She counts eggs. Women’s eggs,
It is what Ms Vijeyaletchimi
Nadasan does every day as
a specialist sonographer at
Singapore General Hospital’s
(SGH) Centre for Assisted Reproduction
(CARE), a one-stop fertility centre under the
Department of Obstetrics and Gynaecology.
“My job is to check the number of eggs
that the ovaries can produce and that can be
retrieved later for in-vitro fertilisation (IVF),”
said the Senior Principal Sonographer.
“I trace, count and measure every single
follicle that is going to mature and ovulate,
starting from the second day of a patient’s
menstruation cycle. We track the progress of
these follicles until it is time for ovulation.”
Follicles contain eggs with the potential
to mature. When one reaches around 18
millimetres, it is ready and must be retrieved
within the short window of time available for
fertilisation. Scanning a follicle takes 5–10
minutes, or 20–30 minutes for multiple follicles.
IVF sonographers at SGH and sister
institution, KK Women’s and Children’s
Hospital, journey with couples through
the many stages of a pregnancy, from the
check-ups and diagnoses for fertility issues
to follicle tracking and pregnancy. When
undergoing their ultrasound scans, patients
may become anxious, which can affect the
quality of the ultrasound images taken. It
is important for sonographers to be able to
calm their patients.
To get them to relax, Ms Vijeyaletchimi.
often tells them about a patient who was
found to have only one good egg. The patient
managed to have that single egg retrieved,
fertilised and implanted. She became
pregnant and delivered a healthy baby. “I
always tell my patients: you don’t need too
many eggs. You just need one good egg to get pregnant. Look forward to that,” said
How sonographers communicate with
their patients is also crucial. “We must
listen to our patients actively and carefully.
Choosing the right words, understanding
their state of mind,” she said.
It is a different ball game when scanning
the foetus to track its growth, health and
other developmental milestones. Unlike an
adult who keeps still when asked, the foetus
is constantly moving, making it difficult to
scan different parts of its body. One solution
is to have the mother go for a walk before
resuming the procedure, when the foetus has
changed its position, and a different part of
the body can be scanned.
Not only do the scans assure parents of
a foetus’ healthy development, seeing the
baby’s heartbeat, movements and features
helps create a stronger bond and connection
between parents and child. “Some of them
have had multiple miscarriages and are
anxious when they come in, so I try to get
the best images of the baby’s features to
show them,” said Ms Vijeyaletchimi.
A keen science student in school,
Ms Vijeyaletchimi settled on radiography
after her sister, then a nursing officer at SGH,
told her of available positions at the hospital.
In the 1980s, radiography was considered
unconventional, in part because of concerns
over potential radiation and its effects. Ms
Vijeyaletchimi was undeterred. She has since
been trained in various aspects of radiography,
including x-ray, CT (computed tomography)
and MRI (magnetic resonance imaging). She
chose to specialise in sonography, finding it so
fascinating that when an advanced diploma
course was introduced, she took up night
classes while pregnant with her third child.
When she left for a period to work in a
private hospital, she performed ultrasound scans on various areas of the body,
including breast, testes, prostate
and thyroid. Returning to SGH in 2010,
she focused on ultrasound for obstetrics
and gynaecology patients. Today, she
performs an average of 16 scans daily,
including IVF-related as well as foetal
abnormalities and fallopian tube blockages.
Having witnessed the beginning of life
multiple times, Ms Vijeyaletchimi cherishes
her recently acquired role as grandmother.
Weekends are spent with her 15-month-old
grandchild at the library, pool and parks. In
her free time, she practises yoga once a week
and enjoys the company of her Maltese-
Poodle mix, Robin.
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