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發表於 10-4-1 17:52 |只看該作者

Dear minimeme,

Sounds good and bad. To look on the bright side, you have got 2 embryos transferred, and one of them is an 8-cell. To me, if I am able to count a total of 8 cells within an embryo, its quality cannot be very bad. So, my assumption is that the rating of 6 out of 20 is only applicable to your 5-cell.

Having said the above, you have had your ET procedure, meaning you will have a bingo chance. Although from statistics, your chance is lower compared to "the world's most ideal scenario", I think you should not get too upset. Relax over the Easter holidays (I hope you don't need to work), and we can review everything in 2 weeks from now.

Oh yes, definitely there are successful cases in history with similar situation. I have seen and heard many of them. I have a classical example to share with you. I used to have this patient who came for her 8th IVF when I started my training as an embryologist. She produced lots of eggs every time (at least 15 or more), but embryo quality was just so-so, or even below average. I believe she was on her 11th or 12th IVF when she finally got pregnant, but ectopic :( She did come back again for yet another cycle, and to everyone's surprise and praise, she got pregnant and this time a baby was born. Since that time she came back for some FET's as well as fresh IVF so I lost track of the no. of her total IVF attempts.

I am not really encouraging couples to do ivf endlessly, but the bottom line is, set up a threshold (e.g. maximum number of ivf) in mind and prepare yourself for the worst situation. While you are still within this threshold, do not give up hope. However, when you have passed it, prepare to pull yourself out. Do not drown yourself in a blackhole.

Cutecutetown

原帖由 minimeme 於 10-4-1 15:30 發表
Hi Cutecutetown,
I'm really upset, I got 2 embryos being transferred today. Due to the bad quality of eggs, only 2 fertilized, 1 of them in 8-cell, another in 5-cell. Doc said my chance is low. I read ...

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minimeme

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發表於 10-4-1 18:22 |只看該作者

I'm really happy that you are here to give us professional advice, those information really light up our life. I shouldn't upset too soon, perhaps I was hurted by what the Doc said, she asked me not to expect and don't hope, my case is really worse, and I should plan for going to PWH private line. From the embryos picture, I can see that even the 8-cell one is not in a very good shape compared to those I did in Union hospital. Thank you for your advice, I will enjoy my Easter holiday.

原帖由 cutecutetown 於 10-4-1 17:52 發表
Dear minimeme,

Sounds good and bad. To look on the bright side, you have got 2 embryos transferred, and one of them is an 8-cell. To me, if I am able to count a total of 8 cells within an embryo, i ...

[ 本帖最後由 minimeme 於 10-4-4 18:29 編輯 ]

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發表於 10-4-11 22:48 |只看該作者

想問下大無人知道 E2 係IVF中既角色係咩?

因為我本身係要食通經藥先可以有PERIOD, 我今個月食左, 不過M黎得唔係太好, 只係黎啡無咩血, DAY 2返去醫院驗血時, E2 係551, 姑娘話太高, 叫我聽日(DAY 4)
再返去驗多次 E2

想問如果E2高對IVF有咩影響架? 如果E2高係唔係唔可以開始打針呢?

唔該哂

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發表於 10-4-12 10:02 |只看該作者

hello sukudo,

E2 (estradiol) in blood results give references to where about is the cycle, be it an ivf or a natural cycle.

In the start of a regular menstrual cycle, E2 stays low. It slowly increases as the follicle starts to grow in size. Its level is also involved in some feedback mechanisms (I try not to go into the details) so that the ovary will ovulate and the endometrium will be prepared for either the implantation event, or else will shed, i.e. period, and the whole cycle starts again.

E2 should be very low at the beginning of a cycle, meaning the ovaries are quiet with minimal follicular growth. If this is a natural cycle, we can monitor this cycle easier. If this is for ivf, we know the ovaries will respond primarily to our medication and follicular growth should be more timely (synchronized).

Although Wikipedia is not very scientific and no authority actually checks if its scientific info is very true, it often gives a very rough and easy-to-understand explanation. You may take a look, simply search "wikipedia" and they have Chinese version as well.

Cutecutetown

原帖由 sukudo 於 10-4-11 22:48 發表
想問下大無人知道 E2 係IVF中既角色係咩?

因為我本身係要食通經藥先可以有PERIOD, 我今個月食左, 不過M黎得唔係太好, 只係黎啡無咩血, DAY 2返去醫院驗血時, E2 係551, 姑娘話太高, 叫我聽日(DAY 4)
再返去驗多次 E ...

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146^#

發表於 10-4-12 10:42 |只看該作者

Cutecutetown

好多謝你既回覆

我以前曾經有過子宮內膜增生架, 而且唔識自己排卵同黎M, 唔知有無關係呢?

我上星期照ultrasound同驗血打算開始ivf時, 醫生話我有3個卵泡, 叫我今日再返左醫院抽血, 今朝姑娘話如果E2 都係高的話, 就唔可以開始Treatment架啦, 一定要等E2回落, 想問下E2會唔會係一個卵巢無咩反應既人身上自然回落架?

同埋如果子宮內膜係開始treatment前已經厚, 係唔係都唔適合開始IVF呢?
會影響著床?

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發表於 10-4-12 16:42 |只看該作者

Hello sukudo,

If your M is irregular or doesn't come very often, plus the fact that you have ovulation issue, then this is likely affecting your E2 level and endometrial thickness. However, I shall leave the medical interpretation of your E2 and reproductive pathology to your doc.

E2 should be low in the beginning of a normal M cycle; generally speaking, it does not reflect ovarian response or function. Growing follicles will produce E2, perhaps this may be the reason why you have 3 follicles already and also a "not-low-enough" E2. Put in very simplistic terms, we need all possible follicles to start at the same time in an ivf cycle; anything that has "cheat-started" will confuse the whole stimulation process.

I am just speculating that you may need another cycle of monitoring, hopefully with ovulation and proper shedding of the endometrial layer (i.e. with a normal menstrual flow/bleed). Your doc will guide you through the process. Although this may take you another month before starting ivf, it can actually prepare your ovaries to give a much synchronized group of eggs as well as a "fresher" endometrium.

Cheers, Cutecutetown

原帖由 sukudo 於 10-4-12 10:42 發表
Cutecutetown

好多謝你既回覆

我以前曾經有過子宮內膜增生架, 而且唔識自己排卵同黎M, 唔知有無關係呢?

我上星期照ultrasound同驗血打算開始ivf時, 醫生話我有3個卵泡, 叫我今日再返左醫院抽血, 今朝姑娘話如 ...

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粒粒豆

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發表於 10-4-12 20:05 |只看該作者

Hi Cutecutetown,

你真係好好人呀, 你專業人士咁忙都成日幫我哋解答問題, 你真係好好呀!你做咁多好事會有好報架!

我啱啱做咗第一次ivf但係失敗咗, 我抽卵前驗e2係20500呀, 醫院話係borderline但係都照幫我放胎, 其實呢個數字咁高係咪我失敗嘅原因呢?我見有其他人喺私家做, 16000都唔放胎啦! 同埋我左邊卵巢有個5cm嘅水泡, 又會唔會減低我下次放雪胎成功嘅機會呢?多謝解答!

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發表於 10-4-13 09:20 |只看該作者

cutecutetown
你令我地無助既心得到安慰, 有d人可能會問個天點解要佢行去ivf呢條路, 在我而言, 可以ivf已經是上天的恩賜

姑娘叫我星期5再返去驗血E2 同照ultrasound, 我相信卵巢水pop係唔會消息, 因為已經半年架啦, 至於E2, 我係唔會放棄架, 我相信一定會回落

好似粒粒豆咁講, 其實如果有卵巢水pop係唔係最好都係唔好開始TREATMENT呢? 不過如果佢唔消失點算好呢??

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發表於 10-4-13 12:38 |只看該作者

Hello 粒粒豆,

No problem la, I rather have the readers know the real reasons behind things if I can help the explanation. Perhaps I easily get upset and worried when I see wrong concepts or semi-true believes being propagated.

The E2 level on the day of hcg trigger (about 2 days or 36 hours before egg retrieval) implies a totally different story than the E2 when a menstrual cycle begins. You may have read my earlier post for sukudo about E2 and try to relate that to your own ivf cycle.

Let's quickly re-visit E2 in the beginning of each cycle. "Beginning" means before starting any medication; in other words, the level reflects what your body in a natural condition produces. Once you are given any medication for an ivf cycle, any hormonal measurement (all those blood results) will tell us how your body responds to external drugs so that we adjust the dosage accordingly. So, back to your borderline E2 before egg retrieval, the 20500 in your case or 16000 in others is only one of the many factors the doc will look at to decide if the woman can have a fresh embryo transfer. The main concern with a high E2 level, as well as other physical signs such as blotted abdomen, is the developing of OHSS (ovarian hyperstimulation syndrome). This OHSS can be a life-threatening situation for the woman, especially if she has an embryo transfer and successful pregnancy. The woman's health and safety is our no.1 priority :)

So, although you had a borderline high E2, you didn't have other signs of OHSS risks and your doc decided that you were safe enough to have your embryo transfer. In the other case, the E2 was lower than yours, but she probably had some other factors and therefore the embryos need to be frozen for later use. Nevertheless, a good-quality embryo should be capable to implant whether it has been frozen-thawed or not.

With your 5cm 水泡 on your left ovary, I don't know what exactly is in that 水泡. It will be the best if you ask your doc to see if you will need it removed before your FET.

Cutecutetown

原帖由 粒粒豆 於 10-4-12 20:05 發表
Hi Cutecutetown,

你真係好好人呀, 你專業人士咁忙都成日幫我哋解答問題, 你真係好好呀!你做咁多好事會有好報架!

我啱啱做咗第一次ivf但係失敗咗, 我抽卵前驗e2係20500呀, 醫院話係borderline但係都照幫我放胎, 其 ...

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發表於 10-4-13 13:03 |只看該作者

Hi sukudo,

Your doc probably knows what (水pop) is in your ovary and its implication. I think you mentioned last time that they are small follicles, or are they cysts instead?

Anyhow, as soon as you get a proper menstruated cycle (with ovulation), your E2 should come back down. Depending on how long you have been monitored by the same doc, he/she may decide to start you ivf anyway. I am still hopeful you will proceed to ivf in another month or so. Lighten up and take it easy!

cutecutetown

原帖由 sukudo 於 10-4-13 09:20 發表
cutecutetown
你令我地無助既心得到安慰, 有d人可能會問個天點解要佢行去ivf呢條路, 在我而言, 可以ivf已經是上天的恩賜

姑娘叫我星期5再返去驗血E2 同照ultrasound, 我相信卵巢水pop係唔會消息, 因為已經半年架啦, ...

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粒粒豆

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152^#

發表於 10-4-13 23:12 |只看該作者

原帖由 cutecutetown 於 10-4-13 12:38 發表
Hello 粒粒豆,

No problem la, I rather have the readers know the real reasons behind things if I can help the explanation. Perhaps I easily get upset and worried when I see wrong concepts or semi-tru ...

唔該哂你呀cutecutetown, 多謝你嘅解答! 我有啲擔心個水泡會影響我嘅成功機會呀, 因為我係做公家症嘅, 如果佢要幫我做手術切個水泡, 可能又要排期排好耐, 唔做我又驚會令到我唔可以成功!所以好擔心呀!之前又話我有輸卵管積水,都唔知佢照到果個水泡係唔係我積咗水嘅輸卵管, 我睇過啲資料話有輸卵管積水又會降低IVF成功嘅機會!
我啱啱果次都有啲ohss嘅symptoms呀, 個肚抽完卵脹咗成十日先退哂, 最犀利果幾日好似有咗五個月咁架, 不過就冇水腫同SOB!
我仲想問吓你放完胎即刻去厠所會唔會減低著床嘅機會呢, 同埋放胎後有冇啲咩可以做令著床嘅機會大啲呢?唔好意思呀, 好多問題!
仲想問你做嘅centre嘅成功率係幾多呢?我就嚟34歲, 我用哂公家症嘅quota就會做私家啦, 同埋你個centre做一個cycle大約幾錢呢?如果呢啲問題你唔方便答你唔洗答架啦, 我明白架!Thanks!

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發表於 10-4-14 09:30 |只看該作者

原帖由 cutecutetown 於 10-4-13 13:03 發表
Hi sukudo,

Your doc probably knows what (水pop) is in your ovary and its implication. I think you mentioned last time that they are small follicles, or are they cysts instead?

Anyhow, as soon as yo ...

THANKS A LOT

我上星期照到既係右面卵巢有3個卵泡, 想問下, 如果真係無一個fresh既環境就去開始IVF, 因為我無排卵又無M, 係唔係反應同結果都會無咁好架呢?

我而家本身係食通經 provera 7日, 每曰2粒, m後即開始IVF, 其實都只係剥落左d內膜, 根本無排卵架麻, 咁會唔會問下醫生, 如果改食排卵藥, 起碼排左卵同黎左period先開始會好d呢?

我而家起初既E2高, 會唔會都有大D機會有OHSS架?

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154^#

發表於 10-4-14 13:00 |只看該作者

hello 粒粒豆,

Have you scheduled your frozen embryo transfer yet? It may not be worthwhile to remove the 5cm cyst until you need to start a new ivf cycle. On 公家症, everything is a long queue. However, if your doc thinks that you should remove that cyst and if you also agree the same, see if you can get in line for such procedure. Then while you will be waiting for this 手術, you can do the FET's. Who knows, you may get pregnant and cancel the procedure; if not, you haven't wasted too much time.

輸卵管積水 and 水泡 are different, and either one of them may affect ivf success. If you will proceed with the cyst removal, I am sure the doc will take care of the hydrosalpinx (輸卵管積水) at the same time.

After embryo transfer, you can resume your normal daily activities any time. If you have a full bladder before ET and worry about urination need while in bed rest, you may ask your doc to help by using a urinating catheter (but there is a very small risk of infection). In general, the embryos will not be expelled from the uterus after ET even when you stand up right after the ET procedure, or ride a very rough public transportation on your way home.

In very simple terms, if your endometrium is normal and the embryo is normal (i.e. embryo good enough to make a baby), there is nothing you can do to either help or stop implantation. Of course, if you do something very stressful and extremes (e.g. work non-stop on a project, little or no sleep, try to get a medal by running the Marathon, etc.), then it may affect not only the outcome but also your overall health.

I know during that 2-week waiting for the bingo test is quite a "killing" experience in itself, so perhaps what you can do is to make sure you follow your doc's instruction in taking the support medication timely and correctly. If no medication is needed (as in most FET cases), then try to relax and stay optimistic.

I am sorry that I will not disclose where I work. However, my opinion is that success rate very much depends on age, and also other factors. If you need ivf anyway and if you don't have a financial concern, then do not delay treatment. Also, success rate has to be interpreted cautiously, because every body is different and ivf is a very individualized treatment.

The cost of ivf in the private sector in HK can range from ~$50,000 to $80,000, + or - depending on doctor's charges, different drug charges, lab procedures involved, and any surplus embryos to freeze. You may call a few centres or doctors to see if you can get the estimates.

Cheers, cutecutetown

原帖由 粒粒豆 於 10-4-13 23:12 發表

唔該哂你呀cutecutetown, 多謝你嘅解答! 我有啲擔心個水泡會影響我嘅成功機會呀, 因為我係做公家症嘅, 如果佢要幫我做手術切個水泡, 可能又要排期排好耐, 唔做我又驚會令到我唔可以成功!所以好擔心呀!之前又話我有 ...

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發表於 10-4-14 14:52 |只看該作者

Dear sukudo,

理論上,反應同結果都會無咁好; however, if it is the way it is, then there is not much you or we can do to make things "perfect". I once worked in a clinic where starting every patient and no cancelling is the goal (obviously a private clinic where money is the main drive); and from there, I did see patients' success without a "perfect" ivf cycle.

I think your doc will know best whether you need also a normal ovulation event before starting ivf. My understanding is that you probably do not need one. When finished with the provera, in 2 days or so you will have your m so that your endometrium will start fresh. This may also take care of the 3 follicles(?) of concern. A proper M bleed will hopefully bring down your E2 level as well.

OHSS relates to the response of the ovaries to stimulation drugs. E2 level during the stimulation is an indicator of such response; E2 will increase over time as follicles continue to grow. IVF is like an artificial cycle, so the E2 measurements during the process will not be related to your "baseline" E2 anymore. Generally, the more follicles you have, the higher the E2 level and higher the risk for OHSS.

Fertility doctors are well experienced and they will decide on the right dosage of drugs to use. From your end being the person to be treated, you should not need to worry too soon and too much.

Try to relax and enjoy your free time. When you are on ivf, you will need daily injections plus a lot of little things to-do and not-to-do.

cheers, cutecutetown

原帖由 sukudo 於 10-4-14 09:30 發表

THANKS A LOT

我上星期照到既係右面卵巢有3個卵泡, 想問下, 如果真係無一個fresh既環境就去開始IVF, 因為我無排卵又無M, 係唔係反應同結果都會無咁好架呢?

我而家本身係食通經 provera 7日, 每曰2粒, m後即開始I ...

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minimeme

大宅

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156^#

發表於 10-4-14 14:57 |只看該作者

Hi Cutecutetown,
My 2nd IVF is failed as expected, due to the bad quality of embryos. My M came on Apr10, which is just Day10 after ET, is it rare, and what causes such a quick M come?

I'm planning to have my 3rd attempt few months later. In the mean time I will take Chinese medicine. I would like to know if there is any way to improve eggs quality. My husband's sperm mobility & quality improved a lot after taking the Fertiaid vitamins and Royal Jelly. But this vitamins seems didn't works well on me, my eggs quality in my 1st attempt was very good, and I took Chinese medicine before that. In my 2nd attempt, I just took the vitamins and Wheat Grass. I have quit the vitamins, and just taking the Royal Jelly & Wheat Grass everyday. Do you think it can help?

Thanks!
Minimeme

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minimeme

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157^#

發表於 10-4-15 11:12 |只看該作者

Cutecutetown,
Can you reply my yesterday post? Thanks!
Minimeme

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發表於 10-4-15 14:39 |只看該作者

Hello minimeme,

I'm very sorry to hear about the news and also sorry having to reply late as I have been very busy with lab work.

The fact that your M came "early" simply tells you that the embryos were not good enough to implant. In cases where implantation is successful, the embryo will continue to give "signal" to the body, which adds onto a similar effect of the luteal support medication to tell your M not to come. In other words, since you didn't have this signal from an implanted embryo, your M eventually came. Although this return of M often happens in ~14days, the length of time may be shorter for some people and longer for others.

Do you know the medication the doc gave you as luteal support after your embryo transfer, both in your 1st and 2nd attempts?

Well, to look on the bright side, we can probably start planning a better cycle. What kind of Chinese medicine did you take in your 1st attempt? I think, go with what your mind tells you, there seems nothing wrong with vitamins, royal jelly, or wheat grass. My ex-boss used to prescribe his female patients prenatal vitamins and folic acid. But my advice is to probably just pick one or two supplements to take; don't take all of them because I believe everything should be in moderation, over-doing or under-doing may result in negatives.

A quick note with egg quality. If I remember correctly, your stimulation duration was somewhat longer than average in both attempts. Quite often, long stim. duration already is a sign for poor eggs; or think differently, if the eggs were good, they shouldn't need so long to grow to the optimal size. Since you will take some supplements or chinese meds, perhaps also use the higher-quality drugs for stimulation if you can choose to do so. Honestly speaking, nobody knows exactly what to do or what to take in order to guarantee good-quality eggs. Sometimes this can be pure luck.

Hope this helps. Take it easy.
cutecutetown

原帖由 minimeme 於 10-4-14 14:57 發表
Hi Cutecutetown,
My 2nd IVF is failed as expected, due to the bad quality of embryos. My M came on Apr10, which is just Day10 after ET, is it rare, and what causes such a quick M come?

I'm planning t ...

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parker123

複式洋房

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發表於 10-4-15 16:48 |只看該作者

I am 34 and did an IVF in Jan. I got 19 eggs but only2 fertilized. The rest stopped development in day 5. I checked the lab they said the sperm quality is aboveavg so I guess it is my problem. My questions are:
how to improve egg quality?
I got preg in that Ivf but in week 9 my dr found the head of bb is abnormal so I am back to square one. Will ivf increase the chance of abnormal babies?

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