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Baby Kingdom - 親子王國香港討論區 › 首頁 › 想生BB› ivf Q & A

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樓主: cutecutetown

ivf Q & A

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發表於 12-8-1 00:16 |只看該作者

引用：Hello+BabyGaga21, Taking+antibiotics+wil

原帖由 cutecutetown 於 12-07-20 發表
Hello BabyGaga21,
Taking antibiotics will not affect your treatment nor egg quality, but make sure y ...

Thanks, cutecutetown. You are so generous to spend your time sharing your knowledge to all the Jms here!

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jennyc0111

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發表於 12-8-23 11:45 |只看該作者

Hi cutecutetown,

If there any difference between 8 cell and 10 cell of Day 3 embryo?

Does D3 embryo with 10 cell have a better sucessfull rate than 8 cell?

How to distinguish the quality of D5 embryo?

Thanks in advance!!

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cutecutetown

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發表於 12-8-23 20:20 |只看該作者

回覆：jennyc0111 的帖子

Hi jennyc0111,

There should not be a big difference between a 10-cell and an 8-cell on day 3, although we tend to transfer the 10-cell believing that it may be better since it is growing slightly faster.

For embryos on day5, we should expect blastocysts. A blastocyst is an embryo with 2 distinct cell types: the inner cell mass (ICM) and the trophectoderm (TE). The ICM will eventually become the fetus while TE will be the placenta. Grading is a little more complicated, but most lab will tell you whether a blastocyst is good, fair/average, or poor. This description is based on the appearance and cell number of the blastocyst.

點評

jennyc0111 Thanks a lot!! 發表於 12-8-24 11:57

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Whicheng

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發表於 12-9-11 20:07 |只看該作者

Hi cutecutetown,

It’s me again. Hope you still remember me. My baby girl is 7.5 months already! I am thinking of having a second baby. I still have 2 frozen embryos. However, according to my doctor, those embryos are quite “ugly looking”. My understanding is that if the embryos are not healthy, they will not grow after thawing no matter whether they are being kept in the lab or transferred to my uterus. Hence, in order to save some cost and avoid the frustration with the 2ww, I plan to ask my lab to thaw those 2 embryos and transfer only if they become blastocyst on day 5. What do you think of this approach?

Also, I got a question on my chance with IVF vs natural conception. I didn’t have problem in ovulation, my tubes are not blocked and my husband semen analysis didn’t indicate any problem. Since I didn’t response well to the drugs, I got mostly only 2 eggs for IVF. My doctor is having the view that even with only 1 egg, IVF/ICSI bypassed a lot of the natural processes and hence making bingo much more easier. Hence he strongly encouraged me to try IVF again if my FET fails. With my very low AMH, I am not sure if I am really better off in doing IVF. Apparently I want a 2nd child but if chance is too remote, I’d rather save some money for my baby girl. May I know what is your view on this?

whicheng

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HYee

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發表於 12-9-11 21:06 |只看該作者

回覆：ivf Q & A

你好，我係29/8抽卵(養和)，31/8放胎(1個是4cell grade2 and 另一個2cell grade 2), 餘下有四個雪胎（兩個 grade2 & 兩個grade2-當中有兩個係當日分裂到3個cell）。問題1）放2days 胎是否因為胚胎質素不好？ 2）餘下四個在同一日雪，這是正常做法嗎？為什麼不再培植多一兩天？ 3）那兩個3cell的胚胎是不正常嗎？謝謝

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cutecutetown

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發表於 12-9-12 12:10 |只看該作者

回覆 Whicheng 的帖子

Dear Whicheng,
Your approach is fine; will you get notified on the morning of day5 whether to go in for a FET or not?

Since you may not proceed further with another new ivf, I would suggest to have the transfer if the embryo(s) do not fall apart upon thawing and also continue to grow. In other words, still have the lab thaw the embryos and culture to day5; if they have signs of growth, still transfer them even if they are not blastocysts on day 5.

It's good that you know the limitation and available options. I will still see the outcome of this FET first. If say you fail the FET but you are still super desperate for a 2nd child, you may try 1 or 2 more IVF. My very personal view is that if you are already happy with one little girl, don't give yourself extra emotional and financial stress; be satisfied with and treasure what you have had. Continue to try the natural way and any 'bonus' will be a blessing :)

cutecutetown

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Whicheng Tks cutecutetown. I know i m very lucky to have my little girl. I will see how the FET goes first. 發表於 12-9-12 13:52

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cutecutetown

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發表於 12-9-12 12:17 |只看該作者

回覆 HYee 的帖子

Hello HYee,
1) Probably, or it could be to fit easier scheduling.
2) Yes, freezing usually done on the same day as ET.
3) No, the two 3-cell embryos should have been normally fertilized or else they would not even be frozen.

cutecutetown

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HYee

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發表於 12-9-12 13:03 |只看該作者

引用：回覆+HYee+的帖子 Hello+HYee,1)+Probably

原帖由 cutecutetown 於 12-09-12 發表
回覆 HYee 的帖子

Hello HYee,

Hi Cutecutetown, thanks for your quick response. I have one follow up question on the first answer. If the embryo us not in good quality that I need to have the ET on the second day, why the lab rank the embryos as grade 2/2-? Per lab, they didn't rank grade 1 for many years and grade 3 is in very poor that ET would not be done. Thanks

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cutecutetown

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發表於 12-9-12 18:12 |只看該作者

回覆 HYee 的帖子

Dear HYee,
I really don't know why the lab doesn't rank grade 1 and yet keep the rank. However, even a perfect grade does not guarantee its successful implantation into the womb. Also need to bear in mind is that the grading is just a morphological assessment at one time point; it only serves as one of the references when deciding what to transfer or what to discard.

cutecutetown

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babyak1

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發表於 12-10-4 22:17 |只看該作者

Hi cutecutetown, it's very nice of you to share your knowledge and opinions with other jm who are on this tough journey to try to have a baby. I'm also thinking of going down the road of IVF but I'm puzzled at what I should do next and hopefully can get some opinion from you.
I'm turning to 34 in a few months and hubby is same age as me. Been trying to conceive naturally for 1.5 yr and got chemical pregnancy last Dec. It was only 2 days after I found out pregnant that I had a miscarriage. Keep trying again after that but no luck so far. Since the clock is ticking, I'm not sure what I should do next. My cycle is very regular about 28 days and previous HCG test seems to show that I ovulate and progesterone was 13 on day 21. Just had my tubes checked and hubby had his second semen test this week. I haven't got the result yet but I'm assuming the result should be positive coz I had been pregnant before and hubby's first semen test was ok. Assuming both test results are positive, I'm wondering what I should do next coz I have no idea at all. Here are some of my questions.

1) What other tests I can do to find out the reason for my "infertility"?
2) Do people normally start with taking ovulation pills alone first? Is it of any help at all? What's the average success rate? Will the Dr. do u/s during the cycle to monitor the development of the eggs?
3) It seems that IUI doesn't have a higher success rate than natural conception. Is it even worth trying at all? considering that I'm 34 soon.
4) If I want to do IVF, what's the average cost for each treatment? I've seen some price list of hospitals but I'm not sure what item I need. Can you pls let me know how much roughly for one treatment in public and private hospital respectively? Does one treatment means one month or the whole thing including the several FETs?
5) I know it's impossible for anyone to say, but do you think I will have a relative higher chance of success considering everything seems normal and ok. It seems like most jm don't succeed on their first attempt. I'm not sure I can handle the physical, emotional and financial stress of several IVF attempts.

Any opinion is appreciated. Thank you very much in advance.

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jlin123

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發表於 12-10-5 23:26 |只看該作者

dear cute cute town!

my first time to ask you questions. really appreciate you've been helping the IVF ladies.

1) i did a 3 day transfer. after 10 days, hcg result is only 7.9! nurse ask me to go back 2 days later. so i will go again today. i just started bleeding yesterday. i'm wondering what's low hcg mean? does it mean it implants but fail later? what are the possible reasons? i'm still on progesterone.
2) so i'm planning for next cycle. 我有一雪胎，第六日的，e生話下個cycle可以iui + 放雪胎，Day 0 放丁丁，day 5 再放胎, 唔會影響裏面正在分裂嘅細胞？i never hear of such a combination of ivi and fet, 請賜教! doctor said this way we won't waste a cycle cuz there's no guarantee whether that only one frozen can survive. it's grade 4BC.

thank you so much!

lin

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cutecutetown

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發表於 12-10-6 00:41 |只看該作者

本帖最後由 cutecutetown 於 12-10-6 11:10 編輯

回覆 babyak1 的帖子

Hello babyak1,
I will still suggest to make an appointment with an IVF doctor to answer clinical questions. My role here is probably to give you some ideas of what you may encounter when you see your doctor, who should be the one making diagnosis and providing treatment.

1) There are indeed more elaborate tests than just measurement of blood hormones and semen analysis. Doctors may refer you to ultrasound, hysterosalpingogram, and/or laparoscopy after the first consultation.

2) Different doctors approach the "problem" differently; some being more conservative and some being more aggressive. Taking ovulation pills may be all you need, but most will add an IUI (i.e. ovulation induction + IUI). This approach is the least expensive and when you have regular menstrual cycles, you can try every month/cycle. Usually you will need ~3-6 cycles to succeed; if this doesn't work, then IVF will be the next step. Some but not all doctors will do u/s during the cycle to monitor egg development.

3) Since you will be 34 soon, you still can afford some time to try a few IUIs, especially you had a chemical pregnancy from natural conception not long ago.

4) IVF costs (strictly IVF, not IUI) vary in different centres in HK. The public queue is a long line (wait of 1.5-3 yrs) and it is similar to visiting government clinics with pay-per-visit scheme (is it some $68 per visit these days?).
If you can afford the treatment, do private treatment to save time. It is very difficult to quote the costs of IVF in the private sector; a very general idea is that it ranges from $50,000- over $100,000. The more extra procedures you have, the more you pay.

One treatment "begins" from the time when your dr starts using drugs to regulate/control your egg follicle growth and "ends" when you have embryos to transfer +/- freeze. In cases where you have extra embryos to freeze, subsequent FETs are considered separate treatment, although FET costs much less because it requires much less medication.

5) Logically yes, you may have a relatively good success chance, and that's why you need to talk to an IVF doctor to understand the pros and cons because IVF gives higher success chance but does not guarantee success.

Good luck :)
cutecutetown

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cutecutetown

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發表於 12-10-6 11:48 |只看該作者

回覆 jlin123 的帖子

Hello jlin123,
1) Low hcg (usually refers to a value below 20) is a chemical pregnancy. The embryo grows a little further inside the womb, but it fails soon after and therefore could not sustain the hcg level. Implanted embryo will continue to produce hcg, that's why we test hcg level in urine or blood to check pregnancy.
Progesterone cannot "stop" mentrual periods when there is no pregnancy.

2) I have heard of IUI+FET, although I have never worked with doctors who actually offer it. In a way, you will not waste a cycle, but if IUI will give you a pregnancy, you might not have needed the IVF in the first place. In my very own personal opinion, this extra IUI may just be a waste of your effort and may give you some false sense of hope.
Your blastocyst is a grade 4BC, which is not a bad grade. My concern is that what if you are very "lucky" to get a pregnancy from both the IUI and also the blastocyst; then you will end up with twins. (The chance is very low, but it is not totally impossible.) What's your age and personal view on multiple pregnancy?

cutecutetown

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schealthy

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發表於 12-10-6 12:40 |只看該作者

提示: 作者被禁止或刪除內容自動屏蔽

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marblecake88

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發表於 12-10-6 22:17 |只看該作者

回覆：cutecutetown 的帖子

您好！多謝你為我們分享！
我四月剛完成了人工流產，這次是自然成孕的，剛屬高齡。
休息幾個月後，我在九月剛完成了第一次ivf +pgd 療程，抽了十個卵泡，有六粒卵，五粒受精，得兩粒正常分裂，最後得一粒肧嚢passed pgd, 可放。不過失敗了並沒有胎可雪
我有以下問題：
1）打puregon 第一二日450iu, 之後8日，每次250Iu. 這份量是高還是中量？
2）以我的年紀，我的卵巢反應算差嗎？。如puregon劑量高一點，卵巢反應及數量多一㸃嗎？
註：我這兩三年試過三次自然成孕及我過去的經期相當準確，都是約28日
3）我不知道自己fsh 那些值，醫生沒有說，我也沒有問，有參考價值嗎？幾實是反影什麼？
4）我打算明年初再做ivf,請問有冇食乜或做乜運動會對卵巢功能有幚助？
5）據你的經驗或認知，素食者的卵巢或受孕機會，會否差一點？
註：我這幾個月我開始成為素食者，只偶爾吃魚和雞
多謝你的意見。

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jlin123

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發表於 12-10-6 23:15 |只看該作者

cutecutetown 發表於 12-10-6 11:48
回覆 jlin123 的帖子

Hello jlin123,

dear cutecutetown,

thank you for your quick response! really appreciate it!

so there's a reason why IUI may work for me. In Jan, I once got positive on day 14 after insemination. hcg was 160. but i also started bleeding red that day. do you think i'ts because i stopped progesterone 3days before the hcg test? i stopped cuz i saw some pink/brown discharge and thought that must be period. then doctor had me check hcg 2 days later again and it dropped to 100, 3 more days drop to 60, 4 more days drop to 6. i never really know what caused this. doctor only said maybe chromosome not good, maybe i stopped progesterone, etc. I'd like to find out more than that. you encountered cases like this? was it ever implanted?
fyi: i already tried 7 IUI and 3 IVFs. only the last IVF, i got one frozen. i try IVF because it's higher probability than IUI in general.

for multiple pregnancy, i'm fine with twins if they are healthy. i'm arleady 36.

lin

點評

cutecutetown there could be multiple reasons, but still mainly embryo being chromosomally abnormal. 發表於 12-10-7 12:10

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cutecutetown

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發表於 12-10-7 00:04 |只看該作者

回覆 schealthy 的帖子

Hello schealthy,
1) I don't think bed rest all the way helps implantation. Of course you should not jump ropes or run a marathon after embryo transfer, but resuming normal daily activities is very OK. Bed rest may make you feel more tired, as you said in your case, especially if you are an active person before the ivf treatment.

2) I won't worry too much over embryo grading. Grade 2 embryos are average-looking embryos; if they didn't look to have potential, your lab wouldn't freeze them in the first place.

Many women just don't bingo on their very first embryo transfer. Have faith and your chance may just be in among these 5 frozen embryos. Best wishes,
cutecutetown

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cutecutetown

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發表於 12-10-7 00:35 |只看該作者

回覆 marblecake88 的帖子

hello marblecake88,
1) the first 2 days were high, but the dosage was stepped down afterwards. The dosage does not have to be the same all the way through; doctors often adjust according to the growth of your follicles.
2) what's your age (35 yrs old?)? Why do you need pgd? Your previous pregnancies gave live birth or miscarried?
3) for you having got naturally pregnant 3 times in the past 2-3 yrs, I don't think fsh will be very meaningful. When we measure FSH, we want to know if your ovaries still have a reasonable egg reserve.
4) you are doing fine in this ivf. If you have read some of my previous postings to other jm, I always recommend a balanced lifestyle - maintain a balanced diet, get quality sleep, do moderate exercises.

Balanced diet means you can eat anything you want, but pay attention to the amount you eat and the way the food is prepared; eat less of fried/junk food and eat more of green veggies. You don't have to become a vegetarian to eat healthily; if you like meat, lean meat is fine (such as fish and lean chicken you mentioned, even lean beef is alright), just watch the portion.
Quality sleep means you need good rest. Sometimes lying in bed is not equal to good sleep. Try to do some relaxation before going to bed if you have trouble sleeping or have very shallow sleep.
Moderate exercises is probably the most difficult to keep up. Any kind of exercises that can make you sweat is good for you. Remember exercises encourage better blood flow, which helps to detoxify your body and bring oxygen to vital organs, which include ovaries and uterus.

5) I don't think being a vegetarian increases or decreases a woman's chance to get pregnant. If it is not for religious reason, I only recommend healthy eating. I feel that meat is a very good protein source which is unparalleled by vegetables; but again, when you over-eat, the food may become "harmful".

cutecutetown