1a. I also think your ovaries behave like PCOS but your doctor said otherwise. To look on a positive side, you may not have very good quality eggs, but your quantity has compensated the situation a little.
1b. In each menstrual cycle, the ovaries recruit a handful of eggs. When leaving things to nature, only one egg "wins" and gets ovulated because this egg "suppresses" the others. In IVF, we "encourage" most eggs in this handful to grow. However, we don't know why some women have a bigger handful compared to others.
2. Suboptimal egg quality may be one of the factors.
3. G2- embryos have a lower success chance than G1 embryos, generally speaking. But do all G1 embryos implant? I don't quite see it. Appearance can be deceiving sometimes.
4. Yes, you may choose to have your FET in Jan; but given your high response and ohss risk in this Dec. IVF, let your body rest and recover for one more month won't hurt.
5. Well yeah, your 11 embryos should be good for at least 3 more rounds of FET!! Simply to relieve your anxiety, your thought on milder stimulation is very logical, and I am sure your doctor will adjust your dosage "downward" should you need another new ivf. The way of stimulation should not be in among your worries because this responsibility should go to the doctor, who will make a fair decision based on your past responses and other factors (e.g. age, hormonal profiles, etc.).
[And also, there may not be jm's who are exactly like you; but there are definitely many who don't succeed in their 1st ivf and do multiple attempts.]
Why not relax for this holiday week! New year often brings new hopes, be ready for a good year to come. Best wishes,
cutecutetown
Long time no talk, hope everything goes well with you.
I start a new IVF cycle this month. Today I got Embryology Summary Report and found a remark "zona thinning" on the page of embryo transfer. I want to know if zona thinning refers to Laser Assisted Hatching for embryo or not? Under what situation, the embryologist will do such procedure? Is it requested by doctor or patient or just the experience by embryologist? I am not sure whether the outer layer of my embryo is too thick which is difficult for ..... therefore the embryologist have to do so or it is just a standard procedure.
Zona thinning is one way of doing assisted hatching. As the name suggests, it reduces the thickness of an area of the zona so that the embryo within can have an easier exit hatching out. Some centres do it as a standard routine, while some offer it with certain selection criteria (e.g. thick zona, advanced maternal age, repeated failure after transfers of good-quality embryos). Nobody ever knows if it really helps; however, based on my own experience, it does no harm.
Dear Cutecutetown,
I'm sad to let u know that my bb stopped its heartbeat when it was 9 weeks and 2 days. It was done by my last FET with 2 grade 1 & 2 embryos in January. Do u think it is common in ivf treatment? How to avoid it next time? Was it the case that my eggs' quality not good enough or i have done something else not good to bb? When I can start a new round of treatment? Sorry for so many questions. Thank you.
Dear ada1103,
I'm very sorry for your loss
Early miscarriages happen in natural conception as well, although we tend to pay more attention to those losses from ivf as it is already difficult to conceive.
In many cases of early pregnancy loss, it is the embryo that has some abnormality. If so, it will miscarry somewhere along the gestation, usually in the 1st trimester. Later (2nd or 3rd trimester) miscarriages may be due to the fetus or maternal factors. If you doctor has not pointed out any specific reason for your loss, it is likely the embryo and not you.
Do you still have frozen embryos? Use them first before starting any new ivf. Spacing ~1 or 2 months from your loss before your next FE or ivf should be fine. Talk to your doctor as well about timing if you want to start again.
Take care.
dear cutecutetown,
thank you again and again for your prompt reply.
我昨天是ivf放fresh embryo後第5日，有塞藥。抽血驗progesterone i1000, result 係92.2nmol/L, or 29.0ng/mL. 上網揾唔到任何關於放胎後既range of progesterone value. 請問你知唔知我既讀數夠唔夠？係唔係越高越好呢？ 有沒有上限？
Thank you for your help!!
Dear 老公個公主，progesterone at this stage 冇upper limit 的, although it cannot be too high. the purpose of checking is to make sure your endometrium is in luteal phase. Sometimes if a woman is not taking her medication or not doing it properly, progesterone will be very low (e.g. <10ng/ml). Your level is fine,放心。
Of course the next thing you have in mind is whether progesterone can tell if the embryo has implanted or not! Sorry to tell you the truth, it cannot. 只要平常心，過多一星期左右便知道。
cutecutetown
You're really resourceful and give a lot of information to us! Really thanks!!! I'm so worried and disappointed............ My FSH is quite high ranging from 10-15 and just entered 38.
I have just stopped my 2nd IVF today. I started 1st IVF on Feb 1 and got injection for 13 days (From 225 to 450 dosage). But the response was not good with 2 eggs at 1.5 and finally failed to get them out.
Then i started 2nd IVF on Mar 1 and got injection of 450 for 8 days. Originally, the doctor saw 5-6 small eggs. But the response was even worse and the eggs did not grow and very small. The doctor asked me to come back in my next period.
I just wondered if i should proceed anymore or should take a rest. And any more chance and any reasons for that?
I am not sure if you still remember me. I wrote to you the first time at around April last year. I just failed my first Ivf at that time and was in great frustration and disappointment. Anyway, I just want to share with you the good news that my baby girl was born on nin Chor 2 (Jan 24). She weighted 7.1lbs at birth. I feel so blessed that she is perfectly healthy. I want to thanks again for your patience in answering my questions and offering emotional support to me during my fertility journey.
Sorry about your frustration. The moment you asked if you can take a rest, I guess you want to continue and yet you feel a little tired from the repeated trying.
It is very difficult to say if there is any more chance because your doctor knows better about the physical aspects of your fertility background. Your FSH is high, which is often predictive of poor response to those injections. While other physiological factors (e.g. anovulation, blocked tubes, endometriosis) could also affect your fertility, is your husband's semen analysis normal? Sometimes stress from work can affect you as well; many jm's in HK have a stressful career while having to deal with infertility treatment. Families and friends could also add extra pressure.
Many of the physical factors we cannot fix, we sometimes wish that we can go back in time. However, if you decide to proceed with at least one more cycle, I would agree that you may take a month or two of rest. During this month or two, get some good rest and do something you enjoy. JM's often ask if they should eat this or that, or avoid eating this or that. I simply recommend a balanced eating habit, "moderation" is my golden word. Healthy lifestyle, try to put in a few hours of true exercises per week (those that can make you sweat) if you can. It doesn't matter whether you are skinny or with a high BMI, you still benefit both physically and emotionally from the few hours of workout. I think most women in HK neglect the importance of exercises, which I can't blame them because our lives are always busy. But, from a fertility point-of-view, regular exercises not just help with weight control, it encourages blood flow. I strongly believe that a good blood flow not only detoxify your body and important organs, it brings oxygen to your ovaries where your eggs are produced. Although we still can't increase the egg number in a cycle, we certainly hope for better-quality eggs.
Thx for your prompt reply. Actually, the sperm quality of my husband (he is 39) is not ok and IVF is our only chance according to doctor. But my chinese doctor asked me not to do IVF in coming few months as it will harm the ovary. But I am already 38 and i want to try again. Do you know if there is any proof that continuing to do IVF will harm ovary?
And do u think acupunture and chinese medicine which can help to improve FSH and ovary condition?
Thanks a lot... i will take more exercise according to your advice!!
Dear Cheers246,
There is no published literature saying ivf will harm the ovary. And to be fair, looking at all the women who had ivf, they are still healthy and many have become mothers with lovely kids. You are only about to start a 3rd cycle; it may still be a little early to worry.
I don't like acupuncture or Chinese medicine, because they may introduce unknown effects to your cycle. However, if you truly believe in them, I would prefer acupuncture over chinese meds. While I am no expert with acupuncture, I see some women do benefit (psychological probably?); but chinese medicine needs to show me its positive effect.
FSH slightly varies with each cycle; some docs may start you if your cycle has a 'lower' FSH. Check with your doc & he may or may not agree.
Cutecutetown
Hi Cutecutetown,
My IVF Dr. told me that by undergoing IVF treament, the medication would stimulate the ovary.
I had the nasal spray and gonal-f injection, and everytime we check the number of follicles, could also see my cysts increase in size. I had chocolate cysts in both side and both incrased by 1.5cm since the treatment began.
I have a one more question (sorry too many questions)
does chocolate cyst = 水瘤 or 血瘤?
people do talk about 水囊, does 水囊 = 水瘤 too?
Dear 老公個公主，
I am not the best person to define those terms for you; if you want a precise & full definition, always ask your doctor or a 婦科醫生。
Just for a quick explanation,
Chocolate cyst =朱古力瘤／卵巢血瘤，caused by endometriosis (子宮內膜異位）with some endometrial tissues moved to the ovary.
水瘤／水囊：cysts, usually benign(良性），因單一詞語比較空泛，所以最好請教醫生。
Cutecutetown
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