You do have a number of questions; I will try to answer them one by one here:
1. Using donor eggs will be one of the better options. Finding an appropriate donor, ethical concerns, and financial support are other considerations you may need to think about.
2. You should not view IVF as an endless journey. IVF helps to increase the chance of having a baby, but it does not guarantee it. There are certainly couples who have gone through IVF but remain childless.
3. All fertility specialists are properly trained and licensed to treat; I can't recommend one or a few particular names. However, you may want to seek opinions from a few and see if they would offer further treatment or other options.
4. 有錢不等如一切; 做十次八次,總有一次得 is not a good spirit. You need to understand your short-coming, set a goal or timeline for yourself, know when to stop or hopefully go with another plan.
I think it can be both, mostly the embryo quality but perhaps the 子宮肌留also affect implantation.
This is only your 1st-time IVF. The sensible thing to do is to do your coming FET. If it fails again, try to get a second opinion of your 子宮肌留 to see if it needs to be removed. Then a 2nd IVF may give a better outcome. No guarantee here, but based on the no. of eggs you have and the presence of sperm in TESE, it is worthwhile to try again.
cutecutetown
原帖由 susumi123 於 11-3-8 07:14 發表
Hi cutecutetown,
This is my first time posting a question here, hope you can give me some opinion.
My hubby did SA last year and found zero sperm in his sample, that means NO sperm at all. and he we ...
I agree with you that my ivf doctor is over-cautious. I am taking the Cyclogest 400mg twice daily and 100mg progesterone once daily up to 12 weeks, which I think is too too much...
The doctor said that since the hcg is going high, yesterday (day 21 after ER or 5 weeks) was 9800, which was fast double 2 days ago, he still assumes that twins probably might happen to me. He is still worry about the one which can be seen at the moment. There still possibility of having 1 in the uterus and 1 is ectopic.... So another scan will be made on Friday. We are still worry...
Actually when will be the lastest time to discover a ectopic?
What is the usual hcg in week 4 and 5? Am I really "too high". Will it hurt if it's "too high" to one embryo?
Still worry.....
Thanks for giving me a way to release....
I will keep you post. Hopefullly good news are coming very soon...
I am glad for you but a little upset by your ivf doctor. I don't know how many ivf docs out there who would ask their patients to do an ultrasound scan in
That's good to know. Quite a good start after all the months of waiting, and when most follicles look ripe (~18mm or more), I am guessing you will probably get your 破卵針 on Thur. or Fri.
E2 is produced by growing follicles. It gives us a reference point to compare with the follicle size as appeared on the ultrasound. Besides, when it rises sky-high (>20,000), doctors will take precautionary steps to avoid OHSS. In your case when E2 is 4000-5000, you really don't have to worry about 過渡刺激卵巢 at all. E2 levels measured at different time before and during the stimulation process have to be interpreted with other clinical findings to be meaningful.
To drink water before ET is to fill up your urinary bladder. A full bladder somewhat presses on the uterus so that the path for ET is straighter. In other words, with ultrasound guidance, the ET process will be more straight forward and the embryos can be placed inside the uterus with much ease. It helps you in the sense that you will experience less pain during ET. As long as the embryos can be placed into the uterus, the full bladder doesn't directly help (nor harm) implantation.
Thanks for telling me your progress. I still think the chance of an ectopic is relatively small, although we will need to confirm with a scan on Friday.
As soon as a prominent sac or even a beating fetal heart can be clearly seen on the ultrasound, anything ectopic should show up as well (being similar size or slightly smaller to the one inside the uterus).
Depending on the number of fetuses inside, hcg level varies, and there really is no "should be" hcg. In ivf pregnancies, hcg is almost always much higher than those of natural pregnancies during early gestation. This may also be one of the reasons why some general gynaecologists couldn't relate the high values with small/none gestational sac because the chemistry is different. I don't have the expertise to comment; however, I wonder if your doctor should at least reduce your Cyclogest/progesterone a little.
hcg is produced by the implanted embryo, so in theory, a high level is just a sign that the embryo is growing and shouldn't be harmful. Up to a certain level (usually by 8-10 weeks), the level will pleateau and become stable.
I agree with you that my ivf doctor is over-cautious. I am taking the Cyclogest 400mg twice daily and 100mg progesterone once daily up to 12 weeks, which I think is too too much... ...
Thank you for your reply. I have talked to my hubby but it looks like we both are not sure what to do next. In fact, I don't think I can be perfectly OK for IVF emotionally and will not be since there are so many ups and downs during the procedure. However, I have done it twice and with the gained experience, I am much better than before. Initially, I'm thinking if my FSH is below 8 in the next cycle, I will give another try otherwise will wait for next. Let the statistics to decide my next move. Do you think it is a sensible approach? Is FSH 8 a good benchmark? Any other benchmark I need to use?
Thank you for your reply and thank you so much for you to spend so much time for answering our question.
I have one more question, is my embryos grading very poor? (G2+, G2, G2-) There's no G1, is that only G1 embryo can be successful? Did you see any case with G2- success?
Also, as per my doctor, the sperm quality seems affecting my embryos quailty. We've got 5 tubes of sperm last time, and they used 2 tubes for my 1st IVF. However, all my embryos are coming out from the same TESE sperm, even if I try another IVF, would the sperm quality the same as this time, or is there any difference between each tube?
That's sensible enough. The FSH level you set is a measureable benchmark; other than this, your doc will probably do an ultrasound scan as well. See what he/she thinks. Also, take your emotional state on that day into the equation. When you are truly ready to start the "journey", then I am always on your side too.
I know you seem to have only one functional ovary and most docs will "push" it hard to get eggs. See if you can get a milder stimulation to get a cohort with good quality (instead of quantity). This really depends on your doc though, I am only suggesting.
Cheers, cutecutetown
原帖由 parker123 於 11-3-9 09:37 發表
Cutecutetown,
Thank you for your reply. I have talked to my hubby but it looks like we both are not sure what to do next. In fact, I don't think I can be perfectly OK for IVF emotionally and will n ...
Embryo grading is indeed a very subjective assessment on the embryo appearance only. Just like buying oranges in a supermarket, we will all choose to buy the good-looking ones. But that is in relative terms; suppose you go to the market in the evening instead of in the morning, you should still find good oranges even though many believe that produces may be fresher in the morning. Whether you have picked and bought a good one or an average one, they are probably equally good and sweet inside. The only thing for certain is that you don't buy an orange that appear rotten on the outside.
Similar logic to us looking at embryos, no doubt that the "rotten" ones would have been excluded from the usable pool. When we think the embryos have potential, we would either transfer or freeze for later use. So again, when we have to compare these usable embryos to each other, we have this natural tendency to think that the average-looking ones may not be as nice as the good-looking ones. However, I don't see all G1 embryos implant, and I don't see all G2/G2- embryos fail either.
The sperm quality should probably be the same and there is no difference in between tubes. Based on your embryo quality, I still think your egg quality (which led to embryo quality later) is no.1 concern, then no.2 is the 子宮肌留, sperm comes much lower in the list. This is based on what you told me in your last message, without knowing your age and other infertility cause(s).
cutecutetown
原帖由 susumi123 於 11-3-9 12:06 發表
Hi cutecutetown,
Thank you for your reply and thank you so much for you to spend so much time for answering our question.
I have one more question, is my embryos grading very poor? (G2+, G2, G2-) Th ...
That's good to know. Quite a good start after all the months of waiting, and when most follicles look ripe (~18mm or more), I am guessing you will probably get your 破卵針 on Thur. or F ...
There is in fact no dramatic difference between a day-2 and a day-3 ET. I personally prefer a day-3 (i.e. what you will have) because one more day of growth in the lab usually allows better selection. In cases where embryos are just so-so, day-3 definitely let us select the nicer embryos for ET. In cases where all embryos are good-looking, then it doesn't really matter which day.
In theory, you can resume your daily activities (work, shop, rest, etc.) on the day of ET. I think the key is to relax and not to feel over-stressed. The 2 weeks of waiting for a bingo test are really some harsh time to "kill". If work can distract you from thinking too much, go back to work. If you feel like resting for a few days, it should be fine as well. I can feel you are quite an optimistic person, so, go with what you feel like.
Now, after this successful first step, there is still some distance ahead to walk through. Feel free to express yourself here :)
cutecutetown
My period has not yet come. My blood test result this morning is less than one, indocating not pregnancy. I miscarriage once. I tried for four years and i preg natrually on 2006. My son is four yrs old now. I love him so much. But during my 26week , I am told I am diabetics. The doctor said might be cured after giving birth.but I am still a diabetic. 也許我十一歲甲狀腺有問題,至十九歲做手術後痊癒,現時亦有定期驗。but no supplement is needed. I reduced my weight fr 65kg to50kg in six months and I had my son natrually while I was waiting ivf in WH.
My husband'sperm is not so good, low mobility, normal one is only 5%.
I had a son. He wants playmate soooooo much. 我告訴他,找了很久,也找不到bb,他說:媽咪,比心機搵啦,比心機就得啦,還拍拍我膊頭。
quote]原帖由 cutecutetown 於 11-3-10 21:18 發表
Dear Creamother,
Uh???? That's really strange and you got me worried. No pressure though, tell me only when you are ready and up to it.
醫生說我的胚胎質素好almost g1 and 2. I was put two embroys and the bingo rate is 40%, twin rate is 4%, failure rate is 60%. The probability of fail is greater than successful rate.
I have 8frozen embroy, I am planning to have et in alternate month.