. Once both have been extracted from the parent bodies it is the job of the embryologist to ensure not only their survivability but also that they thrive, by providing the optimum healthy environment.
During the 3-5 day fertilization period, the embryologist monitors the temperature and pH acidity of the culture media to ensure optimal conditions for the development of healthy embryos. But that is not their only job. They also engage in semen analysis to test the viability of the sperm, and also in freezing the embryos. The embryologist is always researching on improving the overall quality of the embryos and of increasing the success of the IVF treatment so hopeful couples do not fear it was all in vain.
In line with the objectives of ensuring full and comprehensive coverage and services for all maternity and fertility health care management, the Obstetric & Gynaecology Center also provides screening for chromosomal disorders such as the three most common that are Down’s syndrome, Patau syndrome and Edward syndrome.
The first method is via the maternal blood test – where a blood sample is from the mother and the hormones are checked to work out the risk of the mother developing a chromosomally abnormal baby. It’s relatively a simple standard procedure that is safe and non-invasive. The issue with this test is that the results are only 90% accurate. There’s still a 10% chance it could be wrong. Also it measures only two possibilities of the outcome: low risk or high risk. Low risk does not mean there is none. Similarly high risk does not necessarily indicate the baby will be chromosomally defective. In such instances, the mothers with high-risk outcomes will be understandably upset and demand reassurance and answers.
That’s where cytogenetics comes in; another word for it is amniocentesis. It involves inserting a needle inside the mother’s abdomen straight into the uterus to collect sample fluids which will be sent to the lab for it to be cultured, and the cells will be checked for any chromosomal abnormalities.
By definition any pregnancy that’s below 24 weeks is non-viable. In parts of the world where abortion is legalized, abortion can be done within the 24 week period. It is illegal to abort after the 24 weeks because the baby has a chance to survive. In cases of extreme pre-term labor where the baby is delivered after only 24- 30 weeks, the chances for survival are relatively low unless they get intensive medical care. With advances in medical care, knowledge and equipment it is now possible to increase the survival rate for pre-term infants.
The neo-natal Intensive Care Unit (NICU) at the Obstetrics & Gynaecology department hosts two ventilator servers; along with a full range of experienced neo-natal support nurses -under the stewardship of a senior doctor who has great experience in the field.
The results are that they’ve been able to increase survival rates for infants delivered in 25 weeks to about 25% -30%. This shoots up to almost 90% when the pregnancy reaches 20-30 weeks.
List of doctors:
Low Ai Lee
Dr. Anna Padmavathy Soosai, Paediatrician & Neonatologist
Dr. Anthony James Mansul, Paediatrician
Dr. Choy Yew Sing, Paediatrician & Geneticist
Dr. Lim Miin Kang, Paediatric Cardiologist
Dr. Mohd Feizel Alsiddiq, Paediatrician & Paediatric Neurologist
Dr. Malinee Thambyayah, Paediatric Neurologist
Dr. Sharmila Kylasam, Paediatrician & Paediatric Intensive Care Specialist