IVF after 35: Clinic offers gentler, personalised fertility techniques for diverse journeys

As women age, fertility naturally declines, which can make conceiving challenging,  but thanks to modern medical advancements, it’s far from impossible.

One technique helping women on their fertility journey is Piezo-intracytoplasmic sperm injection (Piezo-Icsi), an improved and gentler method of egg fertilization.

Dr Kelly Loi, medical director and fertility consultant at Monash IVF Singapore, explains: 

“In conventional Icsi, a sharp needle is used to inject healthy sperm into the egg by puncturing its outer shell or membrane. While effective, this method can sometimes damage fragile eggs, especially in older women. With Piezo-Icsi, a blunt needle coupled with micro-vibrating motion, are used instead. This approach is gentler and reduces the risk of harming the egg.”

According to Dr Loi, the potential advantages of this procedure include better fertilisation rate with fewer eggs being damaged. The availability of more fertilised eggs may also potentially also contribute to better in-vitro fertilisation (IVF) success rates for women aged 38 and older who have fragile egg membranes, lower egg count and poor fertilisation rates from previous IVF attempts, she says.

Monash IVF Singapore – established in 2021 and which recently moved into a 5,000 sq ft standalone centre in Novena – has been offering its patients the Piezo-Icsi treatment since September this year for patients undergoing IVF.

Dr Loi highlights a recent study published earlier this year by scientists at Monash IVF in Australia. The study involved 108 patients who underwent both conventional Icsi and Piezo-Icsi procedures. Results showed a higher fertilisation rate of 71.6 per cent with Piezo-Icsi , compared to 65.6 per cent with conventional Icsi. In addition, the embryo quality was also increased.

IVF is a process where the sperm and egg are combined in a petri dish and the resulting fertilised embryo is placed back into the woman’s uterus.

As most of its patients have their fertilised embryos transferred during a frozen embryo transfer (FET) cycle, Monash IVF will also be performing the transfer of these embryos in the new facility, notes Dr Loi.

Dr Loi explains: “Fresh embryo transfers are performed soon after the eggs are collected. This is opposed to frozen embryo transfers where embryos are frozen first and transferred later. By doing frozen embryo transfers, patients have time to recover from the side effects of the hormone injections given during an IVF cycle. The clinician also has time to optimise the uterus for embyro implantation.”

These fertility treatment procedures are a result of close collaboration between scientists and clinicians, adds Dr Loi.

She explains: “By doing it directly at the clinic, patients have time to recover from the side effects of the hormone injections which are done to prepare the uterus and the clinician can optimise the uterus for embryo implantation.”

Both of these procedures are a result of close collaboration between scientists and clinicians, says Dr Loi.

“With women getting married at a later age as well as couples postponing starting a family, there tends to be a higher incidence of gynaecological issues that often require concurrent treatment and Monash IVF addresses these needs,” she adds. 

A complete range of fertility solutions under one roof

Dr Suresh Nair, co-founder of Monash IVF Singapore, was motivated to bring the Australian-based fertility centre to a region where he has noticed a growing demand for advanced reproductive health services.

Shares Dr Nair: “We worked together as a team to ensure the centre’s clinical and embryology facilities are equipped with all the necessary equipment to provide a seamless, efficient and pleasant IVF experience for all our patients.”

One such equipment at Monash IVF Singapore is a time-lapse incubator, which enables the embryologists to analyse the developmental milestones of the embryo closely, especially in the crucial first five to six days after fertilisation.

Dr Nair says this technology will help to choose the best embryos by looking not just at their appearance, but also at how they grow and develop in the laboratory. “The time-lapse equipment complements smart analytical tools that can assist embryologists in selecting the best embryo for transfer in a shorter time,” he adds.

In addition to Piezo-Icsi, Monash IVF Singapore also offers other fertility treatments, which includes intrauterine insemination – where the sperm after preparation in the laboratory is directly introduced into the uterus via a catheter (tube). The clinic also offers services such as fertility screening tests, egg freezing and an egg donor programme.

Monash IVF also offers Pre-implantation genetic testing for genetic disorders. Explains Dr Nair: “Pre-implantation genetic testing is used during IVF treatment to identify embryos that do not have a genetic condition and to help families have healthy embryos. Monash IVF Singapore provides pre-implantation genetic analysis for couples who have a child with genetic abnormalities so they can have siblings who are free of these genes.”

Putting patient well-being first

Beyond technology and expertise, Dr Nair also wants Monash IVF Singapore to be known for its compassionate and patient-centred approach.

His vision for the clinic has always been to let patients not only benefit  from medical expertise, but also receive emotional and psychological support throughout their  journey to parenthood.

He says: “The idea was to build an organisation that did not just focus on clinical outcomes but also on the holistic well-being of patients and couples, offering a wide range of services from personalised care to counselling, in a culturally sensitive and supportive setting.”

At Monash IVF Singapore, patients will first undergo a comprehensive pre-conception health assessment. This is to understand their unique circumstances and reproductive goals. Then, a detailed investigation is carried out to identify the underlying causes of the fertility challenges, which allows the doctors to create treatment plans tailored to each couple’s needs.

“Our embryologists also provide embryology counselling to all patients, enabling them to understand every step of their fertility journey in the laboratory, creating an environment where they feel informed, valued, and supported through their fertility journey,” adds Dr Nair.

When patients achieve their dream of parenthood, it brings him great joy. For Dr Nair, there is nothing more fulfilling than witnessing the miracle of birth. “Each successful pregnancy is not just the result of medical intervention, but also a testament to the strength, resilience, and perseverance of the couples,” he says.

Adds Dr Loi: “As a gynae-reproductive surgeon and IVF clinician, seeing the embryo transfer result in a pregnancy and finally helping to deliver a healthy baby brings everyone in the team great joy and a sense of accomplishment.”

Monash IVF Singapore is located at 238B Thomson Road, #17-06 Novena Square, Office Tower B, Singapore 307685. Visit their website for more information.