Conceiving a child might be an easy journey for many couples but, unfortunately, it’s not always an effortless experience. Even with the range of assisted reproductive technologies (ART) available these days – such as in vitro fertilisation (IVF) – a baby isn’t guaranteed. Couples don’t always get the happy ending they so want and going down this route is actually statistically less successful than many think.
Dr Huang Zhongwei, Deputy Director of Bia-Echo Asia Centre for Reproductive Longevity and Equality (ACRLE) at the Yong Loo Lin School of Medicine, National University of Singapore (NUS Medicine), and Consultant in the Division of Reproductive Endocrinology and Infertility, Department of Obstetrics & Gynaecology, at National University Hospital (NUH), cites data from Healthhub for success rates for IVF per age group. At 30 to 34 years old, success rates average 25%, for 35-39 years old that goes down to 17% and for women above 40, it’s as low as 7%*.
Despite the less-than-encouraging stats, there is a perception that IVF is a guaranteed way to have a baby. A 2019 survey by voluntary welfare organisation I Love Children showed that nearly 70% of respondents wrongly think that assisted reproductive technologies are a ‘magic bullet’ that can solve fertility problems.
When Sher Loh, 44, and her husband started trying to conceive ten years ago, they agreed that they would not try any form of ART and only pursue the natural course of conception. But the couple went for a fertility check and her husband was diagnosed with low sperm motility (the ability of sperm to swim efficiently) and intrauterine insemination (IUI) was recommended. However, they looked for alternative treatments while still actively trying on their own. They also sought TCM treatments.
After three years of focusing on career and further education, the couple decided to start IVF treatments in 2019. Sher had older girlfriends who had successfully undergone IVF cycles the year before and this encouraged her to give it a shot.
“Another reason we decided to try IVF was because we could use the government grants,” she adds. “I was 39 then and the grants were only available for women under 40. So we decided to utilise this option as we didn’t want to regret not trying IVF when we could. We attended seminars, did online research and even watched YouTube videos on IVF before we made the decision to give it a try.”
Over the next two years, Sher conceived twice but miscarried once and had a blighted ovum (when the sac and placenta grow but there is no baby) the other time. Their third IVF cycle also failed after which they decided to stop.
Age was one of the main factors but Sher also had discovered a relatively big fibroid in her womb (a possible reason embryo implantation was more difficult). Their doctor advised them to go the egg donor route but that wasn’t something they wanted to consider. “When we started on our IVF journey, I told my husband that I was only going to try once,” Sher recalls. “But being able to get pregnant gave me hope and courage to try again.”
When is it time to stop
Without any success from the next two IVF rounds, Sher “couldn’t and didn’t want to go through the pain anymore”.
“I can deal with physical pain but not the emotional rollercoaster. It was mostly my decision to stop but my husband was my greatest supporter,” she adds.
While Sher wasn’t surprised that IVF hadn’t worked for them, she felt the disappointment more than anything. She notes that while stories in the media were mostly about IVF successes, it was through social media – Instagram in particular – that she came across stories that showed how IVF isn’t that straightforward and rosy. “I have read countless stories on the internet and social media and knew that going through IVF [didn’t guarantee] having a healthy baby to hold in my arms at the end of nine months,” she says. “So I was kind of ‘prepared’ for it. The only thing I was surprised by was going through a miscarriage a second time, that was really hard for me.”
Tina Padia, an accredited life coach and fertility coach, says making the decision to stop treatment, whatever the reason, is extremely tough and heartbreaking and comes with its own challenges.“It’s so important that you seek help and talk to a qualified professional who can help you to process and unpack the layers of emotions that have built up over time,” she advises. “Talking to someone will help you understand and be happy with your decision and will help you find ways to move forwards and make choices that are right for yourself and your partner.
“You are not alone and there are people that can support you in working on your emotional well-being and emotional health,” she adds.
Riding the emotional rollercoaster
For couples who have gone through the process of trying fertility treatments and then experiencing disappointment, Tina encourages them to be kind to themselves after everything their bodies and emotions have gone through. This includes doing things that help relax your mind and body.
“For so long, you’ve spent time and energy on treatments and it really does drain you physically and emotionally. I always say prioritising yourself and your wellness is non-negotiable. Take time out to heal, nurture and reset,” says Tina.
Sher describes being in the IVF program as “like a vicious cycle of trying and failing and you’re just sucked into the whole whirlwind of emotions and expectations”, she says. “It was a rollercoaster journey for me, especially having conceived and lost twice . I felt immense anxiety, sadness and hope.”
One way she found to cope with the experience was to turn to social media. “I documented almost every step of my journey on Instagram and the people (both followers and founders) of the Fertility Support Singapore group were what kept me afloat during those trying times. Working also helped to keep my mind off things too.”
When seeing patients, Dr Huang has an open discussion with couples if they haven’t been successful on their IVF journey, and provides emotional counsel and referrals for psychological support.
“If they are planning for their next IVF cycle, it will be important for them to learn to accept the outcome and re-examine what can be improved,” he explains. “I would emphasise prioritising a healthy and balanced diet, adequate physical activities, some nutrient supplementation and emotional well-being before embarking on another IVF cycle.”
It’s also okay to explore other options, says Tina. You and your partner can discuss other options for building a family such as adoption or surrogacy – if this is something that you want to do. “Make sure that this decision is one that you make for yourselves and not from any external pressures that you might be facing,” she adds.