Specialties & Services

IVF Centre

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Information
I) Introduction

Infertility is defined as inability of a couple to achieve conception after 1 to 2 years of unprotected well-timed sexual intercourse. It is a major problem affecting 15% of all married couples. Approximately 40% of infertility is due to female factors, 40% due to male factors and the remaining 20% due to either combined or unknown factors. For those couples, Assisted Reproduction Techniques (ART) is the best chance and last hope to achieve pregnancy.
II) About HLWE IVF Centre

OBJECTIVES :

i) To render treatment services in accordance to patient’s need using the latest Assisted Reproductive Techniques.
ii) To provide and maintain high quality services in order to ensure the centre remains successful.

CLINICAL MILESTONES :

First IVF baby boy delivered in June 1995.
First ICSI baby boy delivered in June 2000.
First frozen baby girl delivered in April 2001.
First ICSI/TESE baby boy delivered in August 2001.
First blastocyst transfer twin baby girls delivered in February 2006.
First TAFF baby girl delivered in February 2007.
First Vitrified baby girl delivered in November 2011.
III) What is SA?

The study of fresh ejaculate under the microscope to count the number of sperm, to check the shape and size of the sperm and to note their ability to move (motility).
IV) What is IUI?

IUI : Intrauterine Insemination

Painless procedure that involves deposition of washed sperm into the cavity of the uterus through the cervix using a fine plastic catheter.

Painless procedure that involves deposition of washed sperm into the cavity of the uterus through the cervix using a fine plastic catheter.

V) What is Sperm Cyropreservation?


The freezing of sperm in liquid nitrogen (-196°C) for the purpose of storage for future use in IVF.
VI) What is In Vitro Fertilisation (IVF)?

IVF : In Vitro Fertilisation

Literally means fertilization occurs outside the uterus.
Commonly referred as ‘test tube baby’ program.

Procedure involves putting together the woman’s oocyte and her husband’s sperm in a sterile petri dish and placed in an incubator.

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Fertilisation is then allowed to occur.

The resulting embryos (usually not more than four) are replaced 2 or 3 days later after oocyte collection.

VII) What are the Stages in IVF?

IVF programme is made up of four stages:

Stage 1: Ovarian Stimulation and Cycle Monitoring
  • Various hormonal medications are used to stimulate the ovaries to produce many follicles.

  • Ultrasound and blood hormone test are used to closely monitor the development of follicles.

  • Dosage of fertility drugs may be adjusted according to the growth of follicles.

  • Once the follicles are matured, a second hormone medication is given to induce ovulation.
Stage 2: Oocytes Collection
  • Oocytes are collected vaginally using ultrasound guidance.

  • A fine aspiration needle (attached to ultrasound probe) is directed at the follicles and the follicular fluid is aspirated.

  • The follicular fluid is then carefully examined by embryologist for the presence of oocyte – cumulus complexes (OCC).

  • The OCC collected are placed in a special culture media in the incubator.
Stage 3: Fertilization of the Oocyte and Growth of the Embryo
  • The OCC are then mixed with the husband’s sperm (which had been processed and concentrated using special technique) in a sterile petri dish to achieve fertilization.

  • After 16 – 18 hrs, the oocytes are examined for signs of fertilization.



2PN 2PB
A fertilized oocyte

  • The fertilized oocyte (now called embryo) are kept in a special incubator to encourage further growth.
Stage 4: Embryo Transfer
  • Embryos are transferred to the uterus 2 – 3 days later after oocyte collection through the cervix using a fine plastic catheter.

  • If successful, her pregnancy test will be positive at the end of 2 weeks after the embryo transfer.


VIII) What is Intra Cytoplasmic Sperm Injection (ICSI)?

ICSI: Intra Cytoplasmic Sperm Injection

  • Special technique that involves direct injection of single viable sperm into the cytoplasm of a mature oocyte.

  • A real revolution in male infertility treatment.

  • ICSI has been used very successful in treating couples where the husbands have abnormalities in their semen sample parameters:-

  • a) very low sperm count (oligozoospermia)
    b) sperm with poor motility (asthenozoospermia)
    c) high number of abnormal sperm morphology (teratozoospermia)
    d) idiopathic infertility
  • Useful procedure for couples where the husbands have no sperms at all in their ejaculate (azoospermia).

  • Makes use of powerful microscope and micromanipulator to hold and move each oocyte and sperm.

  • The injection needle used for injection is more then 7x thinner than the diameter of a human hair.
IX) What are the Stages in ICSI?
  • ICSI patient also undergoes the same routine as for IVF procedure namely all the 4 stages of IVF programme as described earlier.

  • The only difference is Stage 3. Instead of just mixing the oocytes with sperm as routine IVF procedure and allowing the sperms to penetrate the oocyte on their own, the embryologist shall now inject one specially selected viable sperm into each individual oocyte.


STEP BY STEP IN ICSI

(1) Sperm immobilization
(2) Aspiration of the immobilized sperm
(3) Injection
(4) Post injection


X) What is Testicular Extraction (TESE)?

TESE : Testicular Sperm Extraction
  • Literally means extraction of sperms from the testis.

  • A few small pieces testicular tissues are removed from testis.

  • These tissues are then processed and scanned for viable sperms.

  • If viable sperms can be found, then these tissues are washed and concentrated by a special technique to allow a suspension to form.

  • The testicular suspension can either be used for ICSI immediately or cryopreserved and stored in liquid nitrogen at -196°C for future use.

  • The first pregnancy in the world was successfully conceived in 1997.

XI) What is Embryo Transfer (ET)?

ET : Embryo Transfer

  • A procedure whereby a catheter containing embryos is placed through the cervix into the uterus and the embryos are injected into the uterus guided by ultrasound

  • A maximum of three or four of the best embryos are transferred.

  • It is usually done on Day 3 (6-8 cell stage) or Day 5 (blastocyst stage) of embryo development.

  • The procedure itself is simple as no anaestheisa is required and is pain free.

  • Following ET, hormonal support is given to patient for 2 weeks until the result of pregnancy testing




XII) What is Blastocyst Transfer?

  • The replacement of a blastocyst stage (the last stage of pre-implantation embryo development) into the uterus.


XIII) What is Frozen-Thawed Embryo Transfer?

  • The procedure of replacing thawed embryos that have been frozen from a previous cycle.


XIV) What is Embryo Cryopreservation?

  • The freezing of extra good embryos from a successful cycle.

  • These embryos will be stored in liquid nitrogen (at -196°C) for future use.

  • A fee is charged biannually for the stored embryos.



XV) Tunku Azizah Fertility Foundation (TAFF)

How to apply for sponsorship from TAFF?

TAFF is a charity organization formed and registered on 11 August 2004. The Foudation is helded by a Life President, Her Royal Highness Tengku Puan Pahang,Tunku Hajjah Azizah Aminah Maimumah Iskandariah binti Sultan Iskandar Al-Haj. TAFF provides financial assistance to infertile couples to help them in having child.

To qualify for the TAFF funding,

(1) Couples must receive treatment at the fertility centre recognized by TAFF. Hospital Lam Wah Ee’s IVF Centre is recognized as one of the centres providing IVF treatment under TAFF since 2005.
(2) Registered as husband and wife
(3) Both husband and wife are Malaysians
(4) More than 3 years of marriage
(5) Maximum monthly joint income not more than RM4,000
(6) Wife’s age not more than 42 years old
(7) No sperm/ovum donor

If you need assisted conception and believe that you may qualify for TAFF funding, please collect the application form from IVF nurse at 04-6528893 / 04-6528843 or contact TAFF directly for an application form.

For more information on TAFF, please write to:

Tunku Azizah Fertility Foudation
Istana Abdul Aziz, Bandar Indera Makhota
25200 Kuantan Pahang

Tel: 09-5733241
Email: taff2004@streamyx.com

XVI) Contact Us

IVF Centre is situated on the third floor of Hospital Lam Wah Ee.

IVF Centre

Monday to Friday

Saturday

Sunday & Public Holiday

Lab Hours

8.30am – 5pm (Lunch:1pm-2pm)

8.30am – 1pm

Close

Semen Sample Receiving Time
(Late sample after receiving time will NOT be accepted)

Morning Session
11.30am - 12 noon

Afternoon Session
2.00pm - 2.15pm

Morning Session
8.30am – 11.30am



If you require any further information, please do not hesitate to call or write:

IVF Centre
Hospital Lam Wah Ee
141 Jalan Tan Sri Teh Ewe Lim
11600 Penang, Malaysia.

Tel : 604 – 652 8976 (DID)
Tel : 604 – 652 8888 ext 4010
Email : ivfcentre@hlwe.com
Fax : 604 – 657 0940

XVII) FAQ


Q1: How common is fertility?
A: The most recent estimates indicate infertility affects about 10% of the population in their childbearing years. The prevalence of infertility is ONE in every SIX couples. The most rapid decline in fertility potential among woman occurs from age 35.

Q2: Does a diagnosis of infertility mean I am sterile?
A: Infertility is not same things as sterility. About 90% of all diagnosed infertility cases can be traced to specific causes, which allows the majority of couples to receive appropriate treatment and achieve pregnancy.


Q3: Does infertility only happen to women?
A: While many people associate infertility with women, it actually occurs equally among both women and men, ie 30% caused by female factors, 30% caused by both female and male factors and 10% unexplained factors.


Q4: How often should we have intercourse while trying conceive?
A: Sperm can live 48 to 72 hours in a woman’s reproductive tract and can / fertilise an egg at any time during this period. This is why sexual intercourse every two to three days around the time of ovulation is adequate.


Q5: What affects the ability of sperm to fertilise an egg?
A: Sperm quality and quantity may impact the ability of sperm to successfully fertilise the egg. Sperm movement is an important factor. Even with a low sperm count, men who have highly mobile (or ‘motile’) sperm may still be fertile.


Q6: What are fertility treatments?
A: Fertility treatments increase the likehood of getting pregnant. These treatments can be through a lifestyle change, surgery, medication, or assisted reproduction. These are several treatments under assisted reproduction such as in vitro fertilisation (IVF), intracytoplasmic sperm injection (ICSI). All of these procedures harvest a number of eggs hoping to fertilise at least one, and then insert the fertilized eggs into the uterus.


Q7: How successful are treatments for infertility?
A: Improvements in medication, microsurgery and assisted reproductive technology (ART) make pregnancy possible for a majority of the couples pursuing treatments. In particular, success rates have dramatically improved for couples who require ART. The pregnancy rate for an ART cycle approaches the monthly fertility rate for most couples. Talk to your doctor about your specific case. Success rates vary from patient to patient and from situation to situation.


Q8: Is ART considered experimental therapy?
A: No. Far well over a decade, IVF, donor oocytes, embryo cryopreservation and intracytoplasmic sperm injection (ICSI) have been considered non-experimental by the American Society for Reproductive Medicine (ASRM), the leading professional organization for reproductive endocrinologist and biologists in the U.S. Success rates are continually improving and in many cases exceed the pregnancy rates expected for normally fertile couples.


Q9: Are there side effects associated with the use of hormonal therapies?
A: Clinical studies have shown that hormonal therapies are safe and effective. However, as with all prescription medications, there are possible side effects. Your doctor will discuss any potential side effects as well as monitoring your response to therapy. Remember, too, that it is important to report all symptoms to your physician.


Q10: When is a woman’s most fertile time?
A: A woman’s most fertile time is during ovulation. Ovulation typically occurs within day 11 to day 21 of a woman’s cycle.Counting from the first day of a woman’s last period, day 1 is the first day a woman starts bleeding, the 11th day is most likely the earliest day a woman will ovulate. The 21st day is most likely the last. A woman’s period comes between the 28th and 32nd day of the cycle. This may differ slightly because each woman’s cycle varies.


Q11: Is infertility a medical problem related to the woman only?
A: No, infertility is a medical problem that is related to both men and women. Men and women are affected almost equally. For men, declining sperm counts, increase testicular abnormalities and a decreased reach of climax are recognized as causes of infertility. For women, the most common causes are tubal blockage, endometriosis and waiting until later in life to try to get pregnant.


Q12: How long should a couple try to conceive before going to the doctor?
A: The American Society of Reproductive Medicine recommends women consult their health care provider if she is: 1) under 35 years old and has been trying to conceive for more than 12 months, or 2) over 35 years old and has been trying to conceive for over 6 months.



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