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2221^#

發表於 14-6-28 13:49 |只看該作者

Hi cutecute town,

睇到你呢個POST實在太好了。

事情係咁, 我30歲, 我舊年10月尾小產, 當時係8WEEKS突然停心跳, 我做左吸宮, 休息左3個CYCLE, 再試左幾個月, 今年4月我再BINGO, 但今次更恐怖, 我宮外孕, 一直搵唔到個胎o係邊但個hcg又keep住不停升, 結果, 要打化療針去處理, 打左針後, 醫生話要半年後先可以再懷孕。

問題來了, 醫生話當有過一次宮外孕, 以後有宮外孕既機會係10-15%, 我地真係唔想再有第三次不幸, 所以正打算做IVF, 起碼減低左宮外孕既風險先, 但我老公就話不如照左兩邊輸卵管有冇塞同埋去驗血睇下我地自身有冇問題先, 如果CHECK完出黎一切正常, 佢想再試下自然, 相反, 如果報告上發現我地的確係有任何問題而令我地懷孕不成功, 咁就試IVF。但問題係, 醫生講明就算我既輸卵管無塞亦唔代表唔會宮外孕, 因為可能係輸卵管內既絨毛唔識運送卵子, 一樣會做成宮外孕, 但可悲既係無檢查係可以CHECK到絨毛係咪正常。

對我黎講, 我真係好擔心再有宮外孕出現, 今次我已受折磨左個幾兩個月, 抽左十幾支血, 成件事由開始到依家休養階段我都覺得好折磨。

在你既經驗黎講, 我想問一下, 你覺得IVF能否幫助我, 定係我應該好似我老公咁講乜都唔駛做, 繼續自然試? 香港既IVF好貴, 我地就算做, 都打算去台灣做, 因為較為平同埋口碑亦唔錯。

THANKSSS!!!

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Joeykamhei

複式洋房

積分: 369

2222^#

發表於 14-6-28 14:51 |只看該作者

回覆：ivf Q & A

你好

我是Joey 我想問我下月放雪胎，自然週期沒有打針，只食Estrade . ivf 醫生説植入時間以排卵那天計算，亦叫我在day11照超聲波, 只見卵子最大的0.9cm 內膜1.1-1.3cm
醫生叫我day15再照排卵沒有，那如果還是未排卵，是否一定要打破卵針？及會推遲植入日子而令到內膜血液不合呢？

謝謝

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積分: 9500

2223^#

發表於 14-6-28 22:32 |只看該作者

回覆：Muimuipoon 的帖子

Hi Muimuipoon，
方案是合適的，因為ivf療程本來就可以先將自己的賀爾蒙降到最低，醫生再控制給你體外（以針藥）賀爾蒙，那麼卵巢的反應就更易掌握了。而因肌瘤同時已被壓下，子宮沒被肌瘤所阻礙，放胎便容許胚胎正常著床和生長。

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積分: 9500

2224^#

發表於 14-6-28 22:51 |只看該作者

回覆：iamsosad 的帖子

Hello iamsosad,

的確很同情你的遭遇，但並不要以為做ivf就可減低宮外孕的風險，ivf也有宮外孕個案，不比自然懷孕的機會少。
你還算年輕，是應該繼續嘗試自然懷孕的，而且以你的病歷亦不可算是不育**，固此，不育科醫生未必會受理你的個案。

**要有一年時間，在沒有避孕的情況下未能懷孕才可算是不育

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積分: 9500

2225^#

發表於 14-6-28 22:58 |只看該作者

回覆：Joeykamhei 的帖子

Dear Joey,

不要擔心，醫生會看情形，合適的話給排卵針亦不會影響內膜的。

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Muimuipoon

積分: 2795

2226^#

發表於 14-6-29 11:15 |只看該作者

cutecutetown 發表於 14-6-28 22:32
Hi Muimuipoon，
方案是合適的，因為ivf療程本來就可以先將自己的賀爾蒙降到最低，醫生再控制給你體外（以 ...

Thanks cutecutetown,
我高齡卵少，我想問打完柳培林之後那個cycle的卵會否受影響？卵子會不會變少或質素變差？ thank you.

點評

cutecutetown 卵子不會因此而變少或變差，但留意你本來已經是卵子較少，與藥物抑制無關。發表於 14-6-29 16:28

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sktse88

積分: 1315

2227^#

發表於 14-7-7 12:59 |只看該作者

Hi cutecutetown,
我今次已經第三次ivf放胎失敗了，頭兩次放day3胎，今次是day5，放了一個，有6個雪了（day5），每次都有塞藥同打安胎針，但係都失敗，我想知會唔會系我o既身體對胚胎排斥？定系只可以話因為高齡，卵子質量唔好？我day2既FSH4.7，無驗AMH，我想問仲有什麼方法知道原因呢？多謝。

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Yanli426

別墅

積分: 538

2228^#

發表於 14-7-7 13:41 |只看該作者

Hi cutecutetown！
多謝你解答我們！
我今年二十八歳，抽day2血及超ultrasound 醫生說一切正常。
我先生的精子型態只有1%，其他的均合格。
上月我們曾一次化學懷孕。
請問您認為我們仍可嘗試自然成孕？
還是應該直接ivf 呢？
謝謝！

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積分: 9500

2229^#

發表於 14-7-10 10:19 |只看該作者

回覆：sktse88 的帖子

Hello sktse88,

胚胎質素很多時候也是關鍵所在。Day3靚的胚胎未必能長到day5, 而你似乎在過去三次也是放新鮮胎吧?！
看你有限的資料應該不是身體排斥胚胎，只是胚胎不着床。若你已是35歲或以上，胚胎多有染色體數目異常而導致不着床，你還有6個day5的，機會還是很好，放雪胎成功機會應該有的，不要太擔心。

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積分: 9500

2230^#

發表於 14-7-10 10:25 |只看該作者

回覆：Yanli426 的帖子

Hello Yanli426,

很年輕，又試過化學懷孕，是自然懷孕的嗎？那是一定要繼續嘗試自然懷孕，不要太心急，尤其精子數量和活動力都合格。
只要周期準，多試半年至一年無妨，祝早日成功！

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Micky2014

民房

積分: 20

2231^#

發表於 14-7-22 23:35 |只看該作者

Dear cutecutetown,
On the day when my eggs were extracted, my husband were asked to give samples for the sperms . My husband has the problem of 弱精症. Unfortunately, in the two samples which were collected within one hour interval, no motile sperms were found. Actually my husband has been consulting an doctor and has done TESA in December. At that time, the lab people said that only occasional motile sperms were seen in the right testis and they have frozen them . But on the day when my eggs were extracted( it is in July), they defrost the sperms and said no motile sperms were found. Then my husband did a MESA ,but again no motile sperms were found. So they did not inject the immotile sperms into my eggs. Finally they have frozen my eggs. I would like to know if it is really useless to inject the immotile sperms into the eggs? Is that the case they cannot fertilise the eggs? And will my eggs die after defrost. I am 37 years old and I wonder if I should give up having babies. Please help.

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積分: 9500

2232^#

發表於 14-7-23 18:22 |只看該作者

回覆 Micky2014 的帖子

Hello Micky2014,
Firstly, MESA (MicroEpididymal Sperm Aspiration) and TESA (TEsticular Sperm Aspiration) obtain sperm from 2 different areas along the reproductive tract; so, the maturation state of the sperm extracted might be different.

Do you know if the lab did anything extra to test the viability of the immotile sperm? Immotile sperm could be dead sperm, or they could be immotile but alive.

As for your frozen eggs, there is always a possibility, although very small, that a few or all of them will not survive the freeze-and-thaw process. Assuming they will survive the "defrost", I would suggest to inject them with fresh sperm. This has to be coordinated so that the day of sperm collection/surgical retrieval will match with the day of egg defrost and your natural cycle. Although this sounds complicated, your doctor will coordinate for you; and this is not difficult in your doctor's hands.

When all are well-planned and matched, you can hopefully have an embryo transfer.

Suppose in the worst scenario where there is no sperm from your husband, will you consider using sperm donated from others? What about adoption? There are a number of options available, and you may initiate this discussion with your doctor as well.

cutecutetown

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森蝶

積分: 2709

2233^#

發表於 14-7-23 18:55 |只看該作者

回覆：ivf Q & A

Cutecutetown 你好，先多謝你幫我地解決疑惑

其實我一路都好想知驗精洗精過程，主要係人手操作定機器控制？如果人手，咁結果好壞係咪好睇幫我地洗精的胚胎專家手勢同經驗，does human factor actually affects the process？

另一問題係，我做過兩次iui, 我睇返report佢有寫洗精method (swim up 同唔記得另外一個）其實係咪有好多種方法去洗？胚胎專家係咪會跟據情況決定用邊種？因為我老公第一次有千幾萬，第二次用swim up(另一個lab)得返百幾萬條，想知其實有無影響，因為嚟緊想做ivf，想了解清楚再選擇，many many thanks

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Micky2014

民房

積分: 20

2234^#

發表於 14-7-24 17:08 |只看該作者

Dear cutecutetown,
Thanks for your reply. We just saw the doctor and the lab people today. The embryologist told us that among the immotile sperms, 7% of them are alive . But after testing the sperms with the chemicals, they can no longer be used for ICSI because the chemicals for testing may bring some unknown harm to the embryos. Actually, I just wonder why the doctor chose to do MESA instead of TESA on the day when my eggs were extracted since occasional motile sperms were found when my husband did TESA in December. Will the result be different if TESA was done that day? We will not consider using sperms donor because both of us still can't accept this plan. We still hope that we can have a baby with our genes. By the way, the embryologist suggested my husband to take 'Preseed plus'. From your expertise, do you think it will work for my husband cause some researches show that this supplement is only effective for those males with sub-optimal sperm quality, but not for males with a high percentage of immotile sperms. And I am wondering if I should seek help from another hospital? Should I consult other doctors? Since it gave me an impression that they could not give us further help. Could you kindly give me some advice? Thank you very much.

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森蝶

積分: 2709

2235^#

發表於 14-7-24 18:58 |只看該作者

引用：Dear cutecutetown,Thanks for your reply.

原帖由 Micky2014 於 14-07-24 發表
Dear cutecutetown,
Thanks for your reply. We just saw the doctor and the lab people today. The embry ...

Sorry to interupt, just to share my experience to you.

My husband was suggested to take the proxeed plus together with an antioxidant as his sperm test failed in my first iui.
He has taken the supplememts for 3 months. Sperm test showing that mobolity improved just a little bit while the morphology dropped from 1% to less then1%. I am not blaming the supplements for worsensing the morphology but i thought the improvement from supplements only is limited. And for your information, he later consult a 泌尿科doctor and discovered that he has 精索脈曲張。

By the way, my husband said the taste is yucky and he just left the remaining 2 boxes at the corner of the shelf after knowing that it doesnt help.

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積分: 9500

2236^#

發表於 14-7-24 22:31 |只看該作者

回覆森蝶的帖子

Hello 森蝶,
"Sperm washing" or preparation is relatively simple and routine. We have the swim-up method and density gradient method. Swim-up is more straight forward; as its name implies, we let the sperm swim from the bottom up. It takes a little more time as compared to density gradient, and usually, this is more suitable with sperm of good motility. On the other hand, density gradient utilizes colloidal reagents to separate out the sperm with good motility from immotile ones. Both methods require some technical staff handling as well as a centrifuge to spin down the preparation. I would say human factor does not affect the process as long as you have a trained person doing it.

When it comes to IUI success rate, we usually talk about the success over 3 cycles of IUI. A woman can get lucky to bingo in her first IUI, but usually we can't see its effectiveness until 3 times have been performed.

As for the sperm report, you need to be very clear about what "number" you are looking at because sometimes we talk about the absolute number of sperm, and sometimes we talk about sperm concentration, which is the number of sperm per volume. Also, the numbers would be different before and after sperm preparation. This probably explained why you saw 千幾萬 and 百幾萬 in the 2 IUI cycles.

cutecutetown

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積分: 9500

2237^#

發表於 14-7-24 22:45 |只看該作者

回覆 Micky2014 的帖子

Dear Micky2014,
In your case where sperm needs to be retrieved from the epididymis or the testis, I doubt the effectiveness of Preseed Plus, or any other similar products. I can only say that these supplements should do no harm. However, if it tastes horrible (as 森蝶 claimed), why bother taking it?!

Back to your concern, there was probably clinical judgement involved when MESA instead of TESA was done. While testicular aspiration (TESA) might be done, MESA was "easier" especially if no sophisticated surgical set-up is available. It is always tempting to suggest other alternatives when we look retrospectively, so instead of saying what should have been done, you may consult another doctor(s) and see if they can offer further help. Sometimes under a different occasion and a change of hand may benefit.

cutecutetown

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積分: 9500

2238^#

發表於 14-7-24 22:58 |只看該作者

回覆森蝶的帖子

Dear 森蝶,
A note on sperm morphology. When it's around or below 1%, I would not be too fuss whether it improves or not. For semen analysis, there is sample-to-sample variation, and there is also inter-technician variation. While the absolute values look different, a 0.8% and a 1.1% practically mean the same to me.

cutecutetown

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Bubblebb

別墅

積分: 602

2239^#

發表於 14-7-24 23:01 |只看該作者

引用：Being+in+the+ivf+field+for+>10+years,+I+

原帖由 cutecutetown 於 10-02-12 發表
Being in the ivf field for >10 years, I hope to help in a discussion format any of your questions or ...

Dear cutecutedown,

想問下我呢個case next cycle 再繼續IVF應注意d咩同埋今次點解會有咁嘅情形發生，謝謝！醫生告知我取5粒卵，取卵後第三日全部停止生長，我fsh未開針前8.3, LH5.1, 孕酮0.34, 取卵前一日LH42.8, 孕酮3.67, 打225ui針，many tks!

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森蝶