If I still have my periods, can I be pregnant?
12/22/2016 12:47:00 AM
"If I still have my periods, can I be pregnant?"
It is a common question at fertility centers. The specialist clarified that having periods does not mean having ovulations. Many women with advanced age thought that having periods equals to having potential to be pregnant. The fact is that older the age is, worse the egg quality is. That is why the women with advanced maternal age are harder to be pregnant.
Hyaluronan(HA) binding assay: a good matchmaker to sperm
12/08/2016 05:27:00 PM
For in-vitro fertilization, the oocytes attract
the sperms with better maturation status by hyaluronic acid of the surrounding
cumulus cells.
In the 2016 annual meeting of Taiwan Society of Reproductive Medicine, Dr. Dionisios Sakkas from Boston IVF center, US, shared his experiences in semen processing and sperm selection,
1. Density：Gradient separation
2. Surface Charge：Electrophoresis
3. Morphological Characteristics: IMSI (intracytoplasmic morphologically-selected sperm injection)
4. Motility Characteristics： Microfluidics
5. Membrane Integrity：Hyaluronan(HA)-binding
International medical service provides more convenience to the patients
11/21/2016 11:15:00 PM
To have better medical
service than home country, medical tourism has become a more popular word. For
example, Asian patients with cancer or cardiovascular diseases would go to Japan
or other developed countries for the advanced treatments. In the realm of
reproductive medicine, the condition for patients who need donated oocytes is different.
Since the law restricted the oocyte donation in Japan, patients must find a
solution overseas.
The assisted reproductive technology
has been developed around one decade in Taiwan. In 2007, the oocyte donation was
allowed in Taiwan by the authority decree, and the oocyte cryopreservation for
social reason as well. For patients with authorized marriage certificate, they
can take the oocyte-donation program if the
wife's ovarian reserve displayed significant diminished, because taking more
IVF cycles seems inefficient.
The secret of age—maternal age and embryo aneuploidy
11/08/2016 05:05:00 PM
The chromosomal abnormality (aneuploidy)
rate increases with maternal age.
By analyzing with next-generation sequencing, more precise information can be obtained.
Preimplantation genetic screening (PGS) is an examination to screen the embryos with abnormal dosage of
chromosomes (aneuploid) in the IVF realm, and it is strongly recommended to the
women with advanced maternal age or undergoing recurrent miscarriage. By
excluding the aneuploid embryo transfer, the success rate of IVF can be
significantly improved.
A home-run and an additional Y chromosome
10/20/2016 09:35:00 PM
The result of pregnancy test made her extraordinarily happy — 100% positive.
However, the following amniocentesis report turned her down immediately...
A real story was shared by the doctor of Stork Fertility Center.
She made an appointment for saying good-bye to me. The entire IVF progress was filled difficulties. And just like another temptation to her, God gave an additional Y chromosome to the transferred embryo. Although the risk existed, she decided to continue the gestation. She said,
"I prayed for a Y chromosome, but He gave me two. "
The last four tubes of frozen sperms
10/11/2016 07:03:00 PM
How to grasp the last chance?
In a frustrated manner or an optimistic manner?
A real story was shared by the doctor of Stork Fertility Center.
"For everything there is a season, and a time for every purpose under heaven: a time to be born, and a time to die; a time to plant, and a time to pluck up what is planted..." ~ Ecclesiastes 3, Bible.
As the King Solomon said, there is a beginning and an ending in everything, including the human body. However, most of us are not ready to face the end.
I met this couple at the clinic suite in a beautiful day.
The clinical outcomes of donor oocyte bank
9/09/2016 10:45:00 PM
The benefits of Frozen Oocyte Bank
Register：Oversea Form
Facebook：e-Stork FB Page
E-mail：en_service@icryobank.com
WhatsApp：+886-905-737-501
- We guarantee that the donor has stored at least 10 mature oocytes in our center. Also, these mature oocytes will be provided only for you and will not be shared by another couple.
- By using the most advanced vitrification technology, the average survival rate after thawing in our center is about 90%.
- The treatment is more flexible and based on your time. After we receive the permission from the government, we can thaw the oocytes and fertilize the egg right away!
According to our recent statistics,
patients undergoing oocyte donation program have 50-60% chance of conception in
average. The pregnancy rate and live birth rate of oocyte donation program are
similar to the woman of using their own eggs at or below age of 35.
Our Achievement
The pregnancy rate and the live birth rate
are highly relevant to the quality of oocytes and the age of oocyte retrival. According
to the statistics of Health Promotion Administration (HPA), female fertility
even plummets after age of 34.
Using oocytes from the donor is absolutely
an additional option of happiness for couple who are eagering to become mother
and dad in a short term.
Based on our statistics, oocyte donation
program has great pregnancy rate (about 70%) and high live birth rates (nearly
50%).
Comparison between Frozen Embryo and Fresh
Embryo
To preserve the oocyte, Stork Fertility
Center performs highly efficient vitrification method published by Kuwayama et
al. Based on our center’s statistics, frozen oocyte and embryo survival rates
are 90% in average.
According to the recorded literature, the clinical pregnancy rates
for frozen embryo transfers and fresh embryo transfers are comparable. Similar
results have been obtained at the Center. The pregnancy rate for frozen embryo
transfers has even surpassed that of fresh embryo transfers.
Frozen embryo transfer could be applied in
women with irregular menstruation, asynchronous embryo development, or there’s
further inspection needed.
Comparison between Fresh Oocyte and Frozen
Oocyte Bank
As reported by our statistics, there is no
significance between frozen oocyte program and fresh oocyte program including
fertilization rates, good embryo rate, good blastocyst rate, clinical pregnancy
rate and implantation rate. That is, vitrification method will not cause
significant harm to the oocytes and embryos.
Register：Oversea Form Facebook：e-Stork FB Page E-mail：en_service@icryobank.com WhatsApp：+886-905-737-501The clinical outcomes of donor sperm bank
9/08/2016 10:59:00 PM
The percentage of Stork Fertility Center sperm donation cycles to the total sperm donation cycles in Taiwan:
*The sky-blue bar represents the percentage of SFC oocyte donation cycle, and the sky-blue plus apricot represents the total oocyte donation cycles in Taiwan.
* BT= blastocyst transfer
* FBT = frozen (and then thawed) blastocyst transfer
The clinical outcomes of embryo transfer in the donated-oocyte recipients:
* BT= blastocyst transfer
* FBT = frozen (and then thawed) blastocyst transfer
Across the sea, I stored my seeds (Part 2)
8/23/2016 06:37:00 AM
One of the differences between women and men is the attitude of making decisions.
Men are good at analysis, and women are good at observation.
While obtaining bountiful information,
most women encountered the mess of selection.
How to make decisions reasonably, not emotionally?
Calm down and do some calculations.
Across the sea, I stored my seeds (Part 1)
8/03/2016 07:33:00 PM
Two roads diverged in a yellow wood,
And sorry I could not travel both
And be one traveler, long I stood
And looked down one as far as I could
To where it bent in the undergrowth;
~ Frost Robert,1920
As most traditional Chinese kids, I was always a typical "good" student—organized, concentrated, and keen to study. My life should be like this—studying with good grades, graduation with a honored prize, and marrying to a perfect Mr. Right. I met the "one" when I was 17, and I truly believed that we would be together during the rest of my life.
The best timing of vitrification after blastocyst biopsy
7/14/2016 09:05:00 PM
What is the correlation between the vitrification timing
after biopsy and the following clinical outcomes?
Time is what we want most,
but we use worst.
Through preimplantation genetic screening (PGS), couples
with the indications of repeated implantation failure, recurrent miscarriage,
and advanced maternal age, may select the chromosomally normal embryo to
transfer (euploid embryo transfer). On the widely-used PGS platform—aCGH (now
has been gradually replaced by next-generation sequencing system), the tested
embryos must be vitrified after biopsy to wait for the PGS report release .
When should the embryologists vitrify the biopsied embryo? Does the timing of
vitrification correlate with the following clinical outcomes?
Never say never — Preimplantation genetic screening reveals the quality of embryos
7/05/2016 02:16:00 AM
Perseverance is the hard work you do
after you get tired of doing the hard work you already did.
One more try is the only shortcut to success.
"Hello, Celine."
I am a Japanese-speaking consultant at Icryobank (Overseas division of Stork Fertility Center). She was my first Chinese-speaking case from Hong Kong. When we first met, she insisted to take the autologous IVF treatment at age 42. We both knew that it would be a long and hard way to go, and many centers would just suggest patients with this age taking the donation program instead of autologous IVF. She did not give up.
Since then, I became her special agent.
Oocyte spindle and embryo ploidies
6/20/2016 12:59:00 AM
From oocyte retrieval to blastocyst cryopreservation, the best
timing to do fertilization is always an important issue in the IVF realm. The
techniques of ICSI, or IMSI, can help the embryo technician select the sperm with
the best morphology to increase the fertilization rate. After the development
of spindle microscope (an modified microscope which can observe the spindle of
oocyte), the question of "when to fertilize?" has emerged.
In the newly-released article of Science, the author explained the
reason of higher chromosomal aneuploidy in human oocytes in comparison with the
other human somatic cells, and mouse oocytes. Holubcova el al. developed a
time-lapse system combing with vital stain of human oocyte to record the oocyte
maturation process (from GVBD to MII).
The procedure of sperm donating IVF
6/12/2016 09:26:00 PM
Step 1. Paper Work
For registration of IVF related treatments (e.g. autologous IVF, oocyte-donating, sperm-donating ...) in Taiwan, the Department of Health Promotion Administration
required paper works as follows,
a. Two forms of picture IDs (Your passport must be necessary)
b. Certificate of Marriage which must be certified by Overseas Office of Republic of China, Taiwan
c. Agreements of IVF/Oocyte Recipient/Sperm Recipient programs
(Notes: If you are taking an sperm donating cycle, both agreements for IVF treatment and sperm recipient are required.)
Step 2. Examinations
Before starting the main treatments, several checkup exams must be done to confirm the uterine condition and male factors. They are listed as follows, (You can provide the clinical reports at your local hospitals, or just take the exams when you visit Stork Fertility Center. )
a. Sperm Analysis
b. Hormone tests (AMH, TSH, PRL, FreeT4 ...)
c. Hysteroscopy (The clinical report within half year is more recommended.)
d. Hysterosalpingography (The clinical report within half year is more recommended.)
e. Cervical culture (Chlamydia DNA test and HPV test are also recommended.)
f. Sperm Cryopreservation: If your spouse cannot visit us on the oocyte retrieval date, it is better to preserve his sperm sample in advanced.
g. Bring the prescribed medicines
(Notes: You may spend two to three days staying in Taiwan to complete the exams and required documents. For this visitation, it's necessary for both you and your husband.)
The procedure of undergoing sperm donating IVF is as follows,
If you choose the frozen blastocyst transfer, the procedure is as follows,
The procedure of undergoing sperm donating IVF is as follows,
If you choose the frozen blastocyst transfer, the procedure is as follows,
A patient friendly corifollitropin alfa protocol without routine pituitary suppression in normal responders
6/07/2016 06:26:00 PM
Author
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Huai-Ling Wang1, Hsing-Hua Lai1, Tzu-Hsuan Chuang1, Yu-Wei Shih1, Shih-Chieh Huang1, Meng-Ju Lee1, Shee-Uan Chen2
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Affiliation
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1Stork Fertility Center, Stork Ladies Clinic,
2Department of Obstetrics and Gynecology, National Taiwan University Hospital and College of Medicine,
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Publication
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Keywords
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Corifollitropin alfa; Controlled ovarian stimulation; GnRH antagonist
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Introduction
Reducing the frequency of injections in an in vitro fertilization (IVF) program is a patient-friendly way to decrease the mental stress and financial burden in infertile couples. The release of corifollitropin alfa simplifies daily injections of short-acting recombinant follicular stimulating hormone (rFSH), and its widely-used protocol involves short-acting gonadotropins supplements and a fixed GnRH antagonist regimen, largely based on follicle size. In this study, the feasibility of corifollitropin alfa without routine pituitary suppression was evaluated, and it may further simplify the injection protocol.
ありがとう! Oocyte donation program helps me to have my baby.
5/23/2016 06:18:00 PM
I came to Taiwan with anxiety and stress caused by both the expectations and worries. There are language and cultural barriers between Taiwan and Japan. However, I brought my baby to cross the national boundaries, and finally took her home.
I am 44 years old, and has received infertility treatment for almost 10 years. In this year, no available oocytes could be retrieved after the ovarian stimulation. It seemed that this is the end to the journey. My Japanese doctor suggested me taking the oocyte-recipient program in Taiwan, which has not been legitimated officially in Japan. My husband rejected this suggestion in the very beginning, but I would like to take any chance to have our own babies. Finally, we came to the Stork Fertility Center in Hsinchu.
Spending NTD 500,000 (~USD 16,666) on IVF, I got a baby with Down syndrome
5/09/2016 02:58:00 AM
Ms. Chen, a 43-year-old woman, has spent NTD 500,000 (~USD 16,666) on the assisted reproductive treatments. She got married late, and finally got pregnant after several IVF cycles. However, the report of amniocentesis displayed abnormal in the 16th weeks of gestation. The baby has chromosome 21 trisomy, which has known as Down syndrome. Ms. Chen and her husband was very disappointed at the clinic suite, and repeatedly asked to the doctor " Is it real? Could it be any mistake in the report?"
Doctor, my baby is small. How can I do?
4/20/2016 01:48:00 AM
Nancy lived with her younger sister for a long time until they found each own Mr. Right. They still kept tight after getting married. However, they both faced a difficulty at the same time — having no baby. Her sister chose to take the IVF treatment earlier due to the family stress. After two cycles, she finally delivered a cute baby girl. Nancy was encouraged by her sister, and met the fertility specialist with her husband.
When to take the oocyte recipient program?
4/12/2016 08:30:00 PM
How long should I try to get an IVF baby?
The psychological stress was significantly higher in the patients with advanced maternal age. The uncertainty of each IVF cycle seems to make the journey endless, and the eight things to lead IVF fail could happen more frequently than those with younger ages. The question in each patient mind was that "how long should I try to get an IVF baby?"
Eight things to make IVF fail
3/21/2016 03:21:00 AM
What are the causes of IVF failure? Young patients usually get their IVF babies after 1~2 cycles. In the patients over 38 years or with low ovarian reserve, multiple IVF cycles are always necessary. Eight things are common in the patients over 38 years or AMH < 2 ng/ml.
Eight things to make IVF fail
What can we do to the eight things?
Poor response
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The follicles cannot be stimulated by
external rFSH. It may result in the follicle atresia or growth arrest.
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Premature ovulation
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Ovulation in IVF generally occurs 36-40
hours after the triggering. Premature ovulation during IVF results in the
cancellation of oocyte retrieval.
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Empty follicle
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Mostly one follicle contains one oocyte.
It is found that there is no oocyte in a follicle after the retrieval.
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Low oocyte yield
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Only mature oocyte (MII) can be
fertilized. Nearly 70% of the retrieval oocytes can be used for the following
fertilization in the patients under 35 years; in those over 40 years, the
yield is dropped down to 50% or even lower.
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Low fertilization rate
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The general fertilization rate (2PN) in
IVF is around 70%, but it can be lower or complete fertilization failure.
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Abnormal fertilization
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Two pronuclear zygote (2PN) is observed
after a normal fertilization. An abnormal fertilization happens while three
pronuclei (3PN) or mutiple pronuclei are observed.
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Developmental arrest
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Around 95% of 2PN zygotes grow into the
cleavage stage. Developmental arrest could happen at any time point during
embryo mitosis, e.g. one-cell arrest, 2-4 cells arrest, 6-8 cells arrest,
arrest at compaction stage...etc.
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Low blastocyst
formation rate
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After five days of culturing, an embryo
undergoes cell proliferation and differentiation to become a blastocyst. No
blastocyst formed or no blastocyst with good morphology formed at the end of
culturing happened in IVF sometimes.
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Poor response
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Individualizing stimulation protocol by adjusting with
maternal age is a method, such as mild stimulation, natural cycle, or
multiple retrievals in a IVF cycle.
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Premature ovulation
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Individualizing the time of triggering and retrieval by
adjusting with maternal age, follicle size, and total follicle count.
Non-steroid anti-inflammatory drugs (NSAIDs), which was reported to prevent
premature ovulation in the previous data, can be applied 8~14 hours before
the retrieval as well. For an example, the trigger shot may be injected while
the follicle reaches to 17 mm in diameter to the patients under 40 years, but
it may be injected while the follicle reaches to 15~17 mm in diameter to those
over 40 years to prevent the premature ovulation.
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Empty follicle
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It cannot be avoid if the empty follicle forms
naturally.
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Low oocyte yield
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The patient can undergo multiple IVF cycles to harvest available
oocytes (oocyte accumulation).
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Low fertilization rate
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The quality of sperm and oocyte could be the reasons.
The ICSI/IMSI can be applied to select the sperm with better morphology. Of
the quality of oocyte, it cannot be solved due to the effect of maternal age.
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Abnormal fertilization
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If it resulted in abnormal fertilization (3PN or
multiple PNs) while the ICSI/IMSI had been applied, the quality of oocyte
could be the main reason. Oocyte accumulation by multiple IVFs is the only
solution.
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Developmental arrest and Low blastocyst formation rate
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Similarly, developmental arrest or no available
blastocyst formed during culturing occurs spontaneously and cannot be avoid.
Embryo accumulation by multiple IVFs is the only solution.
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