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1703^#

發表於 12-6-14 23:00 |只看該作者

Hi Cutecutetown, I have PCOS and tried ivf at private clinic in Feb 2011 but requested to abandon the treatment before egg extraction. As the blood test result was poor after 12 days injection, which indicated the quality of follicles were not satisfactory. Do you remember me?

After 1.5 year of waiting, I started my first completed ivf at QM in May and did fresh ET on 02 June. Actually the injection didn't boost a lot of eggs this cycle. I didn't have any nasal spray but straight to fsh injection from day 8 (17 May). I started with 150iu Menagon for 6 days, then 225 for another 5 days followed by a final 2 shots of 300iu. A total of 4 folilicles were extracted on 31 May, but only one has egg inside. Luckily, that only one egg has got fertilized, and transferred on 2 June (4cells, no idea what grade was it). QM scheduled my pregnancy test on next Monday which is day 17 after ET, I have no idea why it is not scheduled 14 days after, would it be related to my cycle? But, according to my normal cycle, it is about 32-35days....so I don't really understand.
I have been given Endometrin for 2 weeks (2x per day), I just realized that the tablet will be used up by Sat morning, so it means I have no more on Sat pm and whole day sunday. Is it normal that dr will have patient to stop having this kind of hormornal support one day before the pregnancy test is done?

Thank you!!!!

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1704^#

發表於 12-6-14 23:35 |只看該作者

回覆 angelababy0808 的帖子

Dear angelababy0808,

I agree with your doctor that you are doing OK. Every IVF cycle is unique; and since this is your 1st time ever IVF, it is good to anticipate some room for improvement. And believe it or not, you don't need a "perfect" IVF cycle to bingo. If every woman's first IVF were a perfect cycle, we would not know what to do if she came back not pregnant :( And how to define "perfect" anyway?

1. I am sure that if you will need a 2nd IVF at all, your doctor will fine-tune the stimulation process, aiming to have 10-20 eggs of better quality.

2. As mentioned in many of my previous postings, embryo grading is based on morphological assessment of an embryo at a given time point. Its usefulness is similar to taking a photograph by a camera; and yet, we try to rely on this one snapshot alone to speculate if this embryo has a good chance of bingo or even live birth. Given this limitation, I can only say that grading provides a reference, but it is not everything.

3. Same as above, when we see an odd number of cells, is it not as good as an even number of cells? Maybe. But cell division is an ongoing process, sometimes I see embryos of 7-cell becoming 8-cell within 2 hours; so is this embryo good or no good?
Definitely you cannot put 4 embryos altogether into your womb. #1 reason is because it is against the law; no one can transfer more than 3 embryos if she is <35. #2 reason is that this is only your 1st-IVF, you may call it a 2nd ET event as this will be your 1st FET. A sensible choice is to transfer 2 embryos if you want to increase the chance. Don't risk the chance of multiple pregnancy.

My view is that don't jump to the conclusion so soon. You are only 33 and are at a much better position compared to many older jm's. Assuming the worst case, i.e. none of your frozen embryos bingo, you will have only used up ~3-4 months more. This is a very reasonable time frame even if you need a 2nd IVF.

Take it easy and one thing at a time. The road may be long, but you are not alone.
cutecutetown

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angelababy0808

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積分: 1607

1705^#

發表於 12-6-15 15:03 |只看該作者

回覆 cutecutetown 的帖子

Thanks so much cutecutetown, I shall have faith and I know the road of IVF is tough but I am not alone..

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piggy_rabbit

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1706^#

發表於 12-6-15 20:37 |只看該作者

ivf Q & A

dear cutecutecutetown,

我好耐無係度問你問題了！你可能唔記得我了！我之前做左2次IVF都失敗，終於係第三次成功了！現在BB已經兩個月大了！我其實一路都有睇呢度既post. 見到有d jm 一路都著緊egg quality既問題！我想說我其實只有33歲又健康，但我d egg quality 都可以唔係好理想！我d embryo 最多只有grade 2 +. 但我都可以bingo 了。希望其他jm 都唔好放棄。我就係抱住得就得，唔得就算的心情做第三次IVF 呢！唔好俾自己太大壓力就可以成功呢！

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Dakiki 恭喜恭喜!

發表於 12-6-18 20:38

cutecutetown Congratulations!!! I still remember you, although I fail to follow-up. Thanks for your sharing

發表於 12-6-15 22:13

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積分: 9500

1707^#

發表於 12-6-15 23:02 |只看該作者

回覆 MeikoBB 的帖子

Dear MeikoBB,

Yes, I remember.

4 cell on day2 is good, don't worry about the grade.

QM has this practice of giving progesterone (Endometrin) for 2 weeks and ask jm to check bingo a day or 2 later (e.g. on day 17); that's right, jm will not have any progesterone for 1-2 days. This is NOT because the doctor did poor calculation, and NOT because of anyone's normal cycle length.

Main reason is that biologically, if an embryo has implanted, it will cross-talk with the womb so that they will support each other by telling the body what to do. The embryo itself will produce HCG, which tells the body to produce progesterone, which tells the womb to nurture the embryo; so the embryo will continue to produce HCG.... so on and so forth like a loop.

You see that we (ivf provider) put embryos into your womb, but we give you progesterone as well, just in case your body is somewhat confused by the ivf stimulation injections and doesn't know what to do. So, we start by "tricking" your womb so that it will welcome your embryo. If your embryo will implant, it will do the loop above and our medication only serves as extra insurance. On the other hand, suppose there is no implantation, the loop is not complete and miss M will be ready to come.

cutecutetown

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1708^#

發表於 12-6-15 23:30 |只看該作者

回覆 cutecutetown 的帖子

Cutecutetown,
Thank you so much for your detailed explanation!
In fact, I also called QM nurse this afternoon and asked if it is OK for me to buy a PT kit and test it on tomorrow given that it will already be 15 days after ET. But she asked me to be a good girl and be patience to wait until Monday when I go back there for a more accurate test

cutecutetown, I really have not much expectation on this trial since my follicle development phase was already not very satisfactory; and only 1 egg is retreived and transferred. I didn't feel nervous and didn't think too much since ET, same life style as before, just that when getting closer to the "judgement day", I started feeling a bit anxious!
Public hospital practice is really different from private clinic, I know very little of everything from the QM dr, they would only say OK or not OK after each U/S and gave me the date of action. However, this kind of practice maybe somewhat good for me as know less = worry less = just follow what they said = less pressure!

Of coz I hope a bingo this time, but I know this is out of my control. I am well prepared for Ms. M to come anytime and start the 2nd ivf again, although there is still no sign as of now.

Really thank you for your support all the way through!!!

MeikoBB

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Add oil

發表於 12-6-16 13:26

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積分: 897

1709^#

發表於 12-6-16 20:36 |只看該作者

ivf Q & A

cutecutetown, hi i am seeking ur professional answers. On june 7th i have already atartedmy nasal spray. i have a few questions for you:

1) if i forget to bring the spray with me, that makes me miss the spray in daytime, does it matter? i am.suggested to spray four times a day but i did forget to bring it with me to work for 2 times. so i just had 3 sprays in a day.

2) nurse actually prescribed me 通經丸，because my cycle is messy. but my chinese herbalist asked me not to take the pills if the intention is just to regulate my cycle this month. she said these pills will mess up my natural cycle afterwards so i ended up listen to her and didnt take the pills and will wait for natural m come. am i affecting my ivf treatment??

3) nurse asked me to come back to qm hospital on june 21 because she said my m would have come on that day already after taking the pills. i asked her what if there is no m on june 21? she answered me and asked me call them to inform them first and not come to hospital on that date as scheduled. may i know why i must have period or period done on june 21 as prerequisite to see doctor? is there another arrangement if my m hasnt come yet?

4) i found out that my basal body temperature rises this cycle after ovulation which i didnt have elevated bmt in my previous cycles and i now have creamy sticky cervical muscus on my panty since 3 days ago (today d30) which i usually had dried up in the past after ovulation. is it all due to the nasal spray?? i am just thinking if i have a chance that i got pregnant this month..

Thx for ur kind advice on this. very appreciated to ease off my mind.

~生命生命這好傢伙,何時我也說他不錯~

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積分: 9500

1710^#

發表於 12-6-16 23:56 |只看該作者

回覆：pigsmoomoo 的帖子

Dear pigsmoomoo,

I replied to you before that 通經丸is to induce menstruation; therefore, it ensures your period will come. It is 'good' that you worried about having missed your nasal spray and told me about not using your 通經丸！I will tell you why in answering your questions.

1) Your missed dose(s) of nasal spray should be ok ; just make sure you won't miss any more.
In case you will miss again, do NOT attempt to spray double upon the next spray time.

2) yes and no, you won't affect your ivf treatment because it has not yet started; but you may possibly delay your ivf because if your period won't come on June 21, there is no point to see the doctor.

3) if you have taken通經丸according to the instruction by QM nurse, your period will come slightly before June 21; that is the time when the doctor can do some blood tests & ultrasound on you. If your period has not come on that day, the doctor cannot do anything to determine the suitability to start ivf injections.
I suggest you call QM and tell the nurse about not having taken 通經丸. It is better to tell them the truth & seek their advice.
(don't panic, they will likely ask you to take it now & see doctor a few days later than scheduled)

4) on the day when you started nasal spray, were you asked to do a pregnancy test? If nasal spray was started on day21 and you did not have intercourse before & around ovulation, you should not be pregnant.

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1711^#

發表於 12-6-17 00:04 |只看該作者

cutecutetown,
Miss M has yet arrived today, but just that I have one question in my mind for quite some time and wonder if you can help me to understand the reason behind.
As mentioned, I started my ivf at QM (public quene) in May. I called QM nurse to report my first day of Miss M in April and the cycle was a bit long that month - 37 days, the nurse calculated and asked me to go back on May 15. I asked what if my period arrived earlier in May as my cycle was normally 32-35days. The nurse told me to call again on my first day of m in May so they would adjust my visit if necessary. My period in May arrived on the 10th, so I called but QM nurse told me to stick with the schedule and go back on the 15th.
So, I went back and did U/S and blood test on that day, around 13-14 small follicles were found, the dr told me I could start injection the next day, i.e. the 16th but to be confirmed by the nurse later that day after the blood result available that pm. QM nurse told me the blood result was all OK but Dr advised to start injection one day later, i.e. the 17th. I always have a question that why injection started so late, as normally it would start on day 3 but I was on day 8......since you know public hospital would never answer your question in detail, so I have never got a chance to understand the reason why my injection started so late.
According to your experience and knowledge, have you come acrossed to such kind of case before? Is it normal for some women who suffered from PCOS or whatsoever reason not to start injection from day 3? Since the nurse also said my reaction wasn't so good after 6 days of injection when I went back for the 2nd U/S , only 4 follicles have grown. Do you think the late start of my injection contributes to the bad result of follicles development?

Sorry for so many questions!
I know this is already not a matter to know this since what happened has happened, but just that I am curious....

Thank you!

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發表於 12-6-17 22:30 |只看該作者

回覆 MeikoBB 的帖子

Dear MeikoBB,

Although you didn't mention in your message, I believe you started using nasal spray around the end of April, right? (In some cases, a single injection dose of decapeptyl or daily small doses of decapeptyl will be used.)

The purpose of nasal spray is to suppress your endogenous hormones (hormones produced by your own body) so that your own control on the reproductive system is very close to completely quiet. In other words, although you still had a period ~May 10, which were supposed to be the beginning of a new cycle, there is nearly no hormone (mainly FSH) to start the actual follicular growth in the ovaries. You may view it as a suspended or frozen time frame until you got your first injection of FSH (e.g. Menogon, HMG, Gonal F, Puregon, etc.) So, this IVF stimulated cycle does not follow your 'normal' count of days; day 1 is actually the day of 1st injection. Then the length of stimulation will vary depending on the speed of follicle growth, with the day of ovulation being the day of egg retrieval.

Since ivf stimulation overrides your 'normal' cycling pattern, it is more likely to be your PCOS nature that results in the suboptimal follicular development. This happens in many PCOS patients, which is often frustrating because some get lots of eggs of poor quality and some get only a few eggs due to the discordant follicular growth. But don't lose faith as there are plenty of PCOS patients who have ivf successes.

It is good to see you ask this question because doctors are too busy to explain and they also don't want to confuse their patients. I am sure many jm's probably have this common misunderstanding of how to do the day counts in ivf.

cutecutetown

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1713^#

發表於 12-6-17 23:02 |只看該作者

回覆 cutecutetown 的帖子

Hi Cutecutetown,
Sorry that I didn't give more details about my ivf treatment in my last post. The reason I have doubt is becoz I really didn't have any nasal spray, but go straight to fsh injection. My period in May came on 10 May, and started injection on the 17th, i.e. day 8. So, I wonder this late start has affected anything.
I guess my PCOS should definitely play a part in the unsatisfactory follicles develpment, but just that this is a bit unusual to me since I always responded very well to fsh injection for my previous iui treatments.

I couldn't keep my word and cheated today.....I did the PT this morning, but the result was negative

The kit (hcg testpack) I used was given to me a while ago from a private clinic which should be quite accurate I believe.
So, I trusted that this ivf cycle is a failure, just don't know why my Miss M has yet come, but still I need to go back to QM for the "official" test tomorrow.....

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1714^#

發表於 12-6-18 14:52 |只看該作者

回覆 MeikoBB 的帖子

Dear MeikoBB,
If you did not use nasal spray, you were put on a "short" protocol. Sometimes it is being used for PCOS women; and even of "short" protocol, there are 2 types. Let alone which type, your doctor needs to see your ultrasound and blood results first before starting gonadotropin injection. This somewhat echoed your saying that your start day was "delayed". Suppose you were started "early" or as expected, you would probably still have the same outcome but using some more injections.

I still pray that you would get a positive "official" test; should it be negative, your period will return in a few days. Take care,
cutecutetown

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kakakaju

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積分: 1609

1715^#

發表於 12-6-18 16:16 |只看該作者

Dear Cutecutetown,

I wanted to find out why I read online some IVF patients need to take aspirin in 80mg after ET? Does it work help to sustain implantation?

Thanks,
Kakakaju

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cutecutetown No, it is not to sustain implantation. 發表於 12-6-18 22:38

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1716^#

發表於 12-6-18 19:15 |只看該作者

引用:Dear pigsmoomoo, I replied to you befor

原帖由 cutecutetown 於 12-06-16 發表
Dear pigsmoomoo,

I replied to you before that 通經丸is to induce menstruation; therefore, it ensure ...

wah cutecutetown. u do have good memory and u can even remember i had asked u question.

Thanks for replying me. like u said, possibly the only effect of not taking the pills is delaying my m come. so can i just naturally wait for its coming and immediately informing the nurse once period is arrived on day one? auntie m sooner or later will visit me!!

the nurse didnt ask me to do the pregnancy test. but i did make love on day 23 and day 24. nurse also didnt ask me avoid intimacy in this month while taking medication. i usually have long cycle such as 41 days. is there any impact on baby if i am pregnant? this morning day 32 after wee we when i cleaned up i found out some light red spotting on tissue....thereafter no more till now. perhaps miss m will visit me soon...

btw would i feel hot after nasal spray. does it affect my body temperature?

~生命生命這好傢伙,何時我也說他不錯~

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1717^#

發表於 12-6-18 19:15 |只看該作者

引用:Dear pigsmoomoo, I replied to you befor

原帖由 cutecutetown 於 12-06-16 發表
Dear pigsmoomoo,

I replied to you before that 通經丸is to induce menstruation; therefore, it ensure ...

wah cutecutetown. u do have good memory and u can even remember i had asked u question.

~生命生命這好傢伙,何時我也說他不錯~

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Dakiki

複式洋房

積分: 324

1718^#

發表於 12-6-18 20:57 |只看該作者

hi Cutecutetown

I have undergone a surgical resection to remove my polyps in my uterus. Dr gave me some pills for my next cycle. I need to take the pills 4 days after my period starts. I've search on internet, the pills is for purpose to delay menstruation and it has side effect of blood clots and bloating. My dr said it helped to prevent the 子宮內膜 become too thick. Does the pills really can prevent the thickness of 子宮內膜. Does blood clot reduce the chance for implantation? Thanks!

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1719^#

發表於 12-6-18 23:04 |只看該作者

回覆 pigsmoomoo 的帖子

Dear pigsmoomoo,

To be honest, I only remember your name, not all your details; but thanks to BK with this function "只看該作者".

So it looks like you haven't called up QM. If you don't mind waiting a little longer, I suppose you can wait for your period to come. However, I believe you are only given a certain amount of nasal spray to use. You may need to call the nurse if your spray runs out before your period comes.

I don't think you are pregnant, especially when you had intercourse quite a long time after you ovulated. Nasal spray shouldn't affect your body temperature.

Hope your period will come soon!
cutecutetown

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