ivf Q & A

ylam88jc
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你好, 我剛發現朱古力瘤第三次覆發, 醫生建議先看不育科, 他說有些醫生即使有朱古力瘤亦會安排做IUI/IVF, 其實安全嗎? 如bingo BB與瘤會同時生長會更危險嗎?
gonggongpopo
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Thank you for your clairfication on anti-body sperm test. And certainly I should consult my dr for further advice about my treatment :)
原帖由 cutecutetown 於 10-3-19 17:45 發表
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) ...
玫瑰野獸
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原帖由 cutecutetown 於 10-3-22 10:48 發表
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". ...


我昨天已放了兩個胎, 我一共抽了12粒旦, 但只找到六隻活丁丁培植, 最後兩個分裂, 胚胎專家同醫生話兩個胚胎幾靚, 我地都好感激。我點做可以令胚胎容易D迫著床呢?
玫瑰野獸
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用唔太ACTIVE既SPERM培植成既胚胎是否不太健康(雖然看起來幾靚)?好難著床?
玫瑰野獸
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點解做IVF人人都有分裂的胚胎放胎, 但又唔係人人都可以最後BINGO呢? 因為著床唔到?
cutecutetown
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Hi minimeme,
Based on the cell stage of those embryos from your last cycle, they appeared to be day-3. How we designate the "day" is:
day 0 = day of egg retrieval
day 1 = day showing fertilisation
day 2 = most embryos should be at 2-cell to 4-cell
day 3 = most embryos should be at 6-cell to 8-cell
Some embryos may be faster by having 1 or 2 more cells (i.e. 6-cell on day 2, 10-cell on day 3). As long as their stage is within range and of reasonable grade/quality, we do not particularly worry about their developmental potential.

Remember that there are ~36 hours from 破卵針 to the actual retrieval. The follicles may continue to grow a little during this time even without injection. Most women on stimulation get follicles of different sizes like you did last cycle, and it is a clinical judgement for the doctor to decide when will be the best timing to give 破卵針. The overall goal is to time it so that the majority of the eggs retrieved will be mature for fertilisation.

I am not a medical doctor with the expertise to comment whether or not you were timed correctly last cycle. However, based on simply the information of the follicle size you gave, most if not all doctors would have timed you the same.

Allow me to clarify that the 1mm growth is just a general reference. Most follicles won't grow that fast, especially when they are no longer small folllicles.


原帖由 minimeme 於 10-3-23 16:50 發表
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 p ...
minimeme
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I see. Many Thanks!

[quote]原帖由 cutecutetown 於 10-3-23 18:19 發表
cutecutetown
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Hi ylam88jc,
There may be risks depending on the 嚴重程度 and location(s) of your 朱古力瘤. Please consult a fertility specialist.

原帖由 ylam88jc 於 10-3-23 17:01 發表
你好, 我剛發現朱古力瘤第三次覆發, 醫生建議先看不育科, 他說有些醫生即使有朱古力瘤亦會安排做IUI/IVF, 其實安全嗎? 如bingo BB與瘤會同時生長會更危險嗎? ...
cutecutetown
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Hello 玫瑰野獸,

Glad to hear from you; so everything turned up OK, that's great. I did worry for a while

I will try to answer all your 3 postings.
(1) Other than following your doc's instructions to take luteal support medication at the right time and at the right dose, there is not much you can do. The medication can be an injection or a vaginal suppository. The format doesn't really matter, it helps your uterus/endometrium to "welcome" the embryo if it implants.
[My warm suggestions to you for the next 14 days or so? Relax, try to relax, sleep well, stop worrying, don't try to pick something to blame yourself or your husband with.]
(2) In your case, because sperm from the testis are used, we can't really compare their activity with those sperm found in an ejaculate.
(3) I wish everybody who gets an embryo transfer can bingo too, but that's not it. Even with natural conception, the chance of intercourse at the right timing will not give a 100% bingo chance either. There is natural selection, and sometimes the embryo (natural or from ivf) may be genetically abnormal. That's one of the reasons why sometimes there are miscarriages along the pregnancy journey.

You have been doing very well so far. Wish you all the best!!

原帖由 玫瑰野獸 於 10-3-23 18:04 發表
點解做IVF人人都有分裂的胚胎放胎, 但又唔係人人都可以最後BINGO呢? 因為著床唔到?
ylam88jc
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Thanks.
玫瑰野獸
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原帖由 cutecutetown 於 10-3-23 19:03 發表
Hello 玫瑰野獸,

Glad to hear from you; so everything turned up OK, that's great. I did worry for a while

I will try to answer all your 3 postings.
(1) Other than following your doc's instruction ...


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。。。
cutecutetown
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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。。 ...
minimeme
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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 follicles size are good? How many of them can reach to an optimal size before ER day? Thanks!

17mm * 2
16.5 mm *1
15mm *3
14.5mm *1
14mm * 3
12mm * 1
11mm * 1
10mm * 1
玫瑰野獸
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原帖由 cutecutetown 於 10-3-24 15:49 發表
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 c ...


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?
cutecutetown
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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 ...
cutecutetown
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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?
little_icy1
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Hi, Cutecutetown,

Do you know which lab in HK provides AMH (Anti-Mullerian hormone) Test to check the ovarian reserve ? How much ?
minimeme
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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 too high, this can prevent OHSS. Is that true? This is what I'm worry about, hormone level no good is the reason why they change me from injecting Gonal-F to some other medicine now. This medicine is injected to "at Pat", and make me feel very uncomfortable, feel pain. Please advise. Thanks!


原帖由 cutecutetown 於 10-3-25 14:47 發表
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 ...
cutecutetown
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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 ?
cutecutetown
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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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