About 50,000 people in Taiwan have been conceived through in vitro fertilization in the past 26 years, according to Chang Sheng-ping, director of the Department of Obstetrics and Reproductive Endocrinology at Taipei Veterans’ General Hospital.
This year’s Nobel Prize in medicine went to the British infertility specialist who first developed in vitro fertilization. Thanks to his pioneering work and the efforts of local physicians, about 2,500 babies are now born in Taiwan each year as a result of IVF procedures, Chang noted.
Chen Hsin-fu, head of obstetrics at National Taiwan University Hospital, said there are three phases in the treatment of infertility. The first involves medication or injections, and serves to stimulate the release of eggs, in the hope that the woman will then conceive naturally afterwards.
If that fails, artificial insemination will be used to implant specially treated, healthy sperm into the uterus after a woman's ovulation has been stimulated chemically. If this does not work, a couple may resort to IVF, commonly known as having a test-tube baby.
Chang explained that the IVF method first involves 10 days of stimulation of the woman's ovaries. On the 12th day, the eggs that have matured are harvested, and observed for six hours in the laboratory prior to insemination. Sixteen hours after the sperm has been placed with the egg, the eggs are once more observed to see whether conception has occurred, and after 15 more days of development, they are reinserted into the mother's body.
From there, it will take another two weeks to determine whether the embryo has successfully implanted into the wall of the uterus. Only at five weeks post-insertion can an ultrasound image reveal whether or not the pregnancy is progressing normally. Chang said the success rate for harvesting eggs is about 95 percent, and about 70 percent of those eggs become embryos.
Chang also warned that the IVF procedures can cause vaginal infections, and the needles used to retrieve eggs can potentially puncture the ovaries, intestines or bladder. The chance of these complications is small, however: about 1 in 1,000.
There is also the possibility of overstimulation of the ovaries, which can lead to bloating, edema and reduction in urine output; in serious cases, this can lead to heart failure, though usually no more than 1 percent of the time.
Moreover, many successful IVF procedures result in multiple fetuses, which can lead to complications such as placenta previa, gestational diabetes or gestational hypertension. And if the procedure fails, couples must often deal with depression or family and marriage issues. Therefore, IVF is not something to be entered into lightly.
Chen stressed that pregnancy rates are related to maternal age. A woman is best advised to have her children before the age of 37; if she does not, the chances of her becoming pregnant, even with IVF, are greatly reduced.
Taiwan’s first IVF baby has already graduated from college. Although IVF has a long history in Taiwan, one such attempt will still cost NT$120,000 (US$3,876) or more.
(This article originally appeared in The Liberty Times Oct. 5.)