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582^#

發表於 10-11-22 15:16

Hi cutecutetown, allsisi and all viewers,

My case is similar to allsisi.

I had the ET on 31/10/2010. This is my first attempt of IVF.

The doctor called me back for blood test on 10/12/2010. (she said it is day 10.)
But how to count the number of days?!
on the embryo report, 31/10/2010 is already count as day 2. so if I did the blood test on 10/12/2010, should I count it as Day 12?

so, on 10/12/2010, my figure is 65.
As I transferred 2 ETs, she said only 1 embryo is successful. so she gave me all the medicine and ask me to take as much as rest at home.
Before I go, she said I need an extra 安胎針.

Is it my figure is similar to allsisi?
But how come my doctor did not tell me that this is marginal case?
If my case is not marginal, then may be allsisi is not marginal too.

I am sorry if my question is stupid as this is my first time in IVF. Um.. just feeling a bit similar to what allsisi's mentioned.

Cutecutetown, Can you pls help and explain a bit. Thanks in advance.

[ 本帖最後由 DwarfMaMa 於 10-11-22 15:30 編輯 ]

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583^#

發表於 10-11-23 02:20

Hello DwarfMaMa,

It is normal to be nervous going through ivf, especially it is your 1st time.
There is no stupid question unless it is not asked.

1.How to do day counts?
You are correct in calling your blood test day as Day 12; what you are counting is along the embryo growth timeline.
On the other hand, your doctor called it day 10 because on Nov 10, 2010, it is the 10th day after your ET.
The day count is more important when preparing for an ivf cycle because the stimulation process requires very precise timing.
Whether it is an ultrasound scan or a blood test, the result is almost always unique to the patient concerned and the doctor has to determine the next appropriate step quite quickly.
However, when it comes to the time after ET, the day count is more of an approximation.
This is because implantation occurs within a time frame (mostly around day 5 to day 7); and then, there is no “universal” system of which day to start counting from.

2.When to call it “marginal”?
Although you and allsisi looked like having the same hcg value, other considerations need to be taken into account.

First, any medication after ET?
--your ET was done 3 days after your egg retrieval, while for allsisi, she was having frozen embryo transfer (FET).
In your case, you might have been given progesterone (does Crinone sound familiar to you?); in allsisi, she might not be given any because she’s probably using her natural cycle.
Second, your hcg test was done 10 days after ET, while allsisi had hers done 11 and 13 days after ET.
As I explained in the previous posting, hcg value should roughly double (increase by x2) approximately every 2 days.
Third, hcg test is the earliest test you can do to tell a pregnancy.
Of course you should be happy with a positive bingo test or a good hcg value; however, I won’t be overly confident until a fetal sac can be seen on an ultrasound scan (~5 weeks of gestation, or ~1 week after bingo test) or even a fetal heart (~6-8 weeks of gestation, or ~2-4 weeks after bingo test).

Fourth, different approach by different doctors.
I try not to make you worry, and I am not a medical doctor to comment.
But my opinion is that you were given an extra 安胎針
because of this “marginal” hcg value.
安胎針 is essentially hcg, therefore, you didn’t have to do another hcg test within 2 days.
By the time you could have your 2nd hcg test, you would probably be due for an ultrasound scan anyway.

I hope my explanations are adequate.
Are you doing ok with your pregnancy?
cutecutetown

原帖由 DwarfMaMa 於 10-11-22 15:16 發表
Hi cutecutetown, allsisi and all viewers,

My case is similar to allsisi.

I had the ET on 31/10/2010. This is my first attempt of IVF.

The doctor called me back for blood test on 10/12/2010. (she s ...

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584^#

發表於 10-11-23 15:31

Cutecutetown,

Thanks for your detail explanation. Helpful and informative.

It seems that I didn't use any Crinone!

The doctor gave me 2 kinds of Vitamins: Materna & Vitamin E. She said I am old lar, so I need extra Vitamin E (now I am 41 lar).
The first 10 days, she also gave me aspirin, she said that my 子宮內膜 is thin, only 8mm?! so aspirin is needed.
Finally, she suggested me to drink 花膠湯 everyday. She said it's really help wor.

Furthermore, there are 2 kinds of tablets I need to insert into the vagina, twice a day.

Endometrin – I believe this is a kind of 黃體素補充劑, am I correct?
Estrofem 2mg – From the instruction manual, this is somehow use to defer 更年期的出現.

Actually before 3/11/2010 (the blood test day), I got the “feelings” that the 'Embryo Landing' is successful inside my body. Therefore, I am not really surprise when the doctor told me that I am bingo.

The doctor asked me to visit her again on 4/12/2010, my week7 pregnancy. To check the size of the embryo and see if any heartbeat can be detected.

However, I know my problem, “the development of the embryo”, seems the quality of my egg/my husband's sperm is not good enough. The doctor reminds us again, YOU TWO ARE OLD LAR

I've miscarriage 2 times already, 1 @ 11 weeks in 2005 and 1 @ 8 weeks in end of 2009.
Thanks GOD that HE sent me an lovely ANGEL in 2007.

So, as you said, I will wait to at least 13 weeks, or even 20 weeks, until I confirmed that the embryo development is completed, healthy and normal.

I am quite OK with my pregnancy. 可能家中有小孩, 實在沒有多餘時間去胡思亂想.

Anyway, I will try my best to eat adequately, take more rest and be HAPPY. Hope for the best!

Cutecutetown, thank you very much again.

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585^#

發表於 10-11-23 23:51

Dear DwarfMaMa,

I am glad that you are doing well.
Indeed, it’s good to be occupied with your family and your little angel (going to kindergarten now?); 胡思亂想 is not helpful at all.

Don’t be obsessed that you are old. In my opinion, being 41 but with previous pregnancies gives higher success chance than those who are 41 but never got pregnant before.

Also to fill you and other readers with the information regarding the supporting medication after ET. Crinone (the kind I mentioned previously) or Endometrin essentially achieve the same purpose because they are both progesterone.

As for Estrofem (a form of estrogen), although one of its functions may be to defer menopause, it is definitely not for this function in the context of ivf. Just treat it as another medication to support the endometrium. Its effect is less direct and I will not go into the details here, too much biology. While it will not do any harm, its beneficial effect is still debatable. That is why most doctors do not routinely prescribe it to women after ET.

Hope you will see a fetal sac of the right size with strong heartbeats. Good luck,
cutecutetown

原帖由 DwarfMaMa 於 10-11-23 15:31 發表
Cutecutetown,

Thanks for your detail explanation. Helpful and informative.

It seems that I didn't use any Crinone!

The doctor gave me 2 kinds of Vitamins: Materna & Vitamin E. She said I am old la ...

[ 本帖最後由 cutecutetown 於 10-11-23 23:52 編輯 ]

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Kandice

積分: 6071

586^#

發表於 10-11-24 10:38

cutecutetown,

真的很感謝你仍然在這裡耐心的回答我們問題，你的專業解答真的令我們這群等希望的jm們苦中有一點甜，謝謝。

我今年內做了兩次ivf(同一個醫生，之前還做了幾次iui 但失敗)，et及fet各兩次，兩次放新鮮胎都是pregnant的，但到8-9weeks因照不到心跳而要吃藥流產，而兩次放雪胎都是沒pregnant的，根據醫生的解釋，失敗都是關乎年紀卵子質素問題(我四十歲了)，亦已驗過沒有抗體之類的問題。經濟上容許我做多次ivf，其實我在想要不要轉個醫生試一試運氣，還是stay with my current doctor，因他比較熟悉我身體的反應?再不是便不要再試了(我希望我這個人的想法沒有discourage其他姊妹)?你的lab做過我這個年紀但第三或四次會成功的case嗎(我似乎是想找一點鼓勵)?可以分享你的看法嗎? 謝謝!

[ 本帖最後由 Kandice 於 10-11-24 10:43 編輯 ]

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587^#

發表於 10-11-25 00:48

Hello Kandice (and all姊妹),

Thank you for liking this blog. With a sympathetic heart, I hope to share your joy and/or anxiety by providing the scientific facts and clarifying some common myths. Whether you (all 姊妹) are walking, or have walked past, the harsh and often painful path to reach your goal, I expect a positive attitude here so that jm’s benefit from the “knowing” but not discouraged.

Back to the more general concern. Very frankly, being 40 years old, egg quality has definitely declined. This decline in quality may be more pronounced in some women but not so much in others. For older women, there is a higher chance of aneuploidy (wrong number of chromosomes) in their eggs.
Interestingly, these eggs will still get fertilized, either naturally or in the lab, but most of the resulting embryos will not be highly graded. And even when you may bingo from them, they miscarry early. For those who continue onto the 2nd trimester, amniocentesis (羊水測試) or chorionic villus sampling (CVS,絨毛膜取樣術) is often recommended. Aneuploidy is also why women over 35 have a much higher chance of giving birth to babies with Down’s Syndrome (唐氏綜合症, i.e. the affected has an extra copy of chromosome 21 in every cell).

While there is no method to go back in time, understanding and weighing what you still have helps your decision-making. In your (Kandice’s) case, although we cannot prove it, I suspect the most probable cause of your miscarriages is aneuploidy.
Before you consider trying further ivf, did you have a reasonable number of eggs retrieved in the past ivf cycles?
Your response to ivf drugs can be quite critical; the logic is that when you have a reasonable number of eggs, you should have better odds of getting a few normal eggs in among the many abnormals. If your ovaries are responding poorly, then other doctors may not even suggest you to continue on. If your response is still ok (say each time with at least 4 or 5 mature eggs), and knowing you can afford the time and financial costs, you may weigh your chance and preparedness if there may be another failure.

In my experience, many women of 40+ do, and can, keep trying. Their success rate is understood to be much lower when compared to the “younger” group. Truly, many still fail to get pregnant, but some do and with normal live births. I can’t really tell if you will be in among the lucky ones, but what I want to tell is to know yourself and your body so that you can be confident of yourself and your decision. Then, be it a success or a failure, you do not need to regret when you look back.

Another long posting……
cutecutetown

原帖由 Kandice 於 10-11-24 10:38 發表
cutecutetown,

真的很感謝你仍然在這裡耐心的回答我們問題，你的專業解答真的令我們這群等希望的jm們苦中有一點甜，謝謝。

我今年內做了兩次ivf(同一個醫生，之前還做了幾次iui 但失敗)，et及fet各兩次，兩次放新鮮胎都是pr ...

[ 本帖最後由 cutecutetown 於 10-11-25 00:52 編輯 ]

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Kandice

積分: 6071

588^#

發表於 10-11-26 11:41

cutecutetown，

希望你在幫忙我們之餘都要有足夠的休息啊!看看你零晨也在回答我們問題。

我先生和我一起看你的回覆，他不斷說奧原來如此原來如此，他說很感謝你這麼詳細的解釋，我們得著很多，亦釋除了心中大部份疑惑，再一次多謝!

醫生說我是偏向有多囊卵巢徵狀，所以卵子質素會較差。我的第一次ivf，打了大概九天針，用藥約225iu，抽了約三十粒卵，有六粒fertilized，第二次打針日數及藥量差不多，抽了廿粒卵，六粒fertilized，兩次的fsh分別是5.5及6.8，醫生說我對藥是有點反應的。我先前沒"聽書"，回看你#574對姊妹回覆轉醫生的問題，我想我大概知道應從甚麼方向去考慮轉醫生這問題了，再謝!
這裡真的是個很好的平台讓我們去分享去發問有關生育的事，希望姊妹們都心想事成!真的，十分謝謝你寶貴的分享cutecutetown!(my husband said you are a very kind person!)

[ 本帖最後由 Kandice 於 10-11-26 12:02 編輯 ]

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589^#

發表於 10-11-26 13:43

Dear cutecutetown & all sis here,

Too bad that this morning when I wake up, I found a little bit pink 分泌 (7am).
This makes me nervous. Then I immediately insert the tablets the doctor gave me.
After I drove my daughter to school, I go home immediately and bed rest for 2 hrs.
In the afternoon, seems no more pink分泌.

I did prepare for the miscarriage. But still, I want to do something to help, if I can.
I want to ask, does BED REST help???
Everytime when I got pink分泌, my current doctor (IVF doctor) reminds me to bed rest, don't move, just wake up to eat and for toilet only.

However, another 婦產料 doctor (上胎幫我生阿女果個)就話, bed rest no use. Don't waste time!

I know it's a bit out of IVF, but I just want to see if you got any information on this area.

Many many thanks.

BTW, how come you reply usually late in midnight. 好似之前mama話齋, 你夠休息嗎?
跟其他準媽媽/媽媽一樣, 非常感激你的幫忙.

DwarfMaMa

[ 本帖最後由 DwarfMaMa 於 10-11-26 13:46 編輯 ]

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590^#

發表於 10-11-26 18:45

Dear Kandice, and many other jm's,

Very observant, I was actually on leave in the last few days; that's why I was kind of naughty, staying up late. But I really appreciate all your caring :)

I usually try to reply as soon as I can because I know most of you must be very anxious and feel helpless with the questions. However, in case you don't see my reply, you know I am probably very busy. And when you see my reply to others but not you, I probably missed your posting because of the poor design of this thread. I find this thread not very friendly because it never allows any kind of search. Very often I need to scroll back and back and forever to find some postings from days ago. If anyone finds a better way to search within a topic, please teach me

cutecutetown

原帖由 Kandice 於 10-11-26 11:41 發表
cutecutetown，

希望你在幫忙我們之餘都要有足夠的休息啊!看看你零晨也在回答我們問題。

我先生和我一起看你的回覆，他不斷說奧原來如此原來如此，他說很感謝你這麼詳細的解釋，我們得著很多，亦釋除了心中大部份疑惑，再一次 ...

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積分: 9504

591^#

發表於 10-11-26 18:54

Dear DwarfMaMa,

Even doctors have different views on bed rest, what can I say!?

I think the essence is to give yourself enough rest and do not 過於粗勞. You may not notice, perhaps your feeling of responsibility to take your daughter to school is a little pressure or stressful for you. Good (or bad?) that the weekend is here; depending on what your "normal" daily life is like, try to reduce your amount of activities for the next few days and see.

Rest up & best wishes,
cutecutetown

原帖由 DwarfMaMa 於 10-11-26 13:43 發表
Dear cutecutetown & all sis here,

Too bad that this morning when I wake up, I found a little bit pink 分泌 (7am).
This makes me nervous. Then I immediately insert the tablets the doctor gave me.
Af ...

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592^#

發表於 10-11-26 22:45

Dear Cutecutetown,

Actually, I took a lot of rest. During weekdays, I sleep a lot.
I sleep in the morning (when my gal is in school).
I sleep in the afternoon (when my gal takes her nap)
I sit still in the late evening (watching TV).
I only drive 2 times a day to take/pick my gals to/from kindergarten.

Today, I consulted the doctor in the late afternoon. She gave me 安胎針.
And touchwood, after I inserted the tablet in the moring, no more pinky come out already.

I will try to take more rest. Thanks a lot for your kind reminder.

DwarfMaMa

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minimeme

積分: 3248

593^#

發表於 10-11-30 11:33

Hi Cutecutetown,

I was miscarriage early this month after my 3rd IVF. I had bio-chemical pregnancy in the 1st IVF. I would like to know if I should check whether I have the problem of 封閉抗體. Do you know which clinic or hospital in HK provide this service? Please kindly advise. Thanks!

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594^#

發表於 10-11-30 16:27

Dear minimeme,

Haven't seen you here for a long time. Many early miscarriages (those of <8-12 weeks of gestation) are due to aneuploidy, i.e. embryo-related. In a few replies ago, I mentioned "aneuploidy" being more common in older women (I think you are not yet 40 yrs old), but it also occurs in among the younger patients. I extracted my previous posting here for easy reference:
Very frankly, being 40 years old, egg quality has definitely declined. This decline in quality may be more pronounced in some women but not so much in others. For older women, there is a higher chance of aneuploidy (wrong number of chromosomes) in their eggs.
Interestingly, these eggs will still get fertilized, either naturally or in the lab, but most of the resulting embryos will not be highly graded. And even when you may bingo from them, they miscarry early. For those who continue onto the 2nd trimester, amniocentesis (羊水測試) or chorionic villus sampling (CVS,絨毛膜取樣術) is often recommended. Aneuploidy is also why women over 35 have a much higher chance of giving birth to babies with Down’s Syndrome (唐氏綜合症, i.e. the affected has an extra copy of chromosome 21 in every cell).

My opinion is that I won't suspect your immune system for 封閉抗體. This is a rare occurrence, much much less frequent as compared to aneuploidy. However, if you want a peace of mind, you should probably consult your ivf doctor first and see if he/she can give you a referral.

cutecutetown

原帖由 minimeme 於 10-11-30 11:33 發表
Hi Cutecutetown,

I was miscarriage early this month after my 3rd IVF. I had bio-chemical pregnancy in the 1st IVF. I would like to know if I should check whether I have the problem of 封閉抗體. Do y ...

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Kandice

積分: 6071

595^#

發表於 10-11-30 19:49

cutecutetown,

左上角(page numbers上)有個"回覆顯示"，你可選擇"新的在前"，那你每次進入這個thread便有最新的message在page1，應該會方便點?!這。。。是不是你想要的哩?如果不是，那我可沒頭緒了。

dwarfmama，

希望你一切安好，多點休息啊!

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bbtam

積分: 2470

596^#

發表於 10-11-30 23:22

cutecutetown,
我有d問題想請教你呀!我今年35歲,26/11放了胎而家等放榜呀,但我期望不大,因為我只放得一個grade 1with 2cell 的鮮胎,我DAY3-10打 Bravelle 75iu + menopur 75 iu,day11打Bravelle 225iu+menopur 75 iu ,一直follow up時都知道卵子不多只有5-7粒大的,day11時就有5粒14mm-19mm大,day13抽卵抽了7粒,我都已經好開心,但day15放胎時胚胎專家話只得一粒受精,因為卵子唔靚呀,我好唔開心,希望會有至少三四粒受精架,就算今次失敗都想有雪胎,無噤大壓力丫嗎!點知......唉!
Q1:卵子質數唔好,會唔會可以抽血驗到架!
Day 2 E2 48.3pg/ml, Fsh 5
Day 9 E2 3235
Day 11 E2 7736
Q2: 有無supplement可以改善卵子質數?我預左今次失敗,希望為下次作準備!
Q3:我Day 13@11AM抽卵,day15@9AM放胎,胚胎得兩個cell,係咪應該可以等多一日,等個胚胎分裂到4CELL至放會好D呢?

Thx a lot

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597^#

發表於 10-12-1 13:15

原帖由 Kandice 於 2010-11-30 19:49 發表
cutecutetown,

左上角(page numbers上)有個"回覆顯示"，你可選擇"新的在前"，那你每次進入這個thread便有最新的message在page1，應該會方便點?!這。。。是不是你想要的哩?如果不是，那我可沒頭緒了。

dwarfmama，

希望你一 ...

Kandice, cutecutetown and all sis,

Thanks very much for your kindness.
漫漫長路, 只希望一切順利. 時間好似過左好耐咁, 但原來數黎數去, 我都未到week7.

我跟你一樣, 年紀不輕了,我還要比你大一歲.
希望今次粒蛋蛋生生性性, 齊齊整整, 正常健康.

這兩天, 我由頭溫習了這個題目一次, 雖然有一些解說我還是不太明白, 但還是覺得得益不小, 實在非常感激cutecutetown.

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598^#

發表於 10-12-1 14:00

Hello bbtam,

It is still too early for you to give up hope. A 2-cell, grade 1 embryo on day 2 is in fact what we call ‘a good embryo’. Since you only had 1 egg fertilized and this would have to go back into your uterus, the day of transfer was not the most important factor.

Perhaps look at your cycle this way; if your eggs were not very good this time, it’s better not to have any embryos frozen because they would likely give you false hope. Given your age and this is your first-time IVF (and also if you can financially afford), you may consider one more cycle in the near future should you fail this time.

Do you know if your eggs were fertilized by ICSI or not?
Also, in response to your questions:
1: Unfortunately, there is no method to tell.
Blood tests only give a rough idea on egg number but not quality.
2: I always ask people to have a healthy lifestyle, including moderate exercises. There is no quick-fix.
I know some doctors may suggest taking vitamins or folic acid; at least these supplements should not harm you.
I am not a big fan of Chinese medicine, but if you want to take some, consult your ivf doctor first.
3: The lab functions similarly as your uterus; so if you have 1 embryo, it will behave the same in the lab or inside you.

Take care, cutecutetown

原帖由 bbtam 於 10-11-30 23:22 發表
cutecutetown,
我有d問題想請教你呀!我今年35歲,26/11放了胎而家等放榜呀,但我期望不大,因為我只放得一個grade 1with 2cell 的鮮胎,我DAY3-10打 Bravelle 75iu + menopur 75 iu,day11打Bravelle 225iu+menopur 75 ...

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minimeme

積分: 3248

599^#

發表於 10-12-1 14:27

Thank you for the information. I have talked with the nurse at my clinic, they don't suggest me to do the blood test for immune system, they said the positive result in my 3rd IVF show that immune system was not the reason of the miscarriage.

原帖由 cutecutetown 於 10-11-30 16:27 發表
Dear minimeme,

Haven't seen you here for a long time. Many early miscarriages (those of

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