Sperm Bank
10/31/2013 01:05:00 AM
by Ashley
“Excuse me. Do you have a sperm bank?” Her voice in the phone sounds with high expectation, though her question was straightforward. After my positive response, she talked over 10 minutes about her attempting to get pregnant. I suggested her visiting us in person while she can be available, so our doctor can give her clear information and she can know the precise process from our lab. It was only the morning, and then she took a long drive from Taipei and showed up in the afternoon. “What made a 34 year-old lady so proactive?” I wondered.She got pregnant in the first year of marriage, but couldn’t keep the baby because of blighted ovum. Although they keep trying, there seemed to be trials to this couple. Her husband was diagnosed with melanoma and treated as well, but they were shocked after finding no sperms in one analysis. After further biopsy results confirmed her husband’s azoospermia, they choose to face the reality and support each other approaching their clear goal.
Now their first goal is to bring back their baby home as soon as possible, so she came to e-Stork. The complicated legal procedure didn’t pull her back, and she didn’t even set up any criteria for the donor’s background. “Just healthy would be enough; I think the education after baby born would affect more.
I haven’t ever seen anyone finished the legal procedure and obtained all the documents that fast. After the examination, she took the first timing to boost the oocytes production. I am glad that e-Stork has a comprehensive service of sperm bank to deserve their efforts and cooperation; and her ovary is functioning well that we took 22 oocytes at once in her first two months coming here.
While we were incubating the embryos, she had to consider the timing for “moving baby,” as her students needs her attending their athletic meet just the day after presumed implantation. She was worried those sports may affect the implantation of the embryos. Even finally we decided to freeze 5 good blastocysts, she had concerned about if the frozen ones are as good as the fresh ones. “If the fresh ones can work better, I would try to give up attending the athletic meet,” she said.
However, she has poly-cystic ovary syndrome, and the doctor wondered her implantation window may already past. Since now the success rate of frozen blastocyst is as good as the fresh one, we suggested her wait for the coming month. “You have been very good since the beginning, how about we take a break and implant the beautiful baby while you are really ready?” Just as expected, the implantation next month was very successful; the frozen embryos stayed cool, and the hCG test showed clearly happy two lines. The sharp data shows all the joys everyone has.
Wherever there is a will, there is a way. Challenges come to our life without knocking doors. We may be afraid of being too late to say or do something. This couple touched me deep down by their spirit – regardless of struggle and challenge, just keep faith and working hard till the last minute. Now they have their happiness, and more than that, they have our blessings.
Sperm Recipient Program Procedure
Oocyte Bank
10/30/2013 12:50:00 AM
We are family！- Thinking of becoming an oocyte recipient
While you feel your life is on track and you almost have everything you want, sometimes a hopeless feeling just attacks you. While having no baby in your hand, and you suddenly find out pregnancy is so difficult, you think this may be a joke….
Our daily job shows us the willingness for a baby of many couples. When the ovary function is not as expected, being pregnant and delivering a birth seems to be a dream getting farther and farther away. Fortunately, the current ART brings you another option rather than adoption. By a younger oocyte donation, you can have a chance to make your dream come true.
It is always difficult to take the first step; especially you need to overcome the tradition to have a baby with different blood from you. The general concerns include the looks, health and the personality of the future baby, as this is a true life coming to your marriage life. We share your concerns and we understand your worries, therefore, we are always very serious on the donor’s health assessment, not only the professional diagnosis on the genetic disease and medical check, but also every interview to understand donor’s kindness and passion.
After you registered as a recipient, living healthy is very important, even if you feel frustrated for document procedure. Keeping good exercise regularly, good healthy diet, and good life style is crucial to prepare for pregnancy, or even further for baby’s health. The unhealthy life style we have seen, such as stressed from the job, sleeping disorder, unbalanced diet by eating –out often, high sugar uptake, smoking, drinking, drug reliance, should be completely avoided. However, the life style change needs a couple’s effort, and it takes time to see the efficacy. You will feel worthy once you bring a healthy baby to your sweet home.
There is not only the physical adjustment, but also the mental adjustment. The recipient couple should keep open-minded during the whole process and ensure each other this is what you really want. A baby coming this way is also your love crystal, should bring you no regrets. No matter you are adopting a child or having a baby through oocyte donation, the matter should be enjoying and delighting in the process of child’s growth and education, instead of how many genes from you. Child is a very important and crucial part of your marriage life.
Although you don’t know your donor, but you share a happy dream with her and that make you both a family.
Oocyte Recipient Program Procedure
Basic Examinations for Female
10/04/2013 01:14:00 AM
Basic Examinations for Female
1. Hormone Study
Purpose:
To estimate the rate of potentially successful pregnancy and if there are any hormonal imbalanaces that causes infertility.
Procedure:
Simple blood test.
The following is a list of items the doctor may possibly order to be tested in a hormonal study based on a patient’s existing symptons/ conditions:
· Anti-Mullerian hormone (AMH)
· Prolactin (PRL)
· Thyroid stimulating hormone (TSH) and/ or Free thyroxine
(Free T4)
· Auto-immune blood test
When to test:
Best time to test will depend on each patient’s condition and their hormone levels at various points during the menstrual cycle. The doctor will discuss further on testing schedule. In order to estimate the ovarian function by FSH, the 1st to 3rd day of the menstrual cycle will be used as a basis.
Reminders:
Certain periods during the menstrual cycle determine the type of hormone present at that time. Therefore, the best times to test for individual hormones will be coordinated according to each patient’s cycle. The doctor shall interpret the results based on his professional judgement.
2. Transvaginal Sonography (TVS)
Purpose:
Sonography (sona) is used to check the interval reproductive organs for any abnormalities, including the cervix, uterus, ovary and endometrium lining. It is also used to estimate ovulation period and measure uterine wall thickness.
Procedure:
· Patient will be asked to lie on her back on the examination
table with feet raised and supported by stirrups.
· The sona technician will cover the probe with a condom
and gel, and then, insert it into the vagina slowly. The probe sends out sound
waves, reflecting body structures to the computer, creating pictures.
When to test:
Best done on the 11th - 12th day of the menstrual period. TVS can be conducted once every 2 days until the oocyte reaches maturity.
Advantages:
Easy, convenient, economical and ovulation may be determined. Since it is using sona, there is no need to worry about x-ray.
Disadvantages:
None determined at the moment
Reminders:
TVS is done with an empty bladder.
3. Hysterosalpingography (HSG)
Purpose:
HSG is an X-Ray test to examine the condition of the fallopian tubes and uterus to determine if there are any blocked tubes, abnormal uterine structures or growths.
1/4 of infertility in women is caused by problems in their uterus or fallopian tubes.
When to test:
After menstrual period and before ovulation. If cycle is regular (28 days), it is best to conduct the HSG on the 7th -11th day of the cycle.
Advantages:
Easy, convenient and with 80%-90% accuracy.
Disadvantages:
There is a chance of inflammation, bloating and abdominal pain, headache or dizziness and a feeling of nausea. If conducted by an experienced doctor, potential for any pain is decreased. Since HSG uses an X-ray dye, it cannot be done to women having their menstrual period or too close to the onset of their cycle. With the advances in technology, HSG has become more accurate.
Reminders:
After HSG is done, rest and lie down for a few minutes to avoid any dizziness or headaches. Drinking lukewarm water can help. It is normal to experience slight abdominal pains and bleeding.
There are many ways to examine the fallopian tubes for any blockages and the uterus for abnormalities. HSG is one of the easiest and most accurate methods.
4. Hysteroscopy (H-scopy)
Purpose:
H-scopy uses a hysteroscope to examine if the uterus and uterine lining are normal. There is a direct correlation between the condition of the uterus and embryo implantation.
Procedure:
Patient will be asked to lie on her back on the examination table with feet raised and supported by stirrups, similar to a pap smear or vaginal exam. An optical instrument connected to a video unit with a fiber optic light source is inserted to check the conditions of the uterus.
If only a simple examination is required, there is no need for anesthesia. The whole process takes about 3 mins, after which, the patient is asked to rest for another 30 mins. For further examination and operation, anesthesia will be administered and the process will take about 5 mins. Resting period is an additional 1-2 hours.
H-scopy uses a hysteroscope to examine if the uterus and uterine lining are normal. There is a direct correlation between the condition of the uterus and embryo implantation.
Procedure:
Patient will be asked to lie on her back on the examination table with feet raised and supported by stirrups, similar to a pap smear or vaginal exam. An optical instrument connected to a video unit with a fiber optic light source is inserted to check the conditions of the uterus.
If only a simple examination is required, there is no need for anesthesia. The whole process takes about 3 mins, after which, the patient is asked to rest for another 30 mins. For further examination and operation, anesthesia will be administered and the process will take about 5 mins. Resting period is an additional 1-2 hours.
When to test:
Best time to test is after the last menstrual cycle and before ovulation takes place for the next cycle. If it is a regular cycle of 28 days, the best time will be in the morning of the 7th to 11th day.
Advantages:
H-Scopy is a higher form of test utilized for difficult pregnancies. It is very safe and accurate. There can be a 100% accuracy rate through visual examination via the hysteroscope.
New advancements in technology in H-scopy uses a smaller, thinner optical instrument of only 2-3mm diameter, thus, the procedure is almost painless.
Disadvantages:
Based on the findings, it is possible that patient will be asked to undergo further tests under anesthesia. There is a slim chance patient will experience some of the risks from the administering anesthesia, such as infection, allergic reactions and bleeding.
Slight bleeding during the period between an H-scopy procedure and the next menstrual cycle is normal.
Reminders:
For couples with continued problems in infertility for a number of years and who have opted for in-vitro fertilization (test tube baby), it is recommended that they undergo an H-scopy exam to determine uterus conditions.
Fasting is required for eight hours prior to an H-scopy exam – no food or water intake.
After the examination, slight bleeding or abdominal pains during the period between an H-scopy procedure and the next menstrual cycle is normal.
5. Cervical
cultures
Purpose:
Inflammation of female genital tract includes viginitis, cervicitis, salpingitis and pelvic inflammatory disease (PID). Chronic inflammation may cause endometirum polyp(s), tubal adhesion, obstruction and/ or hydrosalpinx, etc. Bacteria, Chlamydia trachomatis and human papillomavirus (HPV) are 3 most common pathogens.
Procedure:
Similar to getting a pap smear. It takes about five (5) minutes and is not painful.
To collect a sample, the patient will be asked to lie on her back on the examination table with feet raised and supported by stirrups.
The physician will examine the vagina and genital area. A speculum will be inserted, gently spreading the vaginal walls apart to check the cervix. Using a cotton swab, sample will be swiped from the cervix.
(1) Cervical discharge culture
To check with bacterial infections such as yeast (Candidiasis), Gram-positive bacilli (GPB), E. coli, Streptococcus, Staphylococcus, etc. Antibiotic treatment is recommend when infection was found.
(2) Chlamydia DNA testing
Chlamydia is the most common bacterial sexually
transmitted disease. Chlamydia DNA testing is done to check if the bacteria
Chamydia trachomatis is present and causing any infections. This disease can be
passed on from infected mother to baby during vaginal childbirth. It may spread
to the upper genital tract causing PID which can cause scarring, infertility
and ectopic pregnancies if untreated. Antibiotic treatments for both husband
and wife are recommend when infection was found.
(3) HPV DNA typing
HPV is related to cervical cancer, genital warts (Condyloma) and many different kinds of cancers. HPV DNA typing is to detect if any HPV is present and to identify the type of the HPV. Low risk types: 6, 11, 42, 43, 44...; high risk types: 16, 18, 31, 33, 45, 51, 52, 56...Vaccination is suggested.
When to test:
Best done on the 7th to 11th day of menstrual period.
Advantages:
Easy test, similar to the pap smear, that can eliminate any suspicions of infection or abnormality in reproduction system.
Disadvantages:
Possible bleeding and false negative.
Reminders:
Infections in the reproductive system is very common and causes complications in conceiving, lowering the rates for successful pregnancy.
Most infections may not cause any symptoms in the beginning and may linger inside the body for years. Some symptoms that could eventually manifest are: cervical mucus or discharge, inflammation/ abdominal pain or urgent urination. This disease may remain undiscovered until the Fallopian tubes have become blocked.
Since infections may affect the development of the embryo, it is advisable to undergo this test prior to pregnancy.
Vagina should not be washed prior to testing in order to prevent any false negative results.
(3) HPV DNA typing
HPV is related to cervical cancer, genital warts (Condyloma) and many different kinds of cancers. HPV DNA typing is to detect if any HPV is present and to identify the type of the HPV. Low risk types: 6, 11, 42, 43, 44...; high risk types: 16, 18, 31, 33, 45, 51, 52, 56...Vaccination is suggested.
When to test:
Best done on the 7th to 11th day of menstrual period.
Advantages:
Easy test, similar to the pap smear, that can eliminate any suspicions of infection or abnormality in reproduction system.
Disadvantages:
Possible bleeding and false negative.
Reminders:
Infections in the reproductive system is very common and causes complications in conceiving, lowering the rates for successful pregnancy.
Most infections may not cause any symptoms in the beginning and may linger inside the body for years. Some symptoms that could eventually manifest are: cervical mucus or discharge, inflammation/ abdominal pain or urgent urination. This disease may remain undiscovered until the Fallopian tubes have become blocked.
Since infections may affect the development of the embryo, it is advisable to undergo this test prior to pregnancy.
Vagina should not be washed prior to testing in order to prevent any false negative results.
(please click for more info.)
1. PGS ( pre-implantation genetic screening)
Having a healthy baby is the expectation of each parent. PGS/NGS allows us to examine chromosomal abnormalities prior to embryo transfer, and thus improves the IVF outcomes.
2.
ERA (Endometrial Receptivity Analysis)
By Endometrial Receptivity
Analysis (ERA), which is a technique to analysis the gene of endometrial cell,
we can predict when is the window of implantation, the right time to transfer
the embryo.
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WhatsApp：Basic Examination for Male
10/03/2013 01:15:00 AM
Basic Examination for Male
1. Sperm/ Semen Analysis (SA)
Purpose:
Semen Analysis is done according to 2010 WHO regulations in order to test the forward motility, quality and quantity of sperm collected.
Procedure:
- Make an appointment with the fertility center and acquire a sterilized collection cup.
- There should be no sexual intercourse 2-7 days prior to the intended day for harvesting sperm.
- Using masturbation, collect the ejaculated sperm in the collection cup.
- Within 60 minutes from time of ejaculation, retrieved sperm sample must be submitted to the clinic. Ideal temperature for transporting sample is around 25℃.
When to test:
After 2-7 days of abstinence
2010 WHO references values for Semen Analysis
- Total Sperm number: >39 millions/ ejaculate
- Total Motility: >40% motile
- Progressive Motility: >32% with forward motility
- Sperm Morphology: >4% normal forms