“With 30 years dedicated to helping couples struggling with infertility, I find immense happiness and am deeply touched every time parents bring their children to meet me.”

“It's a doctor-patient relationship where, even after successfully treating them a long time ago, we continue to stay updated and connected, sharing news with each other.”

In vitro fertilization (IVF) is a sought-after method among married couples grappling with infertility. However, the process leading to a viable embryo that can develop into a baby is fraught with challenges, and not every attempt succeeds. In this edition of MedPark Stories, we explore the MedPark IVF Center located on the 20th floor, where we discussed infertility treatment with Wg.Cdr. Dr Viwat Chinpilas. Dr Viwat is an obstetrician-gynecologist specializing in reproductive endocrinology at MedPark Hospital, serving as a physician and administrator.

Dr Viwat earned his Doctor of Medicine degree from Chulalongkorn University and pursued a residency in obstetrics and gynecology. Upon completing his residency, he held a government position as an obstetrician-gynecologist at Bhumibol Adulyadej Hospital from 1987 to 1992. In 1993, he established his fertility consulting practice, offering guidance and treatment to individuals dealing with infertility. Concurrently, he also assumed leadership roles at various prominent medical centers and clinics.

Contemporary couples delay marriage and lack family planning.

Given his extensive experience in providing infertility consultation and treatment spanning three decades, it is conceivable that the babies Dr. Viwat has helped bring into the world may now be married and expecting children of their own. During a casual conversation, we discussed the lifestyles of contemporary married couples.

Dr Viwat has observed that modern couples often choose to marry later in life. Furthermore, young married couples do not rush to start a family. 

“The most common cases involve patients, particularly women over 36, often stemming from delayed marriages, as many individuals do not immediately plan to have children after getting married. Some seek consultation only after reaching 36 or older, which poses challenges in the battle against biological factors. As women age, issues such as reduced egg quality and declining ovarian reserve can significantly reduce the likelihood of pregnancy. Strategic pre-pregnancy planning can address these concerns.” 

“ For instance, consider a patient who opted for IVF at 36, had her first child by natural birth at 37, and raised that child until she was 38. Subsequently, she decided to have a second child and underwent embryo, frozen from the initial IVF cycle, uterine implantation. At 40, she wished to have a third child, and we repeated the process. It's important to note that embryos can be frozen and remain viable for 3, 5, or 7 years.”

Reproductive technology is vital in enabling married couples to fulfill their desire for conception. Nonetheless, a married couple should grasp the concept of family planning and make informed decisions regarding the number of children they want or the intervals between pregnancies. In practice, many couples may not fully comprehend or appreciate the significance of family planning

Gynecological issues are among the factors contributing to infertility.

Young married couples often assume that getting pregnant is straightforward, simply ceasing birth control when they decide to have a child. However, the reality is that they may encounter complications after conception. Many expectant individuals experience miscarriages or spontaneous abortions. Some struggle with infertility for an extended period without success. Only when they consult with an obstetrician-gynecologist do they uncover the underlying causes of their miscarriages, which are often related to gynecological disorders. 

“One common gynecological disorder I frequently encounter is endometriosis. When it affects the ovaries, it's called a "chocolate cyst." When it involves the uterus, it's known as adenomyosis. If the displaced tissue is in the pelvic floor, it's termed pelvic endometriosis. Another frequently observed condition is uterine fibroids. Large fibroids or those pressing on the endometrium can lead to infertility.”

After successfully treating these disorders, if the patients' ovaries remain functional, a physician may suggest attempting natural conception initially. Many couples achieve success in conceiving without the need for IVF assistance.

Patients must comprehend and come to terms with their medical conditions.

Infertility related to advancing age is more prevalent than gynecological disorders. Some patients exhaust every available option, including assisted reproductive technology, yet still do not achieve success. Nevertheless, they persevere, and Dr. Viwat encourages these patients to "embrace the setbacks." 

“We must pinpoint the underlying reason behind their unsuccessful attempts at conception, even after multiple trials. If the cause is untreatable, patients should come to terms with it. For instance, in cases where uterine fibroids are widespread and hinder embryo implantation or when a 48-year-old patient persists in attempting IVF with her eggs after ten unsuccessful tries, I must emphasize that the likelihood of success is exceedingly low.”

Dr. Viwat expresses significant concern for couples with female partners over 35. He underscores the importance of not delaying, advising them not to squander precious time. He strongly recommends early consultation and pre-pregnancy planning in such cases.

Physician-patient teamwork

Successful conception through assisted reproductive technology relies on the expertise and experience of highly skilled physicians and scientists in this specialized field. 

“To determine the specific causes and factors contributing to infertility in each patient, a physician must exercise meticulous attention to detail. Moreover, success in procedures like egg freezing, retrieval, and embryo implantation requires high precision. It is equally important to employ techniques that minimize the risk of injury or harm to the ovaries, uterus, or endometrium, with proficiency in these skills honed through experience.”

“However, it's crucial to emphasize that a single physician cannot achieve successful infertility treatment in isolation. It necessitates a collaborative and cohesive effort among physicians, nurses, and scientists, working collaboratively towards a common goal. Understanding the underlying problems, adhering to treatment guidelines, and receiving cooperation from the patient are all essential components of this collaborative approach.”

Despite the high patient expectations, Dr. Viwat remains unfazed, confident that his team will meticulously follow every step of the treatment process. They ensure that patients receive a comprehensive treatment plan with no omissions. Throughout the treatment journey, patients receive regular update, which significantly alleviates their anxiety.

“Furthermore, the tools and equipment used in the IVF Center are of cutting-edge quality, meeting international standards. Additionally, what sets the center apart is its soothing and relaxing ambiance, offering a picturesque panoramic view from the 20th floor that includes Benchakitti Park and Bang Krachao. The IVF Center boasts excellent air quality, creating a relaxed and hygienic environment. This tranquil setting contributes to the overall success of the treatment, making patients feel at ease and content.”

Pregnancy is not the sole source of happiness for him

For reproductive endocrinologists, happiness extends beyond simply helping couples achieve their goal of conceiving a child. It also involves witnessing the growth, nurturing, graduation, and career pursuits of the children born into these families. 

“I've dedicated three decades to this profession. I am more fortunate than the younger doctors that my patients' IVF babies are approaching their thirties. It brings me immense joy whenever my patients visit me with their children. Only recently, a person met with me and asked if I remembered him. He mentioned being my patient 27 years ago and proudly introduced his 27-year-old daughter, whom I helped conceive. She has since graduated from a university and secured a job.”

“At events I attend, patients often bring their children to greet me, saying, "This is my daughter, thanks to your help. She graduated from Rajinibon School and is now entering the Faculty of Arts at Chulalongkorn University." They express their gratitude and even bring me snacks, filling me with happiness. This bond between a physician and a patient endures, and despite the passage of 20 years, we continue to stay connected and updated in each other's lives.”

The attitudes of the current generation encompass a diverse range of beliefs and perspectives concerning parenting and their children. Deep down, he hopes that adults will come together to build a nurturing society that welcomes children who will play a crucial role in shaping the future course of development of the country. 

“I hope that everyone can adopt a positive perspective on parenthood. When I speak with people, I often hear them express reluctance to have children due to concerns about the challenges and pressures children might face in a high-pressure, polarized society. They fear their children's lives may face more pain than joy. However, I wish they could also recognize the brighter side of the world. When we encounter problems, we must work together for solutions so that future generations can inherit a better Earth than the one we have today.”