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發表於 11-8-7 01:19 |只看該作者

回覆 eko 的帖子

Dear eko,

Sorry I did spent some time & space elaborating on day5 transfer in general before getting back to you. I hope my previous message is not too long and boring.

Let me just summarize some of the information in your post. You conceived and gave birth to your son @~39 yrs old. Then, in 2009 (~41-42 yrs old), you got pregnant but miscarried in your 1st trimester. It looks like embryos had no trouble implanting in your womb; and simply based on age, it's very likely that your pregnancy in 2009 was from an embryo that carried some kind of aneuploidy issue. By doing ivf, you probably hope to buy time rather than trying the natural way, which takes longer and may still not give you a baby.

Back to your questions,
1) I hope you won't need a second round of IVF :) Usually, in first-time ivf, I won't push day5. Particularly in your case, your previous "embryos" had no trouble implanting.
Suppose your 3 day-2 embryos were to be cultured to day-5 before transfer, and let's say 2 of the 3 became blastocysts. How many would you transfer? You would probably still transfer 2; so it is still no difference from your day-2 ET.
However, if you were very firm about singleton pregnancy (and eventually one baby born), then day5 would have allowed you to choose and transfer the best embryo and one of the 2 blasts would have been frozen instead.
Note that day-5 helps to select an embryo that has a better implantation chance, but it won't decrease (nor increase) the chance of a miscarriage.

2) In your case, you have a son and also a pregnancy from not too long ago; these are good evidence that your embryos hatched and implanted ok. Therefore, the lab or your doctor did not offer assisted hatching.

3) Crinone alone won't cause bloated tummy; are you having other injections while on Crinone? You may call your clinic to see if your doctor can check your bloatedness as appearing 4-month pregnant is a little dramatic. Although OHSS is unlikely in your case with 5 eggs, I would suggest you tell your doctor about the condition; then he/she can decide what should be done.

cutecutetown

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lungb

積分: 164

1263^#

發表於 11-8-7 11:21 |只看該作者

回覆 cutecutetown 的帖子

Dear cutecutetown

I failed my 2nd IVF. Would you like to provide your professional advice for

1) Can I take IVF TREATMENT more than 3 times if no frozen egg was transferred
(i.e. high stimulation was injected every time)
Will it endanger my health if I would have taken IVF TREATMENT more than 3 times
because I have seen the regulation of QM Hospital that they are not allowed to do
this ?
Now, I plan to start my 3rd IVF treatment in Sept that I worry about it will be
the last chance for me

2) my 2nd IVF doctor said " the uterus was clinically 14-weeks gravid size " and
" using antagonist protocol " in the referral letter I don't understand what is the
meaning ?

Thanks for your professional opinion

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eko

別墅

積分: 594

1264^#

發表於 11-8-7 18:38 |只看該作者

回覆 cutecutetown 的帖子

Hi Cutecutetown,

Thank you for the lesson on day 5 vs day 2/3 transfer. It's very informative and much appreciated.

Your analysis on hatching and day 3 vs day 5 in my case makes a lot of sense. Now I am double assured that the procedures chosen by my doctor was ok. I think I know which path to chose next time particularly if I have more antral follicles to start with. Thank you!

To answer your question on whether other medicine is causing the bloating, I am having none other than Crinone inserts once a day. Let me check with my clinic on Monday on my condition. For some reasons I always have bloating during the waiting period, even during the last time after I did IUI with low dose Gonal-F for just a few days. Very strange. I'll see what my doc say.

Eko

點評

cutecutetown Hm....interesting. Would like to hear what your doc say too, keep me posted if u don't mind, thx! 發表於 11-8-7 23:35

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積分: 9498

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發表於 11-8-7 23:32 |只看該作者

回覆 lungb 的帖子

Dear lungb,

Sorry about the failed cycle. I re-read your past postings and it has been a rough path for you. I know given your bingo but later miscarriage, you are not willing to give up too soon. However, be sensible and set a maximum number of ivf for yourself. The chance of live birth is low in your age group.

1. You can take IVF stimulation >3 times. There has been no evidence that the stimulation drugs will endanger woman's health. I suspect that the regulation you saw in QM only applied to those women on the public queue. As far as I know, there is no limit if you do IVF private queue or with a private IVF clinic.

2. Those are clinical notes for doctors. They are just neutral comments and shouldn't act against your treatment. For your peace of mind, I will try to explain them but don't take my interpretation as anything authoritative.
The first comment about the uterus refers to the size of it. I don't truly understand its implication, but you can ask the doctor you will see when you give him/her the referral letter. No need to worry, your uterus may be a little bigger than usual (only maybe), and the comment is probably just a description of its appearance on ultrasound.
The second comment is the method of ivf stimulation method to use. The antagonist protocol is the one in which you receive Gonal-F (or other FSH injections) and then with the addition of "antagonist" injection (Cetrotide/Ganarelix) mid-way along the process. Sound familiar now?

So, are you planning to go to QM for your 3rd ivf, or going away from it? Wish you well.
cutecutetown

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jamiemeowmeow

積分: 7588

1266^#

發表於 11-8-8 00:07 |只看該作者

Hi Cutecutetown,

Thanks for your reply on my previous questions.

I have one more question regarding increasing the success rate of ivf. I read an medical abstract and see the conclusion below in the link of :

http://humrep.oxfordjournals.org/content/14/7/1690.abstract

"It was concluded that oral L-arginine supplementation in poor responder patients may improve ovarian response, endometrial receptivity and pregnancy rate. "

what do you think about taking supplements of L-arginine?

I am 37 now and will do ivf in nov 11. Is it advisable to take supplements to increase the chance?

Many Thanks for your advice on this.

Jamie

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lungb

積分: 164

1267^#

發表於 11-8-8 07:49 |只看該作者

回覆：cutecutetown 的帖子

Hi, cutecutetown
Thanks for your opinion

Yes, I will take 3rd IVF in QM in sept

I wish it will have a good news this time

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1268^#

發表於 11-8-8 10:58 |只看該作者

回覆 jamiemeowmeow 的帖子

Dear jamiemeowmeow,

Do NOT take L-arginine supplementation. Many reasons even just based on this article:

1. The article was published in 1999; if L-arginine were as good as we want, we would have incorporated its use into our routine practice already.
2. The women mentioned in the study were all poor responders, i.e. those who had or who were predicted to have very low response to high-dose ivf drug stimulation. Are you in the same group? You haven't done ivf before and you don't have an indicator to believe yourself as a "poor responder". Your age alone does not predict your response to ovarian stimulation.
3. The sample size was too small in the study and any conclusion drawn from it must be interpreted with caution.
4. I followed your link and read the abstract only. If you go to that same link, scroll down a little to read "

eople who read this also read the following articles..." (somewhat to the right of the abstract), the first article titled "adjuvant l-arginine treatment in controlled ovarian hyperstimulation........" showed the opposite. Again, old publication, small sample size, so I won't be bothered by any of the results.

Do you mean you will have your first injection on Nov 11, or see your doctor on Nov 11? I would strongly recommend you listen to your doctor's suggestions and ask for his/her advice if you really decide to take some herbal medicine or supplements. Don't go about trying them on your own without informing your doctor.

cutecutetown

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jamiemeowmeow

積分: 7588

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發表於 11-8-9 23:59 |只看該作者

cutecutetown 發表於 11-8-8 10:58
回覆 jamiemeowmeow 的帖子

Dear jamiemeowmeow,

Hi Cutecutetown,

Thanks for your reply. I agreed with you that I do have doubt on the so called clinical report. Also, more ironic is L-arginine is frequently prescribed to infertile male. So i am very confused whether it is for male or female.

Yes, I agree with you that I should not take these supplements without taking doctors' advice.

Thanks for your heartful advice.

Cheers.

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Hangyan

積分: 229

1270^#

發表於 11-8-16 16:03 |只看該作者

Dear Cutecutetown

Hi, how are you?? I did my 4th IVF early this month and would like to have your comment.

I did blood test on the 10th day after IVF and HCG was 217. I did 2nd blood test 2 days later and the HCG was 306. Since the increasing rate of HCG is less than 1.66times, does it mean the chance is not good??? Hope you can let me have your professional opinion.

Awaiting your prompt reply

Cheers

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積分: 9498

1271^#

發表於 11-8-16 16:25 |只看該作者

Hello Hangyan,

Looks good, except I need to know whether you had any hcg injection(s) after ET.

I suppose you should soon go for your "official" HCG test? At this point I am assuming that you haven't received any form of HCG support; in such case, the "less-than-double" increase is still a reasonable increase and you can stay optimistic.

cutecutetown

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Hangyan

積分: 229

1272^#

發表於 11-8-16 18:42 |只看該作者

Dear Cutecutetown

Thanks for your comment.

I did have HCG injections. Took 1st injection on the day of IVF and took 2nd one 2days after. In this case, is it still a reasonable increase???

Awaiting your prompt reply

Cheers

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Hangyan

積分: 229

1273^#

發表於 11-8-16 18:42 |只看該作者

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積分: 9498

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發表於 11-8-16 23:51 |只看該作者

回覆 Hangyan 的帖子

Dear Hangyan,

Do you mean the 1st injection on the day of "embryo transfer" and the 2nd injection 2 days after? It is very hard to confirm or rule out bingo. The amount of increase is reasonable, but I won't be too happy too soon.

It doesn't seem to work telling jm's not to cheat before their "official" bingo test day. However, if you decide to cheat, try to do so just one or two days prior to your "official" day; checking too early makes life worse if the result is a false-positive.

cutecutetown

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fongfong2

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積分: 559

1275^#

發表於 11-8-22 13:34 |只看該作者

Dear cutecutetown,

Here're some of my backgroud:
I'm 31 while my husband is 32. We had IVF becoz of severe oligospermia. His chromosome test was unremarkable, hormonal profile was alright though testosterone is on the lower normal limit.
We had our 1st IVF in May, 2011, but was cancelled early on Day 6 due to unsynchronized eggs.

We had our 2nd IVF this month. Oocyte retrieval was performed yesterday and 13 oocytes obtained. But my hubby's semen showed no sperm, so he proceeded to MESE +TESE, sadly, only 1-2 very immature were seen which were of no use. As a result, I had all my oocytes being freezed for future use.

I've got several questions and see whether u can help me:

1) I know occyte is much more labile when compared to embryo / sperm, so I'd like to know the viability of frozen oocyte after being thawed.

2) if sperms are a/v later and able to get fertilized, can those once freezed occyte be freezed again as an embryo ??

3) we're now considering sperm donation as hubby worries that even if he can find some sperms, the gene contained maynot be good. Do u have some information about sperm donation ? Can we know some of the past medical hx / family hx from the sperm donar ??

Sorry for so much questions as we're really desperated
Thanks

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發表於 11-8-22 17:34 |只看該作者

回覆 fongfong2 的帖子

Hello fongfong2,

I would be desperate too if I were you. It's often a shock when no sperm was found on the day of egg retrieval. Has there been another MESA+TESE arranged, or your hubby will still try producing ejaculate?

1) Frozen oocytes are getting better survival upon thawing nowadays. Do you know if the lab has reasonable experience in oocyte freezing? Generally, ~70% survival is expected; some labs claim to have >90%. While we don't know until your eggs are thawed, your age is relatively young and I would stay optimistic.

2) Yes, those embryos can be frozen once again. Although we don't encourage it to be a routine, embryos can be thawed and re-frozen when needed.

3) There is no sperm bank in Hong Kong, and sperm donor cannot receive payment. We have a shortage of sperm donors in HK. As a sperm donor, all identifying information will have to be filed with the Council on Human Reproductive Techonology (CHRT); you may ask your doctor for more details. An "easier" option, if you consider sperm donation, is to find a sperm donor on your own; for some couples needing sperm donation, they often asked husband's brothers or good friends.

Not sure about the chromosome test your hubby has done; I believe it is karyotyping? Severe oligospermia may sometimes relate to microdeletions in the Y chromosomes if it is a genetic issue; in other occasions, it may be some obstruction along his reproductive tract. Your doctor may have already suggested you/your hubby to consult a urologist if you haven't already done so.

cutecutetown

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fongfong2

別墅

積分: 559

1277^#

發表於 11-8-22 18:52 |只看該作者

本帖最後由 fongfong2 於 11-8-22 18:55 編輯

Dear cutecute town,

Thanks for your prompt reply, I really feel warm with your words which are full of empathy !

Actually, we have consulted urologist several times, he said it's likely that his testes is not working rather than obstructive causes as TESE results are compatible with semen analysis result. So far, there's no further MESA / TESE arranged as dr said the procedure will cause scar resulting in blockage. So hubby only had MESA +TESE over his Rt testes/epididymus. Dr suggested to leave the Lt side for future sperm collection by ejaculation. Will you suggest further surgical methods for sperm retrieval in our case?

Do u know what's the experience in handling frozen oocyte in Union Hospital ? As i don't know anything about their lab. Also, is the viability of frozen oocyte dependent on duration of cryopreservation ??

Thank you!

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發表於 11-8-22 23:27 |只看該作者

回覆 fongfong2 的帖子

Dear fongfong2,

This is such a strange website, I replied but as I hit "send", it said I didn't log in and the entire message was lost. Very frustrating....

Anyway, let me recap what I just wrote. Firstly, let your hubby rest a little. It is also tough on him as men usually keep their feelings inside. Be supportive to him as well!

Sperm takes ~70-80 days from its making in the testis to finally being ejaculated; so, no rush here for yet another semen analysis. Take this time to rest and I suppose your doctor may have recommended some supplements for you and/or your hubby to take. If there will be sperm in the next ejaculate and freezable, your hubby won't need another MESA/TESE.

I am of no help to comment on Union's experience in egg freezing; but in general, its lab has good standards so I will trust it. And viability of eggs/sperm/embryos is independent of duration of storage, i.e. you can store them for as long as you want. [practically, you will also take into consideration the storage fee, right?]

cutecutetown

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好想好想

大宅

積分: 1508

1279^#

發表於 11-9-2 11:48 |只看該作者

Hi cutecutedown,

我將會係9月做IVF, 但係由於醫生放假, 今個cycle day21開始嘖藥, 但係月經遲左黎, 醫生本身已安排放假, 由於佢要睇左我既驗血報告先確定可唔可打針, 叫我day5要返去睇佢 (當日先返工), 遲左2日先開始打針有無問題架??因為我見大部份人都係day3開始打針架....

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