想生BB 今日: 2 | 主題: 109597

積分: 6810

181^#

發表於 10-4-20 16:05 |只看該作者

Dear cutecutetown,
Thanks for your reply last time. I just confirmed that I've failed my 2nd ivf without frozen embryo. Both my hubby and I are really sad and frustrated. Should we go for the 3rd time? Both times implantation didn't even happen. I do have 子宮內膜異位 and got a 2.xcm chocolate cyst on one side of the ovary. I'm wondering if there's something abnormal with my uterus that's against implantation...

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積分: 9496

182^#

發表於 10-4-20 20:17 |只看該作者

Hello wendycyp,

Embryo quality should not be affected by the length of storage time. If I remember correctly from scientific publications, healthy babies have been born from frozen embryos stored for ~10 years.

If you haven't had major health issues in these 3 years except being older, your age at the time of FET should not negatively impact your success chance because the quality of the embryos mainly correlate with the age when the eggs were produced.

Based on your descriptions, the deceased baby suffered from some cogenital disorder (先天有問題?) and you are interested if there are methods to diagnose any abnormality before even transferring the embryo into your uterus. Do you know if you and/or your husband have any family history of any genetic diseases? Do you know the disorder your deceased baby had?

If you don't have a history of inheritable disease, then it is likely that the disorder happens by chance. Theoretically, there is Preimplantation Genetic Diagnosis (PGD) available to exclude some common diseases or disorders. In general, the more diseases you ask to screen for, the longer it takes and the more expensive the service becomes. Technically, PGD involves opening a hole on your embryo so that one or two cells can be taken out for testing while the embryo will be cultured in the lab until a diagnosis is known.

Let alone the technology itself and the costs that may be involved, you have only had 2 frozen embryos. Unless you decide to start a whole new ivf cycle to obtain more embryos, you are at high risk of having both embryos being abnormal and therefore with no embryo for transfer. An alternative, although not the best option, is to do pre-natal diagnosis, meaning diagnosis on the fetus only after you are pregnant.

Hope this helps. cutecutetown

原帖由 wendycyp 於 10-4-20 15:07 發表
cutecutetown你好, 我大約3年前做咗一次ivf, 好好彩, 果次放咗3個embryos, 有2個成功著床, 另外仲有2個frozen embryos.

不過唔好彩嘅係, 其中一個bb在我懷孕期間發現身體有問題, 最終出世之後不久夭折. 另一個bb就 ...

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積分: 9496

183^#

發表於 10-4-20 20:34 |只看該作者

Dear pibb,
I am so sorry to hear about the bad news. Implantation failure can be due to a number of factors; the uterus may be one of them, and embryo quality may be another. If you start another cycle, your doc will hopefully guide you through. If the problem is in your uterus, he/she may ask you to do some uterine investigation. But if he/she doesn't suspect your uterus, it may be the embryos, which relate to oocyte quality.

In any case, you can't rush your decision when you are still very distressed from the failed cycle. Let yourself rest for perhaps a week, a month or even two months before thinking whether you want a 3rd cycle or forget it altogether. When your mind is less cluttered, you will know what you want and then we can work from then.

Be well and stay well. Cutecutetown

原帖由 pibb 於 10-4-20 16:05 發表
Dear cutecutetown,
Thanks for your reply last time. I just confirmed that I've failed my 2nd ivf without frozen embryo. Both my hubby and I are really sad and frustrated. Should we go for the 3rd time ...

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parker123

積分: 304

184^#

發表於 10-4-21 00:33 |只看該作者

Hi cutecutetown
I'm a patient that needs some time to heal the pain physically and mentally. From reading your reply to other sis I feel the encouragement and the positive thinking. We are all thankful to have you here to guide us thru this long journey.

[]原帖由 cutecutetown 於 10-4-20 20:34 發表

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ccaewsc

積分: 298

185^#

發表於 10-4-21 12:53 |只看該作者

Dear cutecutetown,

感謝你一直幫我地解答疑問，幸好有你!

我有些問題想麻煩你~

我星期五就抽卵，有12粒! 醫生說針藥的效果幾理想，內膜都夠厚。
不過我老公的精液report，所有都正常~ 除了精子形態。他的精子形態一直都唔合格(0%)，而且round and small，醫生話會用icsi技術幫我地。

我想問:
1. 精子形態會影響卵子受精嗎?
2. 精子形態一直都0%，是否表示無正常形態的可以揀? 我聽到有位jm，老公精子形態只有1%正常，最後都bingo了，我希望我也有她那麼幸運
3. 那通過icsi技術，會唔會真係幫到我地卵子受精?
4. 即使受精了，會否影響胚胎grading?

我真的好擔心~ 希望你可以解答我的疑問!
感謝你!!!

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rubyhomffc

積分: 208

186^#

發表於 10-4-21 13:18 |只看該作者

Hi Cutecutetown

I want to let you know that my 1st ivf is fail ...

I know I should take 1 cycle rest before 2nd treatment cycle ... but just wonder:

1. should I start pill from today in order to start 2nd treatment? because I'm thinking to try to conceive naturally during this month...

2. I used puregon in my 1st ivf, although the nurse told me puregon & gonal f are exactly the same ... but gonal f looks easier to use ... & I saw some posts by you & other jm said that one is more "pure" ... so ... which one? can you give me more info about puregon & gonal f?

Thanks very much.

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MusicTV

積分: 7298

187^#

發表於 10-4-21 14:05 |只看該作者

Hi cutecutetown, thanks for your reply.

Yesterday, dr said I have 8 follicles which is good compare with the past two iui. Dr said might not need to retrive three times. Thanks god! However, the size of each is different. What is the appropriate range of size can be used for ivf?

Tmr will visit dr again to see which day retrieve . However, my hubby will not be in Hk so need to frozen sperm. What's the effect about that? I have no choice but go to hospital by myself soon.

And one Chinese dr mentioned to me better input 3 days embryos instead of 5 days. What is the different? And how many embryos should put max each time?

Thanks for your advice!

原帖由 cutecutetown 於 10-4-20 09:58 發表
Dear MusicTV,

If you are not financially tight, then doing at least 2 retrievals will probably accumulate enough embryos. The goal is to select, in among all the embryos, the good quality one(s) for ...

[ 本帖最後由 MusicTV 於 10-4-21 15:14 編輯 ]

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wendycyp

大宅

積分: 1882

好媽媽勳章

188^#

發表於 10-4-21 15:31 |只看該作者

多謝你嘅回覆!

其實兒科醫生都唔知點解我bb會咁, 而我同老公家族都冇先天/遺傳病, 咁係唔係剩低果2個frozen embryos有問題嘅機會唔大呢?

你都講得啱, 其實我只剩2個frozen embryos, 都未必值得去做test去睇下有冇問題... 不過我怕懷孕之後先知有問題, 就唔知點算好. 正如上次懷孕時知道個問題, 我老公都唔想放棄個bb, 希望等佢出世可以醫好!

我上次做ivf已經有1個小朋友 (冇夭折果個), 就算今次做FET唔成功, 我多數都唔會再重新做一次ivf喇, 始終年紀開始大怕唔會好似上次咁好彩, 而且唔想再經歷多一次呢個treatment, 好辛苦呀!

Anyway, thanks again for your advice.

原帖由 cutecutetown 於 10-4-20 20:17 發表
Hello wendycyp,

Embryo quality should not be affected by the length of storage time. If I remember correctly from scientific publications, healthy babies have been born from frozen embryos stored fo ...

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積分: 9496

189^#

發表於 10-4-21 17:26 |只看該作者

Hello ccaewsc,

When we do ICSI, we actually look at each individual sperm and try to choose a moving one with good morphology. Even with normal 精子形態 0%, we often can find enough (good) sperm to fertilize all the eggs. I am not sure if the "round and small" appearance is very significant, because it seems that your husband sperm has normal concentration and motility. Given a reasonable amount of sperm to choose from, I am confident the lab will try its best to help you.

To answer your questions:
1. 精子形態會影響卵子受精嗎? Sometimes, but only very rarely complete fertilization failure will occur, especially you have 10-12 eggs.
2. semen analysis tends to vary among different labs. When the lab is very strict about 精子形態, every man is <14%. Remember, other parameters are important too. When you have the others (sperm count or concentration, motility) pass, the effect of 精子形態 is somewhat "diluted".
3. ICSI directly delivers one sperm into one egg. Figures around the world tell us that in a well-established lab, ICSI fertilization rate is ~>75%.
4. My experience is that 胚胎grading or quality is more affected by the egg quality. Only when the sperm sample is very defective then we see sperm effect on embryo quality.

Don't worry, you have already done very well. 12 follicles are the kind of number I like :) If I am not mistaken, your husband's sperm is only not "perfect" due to its morphology. Sleep well tonight and tmr night, try to relax and enjoy yourself a little. You may feel some little pain and distended tummy after the egg retrieval. I always eat dark chocolate when I am stressed or down but don't know if every jm loves chocolate. Try some if you are also a chocoholic!

Good luck, cutecutetown

原帖由 ccaewsc 於 10-4-21 12:53 發表
Dear cutecutetown,

感謝你一直幫我地解答疑問，幸好有你!

我有些問題想麻煩你~

我星期五就抽卵，有12粒! 醫生說針藥的效果幾理想，內膜都夠厚。
不過我老公的精液report，所有都正常~ 除了精子形態。他的精子形態一直都 ...

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積分: 9496

190^#

發表於 10-4-21 21:02 |只看該作者

Dear rubyhomffc,

Sad, but I must say, not everyone gets their bingo the 1st time even given a "perfect" cycle. There were simply too many unknowns and things to take care of, and always the doubts and worries. It's quite a price to pay failing the first, but with the experience gained, you should feel more confident in knowing what comes next.

1. Your body is somewhat "confused" at the moment after all the ivf drugs. Take it easy and stay off pills if you want to try natural this month (although the chance is low, but still try). However, check with your doc if you want to start your 2nd ivf soon.

2. Gonal-F and Puregon are recombinant FSH, meaning they are very pure. Not sure if you know about recombinant technology, but in simple terms, they are equally pure FSH, but made by 2 different companies. I know Gonal-F pen is easier when you inject yourself. Talk to your doc if you want the ease. Perhaps from the medical point of view is the dosage the doc wants you to have. For some reasons (probably historical), each increment of Gonal-F is 75 IU while each increment of Puregon is 50 IU. This doesn't really concern you though, and the doc in my center uses the 2 drugs simple based on the maths if the patient has no preference.

Take care, cutecutetown

原帖由 rubyhomffc 於 10-4-21 13:18 發表
Hi Cutecutetown

I want to let you know that my 1st ivf is fail ...

I know I should take 1 cycle rest before 2nd treatment cycle ... but just wonder:

1. should I start pill from today in order to st ...

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ccaewsc

積分: 298

191^#

發表於 10-4-21 22:09 |只看該作者

Dear Cutecutetown，

感謝你回答我所有的疑問 ~
現在我沒有任何顧慮及擔心了
非常感謝你!!!

P.S.我非常喜歡黑朱古力~ 你提供了一個非常好的減壓方法呢!

原帖由 cutecutetown 於 10-4-21 17:26 發表
Hello ccaewsc,

When we do ICSI, we actually look at each individual sperm and try to choose a moving one with good morphology. Even with normal 精子形態 0%, we often can find enough (good) sperm to ...

[ 本帖最後由 ccaewsc 於 10-4-21 22:13 編輯 ]

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積分: 9496

192^#

發表於 10-4-22 00:27 |只看該作者

Dear MusicTV,

Great, so your doc also keeps the options open for you. The variation in size always happens, some follicles will be bigger while some smaller. By ultrasound and bloodtests, your doc will find the best time for the HCG trigger so that most eggs will be mature enough for ivf. Usually, doctors will consider giving HCG when there are 3 or more follicles of about 18mm.

Frozen sperm also gives comparable results as fresh sperm. Other than the fact that you will be a little lonely on the day of egg retrieval, there should be no worry.

How many embryos to transfer is always a tough question. Depending on your age and any previous ivf, how many and when (day3 vs day5) differ. Your doc and the lab should have established some guidelines. Other than the ivf centre, you also have a say.

In my centre, for 1st-time ivf, we recommend no more than 2 embryos; i.e. you can choose 1 or 2, depending on how much you accept multiple pregnancies.

As for day3 vs day5, it's a matter of selection. Logically, the less competent embryos will slow and stop growing; therefore, by extending culture to day5, we can see who are the better embryos and increase the success chance by transferring these better ones. However, the other side of the argument is that if the embryo is good, the success chance should not be affected whether we transfer on day3 or day5. More conservative centers will recommend day 3 in general, and selectively do day 5 if you have a number of good-quality embryos on day3. I think most centers in HK are conservative so that majority of patients can have the ET procedure. There are certainly centers that do day5 ET for all patients, but I don't find too many of them in Asia.

Cutecutetown

原帖由 MusicTV 於 10-4-21 14:05 發表
Hi cutecutetown, thanks for your reply.

Yesterday, dr said I have 8 follicles which is good compare with the past two iui. Dr said might not need to retrive three times. Thanks god! However, the size ...

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積分: 9496

193^#

發表於 10-4-22 00:42 |只看該作者

Dear wendycyp,

You are right, the chance of abnormality like last time should be very low. Besides, unless both embryos are equally competent, there may be chances where only 1 implant, or no implantation at all.

Express your concern to your doc when you do the FET. It may be possible to transfer just 1 embryo.

Cutecutetown

原帖由 wendycyp 於 10-4-21 15:31 發表
多謝你嘅回覆!

其實兒科醫生都唔知點解我bb會咁, 而我同老公家族都冇先天/遺傳病, 咁係唔係剩低果2個frozen embryos有問題嘅機會唔大呢?

你都講得啱,其實我只剩2個frozen embryos, 都未必值得去做test去睇下有冇 ...

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rubyhomffc

積分: 208

194^#

發表於 10-4-22 06:09 |只看該作者

回覆 190# cutecutetown 的文章

Dear cutecutetown

Thanks, I feel much better today after talking with my close jm yesterday.

1. I will try to make an appointment with my doc asap. & I personally feel that my body is not very "confused" ... maybe because I was not very response to the drugs used in the ivf ... (just grew one mature egg like natual cycle) ... actually I didn't feel any different physically during the whole treatment ... anyway, I agree with you that the chance of naturally bingo this month is low ... but yes, just try & it won't hurt me ... haha

2. Initially the doc was prescribed gonal f to me @ 350IU ... but the nurse found out gonal f doesn't have 350IU so she changed puregon for me ... then they increased to 450IU after 1st blood test ... so I will discuss the dosage with doc this time & will request to use gonal f if he wants me to start with 450IU.

Thank you very much again for your professional advice here, hope to bring you good news next time!

[ 本帖最後由 rubyhomffc 於 10-4-22 09:38 編輯 ]

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Sbaby

大宅

積分: 3355

195^#

發表於 10-4-22 13:27 |只看該作者

cutecutetown,
I would like to seek your professional advice on my FET cycle.
I have 1st IVF in March but failed. My M come after 11 days of implant on March 24. Today is my Day 30 already, but still no ovulation detected by checking my temperature rise. I am wondering is this normal for ladies don' t have ovulation in the cycle right after IVF treatment. For me, I had 27 eggs obtained in last IVF and now still have 4 frozen embryos left.
Since I am the case in HA hospital, no consultation and advice after My M come and My Dr. just said I can call them after next M come and start my FET after medicated ovulation.
My KWH chinese partitioner was not suggest to start the embryo transfer in the next cycle since my ovaries are not yet recover and no ovulation in this cycle. He afraid I will fail again.
Can you give some advice for me? Should I start my FET at once right after this M come or if no ovulation for this
month will affect the next FET cycle, any impact?
Thx a lot.

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MusicTV

積分: 7298

196^#

發表於 10-4-22 13:49 |只看該作者

Today dr said this sat retrieve and next mon put embryos. Is that day 2 or day 3 embryos? What is the different? If day 3 is better, can I insist day 3 embryos which mean put in the next tue?

Will there be necessary to ask somebody to pick me up after egg retrieval?

原帖由 cutecutetown 於 10-4-22 00:27 發表
Dear MusicTV,

Great, so your doc also keeps the options open for you. The variation in size always happens, some follicles will be bigger while some smaller. By ultrasound and bloodtests, your doc ...

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積分: 9496

197^#

發表於 10-4-22 14:42 |只看該作者

hello Sbaby,

A bit of concept first. Assuming a 28-day menstrual cycle, day 1 is the day when menstrual bleeding begins. It also somewhat corresponds to the day when hormones (mainly FSH) start to recruit a cohort of follicles (containing small eggs inside) for later selection and ovulation. From day1-day7 while there is bleeding, the follicles continue to grow under the influence of hormones. In a natural cycle and among these follicles, one will become dominant and "win the competition". It will rupture to release the mature egg inside, i.e. ovulation, on day 14. If we treat this day of ovulation as the middle of each cycle, day1-day13 is the follicular phase (i.e. for the growth of follicles). After that, some hormones will decline while others increase to prepare for pregnancy. If no implantation occurs, hormones slowly decline and by day 28, the whole cycle starts all over again. From after ovulation to day 28, this is the luteal phase. In most women's natural cycle, the length of follicular phase may vary while the length of luteal phase is somewhat constant and lasts ~14 days.

In IVF treatment, we try to simulate this same cycle, except that we encourage the whole cohort of follicles to grow so that we can obtain multiple eggs. Although the simulated follicular phase may not be exactly 14 days, we can view the day of egg retrieval as the day of ovulation. From there onward, i.e. after egg retrieval, will be the luteal phase, where we supply you with luteal support medication, which tells your body you are pregnant so that your period won't return. If there is implantation, then the implanted embryo together with the medication will signal the body to be in a pregnant state. If there is no implantation, the body will know and overcome the medication effect, then your M returns.

So by now, you probably understand why you can't detect ovulation on day 30, or I believe you mean ~day 19. Sorry for too much biology being explained here, but I try to keep it simple.

Then, if you somewhat understand the above, that is the same reason why there is no actual help from KWH until your M returns. If your M hasn't returned yet, there is no way the doc can tell your day 1 of the cycle. As your doc also suggested, give your body (and ovaries) a month for recovery so that it can better prepare itself for your FET cycle.

Generally, each cycle is independent of each other. Now that you are almost half-way through this unmedicated cycle, wait for your M to come again and remember to call to make your appointment. An FET is much less stressful compared to a full ivf. Good luck!

cutecutetown

原帖由 Sbaby 於 10-4-22 13:27 發表
cutecutetown,
I would like to seek your professional advice on my FET cycle.
I have 1st IVF in March but failed. My M come after 11 days of implant on March 24. Today is my Day 30 already, but still ...

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shanhu

洋房

積分: 43

198^#

發表於 10-4-22 15:42 |只看該作者

Cutecutetown,
我之前Ｐｏｓｔ左上来問Ｆｅｔ後Ｈｃｇ吾跌，懐疑係宮外孕既，我想Ｕｐｄａｔｅ返個進展

原帖由 shanhu 於 10-3-27 17:14 發表
3月1日，排卵
3月5日，FET,打左一枝ｈCG同一枝黄體針
3月6日至3月14日，早晩塞薬
3月15日，Check尿白雪雪,停塞薬
3月18日，早上驗血，HCG５１,打一枝黄體針。中午好似来M甘流血。
3月23日，因流左幾日血（份量好多架）,早上體温都是高,再驗血，HCG４４,照超声波,没有異常。醫生話係早期流産。
3月27日，今日再驗血，HCG68,照超声波,又話没有異常。醫生都解釋吾到,浄係約左2個星期後返去驗血。

4月4日，再驗血，HCG8７,照超声波,又話没有異常，見到医生写内膜7.5。話應不是宮外孕。
4月14日，早上体温変成低温，深夜開始来Ｍ甘流血。
4月22日，今日再驗血，HCG３３,趺左。没照超声波,医生話仲未趺到正常，5月返来再驗血，如果仲係吾正常会考慮用薬

而家只可以…等！

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Sbaby

大宅

積分: 3355

199^#

發表於 10-4-22 15:47 |只看該作者

cutecutetown,
Thanks for your perfect biology answer, and I love your words "each cycle is independent of each other". I hope I can have a better cycle for FE implant next time.
For your more information. My last M is March 24, and now is almost my day 30. I keep check on my temp for almost 30 days but there is no a big jump to indicate ovulation. I am having a unstable cycle before due to the prolactinoma. I have cycle ~ 37 to 50 before. So I kept check on my ovulation day for almost 3 years upon Dr's advice. I wonder this time is the stop of ovulation after IVF or the delay of it. But I believe what I can do now is just wait for the next day 1 and call to KWH to ask their advice on FET.
Anyway, thanks a lot.

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