00:00Some of the myths, if they do IVF, it's 100%. It's not, right?
00:04So age then comes into the medicine.
00:07Sometimes you go, doctor's trying to push me for IVF.
00:09No, we're looking at your age, right?
00:10We know this is the things that we experience statistically
00:14and also on a day-to-day basis.
00:16We do struggle when the wife's age is much more older.
00:22So maybe you could break down the difference between IUI,
00:25intra-retrine insemination, and also in vitro fertilisation.
00:28I mean, just by the name, of course, you know the difference between those two.
00:33But which group of patients maybe they can try with IUI, some of them with IVF?
00:39And what would be the success rate between these two?
00:42Right, so IUI basically stands for intra-retrine insemination
00:45and IVF is in vitro fertilisation.
00:48So the fertilisation occurs outside for IVF
00:52and the fertilisation occurs inside for IUI.
00:55So IUI is super simple.
00:56Basically, we will put the female partner or the wife on some medications,
01:03fertility tablets, just to make the eggs a little bit, one or two, enough.
01:07And then we'll then monitor the follicles.
01:09And once it gets to a certain size where the eggs is mature,
01:12and usually this falls any time between day 11 to day 15 of the cycle,
01:16which is ready for the process.
01:19And we give one injection to basically make the egg ovulate or rupture
01:23and it's fertile time.
01:26And the husband on that day would then come to the lab or the fertility centre
01:31or bring it from home.
01:33And we'll just inseminate a processed sperm,
01:36which means we basically take the best swimming sperm or the fastest moving sperm
01:41so that we get the best pregnancy rate inside the uterus.
01:44Now, how we put it, it's just a very small, fine plastic catheter,
01:48put it through the vagina, through the cervix,
01:52feels like a pap smear or less painful.
01:55Okay.
01:56So it's really super simple.
01:57Then you will wait for two weeks whether your period comes or not.
02:00If your period does not come, possibility you may be pregnant.
02:03And we have like, you know, very simple tablets after the IUI.
02:07Super simple.
02:08You can continue your activity as usual.
02:12Pregnancy rate, unfortunately, is about 10 to 15% for each cycle for the younger ones.
02:17Costs may be roughly about 2,000 to 3,000,
02:19depending on how much hormones you're using and which setting you are doing.
02:24Now, for IVF, it's different.
02:25It's much more strenuous.
02:27You're going to start on your second day or third day of your period.
02:29Depends on the protocol, but majority of the time,
02:32second day or third day of your period,
02:35and then you'll be injected.
02:37Okay?
02:37Injected daily.
02:39I'm sure you've been through it, right?
02:41The majority will be injected daily for at least a good 10 to 12 days
02:45with scanning maybe two to three times in between.
02:48And on the day, usually again, mid-cycle,
02:50anytime between day 12 to day 16 of the period,
02:54you will be ready for an egg pickup.
02:56It's all done as a daycare procedure.
02:58Procedure, nothing at the tummy.
03:00You will be asleep, right?
03:02A light sleep.
03:02So you won't have any pain.
03:04And you'll be then, the needle will go through your vagina,
03:07nothing through the tummy.
03:08You're asleep.
03:09Half an hour procedure, you go home at lunchtime, most of the time.
03:12So no need to stay overnight in hospital.
03:15Then we do the fertilization in the embryo,
03:17the embryologies in the IVF lab.
03:19And usually we'll wait at least five to seven days
03:22to see how many total of fertilized egg or what we call embryo
03:26that we are able to vitrify or what we're able to freeze and utilize.
03:32Right?
03:32So then, after that, usually it's going to be either a fresh or frozen embryo transfer.
03:37Now, fresh means any time between three days or five days after the egg pickup,
03:42you will have a transfer.
03:44Procedure, similar like an IUI, similar like a PAPS immunosomal disease.
03:48Super simple, no sedation.
03:50You'll be fine.
03:50Right?
03:51You don't need the sedation.
03:53Right?
03:53And then, after that, you will wait and you'll be giving some medication.
03:57Some is oral form, some are vaginal suppository, some may require injections.
04:02Okay?
04:03So you will then do that for maybe 10 to 12 days.
04:06Do a urine pregnancy test or a blood test.
04:08Okay?
04:09So then you will know whether you have conceived or you have not conceived.
04:13Now, pregnancy rate depends on the age of the female.
04:1730 to 39 years old, we are looking at 40 to 50% pregnancy rate.
04:22But overall, if you see, it's 30 to 40.
04:25In a good lab, in a good center, we're looking at 40 to 50%.
04:28Between 30 to 39 years old of the female partner, it will drop.
04:33At 40 years old, we drop to 20, 27% and drop much, much faster.
04:39Statistically, more than 45, your pregnancy rate would be less than 1%.
04:44Okay?
04:45So that's something that we need to always tell the patient.
04:48Some of the myths, if they do IVF, it's 100%.
04:51It's not.
04:52Right?
04:53So age then comes into the medicine.
04:55Sometimes you go, doctor's trying to push me for IVF.
04:57No, we're looking at your age.
04:59Right?
04:59We know this is the things that we experience statistically and also on a day-to-day basis.
05:05We do struggle when the wife's age is much more older.
05:10We do struggle when the wife makes her a child.
05:15We belong here.
05:17We're willing to finish the kitchen.
05:21I love you.
05:21I love you.
05:22I love you.
05:23I love you.
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