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男爵府

積分: 7304


發表於 10-2-12 11:02 |顯示全部帖子
Being in the ivf field for >10 years, I hope to help in a discussion format any of your questions or concerns with my relevant scientific knowledge and experience.

Please also let me declare that any of my sharings and discussions here whatsoever are based on my own personal views and opinions; and therefore, my discussions and I in this discussion blog do not represent my employer or my center.

Any of your postings can be in Chinese or English. My response will mostly be in English.

Have a successful Year of the Tiger!


複式洋房

積分: 304


發表於 10-2-14 12:39 |顯示全部帖子
Hi,

do you know the reason why the embryo stops development starting day 3 (2 only 7 cells and 6 are arrested with 4 cells in day 5) and how to improve the quality of embryo (if any) ? Thanks


男爵府

積分: 7304


發表於 10-2-18 17:50 |顯示全部帖子
To answer your first question, there could be many reasons to why embryos stop developing. Some of the more common ones include:
(1) the embryo itself may be genetically abnormal;
(2) there may be a problem in the activation of the embryonic genome;
[generally speaking, < 8-cell embryo is still relying on proteins orginating from the egg which it is derived; embryo with 8 or more cells will make its own proteins]
(3) suboptimal culture conditions.

My answer above somewhat addresses your 2nd question. Besides, some doctors believe milder stimulation may help. The recruitment of another cohort of eggs, i.e. starting a new cycle, may give a totally different picture compared to the previous cycle. However, if embryo quality is consistently poor, it is better to talk to your in-charge doctor and also the ivf lab to come up with the best solution.

原帖由 parker123 於 10-2-14 12:39 發表
Hi,

do you know the reason why the embryo stops development starting day 3 (2 only 7 cells and 6 are arrested with 4 cells in day 5) and how to improve the quality of embryo (if any) ? Thanks


複式洋房

積分: 118


發表於 10-2-18 21:39 |顯示全部帖子
Hi Cutecutetown,

Your information sounds very professional.

I did ivf last month but failed. I am wondering whether it was due to failure to implant or quality of the embryos. Is there a way to find out the reason? I will have another embryos (frozen) transfer next week but started thinking whether to do another ivf if this transfer fails again.

thanks.

原帖由 cutecutetown 於 10-2-18 17:50 發表
To answer your first question, there could be many reasons to why embryos stop developing. Some of the more common ones include:
(1) the embryo itself may be genetically abnormal;
(2) there may be a ...


男爵府

積分: 7298


發表於 10-2-19 02:41 |顯示全部帖子
Will you suggest any preparation before ivf treatment, such as visit chinese dr, drink more milk and the like? thanks!


複式洋房

積分: 304


發表於 10-2-19 08:58 |顯示全部帖子
Hi cutecutetown

I have some further questions
1). Is the genectic problem due to a male or female factor or both?

2) can I take up more protein during eggs stimulation to solve or prevent the embryo that cannot generate enf protein itself?


quote]原帖由 cutecutetown 於 10-2-18 17:50 發表
To answer your first question, there could be many reasons to why embryos stop developing. Some of the more common ones include:
(1) the embryo itself may be genetically abnormal;
(2) there may be a ... [/quote]


男爵府

積分: 7304


發表於 10-2-19 13:01 |顯示全部帖子
It will be nice if you can talk to your doctor or the lab people (embryologists). They are the ones who know your embryo stage and quality.

In my lab, we do not freeze poor-quality embryos. Embryo freezing is for the benefit of the patient so that she does not have to go through another new stimulation cycle in order to have an embryo transfer.

My opinion is that you should not give up your frozen embryos.

原帖由 Happyeverafter 於 10-2-18 21:39 發表
Hi Cutecutetown,

Your information sounds very professional.

I did ivf last month but failed. I am wondering whether it was due to failure to implant or quality of the embryos. Is there a way to find ...


男爵府

積分: 7304


發表於 10-2-19 13:11 |顯示全部帖子
Generally, maintain a healthy lifestyle is the key to everything. e.g. eat healthy meals, exercise moderately, sleep well, know how to relax or relieve stress.

Doing what you believe in moderation is important. It makes you happy and confident about yourself. I do not believe very much in chinese medicine; however, I do not see it will hurt either. My suggestions will be, if you see a chinese medicine dr, try to limit yourself to only the healthy herbs. I will avoid anything with unknown medicinal ingredients.


原帖由 MusicTV 於 10-2-19 02:41 發表
Will you suggest any preparation before ivf treatment, such as visit chinese dr, drink more milk and the like? thanks!


男爵府

積分: 7304


發表於 10-2-19 13:22 |顯示全部帖子
Hi parker123,

1) Can be from father or mother, or both, or de novo (new) from imperfect cell division.

2) Sorry, my answer was somewhat simplified in my last reply. You cannot take more proteins to help your eggs or embryos.
The DNA, or the genes, are the blueprint, and there are other things that make the necessary proteins based on this blueprint. At a molecular level, a lot of events need to be coordinated to have this activation of the embryonic genome.

原帖由 parker123 於 10-2-19 08:58 發表
Hi cutecutetown

I have some further questions
1). Is the genectic problem due to a male or female factor or both?

2) can I take up more protein during eggs stimulation to solve or prevent the embryo ...


複式洋房

積分: 118


發表於 10-2-19 14:28 |顯示全部帖子
Thanks for the advice. I will not give up my embryos. I have 8 forezen. Just that I am preparing for the worst, i.e. all those embryos failed to develop into pregnancy.

原帖由 cutecutetown 於 10-2-19 13:01 發表
It will be nice if you can talk to your doctor or the lab people (embryologists). They are the ones who know your embryo stage and quality.

In my lab, we do not freeze poor-quality embryos. Embryo ...


男爵府

積分: 7889

畀面勳章 環保接龍勳章


發表於 10-2-19 16:29 |顯示全部帖子
我好想知ivf的bb會否較iui或自然懷孕的bb容易出現先天性缺陷?


男爵府

積分: 7304


發表於 10-2-19 17:46 |顯示全部帖子
That depends on what disabilities we are talking about. I think people mainly worry about (1) mental retardation (2) major physical disabilities.

There are a number of reviews on this subject which I have read some but not all. My own interpretation is that when the naturally-conceived bb has an overall abnormality/disability rate of ~2-3%, ivf or icsi bb has a rate of ~4-5%. I have not read enough about iui bb, so I can't really share any rate with you here.

However, please keep in mind that because these are ivf/icsi bb, we tend to follow-up on every little detail. For naturally-conceived, we don't follow every bb and rely on voluntary reporting. Also, some believe that infertility may have genetic components to it; and therefore, it can pass onto the offspring (bb). Or think from another end, if there is no ivf/icsi, these bb may not even be here.

It probably gets down to the real question - if we have trouble conceiving naturally, what are the risks and how much of the risk can we take?

原帖由 Sonatina 於 10-2-19 16:29 發表
我好想知ivf的bb會否較iui或自然懷孕的bb容易出現先天性缺陷?


複式洋房

積分: 118


發表於 10-2-19 17:56 |顯示全部帖子
My husband kept telling me that the abnormal rate for IVF is much higher than IUI. That was the reason why I did 5 IUI but all failed. Finally, I decided to take the risk and did ivf. After all, we are talking about 1% difference between natural conception and ivf.

原帖由 Sonatina 於 10-2-19 16:29 發表
我好想知ivf的bb會否較iui或自然懷孕的bb容易出現先天性缺陷?


男爵府

積分: 7304


發表於 10-2-20 09:51 |顯示全部帖子
A quick note for Happyeverafter, the difference is somewhat more than 1%, and it really depends on what kind of abnormality. However, many people view the risk as "doubled".[2% x2=4%]
Instead of putting everything in a calculable number, I would say the risk is slightly increased, although it is still very low.

Also, consider that ivf itself requires time and more medication compared to iui; the egg retrieval procedure is also invasive. Sometimes couples somewhat forget that the women need to go through some risks themselves before achieving the goal.


原帖由 Happyeverafter 於 10-2-19 17:56 發表
My husband kept telling me that the abnormal rate for IVF is much higher than IUI. That was the reason why I did 5 IUI but all failed. Finally, I decided to take the risk and did ivf. After all, we ar ...


別墅

積分: 863


發表於 10-2-28 15:44 |顯示全部帖子
Hi Cutecutetown
Thanks for starting the thread and it's very informative

I would like to ask, in general in HK or in your particular lab, what's the success rate for IVF for women under 35?

Also, are there any cases people only succeed in their 3rd / 4th attempts?

Thanks


男爵府

積分: 7304


發表於 10-3-1 17:51 |顯示全部帖子
My pleasure, thanks for your support :)

There are 7 licensed centers in HK providing IVF/ICSI services. For those interested, this is the website to begin: http://www.chrt.org.hk/

I don't have the general figure for the whole HK, but in my lab, the overall success rate for women under 35 is >40%. There are other factors that may affect success rates, one of which (as you mentioned) is the number of previous attempts.

And yes, although success chance is lower when attempts increase, it is not uncommon for some to finally "bingo" on their 3rd or 4th attempt. I had personally handled a case who didn't get pregnant until her 11th attempt. A little extreme, but do consult your IVF doctor (MD) for professional advice.


原帖由 dolphindor 於 10-2-28 15:44 發表
Hi Cutecutetown
Thanks for starting the thread and it's very informative

I would like to ask, in general in HK or in your particular lab, what's the success rate for IVF for women under 35?

Also, ar ...


別墅

積分: 743


發表於 10-3-3 09:24 |顯示全部帖子
Hi cutecutetown,

Please share your experience if DHEA can help the poor response patient to improve their no. of egg and quality. Any experience in your lab ?


男爵府

積分: 7304


發表於 10-3-3 11:24 |顯示全部帖子
To my understanding, DHEA may be prescribed to those who have aged ovary; could be a woman of an older age, or a younger woman but having poor ovarian response to stimulation. The logic behind is to try to improve the number of eggs. Whether that may help with egg quality or not I don't have much experience.

If you have had failed IVF(s) before due to poor ovarian response, you may talk to your doc to see if he/she agrees DHEA may help. If he/she has already suggested to you, my opinion will be to follow his/her advice. I did look up some published literature but no clear conclusion can yet be drawn.


原帖由 little_icy1 於 10-3-3 09:24 發表
Hi cutecutetown,

Please share your experience if DHEA can help the poor response patient to improve their no. of egg and quality. Any experience in your lab ?


別墅

積分: 743


發表於 10-3-3 14:18 |顯示全部帖子
Hi cutecutetown,

Thanks for your advice.

I had done 4 times of ivf in PWH few years ago. At that moment, I was 35 and the FSH was not high as 7.7 (LH was 2.43) on day 3. However, I only got few eggs everytimes. My doctor said my response is not good at all but not know the reason. Do you have any experience on this ? Is it related to FSH/LH ratio.

Now, I am 40. I decide to give myself one more attempt this year.

Thanks anyway.


男爵府

積分: 7304


發表於 10-3-3 18:12 |顯示全部帖子
Hi little icy,

Knowing your age and assuming your FSH is still <10, it seems to me that you still want to try IVF one more time but worry about having very few eggs and another unsuccessful outcome.

I won't discourage you from pursuing another IVF if you choose to do so, because I have many cases which are very similar to you in terms of age, FSH, and few eggs. Statistically, the pregnancy chance is still present, although much lower than the younger, good-response group.

With your new IVF cycle, you will probably continue to have very few eggs. DHEA will not do a miracle by giving you 15-20 eggs, however, it won't hurt to ask your doc about DHEA and if it may be useful in your case.

Usually I worry more on the emotional side of the women because some of them are really stressed even before starting and the "guilt" carries forward even after a negative pregnancy test. I know the result means a lot but at the same time it is not the end of the world. There are other options available as long as your mind stays open.

In the mean time, live healthy to keep your body in a good condition and good luck in whatever choice you make :)



原帖由 little_icy1 於 10-3-3 14:18 發表
Hi cutecutetown,

Thanks for your advice.

I had done 4 times of ivf in PWH few years ago. At that moment, I was 35 and the FSH was not high as 7.7 (LH was 2.43) on day 3. However, I only got few ...

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