Materia Medica Malaysiana

The cost of treating infertility

There are many treatments for infertility but couples have to consider the cost of a procedure against its success rate, and the time and energy expended.

Have you consciously planned your lovemaking for months in the hope of getting pregnant but to no avail? Inability to conceive can be very frustrating and depressing, more so when the "trying time" has been going on for too long.

But you are not alone. The World Health Organisation estimates that approximately eight to 10 per cent of couples experience some form of infertility. This means that 50-80 million people in the world suffer from infertility. In Malaysia, infertility affects one out of seven couples.

If you think that you are having difficulty becoming pregnant, you should seek the assistance of your physician. Infertility is a diagnosable medical problem that can be treated by a doctor. But keep in mind that no treatment is a 100 per cent successful.

The first step is to choose a physician with clinical expertise in reproductive medicine — a fertility specialist. It is also important that you feel comfortable with the fertility specialist of your choice, that he or she expresses an ability to listen to and understand your issues and concerns, one who communicates openly about your options, and most importantly, one whom you and your partner feel you can talk to and work with even under stress.

Once you have selected a physician and are opting for treatment, special tests may need to be preformed before a diagnosis is made or confirmed. Identifying the cause of your infertility is important as it may affect the choice of treatment. Possible treatments may include:

Ovulation induction

A series of hormone injections will be given to the woman in order to stimulate egg growth and ovulation. If ovulation can be successfully induced, conception may then be able to occur naturally.

Artificial insemination

This is used in cases where the male has a low sperm count or a high number of abnormal sperm, or the woman has sperm antibodies present in her cervical mucus. Sperm is treated in the laboratory to increase the chances of fertilisation. Large numbers of sperm are then inserted directly into the uterus for easy access to the fallopian tubes.

IVF (In vitro fertilisation)

IVF is used to treat infertility blockages of the fallopian tubes, endometriosis, abnormal sperm, and some cases of unexplained infertility.

The woman is treated with hormones over a number of weeks to stimulate the growth of several eggs in the ovary. When ripe, the eggs are removed from the ovary and put into a dish with the partner’s (or donor’s) sperm. The fertilised eggs are then grown in the laboratory for a few days before being placed into the uterus.

GIFT (Gamete intrafallopian transfer)

This procedure is the same as that for IVF except that fertilisation takes place inside the body of the woman. The eggs and sperm (gametes) are collected and placed directly into the fallopian tubes for fertilisation to occur. GIFT is used in cases of endometriosis, cervical disorders, and some types of male infertility. It is suitable only for women with no abnormalities in the fallopian tubes.

ZIFT (Zygote intrafallopian transfer)

ZIFT involves the same procedure as IVF except that the very early embryo (zygote) is placed directly into the fallopian tube.

This procedure is done when there are abnormal sperm and/or problems with the ability of the sperm to fertilise the eggs.

ICSI (Intracytoplasmic sperm injection)

This is a technique in which a single sperm is inserted directly into the egg. Eggs are obtained the same way as for IVF and then fertilised by injecting a single sperm into them. The fertilised eggs can be transferred to the fallopian tubes of the woman or grown in the laboratory for a couple of days and then transferred to the uterus.

In Malaysia, there are 17 privately-owned and three Government-owned fertility treatment centres which offer assisted reproductive technologies equal to those of other global facilities.

Your financial situation may play an important factor as private treatment can be expensive. For example, the cost for IVF treatment could run up to RM1,000 per cycle. You need to consider the time and energy you need to invest as well. Before going ahead with any treatment you should find out what that particular treatment involves and what the success rate is. Your doctor will help and advise you on which treatment is best for you.