Our Japanese patient is now 43 years old. She has been married for three years when she first came to e-Stork Reproductive Center about a year ago. During that time, she has already undergone three procedures of intrauterine insemination and three procedures of In Vitro Fertilization in Japan.


Reviewing her medical history, I recommended that the best chance for conception based on her conditions was to undergo an oocyte donation program. However, she refused to give-up hope and requested we try the standard procedure of egg induction for artificial fertilization. Since she explained that this is one of her major motivations for seeking treatment in Taiwan, I complied.

On the 3rd day of her next menstrual cycle, she achieved FSH count of 25.8. Her ultrasound also confirmed that both left and right ovaries produced a single oocyte each. Unfortunately, despite preparing a customized treatment, her egg did not develop further beyond the fifth day. In light of the negative result, I suggested again that she enter into the oocyte donation program immediately. But, she was not yet ready to accept such a radical move and went home to Japan.

After two months, she came back with her husband for the holidays. Her determination has not diminished and staying far in the southern Taiwan area did not deter her from visiting our clinic to acquire 2 weeks worth of medicines for her to continue treatment in Japan.

Five months passed before we received the good tidings that she has successfully produced good quality oocytes. We were able to harvest and insert four embryos in total. Since her uterine lining was only 0.7cm thick during transfer, I strongly advised her to rest and refrain from travel until the day of announcement. But being high-level executives, it was impossible for both husband and wife to extend their stay in Taiwan.

A week of shared worry and anxiety followed. Then we received the surprising and welcome news that she was not only confirmed pregnant, but was carrying twins! We all let out a collective sigh of relief. Her babies’ heartbeats are strong – just like their mother’s unceasing belief and will to succeed. It was truly by blessing and divine intervention that amidst the overwhelming odds and with a 50-50 chance, she was able to conceive successfully. March of this year her twin baby boys entered the world; healthy and weighing-in at an average of 2700 grams. We all celebrated their birth, wishing the chance to see her and her handsome babies soon.

Recalling the patient’s medical background - with normal sperm count, fallopian tube conditions and blood circulation, presence of uterine fibroid with a maximum size of 0.3cm, three miscarriages, and low-quality uterine conditions – and how she was able to become a happy mother of twins within a year, I propose to my colleagues the below questions to ponder.

1. At 39 years, and after discovering that uterus conditions are deteriorating, is it better to recommend IUI treatment or IVF?

2. Is it necessary for older women who have undergone artificial reproduction treatments and three natural miscarriages to accept oocyte donation?

3. Is it logical to state that since this patient successfully achieved pregnancy despite a uterine lining of 0.7cm in a 50-50 scenario, the embryo or oocyte quality is more important than the uterine lining conditions?

4. Is there a good chance for older women to carry twin pregnancy to term without complications?

5. Is there really a need for foreign clients to stay in Taiwan for treatment and monitoring until the day of announcement?

6. Is it acceptable for women to travel right after embryo transfer? Does flying have any affect on the conditions of pregnancy?

7. Does the presence of uterine fibroid affect pregnancy? Is there a need to operate and remove the fibroid prior to IVF?