In Vitro Fertilization (IVF) in Thailand: Prices, Clinics and Doctor Reviews

In vitro fertilization (IVF) is a complex of the procedures for infertility treatment when an egg is combined with sperm outside the body — in vitro.   

IVF has been used worldwide for almost 40 years. For many couples, this is the only way to have children. The procedure helps even in cases when natural conception is almost impossible.

In vitro fertilization in Thailand is the best option for patients with infertility. Indications for IVF are:

• tubal infertility because of the absence of fallopian tubes or their obstruction
• infertility associated with endometriosis
• endocrine diseases that lead to ovulation disorders
• hereditary diseases (hemophilia, etc.)
• male infertility 
• premature ovarian failure.

IVF is contraindicated for persons with:

• severe mental and physical diseases
• abnormalities of the reproductive organs
• benign uterine tumors 
• cancer.

Specialists perform in vitro fertilization in 8 steps:

1. infertility diagnosis
2. preparation for the procedure
3. ovulation stimulation
4. follicles puncture
5. egg fertilization
6. embryo cultivation
7. embryo transfer
8. pregnancy control and support.

In vitro fertilization including the infertility diagnosis and preparation for the procedure takes about 2 months. The duration of the IVF procedure itself depends on the protocol type and lasts 25-45 days. During this period, all steps are carried out from ovarian stimulation, fertilization, embryo transfer, to monitoring implantation and final confirmation of pregnancy.

Infertility is diagnosed when a woman cannot become pregnant for 1 year of regular sexual activity without the use of contraception. If a woman is more than 35 years old, this period is cut down to 6 months. In this case, it is necessary to consult a reproductive specialist.

There are a lot of factors that can cause infertility. Causes of infertility can be associated with health problems in both women and men. To define the exact cause of the disorder, the couple should undergo complete body examination and consult with a specialist.

IVF in Thailand is a complex and multi-step procedure that requires both physical and moral preparation. During the consultation, the doctor always recommends preparing the body for pregnancy — quitting all bad habits, controlling physical activity, and keeping a healthy eating plan.

To make sure the IVF procedure is possible, both a man and a woman must undergo examinations and pass tests.

Tests for men:

• semen analysis (spermogram)
• urethral smear
• smears infection test
• blood tests for HIV, hepatitis B, and C, syphilis.

Tests for women:

• consultation with an endocrinologist
• hysterosalpingogram (test of tubal patency)
• hysterolaparoscopy or laparoscopy
• coagulogram (blood clotting test)
• general urine analysis
• blood test for syphilis, HIV, hepatitis B and C
• blood test for hormones
• TORCH screen 
• Pap test
• scrape or brush cytology
• smears infection test
• consultation with a therapist
• chest X-ray
• ECG (electrocardiogram)
• Ultrasound of the mammary glands
• consultation with a gynecologist. 

The diagnostic plan is developed and modulated by a specialist. If necessary, the doctor may prescribe additional examinations.

Ovulation stimulation/induction (in vitro maturation — IVM) is the process of ovulation boosting by medication. To achieve the maturation of eggs number, the doctors prescribe daily injections of gonadotropins — hormones that lead to the maturation of several eggs at once in contrast with the common menstrual cycle when only one egg is maturated. 

The duration of this step depends on the type of induction protocol. The dose of stimulative drugs is selected by the doctor individually. Ovulation stimulation is carried out under the supervision of a specialist.

When the follicles grow to maturity, it is necessary to make a special injection to introduce a trigger for the final egg maturation. Follicle puncture and egg production are carried out in 34-38 hours after the trigger introduction. Only after this step, it is possible to obtain mature eggs.

The procedure is performed under general anesthesia and is monitored by ultrasound. The doctor uses a special needle to collect follicular fluid. After that, the embryologist selects eggs for further fertilization. The more eggs you get, the better result you can achieve.

The obtained eggs and sperm cells are placed in a special incubator where the temperature is 37°C and humidity is high. In these conditions the fertilization takes place.

In some cases, embryologists apply an intracytoplasmic sperm injection (ICSI). Using this technique, the embryologist selects the most qualitative spermatozoon and implants it into the egg cytoplasm. The procedure is performed if the quality of the ejaculate is low or the frozen eggs are used.

The day after fertilization in Thailand, the embryologist determines how many eggs are fertilized and monitors the development of the embryos for several days. In a few days after fertilization, the most qualitative embryo is transferred to the uterus. The transfer is carried out through the cervical canal using a catheter. The procedure is painless.

IVF in Thailand has several types and the specialist selects the procedure method depending on the infertility cause. The basic IVF technique is described above but it is often supplemented by additional technologies.

ICSI — involves the artificial introduction of sperm into the egg using a very thin needle. Usually, ICSI is used if the partner's sperm is motionless and are not able to fertilize the egg on their own. 

PICSI — a modification of the ICSI method when only mature sperm are selected. Before providing PICSI a special test is carried out.

IVM — involves the removal of immature eggs. They mature in vitro, in laboratory conditions. It allows patients to avoid hormonal stimulation. It is also used if stimulation does not give a result.

Assisted hatching — a technology that facilitates the implantation of an embryo into the uterus. The embryo is surrounded by a thin coverage, which is destroyed before the implantation. Hatching is the artificial destruction of this coverage.

According to statistics of Dunya IVF Clinic, the success index of in vitro fertilization is:

• 56% — in women of 20-29 years old
• 51% — in women aged 30-34
• 45% — in patients of 35-39 years old
• 14% — in women over 40.