IVF treatment breathes life into Malaysia's declining fertility rates

September 06, 2022 10:53 AM

Fertility rates in women have been in a decline due to factors such as education, career, economy and infertility.

Fertility rates amongst women in Malaysia have shown a significant drop in 2020, the lowest in 40 years with 1.7 babies per woman, according to Malaysia’s Statistics Department.

Contributing factors include women’s decision to delay starting a family due to education or career goals and opting for smaller families due to economic reasons. In addition, there has been a decline in sperm quantity and quality observed not only in Malaysia but worldwide.

Because of this, in-vitro fertilisation (IVF) has become one of the most common assisted reproductive treatments couples turn to for a chance of having a baby of their own. It is a treatment whereby a healthy egg is artificially inseminated with healthy sperms before being placed back into the woman’s body for conceiving. A full cycle of IVF takes about three weeks to complete and your doctor will be with you throughout the journey.

Before treatment, both partners go through several screening procedures such as ovarian reserve testing and semen analysis. Lifestyle changes to dietary habits and exercise is encouraged to achieve suitable BMI, with necessary supplements given to improve egg and sperm quality and optimise the couple’s IVF success.

Hormonal injections help stimulate ovaries and produce better egg count.

Upon completion of these fertility tests, you as the desiring mother-to-be will be injected with hormonal medications that stimulate the ovaries to produce a larger number of eggs at one time. The more eggs produced, the more samples your doctor has to work with.

These medications include follicle-stimulating hormone (FSH) or luteinising hormone (LH) for ovarian stimulation, human chorionic gonadotropin (HCG) for oocyte maturation (maturation of eggs), medication to prevent premature ovulation and progesterone supplements that help prepare the uterus lining for easier implantation. This process usually takes about 10 to 12 days and begins on day 2 or 3 of the menstrual cycle.

This is then followed by a procedure called egg retrieval. Dr Natasha Ain Mohd Nor, a fertility specialist in KL Fertility Centre, says, “Before beginning the procedure, gynaecologists conduct a scan pre-operatively to assess if there are cysts in the ovaries, fibroids in the uterus and whether the location of the ovaries is accessible vaginally. This assessment is done during the initial fertility check-up.

“During the operation, you would be given a quick anaesthesia by an anaesthetist to ensure your comfort and safety throughout the process. The doctor then uses ultrasound images to help guide a thin needle attached to a vaginal ultrasound probe that is inserted through the vagina into the ovary and the sacs that hold the eggs.”

This needle is connected to a suction device that helps to pull the eggs and fluid out one at a time from each follicle. The same procedure is done for the other side of the ovary to extract as many egg samples as possible.

Egg retrieval is the most delicate step in an IVF procedure as a mistake can cause bleeding, infection or injury to the internal pelvic organs, hence it is important to seek the expertise of trained professionals when undergoing this treatment.

Malaysia boasts a high success rate for IVF treatment which reassures couples seeking this type of treatment in Malaysia.

After the eggs have been retrieved, the embryologist in the IVF lab will go through the quality and pick out the best sperm samples to be inseminated with a mature egg. The resulting fertilised egg (now called an embryo) will then be inserted into the woman’s womb (embryo transfer).

Malaysia has been recording high IVF success rates, as high as 60-70% among younger women, making the country a favourable place for the treatment. With this, Malaysian couples can rest knowing IVF services are safe, affordable and highly accessible.