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602^#

發表於 10-12-2 12:21 |只看該作者

Dear DwarfMaMa,

That's good news from you; I am happy and optimistic that everything will be 順利!

Success rate is not an objective parameter to determine if a doctor can be an ivf specialist. And what exactly you call it a success, a pregnancy or a livebirth? As you know, patients vary in age, infertility cause(s) and history. If a doctor only does 10 cases a year, an 80% success rate (or pregnancy rate) is very deceiving.

My cautionary word to all readers here, while a clinic's success rate gives you hope, do not put all your bet on it. Success rate is a statistical figure which tries to generalize everything into one unity. My opinion is that ivf itself should be an individualized treatment because every couple comes from different backgrounds and reasons. Therefore, your feelings of comfort with your clinic/doctor, of being looked after, and perhaps feedbacks from other couples should guide you if you should receive, or continue receiving treatment from a clinic.

Although I do not like the way the government regulates reproductive medicine, it is fair to base things on case number for a doctor's continual practice in ivf. Patient monitoring, egg retrievals, etc. all require time, hands-on practice, and continual education. The Registry requires an ivf specialist to perform a reasonable number of cases each year in order to renew his/her ivf practice. For those who are not ivf specialists, they are still obstetrics & gynaecology doctors, i.e. they can still see prenatal cases, deliver babies, perform gynaecological check-ups, etc.

One last note, I find it a little unbelievable to hear a doctor arrogantly claiming 80% success rate. No offence to your doc, but if he/she is really that good, he/she should have no trouble meeting the case number for him/her to continue practicing ivf. So, do not worry for these specialists, they can "survive" whether doing ivf or not.

Take care,
cutecutetown

原帖由 DwarfMaMa 於 10-12-1 17:46 發表
cutecutetown,

我剛剛去完醫生度返黎喇.

Thanks GOD, 我見到有嘢'閃閃'下. 醫生話個size好足, heartbeat亦好strong. 希望今次一切都順順利利.

跟住, 醫生就係度訴苦, 話佢下年可能無得做ivf. 事關, 政府唔係計個 ...

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DwarfMaMa

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603^#

發表於 10-12-2 15:09 |只看該作者

cutecutetown, and all sis,

ic ic.. thanks for your view.

She (my doctor) said she don't have enough patients (for ivf), I don't know if she is quite expensive or not.

Actually I don't know the price if I perform IVF in other clinic.
如果喺外面做, 通常每日針藥要多少錢?

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積分: 9498

604^#

發表於 10-12-3 13:56 |只看該作者

Dear DwarfMaMa,

Hopefully you didn't over-pay.

In the private sector, your total costs can vary because your doc's fees, diagnostic tests (e.g. semen analysis), blood tests, drug costs, ivf lab charges and clinic/hospital charges can all be different.

My wild guess is that the total amount a private patient has to pay does not differ a lot from one private setting to another. Afterall the services in all ivf are similar and we need to be compatible with each other.

I think if you go to the more popular doc or hospital you may end up paying more. I won't comment whether you will have a better success chance by paying the extra dollars. The bottom line is, you need to feel welcome and respected with the doc/clinic you go to; otherwise, you will have even more stress and frustration.

cutecutetown

原帖由 DwarfMaMa 於 10-12-2 15:09 發表
cutecutetown, and all sis,

ic ic.. thanks for your view.

She (my doctor) said she don't have enough patients (for ivf), I don't know if she is quite expensive or not.

Actually I don't know the pric ...

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yellow2fish

積分: 1157

605^#

發表於 11-1-5 13:15 |只看該作者

DwarfMaMa

Glad to hear that you have a successful IVF. Congratulations!

I am also the same age as you. I got pregnant (naturally) in Nov and discovered it was missed abortion yesterday at week 9.

I am planning to have IVF because I have been trying to have baby for 2 years, unluckily it aborted. I don't think I have another 2 years for me to try again.

Would you pls share with me what you have prepared before, during and after IVF so you have a successful outcome?

Your doctor gave you 2 kinds of vitamins, you take them before IVF or after IVF?

Your information will definitely help me to prepare for my IVF. Thanks in advance.

All the best to you,your baby and your family

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 yellow2fish 於 11-1-5 13:17 編輯 ]

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lollybb

積分: 1332

606^#

發表於 11-1-5 14:03 |只看該作者

Dear cutecutetown,
我十月做ivf 失敗咗, 但係個肚一直都冇收過水, 至十二月中做了宮鏡檢查,一星期後肚痛, 但係就上腹痛. 太痛之下入了院, ct scan & u/s shows 有很多水在腹腔和卵巢大了, 醫生都淨係叫我等身體吸番d水同比d舒緩腸痛d藥我. 想問下我的腹痛是否和腹水有關? D水幾時先會收? 何時才可再FET?

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susan19771118

積分: 1794

607^#

發表於 11-1-5 16:37 |只看該作者

回覆 604# cutecutetown 的文章

Hello Cutecutetown,

It has been a long time since last time I left message in this column. I was the one who got 26eggs retrieval and 21 embryos fertilized in last April, luckily many of my embryos are grade 1. I had my first FET done in June then with 2 embryos and got pregnant with 2 baby girls finally. My delivery will be end of Feb.

Not sure if you can remember me or not, cause you got so many different IVF fans everyday. This all can't be done smoothly without your kind suggestions, wanna say thank you very much for everything you have done for us. Here I wish you have a very prosperous new year of 2011. Cheers!

Susan

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sangria

公爵府

積分: 26066

608^#

發表於 11-1-5 16:50 |只看該作者

Dear Cutecutetown,

I have been a silent reader of your thread and "unfortunately" I have to raise question to you finally...

I have just reached my 35 and had conducted IUI twice last year and were all failed.

My FSH was 3.x, LH was 8.x at my CD10. The test was conducted at the Family Planning Association and the appointment schedule was fixed and of course it could not fit my cycle so that's why the test was not done on my CD3.

My BMI is 25 and my doctor suggested a "tolerance test" on my blood glucose. I passed and surprisingly, the result was well below the "healthy margin". I had done a blood test on testoterone and the result was 7x which was normal though some doctor might consider it a bit elevated if it is above 50.

Anyway, as you can read from my FSH/LH, I was diagnosed PCOS though no "pearl chain like follicles" were noticed in my U/S.

I have switched Dr as he doesn't offer IVF treatment. My current doctor, after reading all my tests and bbt suggested me to go ahead with IVF and I agreed.

I developed OSHH in my last IUI (Nov 2010), do you think it's a good idea for me to go doing IVF straightly, in one cycle?

Or do you think it's a better protocol to extract the eggs in the first cycle, take a break for the following cycle and then FET in the other cycle?

Which do you think is better and would you please give me some hint about the charge. I understand that keeping cells frozens would need like HKD5,000 to HKD8,000 a year depends on the lab. Will there be some other charge incurred?

Thank you very much!

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609^#

發表於 11-1-6 22:31 |只看該作者

Hello lollybb,

I am sorry to hear your painful experience after ivf. It doesn't happen to a lot of ivf women and the condition will take time to heal. How long depends on the individual.

When you do the ct scan & ultrasound, did you get it from the emergency room or your ivf doc? Definitely let your ivf doc know so that you can ask about your next fet.

Other than medication to help relief your pain and edema, try to do some aerobic exercises. Just do any kind that can increase your cardiovascular function, that is, the kind that makes you sweat. This will increase bloodflow, which flushes out toxins and helps to drain some excess water away. I know it's very cold lately, but that's why you need to warm up your body to speed up healing; be careful not to catch a cold when you cool down after exercising.

cutecutetown

原帖由 lollybb 於 11-1-5 14:03 發表
Dear cutecutetown,
我十月做ivf 失敗咗, 但係個肚一直都冇收過水, 至十二月中做了宮鏡檢查,一星期後肚痛, 但係就上腹痛. 太痛之下入了院, ct scan & u/s shows 有很多水在腹腔和卵巢大了, 醫生都淨係叫我等身體吸番 ...

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積分: 9498

610^#

發表於 11-1-6 23:15 |只看該作者

Dear Susan,

Congratulations!! You are right that I can’t remember all the very details, but I remember you. You are one of the few who had plenty of good embryos. Time really flies and I can’t believe you will soon deliver 2 little “rabbits”. Congrats again!

Thanks for your praises; but you see, I only do the talking, it’s you girls who do all the real work. I am happy to have walked part of your journey with you. There is always a blessing in every journey. For some lucky ones, the blessings are actually what they longed for; while some others may not see their blessings …….yet.

So, Susan, take good care of yourself and your family in this special year and also the years to come. And for other jm’s, may the best bestowed on you.

Best wishes to everyone,
cutecutetown

原帖由 susan19771118 於 11-1-5 16:37 發表
Hello Cutecutetown,

It has been a long time since last time I left message in this column. I was the one who got 26eggs retrieval and 21 embryos fertilized in last April, luckily many of my embryos a ...

[ 本帖最後由 cutecutetown 於 11-1-6 23:17 編輯 ]

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611^#

發表於 11-1-7 00:20 |只看該作者

Hello Sangria,

I think you know your background quite well, and also have got similar advices from doctors. You are well aware that because of your PCOS, you have a higher chance of OHSS (ovarian hyperstimulation syndrome). In PCOS women who go through IVF, they tend to produce a lot of eggs. When there are too many eggs, you need to be prepared that not all of these eggs will develop into good embryos.

Sorry if I misunderstood what you told me, did you have 2 IUI’s last year, failed, and then moved onto another doctor, and have 1 IUI with this doc? I think it is fair to move onto IVF, although I won’t disagree if you want to do one or 2 more IUI’s. If you decide to try 2 more IUI’s, do them soon, say within half a year or so. Don’t wait too long.

If you will proceed with IVF, due to your PCOS, your doc will start you on a very low dose stimulation protocol. It is more of a clinical decision, based on your hormonal level on the day of egg retrieval and also your body responses, to decide whether it will be ok to transfer fresh embryos or freeze all the embryos for later FET cycles. In many PCOS women, as you suspect yourself, need to extract the eggs and freeze all the resulting embryos, take a short break to recover, and then come back for FET in another cycle.

Talking about charges involved.
Let alone your ivf stimulation (consultation fees, blood tests, ultrasound scans, hormonal drug costs, etc,) and egg retrieval (operation-related charges, laboratory fees, etc.), the procedure to freeze your embryos and to store them cost you extra. The freezing process is a one-time charge, and varies among different centres; on the other hand, storage may be charged as a monthly or a yearly fee, again this depends on the centres. Your quote of HKD$5000-8000 is about right for freezing with storage for one year. However, do keep in mind that when you go through one cycle of FET, your doc will charge you (a much smaller amount compared to an IVF cycle) some basic fees; and then there will be a thawing fee from the laboratory. Thawing may cost around $2000-4000, again vary among centres.

My last piece of small advice is that you may try to reduce some weight. I don’t want to hurt your feelings, but it is harder for overweight women to conceive when compared to normal-weight women. Since you are slightly overweight (based on your BMI), it will not be too difficult to modify your lifestyle. Eat healthy and incorporate moderate exercises into your daily life. This will help in many ways without the need to use medication. I am sure you have read my numerous posts before and only need someone to “kick-start” you.

A new year begins with a new you.
cutecutetown

原帖由 sangria 於 11-1-5 16:50 發表
Dear Cutecutetown,

I have been a silent reader of your thread and "unfortunately" I have to raise question to you finally...

I have just reached my 35 and had conducted IUI twice last year ...

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sangria

公爵府

積分: 26066

612^#

發表於 11-1-7 09:48 |只看該作者

Dear Cutecutetown,

Thanks for your reply!

I have done 2 IUIs so far by Dr. A and my current medical advisor Dr. B suggested me to go IVF right the way and I plan to have it done in Feb 2011.

Don't worry, your reminders never hurt my feelings but let me have a more reasonable expectation (especially about the egg quality). Right, I should live a healthier lifestyle. Hope I can shed at least 2 pounds before starting the IVF.

I would like to ask would my E2 level help determining whether the ET will be done freshly or alternatively a FET? Otherwise, what should be the better probe?

About the cost, other then those for frozen embryos, would the cost be lower if the FET to be done via "natural cycle" rather than hormone induced one? Would you please give me some indication on the costs?

Sigh... it is very costly to deliver a baby arh...
:;pppp: :;pppp:

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積分: 9498

613^#

發表於 11-1-7 11:58 |只看該作者

Dear Sangria,

Hm... shedding a minimum of 5 lbs is a more realistic and achievable goal (roughly 1.2 lb per week, counting from now till Feb). I know the Chinese New Year is coming, which means that there will be plenty of temptations which are hard to resist. For those who plan to conceive or who are already pregnant, be very careful with what you choose to eat. Oil/fats give you a sick stomach for a short effect and add up to give you extra weight in long-term. So, while celebrating with good food, choose and eat with moderation in mind!

E2 is one of the factors to determine if your ET can be done freshly or the alternative FET. This E2 is a blood test done usually on the day of hCG trigger, i.e. ~2 days before egg retrieval (ER). Depending on your doc's practice, you may have it re-checked again on the day of ER and even 2-3 days after ER. In other words, when you check E2 on cycle day 3 together with other hormones, it does not determine whether you can have a fresh ET or not. Too early to tell at that point.

E2 (as tested close to the day of ER) is almost the most important "probe" to decide if you can have a fresh ET. Other factors may also be important, such as edematous condition which shows as an increase in your waistline or "water" inside your peritoneum.

Cost. Yes, natural cycle will be cheaper because it requires minimal, if any, medicine. However, if you don't ovulate by a regular cycle, then some hormones will be needed. A $$ figure is hard to give, but very very generally speaking, if medication will be needed, expect it to cost you about half of the drugs/medication in ivf, or somewhat similar to an iui cycle. Don't forget to factor in your doc's consultation, bloodtests, and u/s charges if you are preparing your budget.

Yes indeed, simply in trying to conceive is costly. And then to deliver a baby.... Then perhaps around 20 years+ of upbringing with education and so on.

cutecutetown

原帖由 sangria 於 11-1-7 09:48 發表
Dear Cutecutetown,

Thanks for your reply!

I have done 2 IUIs so far by Dr. A and my current medical advisor Dr. B suggested me to go IVF right the way and I plan to have it done in Feb 2011 ...

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lollybb

積分: 1332

614^#

發表於 11-1-7 13:25 |只看該作者

dear cutectuetown,

thanks a lot. i've seen my ivf doctor, but he seems cannot give any advice to me. i'm just worrying whether the cyst inside me will burst if i do vigorous exercises. also, when can i have FET? and what should i do to increase the chance of success?

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sangria

公爵府

積分: 26066

615^#

發表於 11-1-7 14:43 |只看該作者

Dear Cutecutetown,

OK I got it. I will try to shed more and will not go too extreme in the same time!

OK I got it too. I'll expect $80K to $100K for the whole cost if I need to do FET.

I hope my cost will be low as probably my egg can grow itself just that I need the LH surge. Can the Dr. just give me a dose of hCG?

Thank you very much Cutecutetown, you are very kind. Will keep you post my progress!

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積分: 9498

616^#

發表於 11-1-7 17:03 |只看該作者

Dear lollybb,

You didn't mention any cyst in your last posting; and if it has a chance to burst which in turn poses a risk to your well-being, your doctor would have suggested its removal. So, some moderate exercises should do you no harm.

When your edematous condition recovers, then you can probably have your FET (I assume you still have a follow-up appointment with your doc to take care of any cyst and so on). Once your period returns and the fluid in your abdomen subsides, your doc can prepare you for the FET.

There is no actual "homework" you have to do while waiting. Simply relax and don't stress yourself out. Many women don't get their bingo in their first fresh ET because the body is so confused by all the hormonal injections. Most women have their natural cycles for FET, and even for those who need very mild help with hormones, the success chance is equally good. As long as you have some good embryos in storage, they are always ready when your body is ready.

cutecutetown

原帖由 lollybb 於 11-1-7 13:25 發表
dear cutectuetown,

thanks a lot. i've seen my ivf doctor, but he seems cannot give any advice to me. i'm just worrying whether the cyst inside me will burst if i do vigorous exercises. also, when ...

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積分: 9498

617^#

發表於 11-1-7 17:08 |只看該作者

Dear Sangria,

Yes, be positive with your weight loss plan; I can feel that you can be committed and achieve your goal. "Add oil!"

If you will need a little medication to help ovulation, your estimation of the FET cost is about right. And yes, in that case, your doc will likely use one dose of hCG instead of waiting for your LH surge.

Good luck and happy exercising.
cutecutetown

原帖由 sangria 於 11-1-7 14:43 發表
Dear Cutecutetown,

OK I got it. I will try to shed more and will not go too extreme in the same time!

OK I got it too. I'll expect $80K to $100K for the whole cost if I need to do FET. :he ...

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superwife

積分: 2379

618^#

發表於 11-2-15 15:12 |只看該作者

Dear Cutecutetown,

I am a bit worry from the report today.

I had Gonal-F 7 days of 225iu and the last 2 days of 260iu. I had ER yesterday and 11 eggs were collected. 7 of them were mature and 4 were not. The report from today is:

3 fertilized
3 unfertilized
1 not developed
4 not mature

I have some questions:
1. It seems that my development of eggs varies. Does it mean certain there are "hiden factors"? I had the E2 index of ~7000 on Sat, does it not high enough for the ER on Mon?

2. My doctor suggested me to have ET on day 2 (2 eggs) and day 5 (1 egg)? Does it help to increse the chance?

Thanks

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619^#

發表於 11-2-15 23:13 |只看該作者

Hello superwife,

Do not get too worried; as long as you will have ET, there is always a chance.

Eggs do not all develop at the same speed; some tend to be faster and some will be slower.
While giving you different stimulation drugs, ultrasound monitoring and blood tests all provide useful info to the doctor who will then optimize the best time for ER.
The day of ER mainly depends on the number of mature follicles as measured during the ultrasound scan, with E2 being the next consideration.
Note that we don’t want E2 to go too high because you may have a higher chance of developing ovarian hyperstimulation syndrome (OHSS), which will pose immediate medical concerns; and in high-risk situation, you can’t have ET but all embryos need to be frozen for later FET.

Have gone off a little from your question. In your case with an E2 of ~7000, your egg number is about right. Did you get conventional IVF or ICSI as the method of fertilization? Any idea on your husband’s sperm?

To answer your 2nd question, it is a little unusual to have ET on 2 different days. Most people have ET on one single day, be it day2, day3, or day5. I am not saying ET on day2 and then again on day5 can’t be done, and I indeed worked on a few similar cases before.
Because it is not a routine, I can’t tell if it can increase your chance or not.

I hope you will have some nice embryos for ET.
cutecutetown

原帖由 superwife 於 11-2-15 15:12 發表
Dear Cutecutetown,

I am a bit worry from the report today.

I had Gonal-F 7 days of 225iu and the last 2 days of 260iu. I had ER yesterday and 11 eggs were collected. 7 of them were mature and 4 were ...

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superwife