Miracle of delayed fertilisation when there is no time to lose. Delayed-ICSI can help women conceive even when time is running out.

  Dion’s parents, mother Peggy and father Tim, had been trying unsuccessfully to conceive naturally for some years because of persistent fertility problems. Peggy was already 38 and had almost given up hope. She was also running out of eggs. “With us marrying in our thirties and having our careers to focus on, we began to think about having a baby quite late on in life, probably around the time when I was 35,” said Peggy. “After three barren years, we visited an O&G specialist in the town where we live. We had been to several doctors beforehand but none of them could work out why I couldn’t conceive. The O&G specialist told us that the natural method clearly hadn’t been working and she advised us to undergo IVF treatment to give us a better chance.” The couple were told that it might take several IVF cycles before Peggy conceived due to her age that may affect her quality and quantity of eggs, but they shouldn’t give up hope. The IVF success rate in Malaysia is among the highest in the world, at an average of around 70 per-cent, compared to the global rate of some 60 per- cent. Some Malaysian clinics have even better results, leading it to be one of the key fertility hubs in Asia. During IVF, eggs are collected from the mother’s ovaries and fertilised by the father’s sperm in a lab. The egg may either be fertilised traditionally or through intracytoplasmic sperm injection (ICSI). In traditional IVF, 50,000 or more swimming sperm are placed next to the egg in a laboratory dish, and fertilisation occurs when one of them enters into the cytoplasm of the egg. In the ICSI process, a tiny needle is used to inject a single sperm into the centre of the egg. This approach can be chosen for a number of reasons, including when eggs are not being fertilised by traditional IVF, regardless of the condition of the sperm. With either traditional IVF or ICSI, once fertilisation occurs, the fertilised egg is then grown in the laboratory and transferred to the mother’s uterus. One full cycle of IVF takes about three weeks. Notwithstanding, the likelihood of an IVF cycle being successful drops in tandem with the mother’s age. For instance, a woman aged under 30 is far more likely to become pregnant than one over 38, as Peggy was at the time of her treatment. Now, after years trying to conceive with no avail, the couple realised that they might have to begin contemplating a future together without children. But with one last roll of the dice, their outlook changed completely. Tim recalled reading about a fertility centre in Kuala Lumpur that had an IVF success rate on par with that of the best clinics in the world. Moreover, the article mentioned that it was one of the only centres in Malaysia that would culture eggs harvested from the mother a little longer than usual. This approach allows slower developing eggs to become viable for use in IVF. Typically, embryologists would discard immature eggs under the belief that they are not suitable for fertilisation. But culturing them for a further 24 hours can help improve the chances of pregnancy. Doing so also allows older women like Peggy, who have a dwindling number of eggs available for use in fertility treatment, not to waste eggs that might be viable. The fertility centre Tim had identified, Alpha IVF & Women’s Specialists, had carried out research into delayed-ICSI, and presented their findings from a study earlier this year to a conference of the European Society of Human Reproduction and Embryology (ESHRE). Alpha IVFfound that one extra day in the laboratory allowed some eggs to grow into ones that could be fertilised and potentially grow into viable blastocysts. In its presentation to the conference, the fertility centre’s medical director, Dr Colin Lee, revealed that successful pregnancies had resulted from transferring these delayed-ICSI embryos from eggs that would have been discarded otherwise. Having carried out pre-implantation genetic testing on the embryos to identify any abnormalities, Dr Lee’s team also found that blastocysts cultured this way can be chromosomally normal, and therefore safe for embryo transfer. “It is a routine procedure in Alpha IVF & Women’s Specialists that is used in order to improve cycle outcomes of selected patients, and especially those who are poor responders,” said Dr Lee. “Good pregnancy and implantation rates can be obtained with blastocysts derived from delayed-ICSI. Therefore, patients who are unlikely to have a good number of normally fertilised eggs in the traditional approach should have their immature eggs cultured for another day with delayed-ICSI to generate more utilisable blastocysts.” Knowing that delayed-ICSI might offer them their last chance to become parents, Tim and Peggy travelled to Kuala Lumpur. It was difficult for them not to raise their hopes too much, but given Alpha’s high IVF success rate and its willingness to use this new approach to culturing eggs, Tim permitted himself a moment of expectancy. “We had come so far already, only for our dreams to fall flat. But I knew there was more to this journey, just as long as we kept faith that we could still be parents,” he said. “We just needed to have a stroke of luck and Peggy might conceive. We would never have forgiven ourselves if we hadn’t grasped this last chance.” Finding that the prospective mother’s ovaries were almost depleted, Dr Lee ordered Alpha’s embryologists to keep her viable eggs in the laboratory and mature them in incubators for 18-24 hours. Once Tim’s sperm was injected directly into the eggs, they were cultured for up to seven days and screened for genetic abnormalities. At the end of the process, the most viable embryos was implanted in Peggy’s uterus. “Those days are still a blur; we just couldn’t concentrate on anything else. I remember my husband telling me that he had a feeling that this would be the cycle we had been waiting for,” said Peggy. “I dared not look at the pregnancy test when it was time to take it. I just held it up for my husband to read. His face turned into a beaming grin and I could tell straight away what it meant. I was pregnant!” Now two months old, baby Dion is every bit the healthy bundle of joy his parents had dreamed of for so long, and now they feel their lives are complete. “It goes to show that all things come to those who wait. For us, we didn’t just have to hold on over countless IVF cycles, we now know that by holding back fertilisation for a day longer, we were able to achieve the pregnancy that we had nearly lost hope of. We feel like it has been a miracle.”

DATO’ SRI SITI NURHALIZA’S HEARTWARMING JOURNEY TO MOTHERHOOD WITH ALPHA IVF & WOMEN’S SPECIALISTS

It took 11 years for Malaysia’s pre-eminent singer, Datuk Seri Siti Nurhaliza Tarudin, to become a mother. After more than a decade of dashed hopes, Siti Nurhaliza finally fell pregnant in 2017, and announced her news to the press during her fourth month of pregnancy after the fifth cycle of IVF done at Alpha IVF & Women’s Specialists. The adorable baby girl Siti Aafiyah weighing 3.55kg was delivered via C-section on March 19, 2018 at 8.17am at a private hospital in Kuala Lumpur.

“When I went for the first cycle of treatment, I wasn’t too strict on myself. After the transfer of the embryo to the uterus, I resumed my daily activities and didn’t restrict my movements,” she said.

“But after several failed attempts, I realised that my body was fragile and I should be more focused on being extra-careful throughout the process. On top of that, I couldn’t wait much longer because I wasn’t young anymore.”

On 1st December 2020, Siti Nurhaliza again revealed that she is pregnant with her second child via a virtual press conference after Siti Aafiyah is two-year-old, which is due around April/May 2021.

“I knew when the time is right, we would share this news with all of you, especially our family, relatives, friends, fans and anyone who knows us,” she wrote on an Instagram post alongside a photo that revealed her baby bump.

This ended the speculation of her pregnancy that had been widespread after she scaled down her appearances and had noticeably been keeping under the radar for months.

According to the World Health Organization (WHO), infertility is “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. WHO also declares that infertility and subfertility affect a significant proportion of humanity and it is a public health issue.

If you are trying to start or expand your family and are considering IVF, this is the right time to speak to Alpha IVF’s fertility specialists. The dream of having a child should not be outside of the reach of any family, especially those who are struggling to conceive on their own and who could benefit from fertility treatment.

According to Mayo Clinic, IVF is the most effective form of assisted reproductive technology. During IVF, mature eggs are collected (retrieved) from ovaries and fertilized by sperm in a laboratory. Then the fertilized egg (embryo) or eggs (embryos) are transferred to a uterus to establish into pregnancy.

IS IVF IS THE RIGHT OPTION FOR ME?

IVF may be an option if you or your partner has:

  • Problems with uterus or fallopian tubes damage or blockage.
  • Ovulation disorders.
  • Uterine fibroids.
  • Problem with sperm production or function.
  • Unexplained infertility
  • A genetic disorder
  • Fertility preservation for cancer or other health conditions.

Dato' Sri Siti Nurhaliza’s Advice to Couple Attempting IVF

Her advice to couples who are keen on going for IVF? “Be patient and understand the concept of rezeki — what is meant for you will come to you. The couple must stay focused and be physically and mentally prepared to go through the process especially to overcome the two big challenges in infertility treatments: The process itself and people’s perception.

“On top of it all, the couple must understand and appreciate each other. The husband must understand that the wife is not only facing physical changes but emotional changes as well. Try to stay positive and support each other. And don’t be shy to seek help.”

“My hopes stayed alive because I always believe that rezeki (gift) comes in many forms and Allah will eventually grant what I wish for as He knows what is right for me. That was my strength. That kept me going.

“I never gave up and it was worth the wait,” she says.

EPF for IUI and IVF.

For those worrying that they will be forced to bear the cost of IVF out of their own pockets, the government now allows EPF members to withdraw from Account 2 to fund fertility treatments such as IUI and IVF.

Who Can Apply?

Legally married Malaysians and non-Malaysians under the age of 55 with savings in Account 2.

How To Apply?

1:  Schedule an appointment with our fertility specialists

2:  Visit Alpha IVF for a consultation and assessment

3:  Begin IVF treatment

4: Submit documents to KSWP

5: Full payment will be credited to your account

About Alpha IVF & Women’s Specialists

Alpha IVF & Women’s Specialists is fully equipped with a wide range of revolutionary fertility technology, including EmbryoScope+ time-lapse embryo monitoring and the Cryotec cryopreservation system that consistently achieves complete survival of embryos and blastocysts during the freeze-thaw process to optimise every couple chance to become a parent.

For more details, please call us on 03 6141 6166 or WhatsApp 012 568 6290 now!

SAVIOUR SIBLING PROGRAMME AND DIRECT HLA TYPING FACT SHEET

 WHAT IS BETA THALASSEMIA?

Beta thalassemia is a genetic blood condition whereby the body produces less haemoglobin, an iron-rich protein in red blood cells that carries oxygen to all parts of the body. Beta thalassemia occurs most frequently in people from Mediterranean countries, Middle East and Central Asia.

Beta thalassemia major is the beta most severe form of thalassemia, it is caused by two copies of mutated HBB gene.

If it is left untreated, the affected child may have an enlarged spleen, liver and heart. Their bones may also become thin. Symptoms usually develop in the first 2 years of life. They may have:

  • Life threatening anemia (cooley’s Anemia)
  • Delayed growth
  • Developed yellowing of the skin & white of the eyes (jaundice)
  • Enlarged spleen may occur due to increased red blood cells distraction
  • Formation of blood cells outside of the bone marrow, repeated blood transfusions or iron overload.

Affected individuals will requires frequent blood transfusions lifelong and few will live beyond their early thirties.

CAN THE CONDITION BE TREATED?

Beta thalassemia major can be treated by blood marrow transplantation from HLA-identical donor. After bone marrow transplantation, their body will be able to produce healthy blood cells.

However, unless there is a 100 percent match between the patient and the donor, there is a chance that the bone marrow will be rejected following transplantation. Efficacy of transplantation depending on how closely the HLA compatibility between donor & recipient.

FINDING THE RIGHT DONOR

It is virtually impossible to find the right donor outside the patient’s family. And even within an extended family, the likehood of finding a family member with the right genetics is still relatively low, unless the patient has a sibling.

Whereas an uncle or aunt may have a 6-10 percent chance of being compatible, a brother or sister might be 20 to 30 percent compatible.

To identify the chances of a family member’s HLA compatible, human leukocyte antigen (HLA) typing is carried out from a sample of the donor candidate’s blood.

In the case of a match being made, the donor’s bone marrow will be donated. If this is accepted, the patient will be cured.

If this happens, the parents may consider having a baby that is a complete HLA-match for their sick child.

 SAVIOUR SIBLING PROGRAMME

Saviour siblings are children who are born through in-vitro fertilisation whose haematopoietic stem cells will be donated from blood in their umbilical cord so that a brother or sister may be saved.

A new matching technique called definitive high-resolution HLA genotyping is performed in a laboratory on fertilised embryos to ensure that only an embryo with the exact genetic sequence leads to pregnancy.

DIRECT HLA TYPING

Definitive high-resolution HLA genotyping using next-generation sequencing allows for much more accurate analysis of the human leukocyte antigen gene than the conventional method.

Whereas conventional HLA typing doesn’t test the gene directly rather, it looks for short tandem repeat markers throughout the HLA region.

Definitive high-resolution HLA genotyping typing looks at each of the donor’s various genetic sequences and identifies with complete accuracy if they match with those of the patient.

This accuracy is an essential component of the saviour sibling programme, since the probability is that just one in 16 embryos will provide a compatible genetic match for the sick child.

Identifying with certainty which embryo is suitable is therefore necessary before it is implanted into the mother’s womb.

In conventional HLA, 5 to 10 cells from an embryo containing on average 200 cells are removed each time a test is performed. After multiple tests, the cells in the embryo will be significantly reduced, leaving it less viable after transplantation. This means multiple biopsies is performed for multiple test that a suitable match may not result in pregnancy and the opportunity is wasted.

In contrast, direct HLA enables multiple DNA copies to be created from a single biopsy, and these copies can then be used for a wide range of tests without harming the embryo.

HOW DO STEM CELLS CURE A SICK CHILD?

Following the sibling’s birth, stem cell-rich cord blood is harvested immediately. These stem cells will then be transplanted into the patient with beta thalassemia major.

Stem cells have the potential to develop into many different types of cells throughout the body and also serve as a means to repair defects.

Cord blood contains predominantly hematopoietic stem cells that have the potential to generate blood cells and cells of the immune system, Cord blood stem cells are always a perfect match for the child and are less likely to developing graft versus host disease after transplant than stem cells harvested from other sources.

For Alpha’s savious sibling programme, stem cells are harvested by CryoCord, a Malaysian stem cell bank.

FACTS YOU NEED TO KNOW ABOUT EGG FREEZING

WHAT IS EGG FREEZING?

Egg freezing, also known as oocyte cryopreservation is a procedure in which the eggs from a woman are retrieved, frozen, and stored for future use. The frozen eggs can later be thawed, fertilized, and transferred into the uterus when desired.

Vitrification is the latest method for freezing eggs and the survival rates using vitrification are much higher compared to previous freezing methods like slow freezing. With recent major improvement in the vitrification solutions, such as Cryotec method with certain distinct advantages over all other existing methods of vitrification, egg freezing has become a viable and common option to preserve a women reproductive age.

WHEN SHOULD I FREEZE MY EGGS?

The simple answer is to pursue egg freezing in the prime reproductive years, before 35 years old to take advantage of premium egg quality and quantity. Think of the egg retrieval process and cryopreservation as you would a fall harvest. A woman is born with all of the eggs she will ever have, and over time they diminish in number and cellular integrity.

After 43 years of age, it is usually not recommended to freeze eggs, because the quality of eggs is too poor and the probability of chromosomal abnormalities is high. Do discuss with your fertility specialist to better understand your chance based on your own personal conditions.

WHO NEEDS EGG FREEZINGYou may consider egg freezing if :

  • you wish to delay childbearing;
  • you are single and haven’t met your Mr. Right;
  • you have medical conditions such as cancer requiring chemotherapy or radiotherapy.

Storing frozen eggs gives women the opportunity to preserve their fertility until they are ready to start a family.

WHAT DO YOU EXPECT IN AN EGG FREEZING PROGRAM?

Before you are eligible for egg freezing program, you must first conduct an egg freezing assessment. Then you will be given injections to stimulate your ovaries to produce multiple eggs for collection via a simple procedure using a thin needle. Once the eggs are collected, they are cultured in the incubators for 2-4 hours to encourage egg maturation. The eggs are then vitrified and stored using Cryotec freezing technology until ready to be thawed.

Factors Determine IVF Success Rates

Age The age of the woman is the main factor affecting the success of an IVF. This is because the quality and the quantity of a woman’s eggs reduce as she grows older. Hence, as age increases, the IVF success rate drops. From 24 to 35, women have the highest chances of success with IVF treatment because this is the age range when women are most fertile. (more…)

Perfect 10, Perfect Love

Every child deserves a chance for a bright future. There are some 50,000 children in orphanages and shelter homes in Malaysia who deserve our love and care.In celebration of Alpha IVF’s 10th Anniversary, we are honoured to introduce our ‘Perfect 10, Perfect Love’ project! we are collaborating with Yayasan Nurjiwa founded by Dato’ Sri Siti Nurhaliza and Datuk K to raise funds for the orphans in a charity campaign called PERFECT 10, PERFECT LOVE. This donation drive will provide them with financial support as they integrate into communities and build a future of their own.

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Frozen Embryo Transfer Benefits

Higher Pregnancy Rates

You will have additional opportunities for transfer and therefore more pregnancy attempts. If you can freeze and store embryos while you are attempting a fresh cycle transfer, if the fresh cycle is unsuccessful, you can try again without undergoing another ovarian stimulation or egg retrieval. Hence, it will increase your chance of successful pregnancy rates.

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GENETIC DISEASES IN IVF

Abnormalities in both males and females may cause implantation failure or miscarriage as well as birth defects in a resulting child. Preimplantation genetic testing evaluates embryos for genetic abnormalities prior to embryo transfer during IVF.

Genes is made up of DNA which is an essential part of heredity. Genes come in pairs, with one inherited from the male and one from the female parent. Genes are the dominant elements in DNA that determine a human’s development, function and personal attributes such as hair and eye color. A genetic disorder results when genes are not properly formed, either before birth or through mutation after birth.

 

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