In Vitro Fertilisation (IVF)

IVF juga dikenali sebagai 'bayi tabung uji', ini kerana, persenyawaan berlaku diluar badan (di dalam tabung uji). Indikasi bagi IVF termasuk:

1. faktor tiub (tiub tersumbat atau tidak berfungsi)
2. endometriosis
3. masalah sperma
4. faktor immunologi (antisperm antibodies)
5. rawatan IUI yang gagal
6. ketidaksuburan yang belum dikenalpasti puncanya
7. pendermaan sperma/ ovum/ embrio
8. ibu tumpang

Wanita akan menjalani controlled ovarian hyperstimulation (COH), sama ada protokol panjang, protokol pendek atau protokol antagonis, mengikut kesesuaian. Suntikan hCG akan diberi apabila folikel telah mencecah 18mm untuk mematangkan ovum. 34 jam berikutnya, pengumpulan telur (oocyte pick up (OPU)) akan dijalankan.

OPU adalah proses mengumpulkan telur. Telur akan disedut melalui vagina menggunakan peralatan khas. Prosedur ini memerlukan bius keseluruhan. Sebelum menjalani OPU perkara-perkara berikut perlu diberi perhatian:

  • jangan makan atau minum sekurang-kurangnya 8 jam sebelum menjalani OPU
  • jangan memakai kanta lekap, gigi palsu, alat solek, pewangi dan pengilat kuku semasa prosedur.
  • jangan membawa barang-barang berharga
  • pastikan anda telah menguruskan pengangkutan balik kerana anda dinasihatkan tidak memandu 24 jam selepas prosedur.

Semasa OPU, cecair folikular akan disedut menggunakan pam penyedut dan dikumpulkan di dalam tabung uji. Cecair yang dikumpulkan ini akan diserahkan kepada embriologist yang berada di dalam makmal bersebelahan dengan bilik pembedahan. Embriologist akan mengenalpasti telur menggunakan mikroskop. Prosedur ini mengambil masa 15 hingga 60 minit untuk selesai bergantung kepada bilangan folikel yang disedut. Setelah semua telur disedut, telur-telur ini akan dieramkan di dalam inkubator yang mana suhunya adalah 37ÂșC dan kepekatan karbon dioksida adalah 5%. Ini bertujuan untuk memberi ruang bagi telur melengkapkan fasa Meiosis II sebelum ia disenyawakan.

Pada hari yang sama, pasangan lelaki perlu mengeluarkan semen untuk diproses. Perkara-perkara berikut perlu diberi perhatian:

  • mengekang diri dari hubungan seks 3 hari sebelum sampel dikeluarkan
  • memaklumkan sekiranya pernah jatuh sakit atau mengambil sebarang ubat-ubatan dalam tempoh 2 bulan sebelumnya.
  • digalakkan mengeluarkan sperma secara masturbasi
  • mencuci tangan sebelum mengeluarkan sperma
  • elakkan menggunakan pelincir atau sabun
  • elakkan semen dari tertumpah


Embryologist akan memproses semen dengan mengasingkan plasma, sel-sel dan sperma yang telah mati. Proses pemilihan sperma dilakukan dengan mencampurkan media khas dan beberapa siri pengemparan. Larutan akhir yang mengandungi kepekatan sperma motile yang tinggi akan diinseminasi ke dalam media pengkulturan yang mengandungi ovum seterusnya disimpan di dalam inkubator supaya persenyawaan berlaku secara semulajadi.

Prosedur pemindahan embrio tidak memerlukan bius dan hampir serupa dengan IUI. Perbezaan antara keduanya adalah pemindahan embrio memerlukan bantuan imbasan ultrabunyi manakalaIUI tidak. Imbasan ultrabunyi membantu doktor untuk menempatkan kateter berhampiran dengan fundus dan mengurangkan trauma terhadap endometrium. Keseluruhan prosedur mengambil masa 5 minit sahaja (lihat video).

Selepas menjalani pemindahan embrio, wanita tersebut perlu mengambil sokongan peleutenan sama ada dalam bentuk tablet vagina atau suntikan. Perkara-perkara berikut perlu diberi perhatian:

  • banyakkan rehat dan elakkan aktiviti fizikal yang berlebihan.
  • pastikan anda menggunakan ubat progesteron yang dibekalkan setiap hari.
  • minum air secukupnya.
  • elakkan pengambilan ubat-ubatan tanpa nasihat doktor
  • elakkan hubungan kelamin sekurang-kurangnya 3 bulan selepas menjalani rawatan

Ujian kehamilan akan dilakukan 2 minggu selepas prosedur untuk menentukan status kehamilan.


*** sumber adalah metro IVF Malaysia..


Posted by Diarihatiku1976 on Wednesday, January 25, 2012
categories:

27 comments

  1. farrah Says:
  2. good luck! saya Google pasal IUI hari tu then came across your blog. jgn lupa share info pasal IVF banyak-banyak okay!!

    hmmm berapa kos IVF kat Malaysia ye? ada kat hospital mana?

     
  3. byk hospital dah ada dah IVF ni... sediakan je dalam 15-20k

     
  4. shiemz Says:
  5. Gudluck~!! InsyaAllahhh.... semoga ade rezeki nanti ok.. teruskan berusaha...

     
  6. sya doakan semoga awk berjaya yer

     
  7. LoVEaQshA Says:
  8. gud luck akk~semoga usaha akk nie berhasil sb perlukan kekuatan mental dan fizikal sb duit yg kua bkn ckit and akk plak kna sht betul..
    insyallah kak,bla Allah nak bg rzki pasti akn berjaya..~pape hal nti rjin2la info tau..

     
  9. insyallah, aku doakan ko na....moga berjaya, dan untung2 dpt twin terus....aku pun kalo dh lebih 5 thn lum berjaya, insyallah ke arah itu jugak kalo ade rezeki dari segi kewangan dan persediaan....tp harap2 sgt x lah smpai lebih dari 5 thn tunggu....

     
  10. @e_da Says:
  11. saya doakan semoga berjaya... insya allah

     
  12. lieyalatif Says:
  13. insyaallah...semoga ade rezeki akak....amin

     
  14. Mila@Rimbun Says:
  15. banyakkan berserah kepada Allah dalam apa jua usaha kita ok. kalau nak tanya apa2 experience pasal ivf ni, bolehjugak contact saya yerrr. Pernah buat last 2 years to tak menjadi..

     
  16. SyaNa Says:
  17. saya sokong!!!
    hehee gud luck kak

     
  18. Lina Says:
  19. all the best ya... keep us all posted..

     
  20. good luck utk awak..semoga dapat twin..triplet..hihi..cover tahun2 sebelumnya..hehehe..moga Allah mudahkan rezeki untuk awak kali ni

     
  21. Delimasari Says:
  22. gud luck

     
  23. the kecik Says:
  24. My gynea was from hkl. In msia, hkl lah the cheapest for ivf. 5k, tp waiting list mmg pjg. Such a busy ward, as told by my gynea. Good luck! Moga doa diperkenankan. Amin!

     
  25. supermama Says:
  26. salam,akk dh start treatment utk ivf ke.actually blh sy tau apa problem akk sbb sy pn mcm akk sdg berkhtiar utk zuriat

     
  27. Salam. Good luck! Moga doa doa u dimakbulkan Allah :-)
    by the way, visit laa these 2 blogs - blog mommies with IVF babies yg super cute!
    http://tripletstory.blogspot.com/
    http://thirtyfingers-thirtytoes.blogspot.com/

     
  28. azli Says:
  29. Salam....sy pn nk stat my 3rd ivf tis month..insya allah nk wat natural cycle dlu...jum kt same2 usaha ye.... :)

     
  30. pilihangadiz Says:
  31. Sy skrg hari ke 5 selepas embrio transfer...and dlm 2ww....keadaan sy ada risau ade excited...perut sy mula bloated pd hari kedua transfer...pada mulanyaa sngt risau... selepas itu sy refer ke hospital and alhamdulillah..itu antara tanda2 positive...doakan sy yerrr...

     
  32. hi jangan guna dr.cc chung di gleneagles kl sebab dia itu penipu. bahasa saya tak lancar so saya post english, harap boleh share dengan wanita yang mahu jadi ibu macam saya.
    i had 5 attempts with the same doctor at gleneagles hospital kl and all failed. after speading so much money and yet is failed so i stop trying. my doctor insisted i should continue trying but due to financial problems i didnt. and it was after i stop that i found out through blogs and friends experience that my doctor is a cheater. he was actually well known for telling patients that their ivf treatment is failed and make us pay again and again for another ivf treatment. there was also patients that found out that dr.cc chung actually use those sperm or eggs that he tells his patients is fail to be sold to other patients. please help to share this story out so that there wont be more victims. money wasted with no baby and whats even worst is that now i have to worry if 10years later a kid come and claim money from me because saying that im his/her mother due to the secretly sold eggs to other patient without me knowing from this doctor cc chung from gleneagles kl and clinic at PNB darby park kl.

     
  33. cc c Says:
  34. I am Dr C C Chung. I was alerted by my patient to the post by lee,which I think constitude criminal defamation, and I feel the need to respond.I note that similar words have been posted in other blogs, most likely by the same person under different id.
    First an introduction of myself. I graduated with MBBS from Univ Malaya in 1985. I went to work in Glasgow, Scotland in 1990 and got my MRCOG(UK) in the same year. I soon went into subspecialty clinical and research work in fertility and assisted reproduction in Glasgow.I presented my work in reproductive journals and international conferences in Europe. I underwent special training in ICSI and micromanipulation in Bonn in 1993. I returned to Malaysia in 1994 and was the Head of the Specialist Clinic in LPPKN, which was then the only government IVF facility in the country. I achieved the first ever IVF birth in the public sector in 1995. I was in private IVF practice since 1997.Some of my work was listed in the Malaysian Book of Records: First IVF triplets in the country; and a normal livebirth after >10 years of embryo cryopreservation (frozen embryo). I achieved the first livebirth by VITRIFICATION (a new technique of freezing the embryo) in the country and this was presented in the Congress of the Obstetrical and Gynaecological Society of Malaysia in 2010. I ran a well-received weekly column on fertility and IVF in the Sin Chew Daily newspaper for more than a year in 1997. All in all I have been providing specialist IVF care for 21 years. (to continue in the next post)

     
  35. cc c Says:
  36. I am Dr C C Chung.
    There is ABSOLUTELY no truth in the defamatory remarks made by "michelle chung", or whatever name she uses. I am not sure if she was even a patient of mine, as I hardly (if ever)allow my patient to undergo 5 or 6 fresh IVF attempts, except under very special cirsumstances. What made me especially annoyed is the fact that I always made it a point to do the exact opposite to the allegations, ie I am extra sensitive to ethical issues when dealing with eggs and sperm. For example, I do not use egg donors sourced by “agents”. In such cases, the egg recepient is made to pay RM 10 to 12 k, while the egg donor only get about 4 or 5 thousand ringgit. I think it is not ethical to exploit the donors. I also avoid sourcing eggs or sperm for patients, to avoid the sensitive issues of “doctor selling eggs or sperm”. I also do not offer patients the option of donating their surplus embryos to others, to avoid problems.
    This is what I do with couples who need donor eggs or sperm (eg in husband with no sperm, or wife with very poor ovarian function): I explain their problems. That they need donated gamates to have a realistic chance of success. That they can choose to do nothing, or to adopt a child. For couples wanting donor gamates, I tell them I don’t have them. I don’t source eggs or sperm. I tell them that wife’s sisters (eggs) and husband’s brothers (sperm) are perhaps the best donors.i counselled them about the advantages and disadvantages of known donors versus annonymous donors. I counsel them about all important aspects of using donor gamates.I told them that gamate donation is forbidden by some religions. I tell them that they can ask family member of friends to look for donors. Or list an advertisement with a prepaid number. Or in cyber chat room. How not to get cheated. Look for donors with good reproductive records. Single mothers maybe. Divorcee maybe. If they find somebody, ask the person to see me. I will counsel the person.I will examine her. I will rule out infectious diseases like AIDS. I will take consent etc etc, but I take no part in arranging financial compensation for the donors; the patients will have to sort it out themselves. Having worked in the UK with very strict laws governing IVF, I am adapt at and comfortable with doing IVF properly. Having done IVF for so long, I am not a “fly-by-night” doctor. And I am certainly not a desparate doctor to have to resort to selling eggs or embryos!
    So there you are: my short response to the totally untrue allegations. My lawyer says it is criminal defamation. I will follow this up with a police report.
    If anyone needs further clarifications, call my clinic at 03-21662222 or email me: chungccart@gmail.com

    Dr C C Chung MBBS(Malaya) FRCOG (UK)

     
  37. xchrisz Says:
  38. My cousin ada pernah buat IVF ni... dia berjaya tau. Dia dapat 3 kembar... 2 girls and 1 laki.I also interested to do.

     
  39. In vitro fertilization (IVF) is settling down pretty well in infertile couples. Egg donation is one of the treatments under IVF infertility treatments.

    Egg Donor

     
  40. Sy buat ivf di hkl dgn kos rm3400... setelah que selama setahun... sepatutnya list 2tahun... alhamdullillah nama sy naik tahun ni.. doakan sy berjaya.. tahniah pd yg dah berjaya... yg blum berjaya,jgn putus asa.. teruskan ikhtiar jgn henti berdoa... insyaAllah doa kita smua termakbul...

     
  41. amber Wsd85 Says:
  42. Kene daftar dlu ke sis.mcm mne nak mohon buat ivf dkt hkl.blh sis terangkan lebih lanjut.time kasih kerana bantu kami yg memerlukan.��

     
  43. amber Wsd85 Says:
  44. Kene daftar dlu ke sis.mcm mne nak mohon buat ivf dkt hkl.blh sis terangkan lebih lanjut.time kasih kerana bantu kami yg memerlukan.��

     
  45. amber Wsd85 Says:
  46. Kene daftar dlu ke sis.mcm mne nak mohon buat ivf dkt hkl.blh sis terangkan lebih lanjut.time kasih kerana bantu kami yg memerlukan.��

     

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