What would you do with $100,000? Some people would use it for the down payment of a ﬁve-room ﬂat, pay for a car or ﬁnance a university education.
For 36-year-old Audrey Nah, it was the price she paid in her arduous attempts to get pregnant.
While her peers had no problems making babies, the oil broker had to go through a total of six in-vitro fertilisation (IVF) cycles. She eventually managed to conceive and carry through two successful pregnancies from her second and last cycle.
"I was then 27 years old and never thought I'd have problems conceiving. I remember we started trying for a baby around the same time as another couple. Within four months, they had a bun in the oven. But, for us, nothing happened - even after a year," says Audrey, who was diagnosed with unexplained infertility, which forms about 20 per cent of all infertility cases.
When traditional Chinese medicine and intrauterine insemination failed to help her conceive, Audrey turned to IVF. By then, three precious years had gone by.
For the next few years, Audrey says she became a "pin cushion" from the numerous jabs she gave herself to stimulate ovulation as part of the IVF procedure. She was so determined to have children that she would even bring along her daily injections of follicle stimulating hormone in an ice bag on her overseas trips.
The pain from the injections was nothing, says Audrey. Instead, the toughest part of her IVF journey was the waiting.
"Every day, you're waiting for news like whether you've got a good number of (ovarian) follicles going or whether the embryos are healthy. There are a lot of heartaches and emotional highs and lows," she says.
"I think I spent half of my waking hours at the doctor's waiting. Nothing was as torturous as waiting for calls from the embryologist."
In IVF, an embryologist preps and fertilises your embryos in the lab. He's also the person who will give regular updates on the status of your embryos.
Audrey recalls how distraught she and her husband had been when her ﬁrst IVF cycle ended up in an ectopic pregnancy. Until today, she remembers clearly the day she lost her ﬁrst unborn baby.
"It was particularly devastating for me because it was the ﬁrst time I ever got pregnant. We went through the high of being told I was pregnant, to later the low of learning that the pregnancy wouldn't work out," says Audrey.
Her subsequent cycle was a success, and Audrey ﬁnally conceived a child. Although she was elated with the arrival of her daughter Kaitlyn, who is now ﬁve years old, she was eager to have another child.
As an only child herself, she didn't wish for her daughter to go through the similar solitude she had experienced during her childhood.
When Kaitlyn turned 18 months, Audrey embarked on another round of IVF. By then, it was an uphill climb.
Her third and fourth cycles were "completely wasted", as the quality of eggs collected were not ideal. She got pregnant during her ﬁfth cycle, but it ended in an early miscarriage because of abnormalities in the embryo.
Despite her exhaustion - physically, emotionally and ﬁ nancially - from the numerous IVF treatments, Audrey would not let up. On the other hand, her husband, 37, who works in the shipping industry, wanted her to call it quits.
"I was lucky that I did not suﬀer serious side eﬀects, but my husband was worried about the massive amount of hormones I was pumping into my body every day. Still, I was desperate for my daughter to have a sibling. I knew how lonely being an only child would be. My husband's a twin, so he never knew how it feels to grow up alone," she says.
While patients can undergo as many IVF cycles as they want, Dr Roland Chieng, medical director of Parkway East Fertility and IVF Centre at Parkway East Hospital, says success is "unlikely" if the woman has undergone three cycles that did not result in a pregnancy.
For Round 6, Audrey's doctor decided to try a diﬀerent approach by including human growth hormones in her IVF treatment.
According to Dr Chieng, such hormones, which can cost approximately $1,000 per week, are typically used in women with poor ovary function. Th ey can potentially improve the quality of the eggs.
Audrey's perseverance paid oﬀ . She conceived twin girls, Ashley and Victoria, who were born full-term in Dec 2011 via C-section.
"For the longest time, I didn't acknowledge that I was pregnant because I had gone through so many disappointments. I delayed doing the nursery room. People were so happy for me, but I didn't dare to celebrate until my daughters were born," she says.
Today, Audrey's a happy and contented mum of three girls. Looking back, she had not expected to spend so much money on IVF, but not once has she regretted her decision.
"Yes, I'd have a lot more money in the bank if I hadn't gone through IVF," she shares. "But, that doesn't match up to having three healthy girls."
IVF isn't a sure-ﬁre way to conceive, but it's a ray of hope for couples struggling with infertility, says Dr Roland Chieng.
The treatment is typically tailored to each person, but here's what you can generally expect.
* Before you start, you and your husband will need to go for check-ups, which may include ultrasound and blood tests.
* During the initial phase of IVF treatment, you may need to inject yourself every day - for 10 to 14 days - with follicle-stimulating hormones to stimulate the ovaries to produce eggs.
A new fertility drug, Elonva, launched last year, may reduce the number of injections for certain patients.
The single injection replaces the ﬁrst seven daily ones in a treatment cycle.
* When the ovarian follicles are ready, you'll return to the clinic for egg collection.
While you're under light general anaesthetic, your doctor will use a ﬁne needle to remove the eggs from the ovaries.
* The collected eggs are prepared and fertilised with your husband's sperm. The fertilised embryos are then transferred back into your uterus after two to three days at the clinic.
* Two weeks later, you'll ﬁnd out if the treatment is successful. As a pregnancy is too early to be detected in the urine at this stage, you'll undergo a blood test.
* The entire IVF process from the ﬁrst injection to the pregnancy test ranges from four to six weeks.
* IVF doesn't pose any risk to the husband.
However, the wife may experience potential side effects such as bloating and local soreness at the site of injection. Some may experience ovarian hyperstimulation syndrome.
In severe cases, which occur in about 1 per cent of all IVF cycles, there will be excessive bloatedness, and water accumulation in the abdomen and lungs.
When this occurs, you'll need to be hospitalised for treatment and monitoring.
You may also need to undergo surgery to drain the excess ﬂuids.
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