The Science of Hope: Rewriting Family Planning with IVF — Indonesia

In a quiet clinic waiting room, a woman sits clutching her partner’s hand, her eyes fixed on the clock as if willing time to move faster. They’ve been through this before — the consultations, the injections, the endless tests— but the hope of holding their own baby keeps them coming back. For couples like them, the dream of becoming parents is one of the most important milestones in life. While some people choose to remain childfree, others turn to options like In Vitro Fertilization (IVF), a decision filled with both nervousness and anticipation.

How common is infertility in Indonesia? What are the most common causes that doctors encounter?

Infertility is a growing concern in Indonesia, with an estimated 10-15% of couples of reproductive age experiencing difficulties in conceiving naturally, according to the Indonesian Society of In Vitro Fertilization (PERFITRI). This means that about 1 in 10 couples face challenges in starting a family. The most common causes I encounter include menstrual disorders, such as irregular periods or ovulation issues, often linked to conditions like PCOS (Polycystic Ovary Syndrome), endometriosis, and male-related factors, particularly poor sperm quality.

What usually motivates couples to consult or consider undergoing an IVF program?

Couples who consider IVF are generally highly motivated by a strong desire to have children, driven by several factors:

• Building a family or continuing their lineage
• Social and cultural pressure
• Diagnosis of infertility issues that cannot be addressed through less invasive methods like troubled sperm quality (oligospermia or azoospermia), blocked fallopian tubes, PCOS, or severe cases of endometriosis
• Previous failed attempts to conceive naturally
• Age-related concerns, especially for those who marry later in life and feel a sense of urgency to have children before fertility declines

Currently, there is a trend where people are choosing to live a childfree life. As a fertility specialist, what is your perspective on this phenomenon? Has the demand for pregnancy programs been affected by this trend?

As a doctor, our primary role is to respect the choices of our patients and provide relevant information or services based on their needs. The childfree phenomenon in Indonesia has not significantly impacted the number of patients seeking IVF programs, unlike in some developed countries in Asia, such as Singapore, South Korea, or Japan. In these countries, the rise of childfree lifestyles has been more pronounced, which may influence the demand for fertility treatments. However, in Indonesia, the desire for children and family-building remains strong across various age groups, and many couples continue to seek assistance with IVF when faced with challenges in conception.

Many couples have to wait a long time and try various methods to have a child. How do you support them through the process?

As a specialist in obstetrics, gynecology, and reproductive endocrinology, supporting couples who are struggling to have a child requires a holistic approach that addresses both the medical and emotional aspects. Medically, this involves thorough examinations, explaining the possible causes of infertility, and providing treatment options that can increase the chances of pregnancy. On the emotional side, active listening is crucial — understanding their concerns and hopes without judgment, and building trust so that couples feel comfortable sharing their experiences. Emotional support is also enhanced through collaboration with other healthcare professionals, such as counselors and nurses, ensuring that couples feel supported and at ease throughout the process.

Are there any medical technologies that can improve the success of fertility treatments, particularly IVF?

Advances in medical technology play a crucial role in improving the success rates of fertility treatments, particularly IVF. Some of the key technologies that enhance pregnancy outcomes include:

1. Preimplantation Genetic Testing for Aneuploidy (PGT-A)

This test examines the chromosomes of embryos before they are implanted in the uterus. It increases the chances of pregnancy by selecting embryos with normal chromosomes, which is particularly helpful for women over 35 years old or couples with a history of recurrent miscarriages or previous IVF failures.

2. Time-Lapse Imaging

This technology allows continuous monitoring of embryo development in an incubator. It helps embryologists select the best embryo for transfer by analyzing its optimal development pattern. Time-lapse imaging reduces the risk of damaging embryos by eliminating the need for frequent handling outside the incubator.

3. Intracytoplasmic Morphologically Selected Sperm Injection (IMSI)

Using a high-powered microscope, this technique allows for the selection of the highest-quality sperm before injecting it into the egg. It improves fertilization rates and embryo quality, especially for couples facing male infertility factors.

4. Artificial Intelligence (AI) in IVF

AI is used to analyze embryo data and predict success rates. In the future, AI is expected to assist embryologists and doctors in making more accurate decisions when selecting embryos with the highest potential for a successful pregnancy.

What is the success rate of IVF for couples? Are there any memorable stories of patients who successfully had a child through IVF?

The success rate of IVF varies depending on several factors, such as the woman's age, embryo quality, uterine lining (endometrium), and overall health. Generally, IVF success rates are higher for women under 35, while the chances decrease for women over 40 due to the natural decline in egg quality as women age.

Key factors that influence success include the condition of the uterus and endometrium, as well as the quality of sperm and eggs. For women with conditions like PCOS or endometriosis, IVF can offer a viable solution, but it often requires additional effort and care. High-quality eggs and sperm significantly improve the chances of obtaining a normal embryo, which in turn increases the likelihood of a successful pregnancy.

One of the most memorable cases for me was a couple who initially had no hope of conceiving due to the wife’s congenital condition — she had never had a period in her life and lacked normal secondary sexual development. This condition, known as primary amenorrhea, left them feeling hopeless after previous medical treatments failed. However, after examination, it was found that she still had a good number of viable eggs, and her husband’s sperm quality was also optimal. With the help of IVF, combined with hormone therapy to replace the absent endogenous hormones, they were able to conceive and eventually give birth to a healthy baby. Stories like this are always deeply rewarding and remind us of the power of medical intervention in making seemingly impossible dreams come true.

In the midst of the growing childfree movement, many couples continue to face the emotional and physical challenges of starting a family. For those dreaming of parenthood, RS Pondok Indah IVF Centre offers a supportive path forward. With a team of expert fertility specialists, cutting-edge medical technology, and personalized programs, the center is dedicated to turning those dreams into reality. Take the first step towards your journey to parenthood.

Contact the IVF Counselor at RS Pondok Indah IVF Centre today.

RS Pondok Indah - Pondok Indah

South Wing 6th Floor

Jalan Metro Duta Kav. UE, Kota Jakarta Selatan, Daerah Khusus Ibukota Jakarta 12310 Indonesia

+62 822 6161 3223

This article has been featured in the Issue no. 2 (Childfree Neighbor) of Wonderwhy magazine.