I am on my 6th day of IVF treatment with 抑制排卵針in the morning @ 8am and Gonal-F @10pm.
I am going back to screen my egg and blood test tomorrow, hopes everything goes well. By the way, since I had insominia for a long time and I was on Stilnox (prescribed by my psychologist) for 2 years already. I was worried and my IVF doctor said its still OK to take the pills if I find it really hard going to bed (sleeping is very important during IVF treatment), it will not affect the IVF success rate but I better stop it after ET or most importantly after Bingo.
I just want to seek your opinion that from your expereience, taking Stilnox during IVF treatment will bring negative impact to success rate or having unhealthy baby if I am lucky enough to Bingo? Really thx for your help and advice...
Dear angelababy0808,
I have no experience with the pills. As your doctor suggested, from now till your bingo test, take it if you find it really hard to fall asleep. In the mean time, check with the doctor who prescribed Stilnox to you and ask if the medication is contraindicated for pregnancy. Usually (but not all the time), sleeping pills should be used only when clearly needed during pregnancy.
I think I've answered the same question from you before. Let's re-visit one more time.
安胎針，成份是HCG,因half-life比較長，即留在身體內的時間較長，放胎後到check bingo 前只須隔幾天才打一針，共打兩或三針。好處是不用每天重覆，弊處是不太適合ivf反應良好又放新鮮胚胎的jm，因會增加OHSS（卵巢刺激過度症）的風險。另外，hcg亦是驗孕所驗的hormone,因為著床的胚胎同樣會產生hcg，所以有些jm有打安胎針之餘又偷步驗孕以為bingo,其實有時係一場歡喜一場空。
塞藥，成份是progesterone,要每天塞一至三次（視乎牌子或劑量），起碼要塞10日8日。好處係方便又唔痛，弊處係每天都要記住做，有時稍為有少許滲出內褲，雖然係正常現象，但往往jm就忍唔住擔心。在胚胎沒著床的情況下／即沒有hcg，身體就知沒懷孕，到「週期」末m小姐就會來。
我沒刻意提到hcg和progesterone 嘅生理效用，因比較深奧。但兩者的效用可以說是異曲同工，醫生一般都會考慮各方因素才決定給哪一種較合適。
I went back to clinic last night but my doctor confirmed that he cannot do laser hatching for me as my blastocysts outer shell are thin enough. If performing laser hatching there's a risk to damage the blastocysts completely. I am not sure what he said is true or not? He said performing laser hatching might be suited for more elderly women and for those who failed deliberately in IVF. I wanted to challenge him but didn't go forward cos I also failed my fresh cycle and one FET, don't you think my case he should really consider?
Anyways he said for my case he suspect is more of the eggs quality not being able to develop further. He said my uterus wall are all well in good conditions and he don't think this causes the failure it's more of the eggs. Do you agree with what he said?
Since I have no more faith in this clinic/doctor/lab, I have decided to do the last FET since I am only left with 2 more blastocysts and move to a brand new doctor and new lab. I know I cannot blame the doctor but apart from his patience I see no other quality of him being able to help me out via IVF.
Dear kakakaju,
Indeed, blastocysts have a thinner shell compared to D3 embryos and laser hatching on blastocysts is not routinely done in any lab. Although it is feasible, it is more tricky and you better not risk your 2 blastocysts.
My opinion of assisted hatching (on D3 embryos) is that it causes no harm, as seen in the bingo's of those jm's who had good embryos for all previous ET attempts with no bingo. We never know if the same bingo would be achieved when assisted hatching were not done. In other words, it is not an absolutely necessary procedure and you do not have to regret not having it done.
Your doctor has some truth about egg quality, but it is always easier to review than to predict. Whether or not there is an egg quality issue, we cannot go back in time to fix it. What we need to do is to be forward-looking and learn from our past experience. Based on what I see in my own lab, many blastocysts (fresh or frozen) do well.
I have this recent case to share, which shows that we (jm's and the lab people) should not lose faith. One of my patients, being 39 yrs of age approaching 40, did an IVF in my center, having 2 good embryos and 1 average embryo on day3. We transferred the 2 good ones, cultured the average one to D5. This average embryo grew to a blastocyst on D5; still of average quality, it was frozen for her later use. She didn't get pregnant from the 2 good D3 embryos, but she reported bingo yesterday after FET of that 1 blastocyst.
When we think we know, we actually don't know..... life is sometimes filled with despair, but sometimes with good surprises.
cutecutetown
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smt
Totally agreed with your thinking in the last paragraph
發表於 12-6-5 15:58
Thanks cutecutetown. I am unhappy and lost faith is because I did my fresh embryo transfer back in April with 1 A- and 1 B+ embryo still failed. Hence when I had my FET in May I had one blastocysts transferred under 3BB grade, again failed. Without further guessing, the doctor is going to put the remaining 2 blastocysts for me hopefully by next week or so. I have no clue what the doctor is referring to about egg quality and my old age (39 years old) despite me and my husband health conditions are above average.
I agree with you that a lot of times IVF depends on your luck but I also doubt if the doctor's analysis is too correct saying that my age cheated me for fail IVF. He also mentioned the more IVF you do, the better chance for bingo. Again I am not sure if this philosophy is right. I am getting very tired and frustrated with the doctor and the lab, so I will give myself this last chance thereafter changing a new doctor with a new lab might hopefully work better for me.
Thx so much for your help so far, I am going to have my ER on coming Sunday (10/6) and today the U/S shows 15 eggs are 1.6-2cm. I am 33 and doctor has prompted me thay I might have OHSS as there may be a lot of eggs. I have some questions in mind and would like to seek your opinion:-
1. What is the major factor account to egg quality??
2. In case an egg not being fertilized, can you tell if its the sperm quality or egg quality?
I am a little worried as my doctor keep saying that quantity is the first success but most importantly is the quality of it.
1. To me, age matters most; then have to consider D3FSH if it is >10. Sometimes, during ovarian stimulation there are clues which the doctors will look at, such as the levels of different hormones at various time points, the speed of growth of the follicles, the days of stimulation, just to name a few. When there are many eggs (e.g. over 20 eggs collected), egg quality may not be as good as we want.
2. Fertilization is the successful union of a sperm and an egg. When one sperm sample is being used to fertilize a batch of eggs, it is not usual that a few eggs will not get fertilized. Normal fertilization rate, on average, is ~65 to 80%; meaning there will be ~20-35% of eggs not fertilized. It is very hard to generalize the reasons or pinpoint whether the sperm or the egg were to blame. However, there are often tell-tale signs, based on semen analyses or clues such as those in #1 above, that alert us about a possible poor or lower fertilization outcome.
In your case, don't start to worry yourself yet. Based on your age and the limited info I got from you here so far, you will likely do fine.
Thanks so much for your support so far. I have done my ER today and the result is very disappointing.....I got 24 eggs retrived while 8 of them were 空心, my doctor said it is not a good sign as I shouldnt get that % of 空心卵at my age of 33.
I lost faith and I think the remaining 16 eggs are at poor quality, I think I will try another IVF next year and hopefully my egg quality will improve by then
Is 空心卵an egg shell only with no egg inside? Or no egg was retrieved from its follicle (卵泡內沒有卵子）？
Regardless of the reasons for the above, you still have 16 eggs, which is already plentiful. Just see how many fertilized tomorrow. Sometimes, doctors like to tell you only the negative side of things because many patients have very high (& some could be unreal) expectation. Trying to stand in middle ground, I don't think you should be this disappointed yet.
cutecutetwon, Really thanks for your words and now I feel more 平常心. I think I am scared by my doctor who's saying that when the % of 空心卵 is so high, I have assumed the whole batch of eggs were of no good quality and will not able to get any embryos to be frozen. As I m having OHSS I will not perform ET, so if there's no frozen embryos this round, It will come to an end of this round of IVF...
I am not sure what my doctor were telling about the 空心, he just said (抽了24粒,但有8粒係空心的,所以只有16粒可用)...so I think it should be egg shells with no egg inside found...
Thanks cutecutetown... I will stay strong and accept the reality...
cutecutetwon, Really thanks for your words and now I feel more 平常心. I t ...
Hi CuteCuteTown,
I just want to update you that finally out of that 16, only 11 are mature enough to be used. And 11 of them got fertilized with which 6 of them grown to 6-8 cells on day 3 and got frozen for my later use. This round, my doctor only transfered one fresh 5 cells grade 2- into my womb as the polyp will affect the implant so he said he better transfered this poorest quality one and freeze those "good quality " for FET after my polyp taken out in August after his holiday.
My doctor has reviewed this IVF for me by saying that I am doing OK, however the quality could be better..he is a super nice doctor with lots of smile on his face. But there's one question I dare not to ask him since I dun want him to feel that I am challenging his professional, but I just wanna get some answer and get prepared for my next IVF.
1. This is my first IVF with unknown infertility problem, and i had an injection of 300IU for first 6 days and 375IU for 3 days, total 9 days of injection. it turned out to be 24eggs in total, but only 11 can be used, in case we control the stimulation process and keep it under 20 eggs, will the egg quality be better thus a better grade embryos?
2. I have 6 frozen embryos now,but most of them are in average grades, but my doc and 養和 assured me that as long as the 胚胎專家assessed the embryos are worthwhile for frozen, then its a good embryo, particularly its D3 embryos already with mostly 6-8 cells.
3. Is an 3 cells, 5-cells, 7-cells embryos. not as good as those 2-cells. 4 cells. 6 cells, 8 cells, as I heard from a nurse that singular cells count mean the cell division is not as good?? I am wondering if I shall put 4 into my wombs as they are not @ excellent grade to increase the chance, and if it fails, I shall proceed with another IVF so that I may collect anothr batch of good quality eggs?? Whats your view??
Thanks cutecutetown, without your previous feedback I think I would have been more lost.
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