In Vitro Fertilisation

What is In Vitro Fertilisation or IVF?

In Vitro Fertilisation or IVF is an Assisted Reproduction Technique (ART) . It is the process where fertilisation of an egg and sperm is performed in a laboratory and cultivated for a few days into a healthy embryo before it is transferred to the uterus.

IVF produced it’s first live birth in 1977 ( check) and she has since conceived naturally herself and become a mother. There has been more than 5 million babies born through IVF since then.

Why is In Vitro Fertilisation or IVF surgery done?

IVF is used for eligible couples when there are fertility problems

  1. Blocked or absent fallopian tubes. There is no way for the egg to meet with the sperms in this instance and thus IVF surgery is the only way.
  2. Ovulation disorders. Anovulation or no ovulation occurs when eggs do not properly develop from the ovaries. Women with this disorder do not menstruate in months or may menstruate without ovulating. PCOS is a common problem which leads to this problem.
  3. Premature Ovarian Failure or Age may necessitate the use of IVF as the egg pool is diminishing an time is of the essence in obtaining as many healthy eggs in as short a time as possible.
  4. Male factor infertility with impaired sperm production or function or quantity may necessitate the use of IVF as the chance of natural conception is significantly reduced or impossible as in the case of blocked or absent vas.
  5. Unexplained Infertility – a couple with normal results on diagnostic testing but have been unable to conceive after a year of active trying.
  6. Previous tubal ligation or vasectomy. When either party has previously undergone a steriisation procedure and wants to enter into a new pregnancy, IVF is often a better recourse than reversal of the sterilisation.

What is involved in In Vitro Fertilisation or IVF?

Basic Steps

Both partners need to be assessed for their health and fertility potential. Any concurrent medical problems need to be identified, addressed and treated prior to embarking on an IVF cycle or these may have a negative impact on the IVF surgery outcome.

Basic Investigations


  • Hormonal Profile and Ovarian Reserve Determination
  • Ultrasound Pelvis
  • Nutritional Screen
  • Infectious Disease Screen
  • Saline sonogram or Hysteroscopy (maybe required)


  • Semen Analysis
  • Ultrasound testes
  • Hormonal Profile
  • Nutritional Screen
  • Infectious Disease Screen

Each partner should ideally attempt to be their optimum health ie weight, diet and life style as much as possible two to three months prior to an IVF cycle to allowa new healtheir batch of eggs and sperms to be produced.

Steps in IVF

  1. Ovulation Induction : A process where the ovaries are stimulated by hormonal medication either oral or injectables or both.
  2. Induction of ovulation is done by a timed hormonal injection when there are adequate mature follicles
  3. Egg Retrieval is then performed with the patient under IV sedation. Eggs are aspirated transvaginally by vacuum suction through a fine needle attached to the ultrasound probe. Analgesics and antibiotics are usually given after the procedure to minimise any potential discomfort.
  4. Sperm retrieval. A fresh sample of the semen is obtained on the same day as the eggs are retrieved. A frozen sample is used when a fresh is unavailable.
  5. Egg and Sperm are then introduced to each other and fertilisation is observed following incubation over the next 24 hours. ICSI (Intracytoplasmic Sperm Injection) is now almost routinely performed to ensure that one good sperm is introduced to the egg to optimise fertilisation.
  6. Embryo development is observed in the laboratory for the next few days. Blastocyst or day 5 embryo is increasingly a desired goal as this gives a better indication of the health and the wellbeing of the embryo.
  7. Embryo transfer is performed usually in a subsequent menstrual cycle.
  8. Hormonal support is given to sustain the uterine environment up to the pregnancy test date.

Common side effects of the In Vitro Fertilisation or IVF process

Mild bloating is common due to the water retention from the hormones used Constipation may occur as the elevation of progesterone may cause the intestines to slow down.

  1. Breast tenderness may be experienced
  2. Fatigue is common
  3. Danger signs
  4. Extreme bloating during stimulation
  5. Heavy bleeding
  6. Difficulty in breathing
  7. Blood in the urine
  8. Fever



Women Fertility & Fetal Centre has contributed to a number of successful pregnancies following ART and IVF. Each couple is assessed and each cycle is designed and monitored closely to optimise the outcome.


Dr Ann Tan
Dr Ann Tan, PBM
Obstetrician & Gynaecologist
Dr Ann Tan is the first Singaporean to hold the Diploma of Fetal Medicine from the Fetal Medicine Foundation. She presently serves on the Women’s Health Advisory Committee at the Health Promotion Board. Dr Ann Tan was a Public Service Commission Scholar, and has won several prestigious awards in her field of specialization.
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