We've all heard of the 'test tube baby' and essentially couples consider a test tube baby because of infertility, impotency or hormonal imbalances, plus other reasons. The first test tube success was back in the very early 1980s and developments have moved ahead quickly. Today, infertility treatment is easily available to many, and also has raised many ethical issues.

Fertility treatment started with in vitro fertilization, or IVF where the female egg is surgically removed, mixed with sperm, checked by the specialists and if fertilized, placed back into the woman’s uterus. From here, normal pregnancy follows.

If you think that you and your partner are having difficulty becoming pregnant, consider seeking the assistance of a qualified physician, as there are several types of safe and effective treatments available today. Appropriate treatment is highly individual and may range from the simple medical advice to the complex, high-tech therapies like IVF or IntraCytoplastic Sperm Injection (ICSI).

According to Dr Manop, a Gynaecologic Oncologist at Phuket International Hospital and the first doctor in Phuket to do high-tech fertility treatments through the newly opened Phuket International Safe Fertility and PGD Center, “Couples are considered to be infertile if they have not conceived within 1 year of trying. With Assisted Reproductive Technology about 40-50% of our clients go on to have a successful pregnancy and childbirth after the first cycle, and after three cycles the success rate is 80%”.

Overseas couples are coming to Phuket for fertility treatment because of the success rates and the cost, which can be prohibitive or even illegal in some countries. The development of several high-quality medical facilities has helped Phuket to become a destination of choice for those who wish to combine world-class medical care with a relaxing holiday. While success is not guaranteed, couples may be putting themselves in a better position of getting pregnant while away from everyday stressors. If the holiday is timed well, couples only need to stay in Thailand for about 15 days for treatment, and then return home to follow up with their local obstetrician.

Assisted Reproductive Technology options that have now been made available to both locals and tourists through Phuket International Safe Fertility and PGD Center not only include IVF. In addition, there is Intra Cytoplasmic Sperm Injection (ICSI), a technique developed in Belgium by Gianpiero Palermo around 1991, and now widely used in fertility clinics around the world. With ICSI, the embryologist surgically inserts one healthy sperm into each egg. This is done by carefully perforating the membrane of the egg with a glass pipette containing the sperm and requires extremely high level of skills and experience. As only one sperm is needed per egg to create an embryo, it enables men with a low sperm count to father biological children. It is estimated that up to 40% of cases of infertility are due to problems with the quality and quantity of sperm.

If a male parner has no sperm in his semen, Percutaneous Sperm Aspiration (PESA) is usually the first treatment option suggested. It is relatively painless, requires no surgical intervention and has high retrieval rates (80-90%). A fine needle is inserted through the scrotum into the epididymis from which fluid is gently removed, which is then analyzed for sperm content and motility.

Finally, and possibly the most controversial, treatment is Preimplantation Genetic Diagnosis (PGD). Repeated pregnancy loss or miscarriage is frequently due to genetic problems. This is a difficult and emotionally draining experience, but fortunately couples have new options available, including PGD, which involves the genetic investigation of early stage embryos that have been produced through IVF or ICSI. PGD allows the embryologist to determine the chromosomal make-up as well as sex of any given embryo, and then select those that are most suitable before transferring them into the uterus. PGD is known as the most reliable technique for gender selection with an accuracy rate of more than 99%. PGD is illegal in some countries, and the ability of embryologist to determine the sex of babies prior to birth will continue to raise the many ethical and religious issues associated with it.

Peter Davison is the Manager International Services
at Phuket International Hospital.
Tel: +66 (0)76 249400. Email: info@phuketinternationalhospital.com