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發表於 22-3-19 10:29 |只看該作者

回覆 cutecutetown 的帖子

放左10cell 個果。係人工週期。等粒10cell 長多一日，day 4 時先放.

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chelseywong

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5882^#

發表於 22-3-19 10:44 |只看該作者

Hello cutecutetown,
I am doing 2nd IVF cycle (1st in Taiwan with 5 day5 embryos left). First failed implantation and second missed miscarriage at 8w after heartbeat seen at 6w. No PGS. Did biopsy after d&c and suprisingly results shows embryo is normal karyotype…I would like to seek your advice:
1) Should I do PGS on the remaining 3 frozen embryos (2 day5 and 1 day6) or just continue to transfer them?
2) Similarly, should I thaw and do PGS on the frozen embryos in Taiwan?
3) In your experience, is it uncommon to miscarry a normal viable embryo? Is it possibly related to immune as I am tested APS positive though I have already used heparin/immunosuppresents..any tests I should do further? Dr says its not common
4) Or should I go for another round of ivf cycle with PGS

Thank you so much

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5883^#

發表於 22-3-19 18:32 |只看該作者

ATcheers 發表於 22-3-19 07:09
本帖最後由 ATcheers 於 22-3-19 08:33 編輯

感謝你的回答，非常詳細。

Dear ATcheers,
1. 墮胎唔算。
2. 要看個人需要，menopur是高純度FSH,夾雜了少許LH (唯份量不是fixed unit);而gonal F則是100%FSH, 完全沒有LH.
3. 這程序具爭議性，香港法例不容許.
4.D2 or D3FSH 反映卵巢功能，但去到高齡其實都只能盡量做,慶幸你的FSH 還未過10！但有沒有驗過AMH, 反映卵子儲備？

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5884^#

發表於 22-3-19 18:41 |只看該作者

Havefaith1111 發表於 22-3-19 10:29
回覆 cutecutetown 的帖子

放左10cell 個果。係人工週期。等粒10cell 長多一日，day 4 時先放. ...

Dear Havefaith1111,
可考慮下周期先放兩個day3的。因為你剛抽卵的那個周期卵子看來不太好，下一個周期的卵子可能也差不多，所以倒不如用這個周期放胎。

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5885^#

發表於 22-3-20 06:37 |只看該作者

回覆 chelseywong 的帖子

Dear chelseywong,
Do you mean you have already done your 2nd IVF with egg retrieval, in HK?

From your questions 1 and 2, and if I understand correctly, you have 3 frozen embryos from this second IVF and 5 frozen embryos from the first IVF in Taiwan, is that correct?

To answer your questions 1 and 2, you may consider doing PGS on all your embryos in one lot. Since they are all frozen, you can transport the 5 embryos from Taiwan to HK, then request to do PGS on all of them.

For question 3, depending on how the abortus tissues were obtained, it is not uncommon to also contain contamination from maternal source (i.e. your tissues), and therefore, the karyotyping result will be normal (46,XX). There could be other genetic abnormalities of the embryo even though its karyotype was normal, although we cannot rule out your APS from being a cause. So, it is important to know the embryo is a euploid (normal) when it is transferred into your uterus.

Good luck,
cutecutetown

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ATcheers

積分: 180

5886^#

發表於 22-3-20 10:52 |只看該作者

cutecutetown 發表於 22-3-19 18:32
Dear ATcheers,
1. 墮胎唔算。
2. 要看個人需要，menopur是高純度FSH,夾雜了少許LH (唯份量不是fixed unit ...

本帖最後由 ATcheers 於 22-3-20 15:29 編輯

AMH
9.0 pmol/L (8 April 21)
9.61 pmol/L (6 June 19)

(Age 44)

請問以上單位pmol/L是怎樣換算，我看其他JM是2, 1.2, 0.9, 是不同單位嗎？

Million Thanks

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5887^#

發表於 22-3-21 07:55 |只看該作者

ATcheers 發表於 22-3-20 10:52
本帖最後由 ATcheers 於 22-3-20 15:29 編輯

AMH

Dear ATcheers,
單位可以有不同，她們的應該是ng/ml

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ATcheers

積分: 180

5888^#

發表於 22-3-21 08:04 |只看該作者

回覆樓主:

1.請問卵泡去到多大是過熟？私院說最大24mm也可用, 威院說過20mm便不要。其實標準是幾多？

2.你說過打針天數多令卵質素不好，那麼打針多小天，卵質素最理想？10-14天？

3.你曾說過，放雪胎成功率較高，是基於母體能在一輪針後得到充份休息嗎？

4.放胎前/ 放胎後/ 懷孕時，可每晚/ 間唔中食1mg或更底的褪黑激素助眠嗎？還是酸櫻桃的褪黑激素安全些？

萬分感謝！

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Sugarcub2021

別墅

積分: 659

5889^#

發表於 22-3-21 08:28 |只看該作者

Hi cutecutetown

我想問人工週期同自然週期，邊一個成功率會高啲？比較易植床？

謝謝

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chelseywong

積分: 6831

5890^#

發表於 22-3-21 21:06 |只看該作者

cutecutetown 發表於 22-3-20 06:37
回覆 chelseywong 的帖子

Dear chelseywong,

Dear cutecutetown,

Thank you for your response.

Yes, I have 3 remaining frozen embryos left in HK and 5 in Taiwan. Due to clinic restrictions, those embryos cannot be transported back to HK. In this case, do you recommend I do PGS on those 3 embryos first in HK? Will thawing and refreezing the embryos do more harm than good?

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5891^#

發表於 22-3-22 04:21 |只看該作者

ATcheers 發表於 22-3-21 08:04
1.請問卵泡去到多大是過熟？私院說最大24mm也可用, 威院說過20mm便不要。其實標準是幾多？

2.你說過打針 ...

Dear ATCheers,
1. 卵泡一般在18mm或以上都可以打排卵針了，在18-20mm之間通常都是成熟卵子，20mm以上的，很難介定何謂過熟，但也是可以被抽到並受精，只是質素較差。
雖說卵泡在18-20mm左右是最好，但通常同一個ivf cycle的卵泡有大有小，醫生會盡量安排最合適的時候打排卵針，務求抽到最多的成熟卵子，有時少不免要「犧牲」一兩個跑得太快或太慢的卵泡。
2. 純粹以個人經驗而言，打多過12天才抽卵質素會較差。
3. 可以這麼說，因為身體回復自然狀態，沒有高量賀爾蒙影響生理周期。
4. 不清楚，你最好問你的主診醫生。

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5892^#

發表於 22-3-22 04:24 |只看該作者

Sugarcub2021 發表於 22-3-21 08:28
Hi cutecutetown

我想問人工週期同自然週期，邊一個成功率會高啲？比較易植床？

Hello Sugarcub2021,
人工與自然周期的成功率是差不多，視乎需要而決定用那一種。

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5893^#

發表於 22-3-22 04:59 |只看該作者

回覆 chelseywong 的帖子

Dear chelseywong,
Is it the clinic in Taiwan which does not want to ship, or HK which does not want to receive? Other than these clinics' own policies, it is legally and logistically feasible to ship from Taiwan to HK.

Anyhow, depending on the quality of the 3 embryos in HK, you may choose to do PGS on them first before doing another IVF cycle. Based on published data, embryos that had been frozen-thawed twice but biopsied once, their survival and success rate were similar to those that had been frozen-thawed once; if the embryos had been biopsied twice and frozen-thawed twice, the rates were slightly lower.

Generally speaking, there should be 1 euploid (normal embryo) in every 3-4 blastocysts; the chance of having a euploid often correlates with age. I am not sure if you may consider another IVF cycle to bank more euploids before FET. If so, you can proceed with a new IVF cycle first, and at the same time have the lab to thaw out the 3 frozen embryos so that they can be tested together with the fresh blastocysts from the new cycle.

cutecutetown

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jmbk2

大宅

積分: 1069

5894^#

發表於 22-3-22 17:22 |只看該作者

回覆 cutecutetown 的帖子

Hi Cutecutetown,
見左醫生準備放第三次胎 (recap返我係33, 第一次ivf, 16 eggs -> 10 Day 5 + 3 Day 6 Blastocysts -> transferred 2 times -> 1 no implantation + 1 chemical preg). 見醫生時佢strongly against putting 2 embryos as he think i'm young and he said there are complications associated with multiple pregnancy. At the same time, I asked if my third transfer still do not result in a viable pregnancy, is there further tests that can be done (such as PGT).

His opinion is that even if we do PGT for the remaining blastocysts, there is no guarantee that those normal ones will surely implant and the success rate may still be similar to as if we keep transferring the remaining. He said judging from the number of good grade blastocysts that we have, we should just keep transferring... until a viable pregnancy happens.
He mentioned that there are some patients who (and we may also) need to do second or third round ivf (implying that they may have transferred 10 times or more of embryo transfer) before getting a baby home.

The thought of having to transfer 1x times + even need to do a second IVF after all 1x times failure is killing me.
But I know there is no way I can get a second opinion from another doctor, if i still have that many embryos in this specific lab? not that I want to change to another doctor, but this is already bringing me a couple of sleepless nights...

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5895^#

發表於 22-3-23 05:03 |只看該作者

回覆 jmbk2 的帖子

Dear jmbk2,
Just like my answer back in post #5818, you will need to do a third time FET, whether transferring 1 or 2 embryos. Only if you fail again in this 3rd transfer, the doctor will investigate further if the possible cause is your body or the embryos.

You need to DO one thing at a time, not thinking so much ahead because there are simply too many possibilities. Perhaps you will bingo in this 3rd FET, then all your worries will be unnecessary. If you fail and the current doctor still refuses to offer you additional options, seek another doctor. It is also feasible to transport your embryos to another lab.

A positive attitude helps a long way. Good luck on your next FET.
cutecutetown

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KW2013

積分: 246

5896^#

發表於 22-4-9 10:11 |只看該作者

回覆樓主：

本帖最後由 KW2013 於 22-4-9 23:37 編輯

Del

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sukikeung

積分: 212

5897^#

發表於 22-4-9 19:59 |只看該作者

回覆樓主:

你好樓主，請問放鮮胎Day2同Day3有乜分別？另外想知我淨返一個B-同2個D，2個D係咪無機會去到Day5？

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