Introduction To Infertility
Spontaneous pregnancy is always a matter of chance. A normal healthy couple in their 20s, having regular sex, have about a 20% chance of conceiving in any particular month. For the same couple in their 30s, the chance is about 10%. You may have infertility if you do not conceive after one year of regular intercourse without the use of contraceptives. It is important to seek medical attention as quickly as possible. Infertility can often be treated. It is a common problem, affecting at least one in 8 couples at some time in their lives.
In 1983, KK Women’s and Children’s Hospital produced Asia's first in-vitro fertilisation (IVF) baby. Today, the KKIVF Centre (KKIVF) is one of Singapore's largest infertility centers and offers a wide range of testing, diagnostic and treatment procedures. KKIVF believes in utilising the least invasive treatment for the best possible outcome for each individual patient, provided with personal care and at a competitive cost.
The KKIVF Centre has helped many people, both locals and foreigners, experiencing various infertility problems and these include:
Assisted Reproductive Techniques (ART) Services
KKIVF Centre has achieved a consistently good clinical pregnancy rate over the past years, comparable to international fertility centres. The success rates in KKIVF are expressed as the percentage of embryo transfer procedures which result in a clinical pregnancy. A clinical pregnancy is determined when a pregnancy sac with a heartbeat is visible on ultrasound at around 4 weeks after the embryo transfer procedure.
Clinical Pregnancy Per Transfer
In general, the most critical factor in determining a couple's fertility is female age. At KKIVF, the clinical pregnancy rate per fresh transfer in the years 2014 was:
Women are born with all their eggs for their lifetime already formed (unlike men, who produce sperm constantly for most of their lives). By the time women approach the age of 40, the eggs tend to lack the energy they need for the early stages of development. Also the chance of producing abnormalities such as Down Syndrome increases with age. These can result in failed fertilisation, failure of the embryo to implant, and early miscarriage. In addition to age, results will depend on the condition of the uterus, the number of eggs obtained, the number of eggs fertilised, and the number of eggs or embryos transferred. If spare eggs are fertilised and stored, the overall chance of pregnancy from one stimulation will be higher.
Other Clinical Services
In addition to ARTs, we also emphasis a “One-Stop” fertility management concept. With a group of well-trained experts incorporating
endocrinology therapy and
advanced endoscopic reproductive surgical techniques, we aim to provide a holistic approach to help increase your chance of having a healthy baby!
As reproductive surgeons with expertise in advanced microsurgery and pelvic reconstructive endoscopy, we can improve your chance of a spontaneous pregnancy or improve the success of subsequent IVF in properly selected patients. Some of the surgeries we commonly perform include:
Up to 50% of infertility is due to sperm abnormalities. Our centre provides holistic management in male infertility.
Investigations conducted in our centre include:
Most couple with infertility related semen abnormalities are ultimately managed by assisted conception. However, surgical sperm retrieval may be needed in azoospermia (absence of sperm in semen). Sperm retrieval is successful in almost 100% of obstructive azoospermia. The procedures are performed through the skin using microsurgical techniques.
A holistic management of PCOS.
Women in the various age groups in their reproductive cycle to meet their various needs
This clinic offers a range of family planning options, which includes the following:
Currently, the range of family planning options available includes
The gynaecological endocrinology clinic offers clinical services for the diagnosis, treatment and management of hormonal problems interfering with fertility and/or menstrual cycle regularity. The common conditions are seen at the clinic include:
Sexual dysfunction can affect any couple, preventing them from experiencing satisfaction from the sexual activity.
Common problems related to sexual dysfunction in men include erectile dysfunction, ejaculation disorders and inhibited sexual desire, while in women, the most common problem is that of pain during intercourse.
The Paediatric and Adolescent Gynaecology clinic deals mainly with the gynaecological health of children and adolescents.
This area involves menstrual abnormalities, polycystic ovary disease, genital tract abnormalities, genital infections, endocrine disorders affecting the female reproductive tract, adolescent sexuality, etc.
The range of cases seen at the clinic includes the following: menstrual disorders in girls aged 19 and below
You can get a referral from the polyclinic to KKH's infertility clinic. Alternatively, call the Central Appointments desk (tel: +65 6294 4050) to make an appointment with one of our IVF specialists.
At this initial consultation with the specialist, he will establish with you and your husband what the best form of treatment is. He may also conduct blood and hormone tests to try to find out why you are not getting pregnant. A semen analysis test will be ordered for your husband. Once results of tests are reviewed and discussed, and if you are referred to the KKIVF Centre for fertility treatment, you and your husband will be briefed by our nurse coordinator. This is your opportunity to get as much information as you need before making a decision about treatment. At this briefing, the proposed treatment programme will be explained to you, including the side effects and costs - how much will be Medisave claimable, the government co-funding scheme (if eligible) and how much will be the out-of-pocket-expenses.
Remember, the actual cost of the entire treatment cycle also depends on the amount of medication you need which varies from patient to patient.
If you decide to start the programme, a pre-treatment blood test to screen for HIV, hepatitis, rubella and syphilis will be taken. A counselling session with the counselling psychologist will also be arranged.
The couple will then meet with the IVF specialist for medical counselling. The doctor will go through and explain the medical aspects of the programme, before the couple signs the consent forms. The patient will be instructed to call the nurse coordinator on the first day (day one) of her menses of the scheduled month. Subsequent instructions on the treatment schedule will be given during that first phone call.
Recognising that infertility can be painful and the treatment programmes can be emotionally and physically draining, emphasis on patient care has thus been a focus for KKIVF Centre. The centre has responded by being sensitive to our patients' needs by simplifying the treatment programmes and providing counselling support.
Each patient is given individual and personalised attention to reduce the emotional turbulence that is common during fertility treatment. Prior to the fertility treatment, a counselling session with a specialist in reproductive medicine and a counsellor psychologist is arranged. Counselling helps couples to understand the treatment options, evaluate their decisions and prepare them physically and psychologically for the treatment.
The moment the couple steps into the KKIVF Centre, our nurse coordinators are their primary contact to provide personal support and guide them through the cycle treatment. They are available to answer any questions and will be there to take the patient step-by-step through the treatment programme.
Apart from offering services to the infertile couples, it is also the centre's aim to share its knowledge and expertise with doctors and scientists in the region.
A comprehensive program comprising of personalised teaching and hands-on experience is in place for visiting fellows. Each training session lasts six to 12 months.
Since 1996, KKIVF Centre has trained clinical fellows and embryologists from various countries including the United Kingdom, Seychelles, India, Indonesia, Vietnam, Bangladesh and Malaysia.
Research forms an integral part of the KKIVF Centre. Several clinical and laboratory research projects are conducted every year with yearly presentations at international and local conferences.
The KKIVF team was one of the first in the world to report on sperm motility parameters in the Asian population with male factor infertility and the correlation with superovulation induction and intra-uterine insemination (SO-IUI) outcome.
The team also participated in a multi-centre clinical trial to investigate the efficacy and efficiency of a fixed daily dose treatment regimen of follitropin beta in pituitary-suppressed infertile Asian women undergoing controlled ovarian hyperstimulation.
We have also completed an international multi-centre clinical trial on selective single embryo transfer to reduce multiple pregnancy rates.
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