GENERAL FAQs FOR FERTILITY TREATMENT

The Fertility Center and IVF Clinic
at Bumrungrad International Hospital
Frequently Asked Questions

GENERAL FAQs FOR FERTILITY TREATMENT

1. What should I look for when choosing a clinic to undergo fertility treatment?
Choosing the right clinic is perhaps one of the most important decisions in the fertility process. Although each person has her own criteria, there are essential questions to consider when choosing a clinic:

Does the clinic have the proper credentials and is it trustworthy?
Where is it located? Is traveling there easy, efficient, and safe?
Do you feel comfortable in the clinic?
If using insurance, will your insurance provider cover the procedure at the clinic you choose?

2. How long should I try to get pregnant naturally before seeing a fertility specialist?
Doctors recommend trying to conceive during the “fertile window,” which is the approximately 5 days leading up to ovulation and during the 12-48 hours of ovulation.

It is suggested that women over 35 see a fertility specialist after 6 months, and women under 35 see a fertility specialist after 1 year if natural conception proves unsuccessful.

As well, there are smartphone ovulation apps that can help you track the days that you would be most likely to conceive.

3. What are the success rates for IUI and IVF?
Success rates vary, and success depends on a variety of factors. Some couples may make up to three attempts before succeeding, some may conceive on the first try, while others, unfortunately, may not be able to conceive.

The factors that can impact success rates for IUI and IVF include age and the cause of infertility, amongst others. The method you choose when undergoing fertility treatment will also affect the likelihood of success.

4. For how long should I try a more conservative method, such as timed intercourse or IUI, before switching to IVF?
Timed intercourse does increase a couple’s chance of success. Couples should try timed intercourse for at least 6 months before seeking out fertility treatment.

As for IUI, today, couples average 3 IUI attempts before opting for IVF. In the past, couples would try up to 6 attempts; however, statistics began to show that after a third failed IUI attempt, chances of success drop by half.

5. How can I plan financially for IVF? Will my insurance policy cover the cost of fertility treatment?
You can consult the IVF Clinic at Bumrungrad International and request a price quote. Keep in mind, however, that further procedures may be required in the event the first attempt is unsuccessful.

Ask your health insurance provider whether fertility treatment/IVF is covered, and if so, check whether it is covered outside your home country.

You should also check whether your insurance has a direct billing agreement with the hospital. Click here for more information.

6. I’m worried about the stress and emotional toll IVF will have on me and my family. What should I do?
The process can be quite an emotional roller coaster as the possibility of disappointing results comes along with IVF; however, there are things you can do to help ease the stress and worry:

Educate yourself beforehand; learn about the procedure and statistics on the success and failure of IVF.
Plan out the costs. If it doesn’t succeed on the first try, will you be financially prepared for the second or third attempt?
Discuss the various scenarios with your partner in order to be prepared for each possible outcome.
Look for support from friends or other couples who have gone through IVF.
Confide in friends and family for emotional support.
Consider IVF support groups and communities that are available for couples undergoing IVF.
Try to clear your mind of other stresses, so as not to overexert yourself.
Find ways to reduce your stress, such as exercise or hobbies.

7. What do all those acronyms I’ve been seeing online mean?
Women who are going through fertility treatment may have their own social media language within their IVF support groups and communities. Here is what some of the common acronyms stand for:

AF – “Aunt Flo” meaning menstruation/period
BC – birth control or before children
BBT – basal body temperature
BFN/BFP – big fat negative or big fat positive on pregnancy test
CD – cycle day
HPT – home pregnancy test
MC – miscarriage
O – ovulation
O’d – ovulated
SD – sperm donor
TTC – trying to conceive
US or U/S – ultrasound

SPECIFIC QUESTIONS REGARDING IVF AND ICSI

1. What is the difference between IVF and ICSI?
In vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) both involve eggs and sperm collected from each partner. The difference is in the process of achieving fertilization. Whereas with IVF, sperm and eggs are left to be mixed “naturally,” meaning on their own and left up to chance, with ICSI, a single sperm is directly injected into an egg, assisting in and speeding up the process — as well as increasing the chances of fertilization.

2. Should I choose fresh or frozen cycle IVF/ICSI? What’s the difference?
Fresh Cycle Pros:

This method has been around longer
If successful, there is no need for additional hormone treatments
Embryos are immediately transferred to the uterus

Frozen Cycle Pros:

Your body has time to rest and recover
You are able to schedule the implantation date
There are fewer potential side effects
Frozen eggs can be kept for a long period
The success rate is higher compared to fresh cycle transfer

3. How long will the IVF/ICSI procedure take? And how long will we have to stay in Thailand?
The average IVF/ICSI procedure lasts 3-8 weeks (depending on the time between egg retrieval, fertilization, and embryo transfer), although each case is different based on factors such as age, fertility status, and hormone levels.
The average IVF timeline breaks down as follows:

You may be given fertilization drugs for ovarian stimulation for between 2-4 weeks.
Your IVF/ICSI cycle officially begins on the second day of your menstrual period nearest to your scheduled IVF treatment.
You will then begin the ovarian stimulation process, which will last 8-13 days.
Following, if all is well, you will be given your ovulation trigger shot to stimulate egg release. You must then be at the hospital 34-36 hours later for egg retrieval.
Simple sperm retrieval is performed on the same day as egg retrieval. If TESE (testicular sperm extraction) or PESA (percutaneous epididymal sperm aspiration) is required, it can be performed any time prior to, or on the day of, egg retrieval.

Fertilization takes place for both fresh and frozen IVF/ICSI within a few hours after egg retrieval.
If fertilization is successful, your embryo transfer can then be scheduled for 3-5 days later if you chose the fresh cycle; for a frozen cycle, you will be able to schedule a later date for embryo transfer.
9-12 days after the embryo transfer, you will be tested to see if you are pregnant.

4. If I get pregnant through IVF/ICSI, will managing my pregnancy be any different from a pregnancy through normal conception?
Once IVF/ICSI is successful, during the first month, you will require some detailed follow-ups, including hormonal and ultrasound tests, then carry on through your pregnancy following normal pregnancy guidelines; however, remember that each pregnancy is different whether through normal conception or through IVF/ICSI.

After successful IVF/ICSI treatment, your obstetrician may choose to monitor your pregnancy for the first few months and then transfer you to a regular obstetrician, or choose to monitor you throughout your entire pregnancy.

Also, follow-up visits may be more frequent for IVF/ICSI pregnancies and may also require additional medications and/or hormones.

LEGAL QUESTIONS ABOUT FERTILITY TREATMENT IN THAILAND

1. Do I need to be married in order to undergo fertility treatment in Thailand?
Yes, Thai law requires couples to be legally married in order to undergo IUI and/or IVF/ICSI. You will need to present your marriage certificate at the hospital.

However, ovarian stimulation and some fertility medication treatments are permitted without being married.

If your marriage license is in a language other than English, you will need to have it translated into English and validated by your local embassy in Bangkok. Please feel free to email us ahead of time to find out more details for your specific case.

2. I am legally married to a person of the same gender in my home country. May I undergo IUI or IVF in Thailand?
Thailand does not recognize same-sex marriage, and same-sex couples wishing to undergo IVF or IUI are forbidden from doing so in Thailand — this applies to both Thai nationals and to foreign couples, even with a legal marriage license from a foreign country.

3. Is egg donation an option in Thailand?
Egg donations are legal in Thailand; however, commercial egg donation is not (egg donation for profit is prohibited in Thailand).

Egg donor recipients are not allowed to receive eggs from more than one donor per treatment.
The patient requiring egg donation will need to provide her marriage certificate, and her husband must sign a letter of consent. The egg donor must also sign a letter of consent.

Egg donor qualifications include:

Must be 20-35 years of age
Pass a physical and mental health assessment
Must have the same nationality as the egg recipient
Spouse of the egg donor must sign a letter of consent
Has not donated eggs more than 3 times in her lifetime
Egg donor information will be documented for 20 years

4. Is sperm donation an option in Thailand?
Sperm donation is legal in Thailand; however, commercial sperm donation is illegal (sperm donation for profit is prohibited in Thailand).

The patient who requires sperm donation will need to provide her marriage certificate, and she and her husband must sign letters of consent. The sperm donor must also sign a letter of consent. Also, the sperm donor is limited in conceiving a child with no more than 10 families.

Sperm donor qualifications include:

Must be 20-45 years of age
Pass a physical and mental health assessment
Spouse of the sperm donor must sign a letter of consent
Must not be a relative of the sperm recipient
No history of drug abuse
No history of sexually transmitted diseases
No history of hereditary diseases
No history of pestilential diseases (e.g., HIV/AIDS)
The sperm donor must also agree to be screened for HIV/AIDS upon submitting the sample — and repeat the test 6 months later before use of the sperm in the procedure

5. What are the legal requirements regarding egg freezing?
The legal requirements for egg freezing include:

Prior to egg freezing, the patient must sign a letter of consent
The patient must undergo a health screening for contagious disease
Screening to separate “infected” from “uninfected” eggs (e.g., HIV/non-HIV infected)
Eggs kept longer than 5 years after the passing of the wife may not be used
A husband wishing to use eggs from his deceased wife must have her written consent
If frozen eggs are used after the death of the wife, the Ministry of Public Health (Thailand) must be notified

6. What are the legal requirements regarding sperm freezing?
The legal requirements regarding sperm freezing include:

Prior to sperm freezing, the patient must sign a letter of consent
The patient must undergo a health screening for contagious disease
Screening to separate “infected” from “uninfected” sperm (e.g., HIV/non-HIV infected)
A wife wishing to use sperm of her deceased husband must have his written consent
Sperm kept longer than 5 years after the passing of the husband may not be used
If frozen sperm is used after the death of the husband, the Ministry of Public Health (Thailand) must be notified

7. What are the legal requirements regarding embryo freezing?
The legal requirements regarding embryo freezing include:

A couple wishing to undergo embryo freezing must be legally married
Prior to embryo freezing, both husband and wife must sign a letter of consent
The couple must undergo a health screening for contagious disease
Screening to separate “infected” from “uninfected” embryos (e.g., HIV/non-HIV infected)
A husband or wife wishing to use embryos after their spouse has passed must have a written consent
If frozen embryos are used after the death of a spouse, the Ministry of Public Health (Thailand) must be notified
Embryos kept longer than 5 years after the death of a spouse may not be used

8. Is pre-implantation genetic screening an option in Thailand?
Thailand permits pre-implantation genetic screening, which is usually done in the following cases:

The female is over 35 years of age
If the female has had more than 2 abortions/miscarriages prior to 12 weeks of pregnancy
Couples with a history of recurrent miscarriage
Known to have unusual genes
Has failed to become pregnant from IVF after 2 consecutive attempts
Has previously given birth to a child suffering from birth defects
There is reason to believe that there is an embryo irregularity
Severe male factor infertility

9. Does Thailand permit selective fetal reduction?
Selective fetal reduction is not available at Bumrungrad International Hospital.

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