Ask The Expert: What’s New With IVF and Saviour Siblings

A doctor's opinion on what to expect with the recent advancements to IVF.

One of the highlights of Budget 2020 has to be the initiative tabled for couples looking to try in-vitro fertilization (IVF). You may now withdraw from your Employees Provident Fund (EPF) to finance the procedure. However, physically and emotionally, it’s still a daunting (though also exciting!) process. Our writer, Lorraine, gets up to speed with Dr Leong Wai Yew, a consultant obstetrics and gynaecology fertility specialist from Alpha IVF & Women’s Specialists, on what you need to know if you’re considering IVF, either as a fertility treatment or to get a ‘saviour sibling’.

READ: ICYMI: BUDGET 2020 AND HOW IT’LL AFFECT YOU

Image: Depositphotos

HW: Is IVF suitable for everyone?

Dr Leong: Not quite, unfortunately. IVF can help almost all cases of male & female infertility. In the case of sperm issues, good or better sperm can be singled out in IVF and injected into the eggs (ICSI) to produce embryos for IVF use. Sperm can be obtained surgically from the testes in severe cases. But for total testicular failure, a sperm donor is needed in permissible cases. As long as the female partner is in the reproductive age group with functional ovaries, IVF can be attempted. In cases of ovarian failure, egg donation programme via IVF is needed, in permissible cases.

HW: What should one consider before deciding on getting IVF treatment?

Dr Leong: Get a complete gynaecological assessment from a fertility specialist with pelvic scans and a holistic health screening. For the males, a seminal analysis with general health screening is mandatory. All in all, I would suggest seeing a fertility specialist first for proper counselling and lifestyle analysis with advice on lifestyle changes, besides the said assessment, before coming to the conclusion of starting IVF or not.

HW: What should one expect throughout the treatment? Are there side effects?

Dr Leong: Side effects from the instituted hormones is quite tolerable and minimal nowadays for women. Plus, with the advent of embryo freezing and embryo transfer at interval, serious side effects are almost unheard of now. The course of the IVF cycle generally does not exceed 2 weeks, and the frozen embryos are safely stored and can be transferred anytime at the patient’s convenience.

HW: What’s after the treatment?

Dr Leong: Generally, close monitoring and extra hormonal support are given in the first 3 months of the pregnancy after IVF success. Following that, the mother does not need any different management of her pregnancy from natural pregnancies.

HW: Can you explain what a ‘saviour sibling’ is and how it’s done?

Dr Leong: In a nutshell, it means doing IVF with genetic screening for HLA (Human Leukocyte Antigen) on the obtained embryos to match a living sibling with leukemia, for example. Upon the birth of the HLA matched child via IVF, cord blood can be obtained to institute therapy for the affected older sibling.

HW: What is the success rate of having a saviour sibling in Malaysia?

Dr Leong: The rates are no different from normal IVF with PGS (preimplantation genetic screening), depending on maternal age and other factors, with the exception of having matching HLA with the affected sibling. As this is still new, results still need to be compiled.

HW: What should be considered before getting a saviour sibling?

Dr Leong: Contemplate on the fact that the couple is ready for another child. If so, IVF and genetic screening for HLA matching can be advocated. Both couples need to undergo full IVF assessment and blood tests at a centre of reproductive medicine with a geneticist and the capability to offer such a programme. A visit to the haematologist to discuss possible treatment options for the affected living child once a saviour sibling is born is paramount.