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If I still have my periods, can I be pregnant?




"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.



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Hyaluronan(HA) binding assay: a good matchmaker to sperm



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 


4. Motility Characteristics: Microfluidics

5. Membrane Integrity:Hyaluronan(HA)-binding

6. Surgical:MESA/TESE 


Stork Fertility Center Stork Fertility Center Author

International medical service provides more convenience to the patients


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.


Stork Fertility Center Stork Fertility Center Author

The secret of age—maternal age and embryo aneuploidy


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.

Stork Fertility Center Stork Fertility Center Author

A home-run and an additional Y chromosome









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. "



Stork Fertility Center Stork Fertility Center Author

The last four tubes of frozen sperms



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.

Stork Fertility Center Stork Fertility Center Author

The clinical outcomes of donor oocyte bank

The benefits of Frozen Oocyte Bank

  1. 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.
  2. By using the most advanced vitrification technology, the average survival rate after thawing in our center is about 90%.
  3. 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:+886-905-737-501
Stork Fertility Center Stork Fertility Center Author

The clinical outcomes of donor sperm bank

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.


The clinical outcomes of embryo transfer in the donated-oocyte recipients:



* BT= blastocyst transfer
* FBT = frozen (and then thawed) blastocyst transfer
Stork Fertility Center Stork Fertility Center Author

Across the sea, I stored my seeds (Part 2)



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.




Shanghai, the city lightning all night, impressed people by the spring-up skyscrapers, population density and mortgage. At this transportation hub and financial center, people were good at calculations.


Stork Fertility Center Stork Fertility Center Author

Across the sea, I stored my seeds (Part 1)

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.

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Stork Fertility Center: Google surround shot



Please visit the link here:

https://goo.gl/aOBTZy
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The best timing of vitrification after blastocyst biopsy


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?

Stork Fertility Center Stork Fertility Center Author

Never say never — Preimplantation genetic screening reveals the quality of embryos





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.

Stork Fertility Center Stork Fertility Center Author

Oocyte spindle and embryo ploidies



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).

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Stork Fertility Center Stork Fertility Center Author

The procedure of sperm donating IVF


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,


Stork Fertility Center Stork Fertility Center Author

A patient friendly corifollitropin alfa protocol without routine pituitary suppression in normal responders



Author
Huai-Ling Wang1, Hsing-Hua Lai1, Tzu-Hsuan Chuang1, Yu-Wei Shih1, Shih-Chieh Huang1, Meng-Ju Lee1, Shee-Uan Chen2
Affiliation
1Stork Fertility Center, Stork Ladies Clinic, HsinchuTaiwan (R.O.C)
2Department of Obstetrics and Gynecology, National Taiwan University Hospital and College of Medicine, TaipeiTaiwan (R.O.C)
Publication
Keywords
Corifollitropin alfa;  Controlled ovarian stimulation;  GnRH antagonist












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.

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ありがとう! Oocyte donation program helps me to have my baby.


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.


Stork Fertility Center Stork Fertility Center Author

Spending NTD 500,000 (~USD 16,666) on IVF, I got a baby with Down syndrome




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?"


Stork Fertility Center Stork Fertility Center Author

Doctor, my baby is small. How can I do?




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.


Stork Fertility Center Stork Fertility Center Author

When to take the oocyte recipient program?


Wood, Fall, Tree, Nature, Footpath, Path, Pathway


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?"


Stork Fertility Center Stork Fertility Center Author

Eight things to make IVF fail


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
Poor response
The follicles cannot be stimulated by external rFSH. It may result in the follicle atresia or growth arrest.

Premature ovulation
Ovulation in IVF generally occurs 36-40 hours after the triggering. Premature ovulation during IVF results in the cancellation of oocyte retrieval.

Empty follicle
Mostly one follicle contains one oocyte. It is found that there is no oocyte in a follicle after the retrieval.

Low oocyte yield
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.

Low fertilization rate
The general fertilization rate (2PN) in IVF is around 70%, but it can be lower or complete fertilization failure.

Abnormal fertilization
Two pronuclear zygote (2PN) is observed after a normal fertilization. An abnormal fertilization happens while three pronuclei (3PN) or mutiple pronuclei are observed.

Developmental arrest
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.

Low blastocyst formation rate
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.


 




What can we do to the eight things?
Poor response
Individualizing stimulation protocol by adjusting with maternal age is a method, such as mild stimulation, natural cycle, or multiple retrievals in a IVF cycle.

Premature ovulation
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.

Empty follicle
It cannot be avoid if the empty follicle forms naturally.

Low oocyte yield
The patient can undergo multiple IVF cycles to harvest available oocytes (oocyte accumulation).

Low fertilization rate
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.

Abnormal fertilization
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.

Developmental arrest and Low blastocyst formation rate
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.



Stork Fertility Center Stork Fertility Center Author

Overseas IVF: the best gift after visiting Taiwan twice


Baby's Feet on Brown Wicker Basket
Although my parents-in-law did not push us to have babies, I knew that they were eager to have grand children. When the baby really came to my family, I felt that our home became more complete.


When I see my adorable baby, I can't stop appreciating the anonymous donor and Stork Fertility Center. My mother-in-low told me that she is refreshing and energetic every day. My father-in-low said that he feels released from his chronic disease and joyful. These happened after the baby came to my house.


At first of my marriage, my parents-in-law did not push us to have babies, but I just knew that they were so eager to have the grand children. That's why my family have been changed so much after the baby came. In the very beginning, I was not that eager to be a mother, and I did not want to be a dinky in the rest of my life either. As time went by, I found that my friends became parents gradually, and I was still occupied by piles of work. I started to join several mother-to-be forums and hoped that it would be my turn soon. However, my baby did not show up. It might be caused by my terrible life style, which was filled by tight works and lack of exercises. I noticed that pregnancy was difficult, so I started trying some herbal medicines. Luckily, I was pregnant after trying for a few months. Since the beta-HCG value seemed so good, I stopped taking the herbal medicines and the related monitoring. I thought that it was all right.



The worst thing occurred after the first trimester. When I went back to the hospital, my doctor told me that the embryo had stopped growing. It was such a shock!

I began googling and trying again, but the things did not work. After I did the genetic exam, the report said that my chromosomes existed balanced translocation, which was a common cause to recurrent miscarriage. The related websites said that IVF plus PGS/PGD may help the success rate, but the technique was not prevalent at my locality.

At first, I underwent several IVF/PGS programs at some nearby cities, but the results were disappointed. I clearly knew that I must find another solution. Nothing could stop me to be a mother. I prepared to do it overseas, and applied for a new work position, which was more flexible, and exercised three times a week. 


After doing some online works, I choose the Stork Fertility Center. The doctors there suggested me doing the IVF/PGS again. Considering about my schedule and budget, I finally decided to take the oocyte donation program, which was more efficient at my age. Like the other recipients, I was bothered by the relatives' attitudes, the future appearance of child and the other trivial concerns.

I asked myself," which is more important, the appearance or the health of my child?" 


If the baby's blood was not from me, wouldn't we love him/her that much? Absolutely no. He or she would be in my womb, and exchange everything with me. After he/she was born, he or she would accompany with us in so many years. Compared to the desire of having a child, these problems seemed so negligible.

I finally made up my mind, and entered the program. The decision was so right.

During the program, I only came to Taiwan two times, one for the paper works, and one for the frozen embryo transfer. The embryo was just stably implanted in my womb after the first cryotransfer. Until the baby came out of my body, every one said that he looked like me so much.



The journey of having babies was not easy every moment, but I almost could not remember that period when I am with my baby. When the miracle really came to my home, all the pain was just in the hazy memory.

arms, baby, birth
Per two patients with egg-donated program in Taiwan, there would be one from the Stork Fertility Center. 

Stork Fertility Center Stork Fertility Center Author

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