吹水玩樂

時事理財

由家出發

媽媽天地

育兒教養

情報分享

意見反饋

聯絡管理員

我的中心

Baby Kingdom - 親子王國香港討論區 › 首頁 › 想生BB› ivf Q & A

想生BB 今日: 2|主題: 109092

收藏本版

回覆發帖

返回列表

跳至頁

樓主: cutecutetown

ivf Q & A

123 4 5...139

積分: 9231

21^#

發表於 10-3-17 14:12 |顯示全部帖子

Hello Milly,
In normal fertilisation, only one sperm can go into the egg so that the resulting embryo/baby will have half the genetics from mom and half the genetics from dad. In the "abnormal" embryo as you described, 2 sperm has entered one egg; so the genetics is not correct. Therefore, these embryos are no good for transfer.

During human embryo development, at least for those seen in the lab, we quite often see fragmentation (碎片). The more the fragmentation, the lower potential of the embryo. Usually, if the fragmentation does not exceed 20-30%, the embryo still has a good potential to implant and make a baby.

It looks like you have already transferred 3 embryos into the uterus and have 3 surplus embryos frozen. In most ivf labs, we transfer the better-quality embryos and freeze the remaining good- or average-quality embryos.

原帖由 Milly18 於 10-3-16 19:34 發表
想請教下,我抽了13粒卵,12粒受精,但其中有6粒是怪貽,即2條精子入了去一粒卵子,要丟掉...是什麼原因? 另外雪了3垃粒,其中一些有碎片,又代表什麼,很難中嗎? ...

私人傳訊回覆引用

cutecutetown

男爵府

積分: 9231

22^#

發表於 10-3-17 16:02 |顯示全部帖子

Not all the time, it depends on your doctor's decision. However, 腹腔鏡 does allow further investigation of your fallopian tubes (輸卵管) as well as the peritoneal cavity. It may provide more information to your "unexplained" infertility.

原帖由 Lumpy 於 10-3-16 19:42 發表
cutecutetown,

我想問下, 做ivf之前,係唔係一定要做腹腔鏡呀?

事關我做左3次iui都唔得, 又未到高齡, 輸卵管又無塞, 打左針後卵泡夠大內膜夠厚,但偏偏唔知咩原因不孕. 醫生都估唔到係咩原因.

謝謝你! ...

私人傳訊回覆引用

cutecutetown

男爵府

積分: 9231

23^#

發表於 10-3-17 16:44 |顯示全部帖子

Whether the sperm is dead or simply not moving really depends on the cause(s) of the men's 無精症. I can only say that most of the time, the sperm is simply not moving. I am taking a wild guess that in your case, your husband's sperm is not moving; because if there is only dead sperm from TESE, your doctor will not even start your ovarian stimulation for ivf/icsi.

For a sperm to acquire motility, it has to pass through and mature in 輸精管. Roughly speaking, the maturing process takes ~70 days.

There is no way to tell what grade the embryo will be; an embryo is a "combo" of both an egg and a sperm. It is normal for you to feel anxious & nervous as there seems so many unknowns in front of you. But remember that as long as you produce some eggs and your husband's TESE has sperm, it is the ivf center's job to take care of fertilization and hopefully give you some embryos.

The ONE thing you can do now is to follow your doc's instructions and also try not to be overly nervous. I know you can do this, and because you can do it, you should not feel nervous, right? I hope you and your husband are giving support to each other. What I find over the years is that having a supportive spouse and a positive attitude help the whole process a lot, both physically and emotionally. If you don't mind sharing, let me/us know when it's about time for your egg retrieval. Good luck!

原帖由 玫瑰野獸 於 10-3-17 13:18 發表

多謝你的鼓勵！通常TESE抽出來的ｓｐｅｒｍ係死ｏｒ只是不動呢？用不動ｓｐｅｒｍ做的胚胎一般會ｇｒａｄｅ幾？（好多問題，因為我太緊張，我地只有這個ｃｈａｎｃｅ．．．．．． ...

私人傳訊回覆引用

cutecutetown

男爵府

積分: 9231

24^#

發表於 10-3-18 16:13 |顯示全部帖子

Some labs will thaw on the day of your egg retrieval and some may thaw the day before.

原帖由 玫瑰野獸 於 10-3-18 15:20 發表

唔知幾時抽旦, 醫生話要等個驗血報告出來先知道, 請問胚胎專家會幾時將老公做TESE抽出的組織解凍和用營養液測試sperm呢?

私人傳訊回覆引用

cutecutetown

男爵府

積分: 9231

25^#

發表於 10-3-18 18:32 |顯示全部帖子

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 a very very small chance of cancelling the egg retrieval.

I can't really say for other ivf centers, although we should be practicing in similar ways. In my lab, when a man has a TESE done, we examine the samples to see if there are sperm. If none, case is closed. If yes, we will try to freeze. We always do a test-thaw to see if the sperm will survive the freeze-thaw process. Afterwards, we will inform the doctors so that they can plan ovarian stimulation for the woman.

Suppose the test-thaw result is very bad, then a "back-up" TESE procedure will also be arranged. If the frozen sperm really turn out dead on the day of egg retrieval, then we may still obtain fresh sperm by TESE on the same day.

原帖由 玫瑰野獸 於 10-3-18 17:13 發表

多謝你既回答, 令我放心一d, 如果是在我抽旦前thaw, 若找不到活丁丁, 是否我連旦都唔駛抽?

私人傳訊回覆引用

cutecutetown

男爵府

積分: 9231

26^#

發表於 10-3-18 18:36 |顯示全部帖子

Thank you for your encouragement. I am glad to know you find this blog helpful.

原帖由 玫瑰野獸 於 10-3-18 17:27 發表
忘了說, 你好pro, 好好心地! 我地做ivf既一般都擔心呢樣個樣, 見到醫生又唔問得甘多甘清楚. 希望你可繼續幫助回答jm對ivf既疑問! 多謝!

私人傳訊回覆引用

cutecutetown

男爵府

積分: 9231

27^#

發表於 10-3-18 18:47 |顯示全部帖子

尿道 & 陰道 are two separate structures although they are very close to each other. My suggestion is that you should try to seek advice from your fertility doc. first. He/she may tell you exactly what to do and prescribe some medication if needed.

If you really can't see your fertility doctor, go to your family doctor or a general doctor and tell him/her about your condition (pain and itchiness). It is very important also to tell this doctor that you have just had an ivf treatment with an embryo transfer done. Hopefully this doctor will be helpful.

Wish you well and take care.

原帖由 Milly18 於 10-3-18 18:15 發表
Thank you for yr detail explanation.

By the way, I want to ask if 尿道炎/陰道炎會影響bingo, 因為我ivf放胎後day3開始有尿道炎, 第一日流血和去vv時痛。現在ok,但成日急v,要去洗水間,又好似v極都有... 陰道有 ...

私人傳訊回覆引用

cutecutetown

男爵府

積分: 9231

28^#

發表於 10-3-19 16:23 |顯示全部帖子

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 ...

私人傳訊回覆引用

cutecutetown

男爵府

積分: 9231

29^#

發表於 10-3-19 16:46 |顯示全部帖子

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！！！） ...

私人傳訊回覆引用

cutecutetown

男爵府

積分: 9231

30^#

發表於 10-3-19 17:45 |顯示全部帖子

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 ...

私人傳訊回覆引用

cutecutetown

男爵府

積分: 9231

31^#

發表於 10-3-20 12:31 |顯示全部帖子

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 ...

私人傳訊回覆引用

cutecutetown

男爵府

積分: 9231

32^#

發表於 10-3-20 12:41 |顯示全部帖子

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 ...

私人傳訊回覆引用

cutecutetown

男爵府

積分: 9231

33^#

發表於 10-3-20 12:49 |顯示全部帖子

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? ...

私人傳訊回覆引用

cutecutetown

男爵府

積分: 9231

34^#

發表於 10-3-20 13:13 |顯示全部帖子

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 ...

私人傳訊回覆引用

cutecutetown

男爵府

積分: 9231

35^#

發表於 10-3-22 10:30 |顯示全部帖子

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 ...

私人傳訊回覆引用

cutecutetown

男爵府

積分: 9231

36^#

發表於 10-3-22 10:48 |顯示全部帖子

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？

私人傳訊回覆引用

cutecutetown

男爵府

積分: 9231

37^#

發表於 10-3-23 16:16 |顯示全部帖子

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 ...

私人傳訊回覆引用

cutecutetown

男爵府

積分: 9231

38^#

發表於 10-3-23 18:19 |顯示全部帖子

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 ...

私人傳訊回覆引用

cutecutetown

男爵府

積分: 9231

39^#

發表於 10-3-23 18:30 |顯示全部帖子

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? ...

私人傳訊回覆引用

cutecutetown

男爵府

積分: 9231

40^#

發表於 10-3-23 19:03 |顯示全部帖子

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!!