IVF & ICSI
In IVF, eggs and sperm are brought together in the laboratory and an embryo is placed in the womb a few days later. Each cycle is planned around your test results, your age and anything that has happened in earlier treatment.
With Datuk Dr. Navdeep Singh Pannu, FRCOG, at Alpha IVF & Women's Specialists, Kota Damansara
- One cycle
- About 4–6 weeks from the first injection to the pregnancy test
- Injections
- Usually around 10 days, checked with scans
- Egg collection
- About 10–15 minutes, under sedation
- Pregnancy test
- About two weeks after the embryo transfer
What it is
IVF (in vitro fertilisation) means fertilisation happens outside the body. After a course of hormone injections, mature eggs are collected from the ovaries and put together with sperm in the laboratory. The embryos are watched as they grow over the next few days, with time-lapse imaging and grading, and the best one is placed in the womb.
With ICSI (intracytoplasmic sperm injection), the embryologist injects a single sperm directly into each mature egg. It is used mainly when the sperm count, movement or shape is low, or when eggs did not fertilise in an earlier cycle.
Good-quality embryos that are not transferred can be frozen. A frozen embryo transfer (FET) uses them later, without repeating the injections or the egg collection.
Who it can help
- Couples who have tried for a year without success, or six months if the woman is 35 or over
- Blocked or damaged fallopian tubes
- Low sperm count or poor sperm movement (with ICSI)
- Endometriosis
- PCOS, when ovulation tablets or IUI have not worked
- Unexplained infertility
- Several IUI cycles that have not worked
- Couples who want their embryos screened with PGT
How it works
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Consultation and tests
Your history is reviewed and you both have the key tests: a pelvic scan, hormone blood tests including AMH, and a semen analysis. Your plan, drug doses and timing are set from these results.
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Ovarian stimulation
Daily hormone injections, usually starting on day 2 of your period, help several eggs mature at once. Scans track how the follicles grow, and the doses are adjusted as you go.
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Egg collection
When the follicles are ready, a final "trigger" injection matures the eggs. They are collected about 36 hours later with a fine needle guided by ultrasound, while you are sedated. You go home the same day.
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Fertilisation
On the same day, the semen sample is prepared in the laboratory. The eggs are fertilised by IVF or ICSI, and the embryos grow in an incubator for three to five days.
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Embryo transfer
The chosen embryo is passed into the womb through a thin, soft tube. It takes a few minutes and usually needs no sedation. Spare good-quality embryos can be frozen.
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Pregnancy test
A blood test about two weeks later. You keep taking hormone support (progesterone) until then.
Good to know
Side effects and risks
- Side effects from the injections, such as bloating, tender breasts, headaches and mood changes
- Ovarian hyperstimulation syndrome (OHSS): swollen, painful ovaries and fluid build-up. Doses are tailored and monitored to keep this risk low
- Mild cramps or spotting after egg collection; bleeding or infection are rare
- Twins or more if more than one embryo is transferred, which makes pregnancy riskier for mother and babies
No guarantees
IVF cannot promise a baby. Your chances depend mostly on the woman's age, the egg reserve, embryo quality and the cause of infertility. Some couples conceive in the first cycle; others need more than one.
Costs and EPF
Costs depend on your medication doses and which laboratory procedures you need, so ask about them at your consultation. Legally married couples under 55 can apply to use their EPF Account 2 savings for IVF, ICSI and IUI; check the current rules with KWSP.
Looking after yourself
Treatment and the two-week wait can be hard. Lean on your partner and the people you trust, and tell the team if you are struggling. More on mental health during treatment.
Questions people ask
Is IVF painful?
The injections sting briefly. Egg collection is done under sedation, and most women have mild cramps for a day or two afterwards. The embryo transfer feels similar to a smear test.
Do I need to stay in hospital?
No. Egg collection and embryo transfer are day procedures. After sedation you should not drive, so bring someone to take you home.
Will I need ICSI?
It depends on the semen analysis and on how your eggs fertilised in any earlier cycle. Dr. Navdeep will explain which suits you once the results are in.
How many embryos are transferred?
This is decided with you. Transferring one good-quality embryo keeps the risk of twins low, and any others can be frozen for later.
Can we do anything to improve our chances?
Aim for a healthy weight, stop smoking, cut down on alcohol and take folic acid. For men, sperm take about three months to develop, so changes take time to show. The do's of IVF has more.
What happens if the cycle does not work?
You will go through what happened together: how the ovaries responded, the eggs and embryos, and the transfer. Then you decide what to change next time. Hope after a failed IVF.
Further reading
This page is general information and does not take your personal circumstances into account. Please speak to your doctor for advice that is right for you. Disclaimers