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cutecutetown


男爵府

積分: 9231


41#
發表於 10-3-24 15:49 |顯示全部帖子
I think you are getting a bit worried and nervous, which then give you a small stomachache or stomach pain. There is nothing we can do to tell if the embryo(s) continue developing. The first bingo check will be by urine (vv) or blood check. Only 2 weeks after a positive bingo test a fetal heartbeat can be seen on an ultrasound.

I don't suggest women to sneak-check, i.e. cheat, by over-the-counter pregnancy kits. Some of these kits are not sensitive enough, while some are super sensitive. Also, some of the medication prescribed by your doc may contain the hormone which will show up positive on these kits. Just be good and wait for the specified day from your doc.

One thing I can tell you though, you can sleep whicheverposition you want as long as it is comfortable. No extra bed rest is needed either. Normal daily activities can beresumed, that will help to distract you from worrying toomuch.

Also, there is no such thing as 著床血, this is ridiculous, Idon't know where you got this piece of info from, but this is totally ridiculous!! If there is implantation, the last thing you want to see is blood, whether it is just a small brown spotting or light to heavy flow.

原帖由 玫瑰野獸 於 10-3-24 11:29 發表


多謝你既關心! 雖然知道而家擔心都無用, 但控制唔到個心卜卜跳得好厲害。。。有無方法早D 知道胚胎有無繼續分裂, 例如照音波? 係咪如果成功著床一定會有著床血? 幾時會有呢?放胚胎后側訓可以嗎? 今日個肚有D痛。。 ...
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cutecutetown


男爵府

積分: 9231


42#
發表於 10-3-25 14:47 |顯示全部帖子
Hello minimeme,

The sizes look fine. I agree that you will probably have your egg retrieval on Monday. Many centers aim for a few follicles of >18mm before giving 破卵針. It is still too early and very difficult to predict how many eggs will be retrieved; your u/s on Sat. may tell more.

Hope to hear again from you in 2 days :)


原帖由 minimeme 於 10-3-25 11:14 發表
Hi Cutecutetown,

I had u/s this morning, the follicles size are as follow. Doc suggested me to take 2 more days injection and most likely they will retrieve the egg on Monday. Do you think the follic ...
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cutecutetown


男爵府

積分: 9231


43#
發表於 10-3-25 15:07 |顯示全部帖子
Dear 玫瑰野獸,

Implantation takes place around day 6 to 10. There is no exact day or time, and no woman can "feel" an embryo implanting.

If I get it correctly, the two sides of your tummy are 陰陰痛 because of the egg retrieval. Remember egg retrieval is a small surgery, with a needle poking the left and right ovaries to aspirate (suck out) the follicle contents.

Will there be any check-up by your doc from now till the day of bingo test? If so, you can tell your doc about the pain at the check-up, or call the nurse to get some advice and medication for pain relief.

Take care!

原帖由 玫瑰野獸 於 10-3-25 11:23 發表


Thank you so much! 放胎后幾日會著床架?我個肚兩側仲係陰陰痛, 係咪放完胎一般都會甘架?
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cutecutetown


男爵府

積分: 9231


44#
發表於 10-3-26 09:06 |顯示全部帖子
To my knowledge, there is no lab in HK doing in-house AMH testing. The sample needs to be sent to the UK.

原帖由 little_icy1 於 10-3-25 21:17 發表
Hi, Cutecutetown,

Do you know which lab in HK provides AMH (Anti-Mullerian hormone) Test to check the ovarian reserve ? How much ?

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cutecutetown


男爵府

積分: 9231


45#
發表於 10-3-26 09:32 |顯示全部帖子
Dear minimeme,

If just based on the size and number of follicles you said earlier, your egg retrieval will likely proceed and your risk for OHSS is also very low. A while ago your switch from Gonal-F to something else was probably related to your LH (luteinizing hormone) level; this hormone has nothing to do with OHSS. With OHSS, a different hormone (estradiol) is involved, which becomes a concern when its level gets too high.

In cases when the women have a high risk for OHSS, the embryos will be frozen for later FET. The reason is that if the woman develops OHSS with or without a fresh ET, it is life-threatening in severe cases; the successful implantation of an embryo makes it even worse. There is in fact no rush as long as you have embryos. If an embryo is good (to eventually make a baby), it will still "behave" after freeze-thaw. If an embryo is no good, it won't implant even if you transfer it fresh.

原帖由 minimeme 於 10-3-25 23:36 發表
Hi Cutecutetown,
What will the Doc do if my hormone level is not up to their standard or up to the acceptable rate? I read from other thread that Doc will do FET instead of ET if the hormone level is ...
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cutecutetown


男爵府

積分: 9231


46#
發表於 10-3-26 12:09 |顯示全部帖子
In a normal menstrual cycle, LH stays low but will rise before ovulation (LH surge). It triggers oocyte maturation and follicular rupture so that the egg will meet up Mr. Right (sperm) and ferilisation takes place. If there is implantation and pregnancy, there will be physiological/hormonal changes, including the increase of HCG and progesterone. LH has no role in supporting the embryos during and after implantation, whether it is a natural cycle or an ivf.

In ivf, too much LH will cause pre-mature ovulation, i.e. cancelling of the cycle. Too little LH (really depends on how little) may have a negative effect on oocyte quality.

原帖由 minimeme 於 10-3-26 10:31 發表
Well noted. Then what is the impact of LH? is it the hormone to support embyros during implantation?
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cutecutetown


男爵府

積分: 9231


47#
發表於 10-3-26 16:49 |顯示全部帖子
That's a little strange, "一大灘水"??

Please call your DR or nurse and see if they can help you.

原帖由 玫瑰野獸 於 10-3-26 15:43 發表


琴日開始getting better and better 啦! Thank you! 我呢兩日都有一大灘水流出，又唔好意思問
ＤＲ，係咪塞黃體ＧＥＬ既反應？
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cutecutetown


男爵府

積分: 9231


48#
發表於 10-3-27 13:39 |顯示全部帖子
Dear minimeme,

I am just guessing that your last injection this morning was probably intended to give the few smaller follicles a chance to grow. Your follicles grew a little slow both in this cycle and your previous one at Union.

It is difficult yet to guess how many eggs will be fertilized because we don't know how many eggs will be retrieved. On average, ~70% of retrieved eggs will be fertilized. For now, I am making an estimate of ~11 eggs retrieved.

As for your husband, the doc is correct that the antibiotics should have no effect on his sperm. You do not have to worry, and it should not even be on your "worry list" :)


原帖由 minimeme 於 10-3-27 10:57 發表
I just did the u/s this moning and I have 15 follicles, which sized as follow. I'm wondering why I still need one more stimulation injection this morning, even though my follicles are big. I would exp ...
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cutecutetown


男爵府

積分: 9231


49#
發表於 10-3-27 14:11 |顯示全部帖子
Hi Apple8,

On day-2, 2-cell embryos are quite common. I know you want them to be 4-cell, but this really depends on what time you assess the embryos. I often see 2-cell embryos early in the morning and it will divide to 4-cell late morning or early afternoon. Well, that may also relate to the time of egg retrieval too; I have been in places with egg retrievals scheduled after 3pm. Grade 2+ or grade 2 are above-average or average quality; these embryos should have reasonable chance.

As you are aware already, implantation depends on the woman's age, embryo potential, and sometimes the woman's etiology. Age and embryo quality are inter-related; generally, oocyte quality, which also translates to embryo quality, declines with age. As for the presence of chocolate cyst, I think your doc is aware of its presence. I am not a medical doctor and cannot comment whether it should be surgically removed or not; but I know such decision depends on the number of cysts present, their position, and severity of symptoms on the patient. Besides, cysts may re-occur even after surgical removal.

In my opinion, doing ivf every month is a little too aggressive. Accumulative success rate is not a simple math; however, if consider doing ivf for the first 3-6 attempts, cumulative pregnancy rate can reach up to ~60% (this is from published data in 2007). Please note that getting pregnant is different than having a live birth.


原帖由 Apple8 於 10-3-26 20:32 發表
I have a 3 cm chocolate cryst. I didn't do any operation but have the depression on my first IVF. I got 9 follicles and only 4 embryos developed. The grade ranges from Grade 2+ to Grade 2. But some of ...
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cutecutetown


男爵府

積分: 9231


50#
發表於 10-3-27 19:38 |顯示全部帖子
Hello shanhu,

I would also suspect an ectopic pregnancy (宮外孕), but it really needs your doc to confirm with the help of yet another blood test and u/s ~2 weeks later. "Hints" of embryo implantation are very hard to detect by u/s until 5-6 weeks into the gestation (which in your case will be in ~2 weeks as your doc advised). However, your heavy bleeding may be a concern if it continues to be heavy for more than a week. Make sure to keep your doc posted on your bleeding.

Regarding your HCG measurements, don't take them as absolute values. Even the same sample, if tested twice, will give 2 different numbers which are similar within a narrow range. My interpretation of your 3 test results is that your HCG stays quite stagnant over the past 2 weeks, which is not something of a normal pregnancy. I am very sorry that the HCG results had actually confused you. I hope the jm here will continue to give you comfort and support. Take care.


原帖由 shanhu 於 10-3-27 19:04 發表
Bibifa,
医生2様都無講呀…照都係因為我之前有過宮外孕,佢想快ｄ睇下咋。
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cutecutetown


男爵府

積分: 9231


51#
發表於 10-3-27 22:02 |顯示全部帖子
Dear shanhu,
I think your doc meant that if it is an ectopic pregnancy with an hCG >2000, then it will become dangerous. Since your hCG stays low so far without any dramatic increase, the risk should be very small. However, if you experience any unusual pain or bleeding during this 2-week wait, you should still call up your doc to get further instructions.
There is not much you can do during this wait, whether you are pregnant or not. I know by telling you this in itself may be stressful enough. So, why not simply do something you like, or do whatever that is your normal routine. Just note any unusual physiological changes to keep your body from the risk mentioned above.
Wish you well!

原帖由 shanhu 於 10-3-27 20:11 發表
Cutecutetown,
多謝你覆我。我已経無流血拉,甘次真係好似M来,頭個2-3日好多,慢慢少返,我仲以為係M到！

我想再問下你,真係宮外孕,2個星期之後先再返医院,会吾会太遲？醫生話ｈCG2000以上先有危険,係吾係真架？有ｄ乜野我可以做 ...
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cutecutetown


男爵府

積分: 9231


52#
發表於 10-3-28 20:35 |顯示全部帖子
Dear 玫瑰野獸,
To me, they may not be the perfect embryos, but as you said, even perfect embryos can fail. It is not just the appearance that matters; similar logic for both people and embryos :)
Let's translate those 1234's into ABCD's. An "A-" and a "B+", what do you say? I am very happy with such grades, and even though they are not perfect, they are much much better than 麻麻地.
Relax


原帖由 玫瑰野獸 於 10-3-27 23:14 發表
我今日彤罕睇左DR比我既REPORT, 原來我有一個胚胎GRADE 1-, 另一個GRADE 2+ ONLY, 係咪麻麻地? GRADE 2 係咪唔係甘好, 好難著床同成長? 好多人有2個GRADE 1 都FAIL既。。。 ...
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cutecutetown


男爵府

積分: 9231


53#
發表於 10-3-29 19:11 |顯示全部帖子
Dear 玫瑰野獸,

Wow, time flies, it's almost a week already. It doesn't really matter what the nurses told you about "feeling after ET". I used to work in a clinic where almost all patients swear that they feel this and that after ET (such as nausea, bloated tummy, etc; all symptoms pointing to a pregnancy). Obvious enough, not all of them got pregnant. I suspect what they felt were a mix of (1) pain from all the past injections and a bit from the egg retrieval, (2) some discomfort from the daily vaginal or injection-type support medication, and (3) various degree of anxiety while having to wait 2 weeks for a "report card". I think you have done your best and as long as you feel good about yourself, it is all that matters now.

I truly pay my respect to all the women who have gone through at least 1 ivf cycle. Whether or not the cycle has given you the precious gift of life, you should all feel good and be proud of yourselves.


原帖由 玫瑰野獸 於 10-3-28 20:42 發表


Thank you very much for your encouragement and wonderful 比喻! 我今日係放胎后第六日, 琴日個肚仲好漲, 今日唔漲啦! 我到而家都無咩感覺, 我DR既姑娘話無咩感覺多數唔得, 係咪真架? ...
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cutecutetown


男爵府

積分: 9231


54#
發表於 10-3-29 19:32 |顯示全部帖子
Dear minimeme,

Don't get too disappointed, these 8 eggs are probably mature. Only mature eggs are fertilisable; eggs that are not mature only make up a "nicer" total, but they are not useful in contributing to your potential embryos.

Very sorry to hear about your bleeding. Egg retrieval is a procedure which punctures through the cervix to access the ovaries; as a result, there will be small wounds at the points of puncture. I hope your bleeding was not too severe.

It looks like you will have an embryo transfer on Wed. or Thur. Take some good rest and wish you good embryos

原帖由 minimeme 於 10-3-29 17:24 發表
Hi Cutecutetown,
I'm disappointed with the number eggs retrieved today. I got 15 follicles, but Doc said some of them are too old and young, so they only take 8 of them for fertilization. I'm thinking ...
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cutecutetown


男爵府

積分: 9231


55#
發表於 10-3-30 14:37 |顯示全部帖子
Dear ABCMum,

I am not sure what 排卵丸 you have been using; but there is one kind that's commonly used for natural cycle IUI. Its benefits still outweight its disadvantage; however, in some people, it does cause a thinner endometrium. When you do ivf, this 排卵丸 will not be used and your endometrium hopefully will be of normal thickness. Besides, there will be endometrial supporting medication after the embryo transfer. If you are seeing a different doc for your ivf treatment, make sure you tell him/her about your suspected thinner endometrium.

I don't have any diet supplementation I can recommend. You may continue your 花膠湯 or fresh milk, but separate from each other. To me, it seems too thick & sticky to swallow down the soup if you make it with milk.

If you don't have a thin endometrium naturally, I think the problem will resolve itself once you are taken off from the 排卵丸. Any chance you have a high BMI (body mass index)? Probably not, because most Hong Kongers are a little skinny. Whether you are a little overweight or underweight, a healthy lifestyle will never hurt. Be optimistic and keep an open mind!

原帖由 ABCMum 於 10-3-30 09:15 發表


i did it together with fresh milk, but seems not work to me, thus, i m very worry about this!
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cutecutetown


男爵府

積分: 9231


56#
發表於 10-3-31 12:09 |顯示全部帖子
I think you better listen to your nurse this time. Depending on the kind of hormone used in your 安胎針, it may give you a false result if you 偷步.

原帖由 玫瑰野獸 於 10-3-30 20:03 發表
打完安胎針要過幾多日先可以驗孕架? 姑娘要我APRIL 6先驗(放胎後DAY16), 我想偷步呀!
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cutecutetown


男爵府

積分: 9231


57#
發表於 10-3-31 18:16 |顯示全部帖子
Hello rubyhomffc,

Did you also have an ultrasound this morning? Usually the oestrogen level is more critical toward the mid to late stimulation process; since you had only had 4 days of injection, i.e. a bit early, you don't have to worry too much.

I assume you have to self-administer at home the Puregon yourself daily, right? Just a gentle reminder to ensure you get the right dose and inject correctly. [Although rare, I have heard of patient's husband helping with the injection but giving not the full amount.] Pay attention when you change cartridge and so on, I think you have already got all instructions from the nurse :)

To further answer your questions,
1. As long as you follow your daily dosage, the follicles will grow. Relax, 不用心急.

2. I agree with your centre that only if you have >6 embryos available, then you may consider blastocyst transfer. Since this is your first-time ivf, you have enough to handle at the moment. How many and at what stage to transfer is not really a big problem and can be decided much later.

To give the readers here a little of the pros & cons of blastocyst transfer, I believe the biggest worry when you don't have enough embryos is that there is always a risk of having no embryo for transfer. From a patient's perspective, an ET procedure probably represents a big benchmark with both real and symbolic meanings. Real is because whenever an embryo is transferred, there is a bingo chance. Symbolic being a sign of accomplishment, marking the end to the tough period of daily injections and the start of a 14-day wait.

However, if we reduce everything down to simple science and also assume we have a good in vitro lab environment, what does it tell you when an embryo can't grow to a blastocyst? I will leave this open-ended.

原帖由 rubyhomffc 於 10-3-31 17:08 發表
Hello cutecutetown

This is my first time here and I'm going through my first ivf cycle...

I was miscarried two years ago and infertility til now. Just done my 2nd laparoscopy surgery for endometrios ...
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cutecutetown


男爵府

積分: 9231


58#
發表於 10-3-31 19:17 |顯示全部帖子
Dear rubyhomffc,

You are right, you had 6 days of injections and probably will have your 7th tonight. I hope your job doesn't require you to work during this Easter holiday; then you can relax a little. Perhaps do and eat something you like, breathe some fresh air (hiking/bicycling), see a movie, or simply rest and sleep in.
[we the lab people almost always work on public holidays; but good embryos and pregnancies have been giving us strength!]

I hope your u/s scan and bloodtest will be more promising. Take care.


原帖由 rubyhomffc 於 10-3-31 18:54 發表
Thanks for your prompt reply~

I haven't had ultrasound this morning...in fact I had 6 days injections already.... I will try to relax ... but my work is very stressful....will it affect the effect of ...
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cutecutetown


男爵府

積分: 9231


59#
發表於 10-4-1 17:52 |顯示全部帖子
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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cutecutetown


男爵府

積分: 9231


60#
發表於 10-4-12 10:02 |顯示全部帖子
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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