ivf Q & A

玫瑰野獸
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原帖由 cutecutetown 於 10-3-18 18:32 發表
Good question, this is something you may want to find out by asking your doctor, i.e. whether the lab will thaw before or after the egg retrieval. If the lab will thaw before egg retrieval, there is ...


做thaw test係咪會將sperm放入營養液睇下是活or死?test過既sample可以再雪番嗎?其實解凍要幾耐時間架?
(我有好多問題,真係唔好意思!!!)
cutecutetown
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It should not affect "bingo" as your doc. explained; but I think if you find blood when urinate, with persisting pain and itchiness, you should definitely see a doc. If no blood, then drink more water as adviced by the nurse. Although you need to vv a lot, it helps to cleanse the urinary tract.

原帖由 Milly18 於 10-3-18 19:01 發表
Thanks for yr rapid reply. The nurse fm my IVF doctor said 尿道炎不會影響bingo, 因為是2個不同部位。她話唔使食吁藥,飲多o的水就ok。

另外上次我抽卵後有尿道炎,vv時流哂血, 醫生知道情況照放胎,只是給了些抗 ...
cutecutetown
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No problem, I understand your anxiety. The thawing process itself takes only ~10-15 minutes, but if extra processing is needed, give the lab ~30-45 minutes.

When my lab does test-thaw, we only thaw a very little portion. We try to save/keep all the TESE sperm for the actual egg retrieval. The little portion used in the test-thaw will not be re-frozen.

There are 2 ways commonly used to see if an immotile sperm is alive or not. I won't go into the details, but in simple terms, the sperm being tested can also be used for the ICSI procedure.

I believe your doc simply didn't tell you all the details because the technical parts should have been taken care of by the center/lab. Your doc will let you know should anything turn up unexpected. Many of us (the staff) adopt an informal policy of "no news is good news" so that we don't cause unnecessary worry for anyone.

I sincerely wish everything relating to your procedure be alright tomorrow. All you need to do now is to let go of your worry and sleep tight tonight. You and your husband have both done the best you can; so, leave the rest to your doc. and the ivf center. Take care!


原帖由 玫瑰野獸 於 10-3-19 11:46 發表


做thaw test係咪會將sperm放入營養液睇下是活or死?test過既sample可以再雪番嗎?其實解凍要幾耐時間架?
(我有好多問題,真係唔好意思!!!) ...
cutecutetown
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Being an embryologist but not a medical doctor, I can't really give you any medical advice. However, I can share whatever I know and I can tell you what I don't know.

We (in the reproductive field) don't really know why some couples have "unexplained infertility". There is really no physical cause easily identifiable by modern-day science. Some couples do look into anti-sperm antibody, just like what you & your friend did. Results from blood and sperm should both be valid, but even if you found a positive test result, there is no way to cure or revert to a negative test.

As for acupuncture, it has become somewhat popular especially in the western world. Published data so far do not give clear conclusion, and success chance does not seem to be increased by doing acupuncture. My personal view is that it does not help and it does not hurt either. Therefore, I have no objection to patients doing it if they choose to do so.

I really don't know what propolis can do, and health supplements generally do not harm your health. Do keep in mind that "supplements" are not drugs and are not regulated by pharmaceutical regulations. If you decide to take any, try to buy from well-known brands. Vitamins are ok in general, and when other less-popular supplements, I will look at where it's from and whether the manufacturer has some kind of certification (e.g. ISO, CE Mark, FDA approval).

You are still young and have only done 2 iui's. Since your medical history and any relevant test records are with your doc, he/she is the best person to give you advice to proceed with another iui or go for ivf. From a lab standpoint, ivf is definitely more involved and invasive as compared to iui. My suggestion is to follow your doc's advice; if still undecided, seek a second opinion from another doc. Meanwhile, take care of your physical and emotional health. I strongly believe the mother's body plays a very important part in the whole process. When your body is in good conditions, everything will come easier.

Oh, and also remember, while you are in between iui/ivf treatments, do not be overly stressed and totally stop any intimacy with your hubby. Afterall, both the man and the woman need to love each other before a baby can/should come.


原帖由 gonggongpopo 於 10-3-18 22:06 發表
Hi Cutecutetown,
I have a similar case with sally2009wong..I am 33 years old, i have been trying to have baby for 2 years and have tried 2 times iui with different dr...both doctors concluded my case ...
mschu
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Hi cutecutetown

As an embryologist, can you tell us if the quality of eggs and sperms is the major factor determining the development (or grading) of the embryo? Are there any exceptions there, I mean, are there cases where good eggs and sperms make poor grading embryos? If there is exception, is the exception (rather) commonly found in your daily practice?

Your comment is much appreciated.
sasamama88
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Hi Cutecutetown,
I want to know whether IVF would increase the chance of having cancer as it has an intensive injection of hormones. I am thinking of IVF but my family has history of cancer and thus worried whether this would induce cancer. Thanks for your advice in advance.
玫瑰野獸
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原帖由 cutecutetown 於 10-3-19 16:46 發表
No problem, I understand your anxiety. The thawing process itself takes only ~10-15 minutes, but if extra processing is needed, give the lab ~30-45 minutes.

When my lab does test-thaw, we only thaw ...


"No news is a good news" + 詳細既描述, 我放心好多啦, THANKS ! 其實做你地呢行要好有耐性, 因為IVF PATIENTS好容易疑神疑鬼, 你地仲要顧及PATIENT感受, 好野! 我星期六抽旦, 星期日LAB咪無人睇住D胚胎?
sukudo
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原帖由 sasamama88 於 10-3-19 20:38 發表
Hi Cutecutetown,
I want to know whether IVF would increase the chance of having cancer as it has an intensive injection of hormones. I am thinking of IVF but my family has history of cancer and thus ...


我古好多人都有你呢個憂慮, 不過我上次去QM尼講座時, 姑娘都只係話無証據指2者有關係....

其實我之前子宮內膜都有增生問題 - 細胞有病變, 雌激素係一個主因, 所以我都有問醫生, 不過醫生話問題不大, 佢地用藥會小心, 如果你真係憂慮, 可以考慮iui, 用小好多藥架...
smallbrother
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hi..妳好,本人已做了3次 iui都失敗,報告顯示是c6的精子形態不足,仲要越來越差,差到得1%,所以今個月決定做ivf,之前已谷c6吃補藥,冬虫夏草,鹿尾巴丸,中葯,針灸,蠔皇素,維他命鋅等,上星期放了胎,醫生話精子形態有5%,算係略有好轉,但出來結果是11個胚胎只得4個分裂,2個grade2,2個grade3,醫生話機會都不差的,但亦講過發現c6的精子普遍有泡泡,佢唔肯定結合的4條是否有泡泡,到現在已是放胎後10天,本人只感到間中頭暈,肚側間中忍忍作痛,但昨天沒有,其余沒有任何特別感覺.
本人想問問--1)grade 2的成功率是否己不大
?
2)精子有泡泡即係點,有咩影响?成功率是否打了折扣?
3)本人身體的現況反應,有否顯示成功著床的機會率?
謝謝!
cutecutetown
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Hi mschu,
Generally speaking, yes, the quality of eggs and/or sperm has a direct relationship with the embryos subsequently developed. But also 2 things to keep in mind:
1. what determine the quality of the eggs and sperm;
2. we kind of tell the quality by their appearance only, it is more difficult to tell the genetics.

There are certainly times when the "good quality" of the eggs or sperm does not translate to the embryos. It is probably part of life and part of natural selection. That's the reason why in IVF we stimulate multiple eggs in one cycle (as compared to just one egg in a natural menstrual cycle).

Suppose we get 10 eggs in an IVF cycle (just an example here, please don't take this number as a golden rule because ovarian response to stimulation varies, and also the drug dosage varies due to different medical considerations). Even with good quality sperm and eggs, often only ~70-80% fertilized. So in among these 8 embryos, it is very normal that some will be of better quality while the rest will be of average and perhaps one is poor.

From my experience, both the good and average quality embryos have success chance while poor embryos rarely implant. My take is that as long as there is an embryo transfer (can be a fresh or a frozen transfer), there is a bingo chance. I know statistics quotes you a lot of numbers and general trends, but exceptions do happen (both ways). Over the years, I have seen enough "surprises" that those with average to poor embryos bingo while some with excellent embryos fail. We can't win all the time......


原帖由 mschu 於 10-3-19 18:47 發表
Hi cutecutetown

As an embryologist, can you tell us if the quality of eggs and sperms is the major factor determining the development (or grading) of the embryo? Are there any exceptions there, I me ...
cutecutetown
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Thanks sukudo has also replied. As she mentioned, there is no evidence that IVF would trigger or increase the chance for cancer.

Without knowing your medical history or background, perhaps IUI is more appropriate if you worry. However, IUI is not the effective choice in people with tubal problems (e.g. blocked fallopian tubes). Talk to your doctor and make sure to tell him/her about your family history.

原帖由 sasamama88 於 10-3-19 20:38 發表
Hi Cutecutetown,
I want to know whether IVF would increase the chance of having cancer as it has an intensive injection of hormones. I am thinking of IVF but my family has history of cancer and thus ...
cutecutetown
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Hello 玫瑰野獸,
How was your egg retrieval? I hope everything went well.
To give you peace of mind, embryologists work weekends, Sundays, and public holidays as well. We take shifts.


原帖由 玫瑰野獸 於 10-3-19 23:44 發表


"No news is a good news" + 詳細既描述, 我放心好多啦, THANKS ! 其實做你地呢行要好有耐性, 因為IVF PATIENTS好容易疑神疑鬼, 你地仲要顧及PATIENT感受, 好野! 我星期六抽旦, 星期日LAB咪無人睇住D胚胎? ...
cutecutetown
|
Wow, I hope all those supplements and chinese medicine did help. Not too long ago I wrote in one of my replies that sperm takes ~70 days from its production to coming out in the ejaculate; so if your husband wants to improve his sperm's "overall health", he needs to take this physiological timing into consideration.

To answer your questions,
(1) do you know the embryo grading system of your lab? In some labs, the bigger the number, the better the quality; while in others, the smaller the number, the better the quality. In your case, did you transfer all 4 embryos?
(2) I am not sure what your doctor refers to as the "bubbles" in sperm. I suspect the bubbles are a kind of neck defect in its neck. The neck region does not contain any DNA and may not affect your success chance.
(3) I can't really tell if you bingo or not based on those symptoms. At such an early stage, there is in fact no physical sign to tell you whether you are pregnant or not.

I know in a few days you will need to check your pregnancy status if your period won't come. Wish you good luck and let us know.


原帖由 smallbrother 於 10-3-20 12:18 發表
hi..妳好,本人已做了3次 iui都失敗,報告顯示是c6的精子形態不足,仲要越來越差,差到得1%,所以今個月決定做ivf,之前已谷c6吃補藥,冬虫夏草,鹿尾巴丸,中葯,針灸,蠔皇素,維他命鋅等,上星期放了胎,醫生話精子形態有5%,算 ...
mschu
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Hi Cutecutetown

Really appreciate your prompt reply.

According to what you said, and correct me if I am wrong, you seem to suggest that what appears to be good looking embryos may "sometimes or occassionally" be not so good because their "inner" genetic factors are not as good as what they appear to be? Is my statement 50% or 80% true? :D

Or does it mean that both 1) appearance and 2) the "inner" genetic quality of an embryo go hand in hand to determine the "actual quality" of the embryo, and that's why we would see those many exceptions and "surprises" outcome in reality?

Taking an analogy, is it just like when we see people, we cannot only tell whether they are good just from their appearance, but we should also look at their inner quality such as character? :D

One more question:
1. I am always experiencing sneezing and runny nose the day after intercourse (I have "nasal allergy"), is there any possibility that my body builds up resistance against sperms/embryos or that my immue system may be the cause of infertility? Do you think I need to do in-depth check-up with the doc?


原帖由 cutecutetown 於 10-3-20 12:31 發表
Hi mschu,
Generally speaking, yes, the quality of eggs and/or sperm has a direct relationship with the embryos subsequently developed. But also 2 things to keep in mind:
1. what determine the qualit ...
玫瑰野獸
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原帖由 cutecutetown 於 10-3-20 12:49 發表
Hello 玫瑰野獸,
How was your egg retrieval? I hope everything went well.
To give you peace of mind, embryologists work weekends, Sundays, and public holidays as well. We take shifts.


過程一切順利, 但未知有無活丁丁, 姑娘無講,LAB是否一般抽卵后翌日打電話比CLIENTS通知胚胎情況? 星期日會打嗎?
cutecutetown
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Dear mschu,

Nice analogy, indeed yes, you are getting the general picture. "Good-looking" embryos usually have better potential compared to "poor-looking" ones. Over 80% of poor-looking embryos are genetically abnormal; with good-looking ones, we are still talking about ~40% more or less. I try not to go into too much details here because I may confuse or even worry some readers.

For nowadays IVF, the common practice still bases embryo selection on appearance. Outside HK, depending on countries, there are ivf centers providing preimplantation genetic diagnosis (PGD) as a clinical service [not on research protocol anymore]. However, bear in mind that this procedure is relatively expensive to the patients, invasive to the embryos, and also technically demanding.

As for your nasal allergy, it's hard to tell if your body has built up any immunity to sperm and/or embryos. My guess will be no, but certainly you can tell your doc and see what he/she suggests. I know some people really go all the length to do immune testing; and if it turns up positive and you decide to seek therapy, it is very very costly. Note that this immune testing will have to be done by yet another specialist. But before you even consider this testing, may I ask why you think it's immune system related? How many cycles you have had, with good-quality embryos transferred, but without bingo?


原帖由 mschu 於 10-3-20 20:13 發表
Hi Cutecutetown

Really appreciate your prompt reply.

According to what you said, and correct me if I am wrong, you seem to suggest that what appears to be good looking embryos may "s ...
cutecutetown
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Some centers will phone the patients regarding their results, depending on their policy. My center does not call because we have plenty of patients everyday and our policy is "no news is good news". We only call to break bad news. If only you were my patient and made this special request, I could make an exception.

Notice that 抽卵后翌日only shows fertilisation; so, if your eggs are fertilised, you may not hear from the center until the day of embryo transfer. Good luck and keep me posted.

原帖由 玫瑰野獸 於 10-3-21 00:27 發表


過程一切順利, 但未知有無活丁丁, 姑娘無講,LAB是否一般抽卵后翌日打電話比CLIENTS通知胚胎情況? 星期日會打嗎?
minimeme
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Hi Cutecutetown,
Assumed that I will do the egg retrieval on Sat, will they put me on ET if there are fertilized embryos, the nurse didn't tell me much about my schedule, probably they want to see my u/s and blood test result this Thursday before confirming my schedule.

What is the best number of cell a 2 days embyro should have? Thanks!
cutecutetown
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I think the nurse really can't predict your schedule at the moment. The most probable day for your egg retrieval is Sat, but don't get upset or disappointed even if you will be scheduled for next Mon or Tue egg retrieval (ER). The ER day really depends on your U/S and blood test results this Thurs.

On the morning of day-2, an embryo can range from 2-cell to 6-cell, but we generally prefer a 4-cell.

原帖由 minimeme 於 10-3-23 15:13 發表
Hi Cutecutetown,
Assumed that I will do the egg retrieval on Sat, will they put me on ET if there are fertilized embryos, the nurse didn't tell me much about my schedule, probably they want to see my ...
minimeme
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Do you mean the morning of Day-2 after ER? If ER on Sat, the best number of cell on Mon morning is 6-cells? In my 1st IVF, 3 grade 1 embyros with 8-cell & 6-cell were transferred, and I was chemical pregnant.

Will the follicle still growing 1mm a day without medical injection? I'm trying to predict the size of my largest follicle, and hope that they won't be too "old".

Below were the number of eggs retrieved in my 1st IVF with Union Hospital. If the acceptable size is 18mm, I think my 1st IVF was not done in the right time, as most of the eggs were not in an optimal size.
Left Follicle
26x13=19.5
21x16=18.5
15x18=16.5
16x16=16
15x14=14.5
Right Follicle
14x14=14
15x13=14
12x10=11
12x8=10
7x11=9




原帖由 cutecutetown 於 10-3-23 16:16 發表
I think the nurse really can't predict your schedule at the moment. The most probable day for your egg retrieval is Sat, but don't get upset or disappointed even if you will be scheduled for next Mon ...
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