The Reality of IVF

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Many couples choose their Fertility doctors because of their preference towards a characteristic of the doctor, however, many more choose to undergo their IVF treatment under a doctor or a centre because of the perceived success rates of the doctor or a centre. A published survey in the UK revealed that success rate of a centre or a doctor is the key determining factor for the decision of going through IVF in a particular Fertility Centre.


Therefore, all IVF doctors and centres strive very hard to increase the success rates of their patients. We emphasize on the patients’ lifestyle and age, in hope to get them to come at a younger age and in a better state of body fitness, so that we can obtain better eggs and sperms and hence make better embryos. We improve our laboratory environment and technology to mimic the uterus environment to yield a better fertilization and growth rate. We pat our own shoulders when we produce good quality embryos. And then we transfer the good looking embryos into the uterus and we wait……


10-12 days later, we either rejoice with the patient for a positive result, or we put on a very sad and sorry face to deliver the bad news

So what happened in between the time after we put those embryos back into the uterus until the time we test for pregnancy?   The answer to this is that nobody knows.

As doctors we placed the embryos back, and nobody actually knows when and how the embryos get implanted, and what determines whether the embryos will get implanted or not.

This is the Holy Grill of the science and wonders of IVF

Many people had tried various things, complete bed rest, baby aspirin, steroids, hanging the legs up and etc etc etc.

Studies after studies failed to show any good recommendation on what we should do to improve the implantation rates. Some people believe that by performing a Pre-implantation Genetic diagnosis (PGD) can improve the implantation rates. There is some logic behind this: by selecting the normal chromosomal embryo to put back into the uterus, the chance of implantation increases. However, years had gone by with such a practice being implemented in some centers and there is only a marginal increment in pregnancy rates.

A recent study conducted at KL Fertility Centre (Monash IVF, KL) showed some interesting data.

We looked at all the women going through one IVF and divide them into 3 different groups by age.

Women who are under the age of 35 have 60% chance of getting pregnant during the fresh cycle when we put back the embryos into their uterus.

If they do not get pregnant during the first round and have good embryos which can be frozen and to be used in a later date, the chance of them getting pregnant by replacing 1-2 frozen embryos is around 60%.

By the time this group of women exhausted all their embryos which were produced by ONE IVF treatment, the likelihood of them having at least one baby is around 80%.

This translates that 4 out of 5 couples who are under the age of 35 will get pregnant with just ONE IVF attempt.

The success rate is about 60% in women between the age of 35-40 with the same trend observed.

Even for the group of women who are in the range of over 40 years of age, the success rate is close to 30%.

This certainly have a significant impact on the way we think….we now know that the chance of pregnancy is extremely good by just having ONE IVF without even having to subject the embryos to expensive and potentially hazardous pre-implantation genetic testing.


The key thing is to just keep moving on!!!!!


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Success Rates of IVF

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A published survey from the UK showed that the success rates of a particular Fertility Centre is a key factor for patients  in deciding which Fertility Centre they choose.

Therefore, it is not unusual for patients to ask me what is the success rate of IVF in my centre. In places like UK, it is mandatory to submit the centre’s data to the authority (Human Fertilisation & Embryology Authority, HFEA) for publication and regulation. However, in Malaysia, these data are not readily available.

The data from most clinics in the UK suggested that most of the centres were about the same in terms of the success rates. According to the HFEA, an individual centre’s success rates can be affected by:

  • the type of patients a clinic treats e.g., their age, diagnosis and length of infertility
  • the type of treatment a clinic carries out
  • a clinic’s treatment practices

A clinic that treats proportionately more patients with complicated diagnoses may have a lower average success rate than clinics that treat more patients with common fertility issues.

Clinics may have higher success rates for treatment if they treat women who are not infertile but who have no male partner and are using donated sperm in their treatment.

Quoted :

A comparison of KL Fertility centre’s data suggested the same trend:

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The chart above showed that if you are under the age of 35 and attempts one IVF, your chance of getting pregnant by putting back 1 or 2 embryos during the same cycle is around 60%.

If you do not get pregnant during the fresh attempt and have enough good quality embryos frozen resulting from that particular IVF cycle, your chance of pregnancy by having a frozen embryo transfer is around 60% as well.

Hence, if you look at the pool of patients under the age of 35, taking into account of both fresh and frozen embryo transfer, the success rate is around 80%.

This translates that 4 out of 5 couples who are under the age of 35 will get pregnant with just  an IVF attempt.

Therefore, if you have not been successful during the fresh embryo transfer cycle and have enough embryos frozen, you can be reassured that your chance of pregnancy is extremely likely during the frozen embryo transfer!!!