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The Key for Implantation - Endometrium Thickness

The Key for Implantation - Endometrium Thickness 

Stork Fertility Center
Dr. Lee

In IVF, we’ve been discussing the ideal thickness of endometrium for implantation.

Besides, is the criteria the same for both fresh blastocysts and frozen-thaw blastocysts implantation? Will it be the same? We did not have many studies on the above issue.

This September(2018), Human Reproduction, a research team from Canada, using the database of local IVF treatment, analyzed over 40 thousand implantation cycles of both fresh blastocysts transfer(BT) and frozen-thaw blastocysts transfer (FBT).

A result had been found: Clinical pregnancy and live birth rates decline as the endometrial thickness decreases below 8 mm in BT and below 7 mm in FBT cycles.




As shown in the study,in the BT cycle, the pregnancy rate for endometrium thickness ≥8mm is 43.2%, the abortion rate is 22%, the live birth rate is 33.7%. Comparing to the statistics of thickness.




In FBT, the pregnancy rate of endometrium thickness≥7mm is 38.3%~38.4%, the abortion rate is 26~28.4%, the live birth rate is 27.4~28.4%. Comparing to the statistics of thickness.


To conclude, the indicator of endometrium thickness for implantation are as following: 

Fresh blastocysts transfer: ≥8mm

Frozen-thaw blastocysts transfer: ≥7mm

With a good uterus environment, comes with a better clinical outcome. Good things are worth waiting for.   


REF:

Hum Reprod. 2018 Sep 17. The impact of a thin endometrial lining on fresh and frozen-thaw IVF outcomes: ananalysis of over 40 000 embryo transfers. Liu KE, Hartman M, Hartman A, Luo ZC, Mahutte N.




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[Patient Testimonial] Egg Donation, give my kid back


We lost our daughter on the day before Christmas Eve and could not fall asleep in the following 7 days . One Day, at 2 AM, I bought a magazine at 7-11, went to McDonalds and then ordered a cup of coffee. That was a quiet early morning; nobody was on the street. It made me felt like I was the only person in the world. After two weeks, my husband and I went back to work, because we shouldn’t stay at home and keep thinking about our baby daughter. Both of us are over 40 years old. Our Families, friends and doctors all told us " May her rest in peace, both of you need to let it go and move on." We try to make a new life, we scheduled to travel or be volunteers. One year passed, both of us still felt upset. So we made a decision: to make a IVF baby. In the  following two years, we had done IVF for 3 times. However, all of them were failed. because the reasons might be our eggs were fewer quantities, poor quality, no fertilization and abnormal development. As a result, our doctor told us no oocytes that they found via Ultrasonic and even told us to give up. That day I cried a lot, and told my closed friend. She mentioned about "egg donation". I did hear it before, but didn't understand it at all. However, I kept these words “egg donation” in my mind.


After that, I started searching the information of egg donation. I was so surprised that many moms from Hong-Kong wrote lots of articles about it. In additional, there were many cases from Taiwan and Thailand. Some of articles did provide detailed information. Due to familiar with IVF treatment, it was easy for me to tell the reality of these articles. I was impressed by an article from Stork Fertility Center. That's why I searched the website of Stork Fertility Center, read about their background, service, doctors, cases and the Taiwan Artificial Reproduction Act. After one year consideration, we flew to Taiwan, and began our journey to Stork Fertility Center. The equipments of center were much better than my expectation. In  the beginning, we only wanted to look around the center and doctors and compare to another center. However, after I met Dr. Lai, I could easily understand his professional suggestions. Therefore we decided to process egg donation program with Stork Fertility Center.


The doctor in Hong-Kong wouldn’t like to answer our question and not easily close. Compare to previous experience, Stork Fertility Center has much greater service. The center arranged a personal consultant for us to begin with. She assisted with every process from meeting with doctor, completing all the files, physical examination, Hysterosalpingogram to sperm pick up, she accompanied with us during whole procedure. Besides, the center provided some snacks and lunch. We completed all the processes within a few hours with their amazing teamwork and their professional services. When we reviewed my report, it showed one of my fallopian tube was blocked that was the issue never been brought out before. Therefore, Dr. Lai gave me the treatment for my fallopian tube and then we went back to Hong-Kong and waited for the report of matching and GPS. One week later, we received the report of Hematology test which showed my ANA, ANTI-TPO, and ATA index were higher than normal. I took doctor’s advice and went to see Immunology Doctor. I had been diagnosed with Xeroderma which was one kind of Autoimmune disease by two times of blood test and Nuclear Medicine Salivary Gland Scan. In order to prevent the antibody effect embryo, it was necessary to take medication.


Four month later, I got the news from Stork Fertility Center. We matched a egg donor who provided 17 eggs. after insemination, we had 7 blastocyst. Also we chose to pick 5 to process PGS, we had 3 normal blastocyst. 8 months later after we meet Dr. Lai, we went back to Stork Fertility Center for transferring a normal blastocyst. Dr. Lai smiled and told me " blastocyst looked so beautiful, and endometrial thickness is good with perfect transfer spot." We had less stress than before, and then we went back to Hong-Kong waiting for result. I had strong feeling and confidence of believing in this time would be successful  . I went to Laboratory for blood check, and it's true. I was pregnant.


Because I was with advanced maternal age, so my pregnant period was not quit easy. I had Gestational hypertension, gestational diabetes mellitus, and Sjögren syndrome. Every issue might affect my baby. I still felt so happy to see my baby every month from monthly prenatal exam. As long as I know that she was healthily grow up in my belly, I felt good. Of course I took care my body very carefully. Finally, I gave birth with caesarean section at 37 weeks and got a 5.5 pounds baby girl.


Today, my baby daughter is 7-month-old, the weight is 17 pounds. She is very charming, she is our sunshine. People say she looks like her father who has beautiful eyes. My husband told  me my baby daughter's personality is like me. Of course, she is my daughter! Now, I won't feel lonely anymore, instead I usually tell my daughter" mom needs to do something, so please play by yourself, okay?" "God never shuts one door without opening another." Our past experience was our testimony. Today, we appreciate that Reproductive medicine could bring people hope. And we really feel happiness, and give us chance to hold our daughter’s hands.


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Why do I have miscarriages over and over again?



Being pregnant can be as a duck takes to water, however for many people, it can be easily achieved, but how to "safely reach full-term" seems to be a challenge that is harder than climbing up to the sky.
"Why do I have miscarriages over and over again?"
After having the examination, we found out that some mothers have problems with the immune system that is easy to attack the blastocyst and cause the miscarriage.

The process of pregnancy is a well-designed by the God. The reason why the blastocyst isn’t attacked by the immune system is mainly the barrier formed by the placenta between the fetus and the mother, which can make the immune system unable to identify the fetus as a foreign substance.
Through the effect of hormones, the blastocyst can peacefully coexist with the mother. The mechanism involved in the process is very complicated.  As long as one of them goes wrong, it will destroy the mechanism and allowing the immune system to produce antibodies against the blastocyst during pregnancy. Usually this immunoreaction may be normal before pregnancy.
Once pregnant, the defense mechanism begins to be so problematic that the blastocyst cannot continue implanting and cause abortion.

In general, there are many autoimmune diseases have a strong relationship to habitual abortion such as Antiphospholipid syndrome (APS), Systemic Lupus Erythematosus (SLE), Thrombotic Thrombocytopenic Purpura (TTP) and so on.
Due to the problem of the immune system, it is easy to form the thrombus, block up the blood vessels of the placenta, and cannot supply nutrients to the fetus. Or it can cause the placenta itself to become inflamed, produce antibodies to attack the blastocyst and lead to abortions.

In recent years, it has been discovered that there is an immunocyte in the mother's body called "natural killer cell (NK cell)". Under normal conditions, this immunocyte which is produced by the bone marrow in the blood plays the first line of defense to protect the human body. Induced by the thymus gland, it can attack foreign bacteria and viruses, or kill tumor cells. In addition to the NK cells in the blood, there are NK cell also existed in the uterus. Basically, the NK cells in the uterus are different from the one in the blood. It can not only avoid inflaming but also having considerable benefits for implantation. However, if there are excessive NK cells in the uterus, it may cause infertility or abortion.

Therefore, except for the examination of immune diseases such as complement system (C3, C4), antinuclear antibody (ANA), antiphospholipid antibody (APA) and anticardiolipin antibody (ACA), the concentration of NKcells in the uterus can be included in one of the examination items for habitual abortion.
As long as the concentration of autoantibodies in the body is too high, it's necessary to treat with the medication before pregnancy. The medication is including Aspirin, Steroid, Immunosuppressive drug or Heparin and some patients are suitable the Immune Globulin and Cancer Immunotherapy.

However, it's still a mystery in the medical field that what reasons cause the immunocyte to attack the blastocyst. Therefore, the immune problems and related treatments still need to be evaluated by professional physicians. To increase the pregnancy rate, it’s necessary to deal with it.



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The Grand Opening of our Branch in Taipei City - Stork 11

「賴興華」的圖片搜尋結果

Back to the future - the secret of 11

With the anticipation by all of the customers of Stork Fertility Center, The grand opening of Stork 11 (Taipei branch) is finally launching! Everything has its own reason. Why we decided to set up a branch? Why we named it Stork 11? And what is our expectation toward Stork 11?

The story began from the financial crisis of 2008. At that time, we launch our egg collection (EC) and blastocyst collection (BC) treatments, two accumulative strategies of oocytes and blastocytes. By means of these two treatments, we encourage our customers with diminished ovarian reserve (DOR) to speed up their path of having a baby. The ideas popped up one day when I was on my way to Starbucks across the street. Surprisingly, I realized the Starbucks, which never has any discount, was having a buy one get one free campaign to overcome the economical distress. During that period of time, I always remind my employees that "getting something to do is better than nothing to do", in case they were fooling around during work time.

The concepts of "similar protocol treatment" and "doing more than we could" became a motivation to help our customer, especially for those who had only 1 to 2 eggs at a cycle, to save the cost of the IVF treatment. After finishing the collection of more than 6~10 mature eggs, they can consider thawing the sperm and performing the insemination at once. This strategy could not only hugely save the cost of treatment but also ease the mental burden of our customer. Most importantly, this act also meets the belief of Stork Fertility center: Helping others may amazingly lead to great self accomplishment.

Since our treatment designs were originated from the customer perspective, our treatments attracted many DOR customers in a very short period of time. As for those who are going to give up and considering the oocyte recipient program, most of them are living in Taipei city with age over 40. I was particularly struck by a case; a 47-year old lady got pregnant and gave birth to her daughter by using her own eggs. Besides her miraculous story, many of our customers with the age of 45 also got pregnant by receiving the treatment in Stork Fertility center. However, some of them can only consider the oocyte recipient program in order to successfully reach the pregnancy. With the accumulation of abundant cases, our experience also indirectly boosted the development of our oocyte bank and oocyte cryopreservation business.

One of our case, Miss S, is a career motivated 37-year old female from the US. Although her AMH value is only 0.79, she never consider giving up on the idea of being a mother. She flew to Taiwan for treatments and 5 times oocyte pick-up operations, because she strongly believes that she can one day realize her dream. For now, she already has 12 mature oocytes for future use.

According to the statistic here in Stork Fertility center, In 2017, we thawed 326 case of donated oocytes from our oocyte bank, which were 5,493 mature oocytes in total. With the survival rate of 94% after thawing, 5,136 oocytes were survived. The fertilization rate is 78% (3,983 embryos), and the good blastocyst rate is 54% (2,133 blastocysts). To sum up, 1 good blastocyst can be created by only using 2.86 mature oocytes in average. The high quality performance and outstanding oocyte survival rate after thawing are owing to not only the leading laboratory techniques but also the strict selection of the ooctye donors (only 8 out of 100 girls could pass the criteria of oocyte donor).

According to the Stork Fertility center Happiness Pregnancy code (P code), female below age of 37 with 15 mature oocytes will acquire 90% of chance to bring a baby home in the future. This means that the dream of Miss. S is definitely worth expecting. The statistic analysis shows that about 13 oocytes will survive after thawing 14 oocytes with no accident. The survived oocytes will lead to 10 fertilized eggs and 5 good blastocysts in the following procedure. The euploid rate of blastocyst for age 35-37 is 43.8%. The pregnancy rate can increase to 60-70% after the Preimplatation Genetic Screening (PGS). What's more, the pregnancy rate can even increase to 70-80% if you also do the Endometrial Receptivity Analysis (ERA, third generation plus). With the personalized precision IVF treatment (PP-IVF), the successful rate of implanting 1 blastocyst with third generation plus examination is 80%. By all these evidences, you will understand what a great chance for Miss. S to fulfill her dream of having a baby in the future.

The future is decided by now! Will you believe in yourself if you are a 35-37 year-old female just like Miss. S? If being a mother is the deepest dream of yours, why don't you start collecting your young oocytes from now? Saving 15 mature eggs as a present for you in the future is also a prevention from being a oocyte recipient and waiving away large amount of money.

Located in Hinschu, in Stork Fertility center, there are about 40% of our customers are from Taipei (foreign customers are also the same amount). Our Taipei branch- Stork 11 finally comes to realization after 10 years of anticipation from our customers. "11" indicates our commitment to all the female below age of 35 (35 is not included) . With 11 mature oocytes cryopreservation, you will have 90% of probability to bring back a baby in the future. Our definite goal is to help everyone realize the happiness and dream of having a baby in your family.

Stork 11 is also a building of Nara. With the combination of our company culture and spirit of art, we also welcome people who love Yoshitomo Nara (奈良美智/ならよしとも) to visit Stork 11.

Stork 11 will also inherit the DNA of Stork Fertility center. We will continuously provide prestigious services in the future.

 ~wrote by Dr. Hsing-Hua Lai, Dean of Stork Fertility Center




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Quality and quantity , Guide for transferring blastocysts


To maintain the success rate of artificial reproductive and to lower the rises of multi-birth. Countries have been giving out guidelines at numbers of blastocysts for implantation, which provides for different reproductive centers. How many should we transfer to provide the most genuine help? 


"The doctor told me that transferring 2-3 blastocysts are good enough, but my husband wants to do all 4 that all we have, as the previous 3 went through PGS were abnormal..." When I got your call, I can feel your worries, hopeless, hesitating, wanting to talk to someone.

one is the success rate of IVF, the other one is chances of having multiple births, how can we find the balance? From the perspective of modern artificial reproductive, the goal is to bring a healthy baby back home asap. 
Multi-pregnancy pregnancy bears high risks for the mother and the baby as well, including premature birth, gestational diabetes, pre-eclampsia, fetal underweight, etc., and there are risks in fetal reduction surgery.

To maintain the success rate of artificial reproduction and reduce the risk of multiple births, countries have begun to set guidelines for the fertility centers, suggesting the number of blastocysts for implantation.
How many should we transfer? How can we provide the most substantial help?

European countries set a guideline for themselves considering the number of implants, blastocysts grading, age, and other parameters.
According to the Taiwanese Society for Reproductive Medicine (TSRM), the suggested number of blastocysts for implantation are as follow. For blastocysts with normal PGS result, transferring one will be enough. 




Strok Fertility Center collected the four-year data from 2013.-2017.01, there were 2,857 thawed blastocysts implantation cycles, which were divided into five age groups according to the TSRM index. The average number of implants was 1.65 vs. 1.82 vs. 1.97. Vs. 1.98 vs.1.00; and multiple birth rates were 16.1% vs. 15.2% vs. 9.9% vs. 4.7% vs. 0.3%.


We measured the live birth rate data from the period of 2013.01-2015.12. There were 1,842 thawing implantation cycles, and the average number of implantation is 1.70 vs. 1.80 vs. 2.01 vs. 1.96 vs. 1.00. As for the live birth rate was 52.9% vs. 48.8% vs. 33.6% vs. 17.5% vs. 43.0%.


"Transferring a normal blastocyst, giving you a healthy baby" has always been our biggest goal. As we mentioned at the beginning, the client was facing a predicament that all the blastocysts were abnormal and cannot be implanted. 
Although she was 37 years old and the prevalence rate of embryo abnormality is high, I still did not recommend that she transfer all the rest four unexamined blastocysts. 

After listening to my analysis of the pros and cons, she thanked me happily. It seemed to help the client to clear her thoughts. I believe that no matter what the final decision is, she will be okay.


Reference: 
1.Clinical data by Stork Fertility Center
2.TSRM guideline (2016)

















Andi's word

1. The abnormal rate of the 37-year-old group woman is about 46.2% based on the PGS(preimplantation chromosome screenings)  test of 2,980  of blastocysts. However, according to the study of the relationship between
the result of transfer a single embryo with normal chromosome and the grading of blastocysts that published by our center in 2017, not every blastocyst is suitable for PGS, and the blastocyst with poor grades are more vulnerable even if the test results show that the chromosomes are normal. Result in a lower pregnancy rate.




2. The Taiwanese Society for Reproductive Medicine (TSRM) introduced a guideline based on the "maternal age", "with or without chromosome screening" considering the clinical data of local fertility institutions.
the success rate of transferring a blastocyst with normal chromosomes is about 60%, but it is true that not every blastocyst is suitable for biopsy and examination. As the way of cultivation might be different at each different institution (eg. splinter culture vs blastocyst stage culture), blastocyst parameters are different (pollardization time, appearance grading), different personal experiences (implanted several times, maternal environment), it is not the best way to apply one single fixed formula to each case.
The primary purpose of Personalized Precision(PP-IVF) is to provide tailor-made medical assistance that best meets the needs of the individual.

We have to keep a balance of the pregnancy rate and the risks of multi-birth. 
Other than adjusting the number of blastocysts for implantation, "immune system screening", " hysterosalpingogram (HSG) ", " Hysteroscopy ", and "ERA (Endometrial Receptivity Array)” etc. are also factor that might affect the bedding. We no longer just transfer with few blastocysts, we transfer the right one at the right time in the right place! 

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[Patient Testimonial] advanced maternal age with Egg Donation



My baby just finished his milk; and now he was sleeping in my wife arms while I was writing our story. My wife held my hand and gave me a lovely smile. This simple happiness made me so happy. However, this simple happiness was hard to come by.
My wife and I were considered as late marriage. After marriage, having a child was not our top priority because we were concerned about work, life, and dream more. Around 7 years ago, by seeing friends and colleagues sharing their happy family life with their children, suddenly I felt it’s time to have a child. I discussed with my wife and realized that actually my wife had been thinking about having a baby for a long while, but she never told me because she chose to support and respect my decision. Therefore, we started to trying, completing our physical checkup, taking Chinese-medicine therapy, exercising, adjusting daily diets and living...etc. However, my wife didn't get pregnant. About 3 years ago, we accepted the treatment of IUI, but it didn't work out. We were so disappointed, but we still believe we should try our last chance, IVF.

I still could remember the day we went to see our doctor, it was on February, 2016, it was still cold in Hong-Kong. We met the doctor of Reproductive Medicine from Hong-Kong. He told us" Look at the number of the chart. Because of your age, success rate of IVF is still very low. To be honest, I would like to suggest you not to waste your money on this valueless treatment. Nevertheless, if you still insist on trying, I will try my best to help you. " We appreciated the meaning of doctor's truth and we felt hopeless after the appointment.

We didn’t say any words on the way home; we could not stop crying when we were home. I still remembered that heartbreaking feeling. We decided to have one last treatment of IVF in Hong-Kong. After that, we experienced 4 months treatment: medicine, injection, ova harvest ...etc. Finally, we collected 3 eggs, but only one egg grew up to day 3. We transferred the embryo without knowing the quality of the embryo because they didn't explained it. It had a fair knowledge of consequence, my wife didn't get pregnant. We accepted the result with peace and calm this time.

We didn't give up! And Keeping trying to find hope and success. Suddenly, we have found many research paper all mentioned about "44 years old" is a boundary lines to accept the suggestion of egg donation. What a coincidence, that's also my wife's age of that year. That was the first information regarding egg donation. Therefore, We did lots of search and also knew Stork Fertility Center which is the top of this field, and then we registered for consulting.Soon, the consultant of Stork Fertility Center reached us, answered us all the question of regarding egg donation with detail patiently. So that we made decision right away. Based on the Tawianese law, In order to have the IVF treatment in Taiwan, we needed to prepare the document for proofing our legal marriage. We spent a little long time with it. However, thanks to the consultant's assistant, we had our all paper works ready.
Maybe we've got many frustration in Hong-Kong. “So that we looked so tired while arrived Stork Fertility Center.” For that reason, we looked listless when we first time met Doctor Wang. However, Doctor Wang's profession and confidence that gave us a lot of hope.  Also he gave us detail explanation on our report of physical checkup, which let us know we still have some positive side. After that, we've stayed couple days in Taiwan. We went to Pingxi for sky lanterns. Wishing for good luck, we left the words "Wishing for a baby boy and making us happily after".I thought the God heard our wishes, we found the right girl for egg donation. We trusted this team so much, so we didn't take long time to make decision on each step and also believe in Stork Fertility Center would help us pick the best option. For example, there was quality issue on my sperm, after reviewing my physical checkup. Therefore, they suggested the best way for us is using fresh sperm instead frozen sperm to get the good blastocyst. The only thing I needed to do was an extra trip to Taiwan. Everything went so well and showed all suggestions Stork Fertility Center made were so right. We got many good blastocysts. Also we took their advice to transfer one blastocyst that professional team chosen. After transferring, we went back to Hong-Kong waiting and waited for good news.

We really appreciate all the assistant from Stork Fertility Center. Without their support, we wouldn’t have such hopeful treatment on IVF.Eventually, we would like to tell our anonymous egg donator: “Thank you so much for everything. What you did was so meaningful for us. Your sweet heart made our wishes come true and also gave us a completed family. We wish you live happily ever and after.”


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[Patient Testimonial] The Most Important Choice in My Life



I am a woman who has gotten primary ovarian insufficiency, so I stopped having a menstrual cycle since I was in high school. I have to take pills to make my menstrual cycle regular. Thus, I started my infertility treatment immediately after I got married. However, I did not get any oocyte that could be used for my IVF treatment after several times doing the OPU (Oocyte pick-up) surgeries. After all of these treatments, I decided to do IVA (In Vitro Follicle Activation) test to know how many oocytes that I still have. The final test result is that I do not have any oocyte or follicle in my ovarian, and it also means that I don’t have any opportunity to use my own egg having a baby. Therefore, using an oocytes bank is my new hope to have a baby.

At first, we did some research online. My husband and I only found information on oocytes bank in the U.S., but price of these treatments were way too high than we originally expected. In the same time, my original clinic in Japan recommended us to go fertility center in Taiwan. After couple days discussion, my husband and me realize that we could do the oocyte bank in Taiwan, and the price of oocyte bank in Taiwan is more affordable than if we go to the U.S.. Also, the distance from Japan to Taiwan is much closer than from Japan to The U.S.. My original clinic in Japan introduced us to two fertility centers in Taiwan. At First, my husband and I had hard time to make a choice for these two fertility centers in Taiwan, so we e-mailed both of them in the same time. These two fertility centers were replied our question kindly and quickly. Eventually, we choose Stork Fertility Center because most Taiwanese to go here to do IVF or do oocyte bank. Even though another fertility center is more famous in Japan and we can find a lot of information online, we still believe that only local people know these fertility centers better than foreigners like us who from Japan.
   
In the beginning of September, we went to Stork fertility center first time. We took bus from Taiwan Taoyuan International Airport to High Speed Railway Taoyuan station for 15 minis, and we spend another 10 minis for taking High Speed Railway from Taoyuan to Hsinchu. The last step is that Taking a Taxi from High Speed Railway  Hsinchu station to Stork fertility center for 15 minis. When we arrived stork fertility center, and we saw a giant and elegant building in front of our face. If people do not know this building is a fertility center, people may think this building is an art museum. This how amazing that building is. Also, their staffs open the door for you, when you into lobby. I never see any clinic has this kind of service which is like you check in to a hotel.

Finally, we saw the person who was kept sending email with me is our Japanese consulter, Celine. She is a woman who looks very kind and outstanding. She helped us to figure out how to arrange some instruments of law for applying to the oocyte bank, and went to bank to exchange money. The most important thing is that stork fertility center will pay all of the taxi fees for their customers. Also, we have to exchange a large amount of money. It really makes feel safer and sweet that Celine can go to the bank with us. Especially, she found a bank which had a better exchange rate for Japanese to Taiwan currency. When we finished all of paper work for some instruments of law, we still had couple hours waiting for our first visit with deputy superintendentsur. Thus, Celine asked us if we want to have a dinner first, then she print out a map to us, and recommend us a famous local restaurant. Although this restaurant can’t speak Japanese, it still was a great experience to have such tasty food and experience Taiwanese culture.

The deputy superintendent in Stork fertility center can’t speak Japanese, but the first visit with deputy superintendent still was great because Japanese consulter will help translate very thing what deputy superintendent said to us. The Deputy superintendent patiently answer our questions and told to my husband and I that “ I think you will have your baby this year”. This sentence really cheers me up a lot, and helps me use a positive attitude to face the unknown future. Moreover, I noticed that the equipment are better and newer than Japan clinic during the tests. After these tests, we told our conditions to Japanese consulter because under reproductive law in Taiwan, oocyte receiver can’t know how oocyte donor look or any information of this oocyte donor.

When we got all of paper work and tests done, and there were a lot of Taiwanese patients in the waiting area. I recognized that no matter what country you go, there are always a lot of people who have infertility problems. Also, we make sure that the Stork fertility center is very famous and popular in Taiwan. Before we left Stork fertility center, my husband and I went to visit their room which is for foreigners. It is very clean and cozy, just like a deluxe hotel. It’s price for one night also a little bit high as well. Stork fertility center also help us to find a taxi to go Hsinchu train station, and we do not have to pay any fee for this ride.

After we back to Japan one month later, we received a message that they found a oocyte donor from Stork fertility center. However, this donor is not too fit with our expectation, so we decided do a one more round for pair up a new donor. Two weeks later, they found another donor for us, and my husband and I agreed with this donor. Therefore, this all pair process only took around one and half month. This is much faster than I thought. In the end of November, oocyte donor complete OPU (Oocyte pick-up) surgery. During this time, Celine kept updating every single detail of that oocyte bank process. Sometimes, I asked something is not that relate to this oocyte bank, Celine still answered my question very soon and accurate.

The Day Came that I do BT(Blastocyst Transfer). The Deputy Superintendent showed me the photo of that blastocyst before we start to do that surgery,and He told me that the process of thaw blastocyst is good. A minute later, Deputy Superintendent said this BT(Blastocyst Transfer) is going very well, and I still can’t believe that how soon that deputy Deputy Superintendent complete this surgery. Then they moved me to a quiet room for recover, and the staff also prepare a meal as my lunch. It really makes me feel warm and sweet. Two later, I did the blood test in Japan clinic told me that you are pregnant. From the first visit to I'm pregnant, my husband and me only spend four months. I would never believe everything will be that easy to happen.

After 10 months and 10 days, I have my own child, and my family. Even though I took a lot of convoluted path before I want to Stork fertility center, I hug my lovely daughter now. Before I see my daughter, I was worried about my daughter is not look like me. If she is not look like me, do I still love her without any question? However, I see my daughter at first sight. I know these worries are not necessary. I certainly sure I will love her, my daughter forever. Thanks so much to Stork Fertility center for bringing this amazing happiness to me, and also thanks Celine who is our Japanese consulter during this time. Choosing Stork fertility center is the most important choice in my life, and it is the most correct one as well.


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Female Premature ovarian failure


Modern people have the phenomenon of late marriages and late child-birth. For a woman, the age is the biggest factor affecting fertility. The older women are, the poorer oocytes quality they have. Not only the fertilization rate, blastocyst implantation rate, pregnancy rate, but also even if they are pregnant, their abortion rate, fetal chromosomal abnormality rate, risk of delivery, are higher than younger women. Through medical tests and examinations, we can know our ovarian function in advance, and let women who are on the journey of having babies to know their own natural conception rate.

Is there any way to know if our ovary is aging and how do we know if our ovarian function is aging?
There are several ways of testing and examining in medicine science that can be predicted in advance.
Below are some ways of evaluating the ovarian function

Follicle-Stimulating Hormone, FSH
FSH is a gonadotropin, a glycoprotein polypeptide hormone. It is synthesized and secreted by the gonadotropic cells of the anterior pituitary gland, and regulates the development, growth, pubertal maturation, and reproductive processes of the body.

Reference
1. Having the blood test on the first day to third day of our period, and it can be used as an indicator to evaluate the "ovarian reserve".
2. This indicator has great variability, and it is recommended to continuously evaluate 2~3 cycles for reference.
3. The reference of values is reduced for who have the ovarian surgery or endometriosis  .


When FSH is above than 10, it is more predictive.
However, 75% of women's ovarian reserve has declined, and this hormone is still within the normal range.
Once it is detected that this hormone has risen, it is usually too late.



Anti-Mullerian Hormone, AMH
AMH is expressed by granulosa cells of the ovary during the reproductive years. It declines with age and oocytes. Due to its high sensitivity, stability and low volatility, it has become the most important indicator for assessing the ovarian reserve.

Reference
1. As the age increases or ovarian reserve begins to decline, AMH will become lower and lower.
2. It is low volatility that we can have the blood test in any day.
3. Combining with FSH and AFC allows, it's more accurate for assessing the ovarian reserve.
4. On average, AMH has declined to 50% when women aged from 30 to 37. However, FSH has only slightly increased. (AMH sensitivity is better than FSH)
5. AMH is associated with the number of retrieval oocytes, fertilization rate, blastocyst quality, pregnancy rate, and abortion rate when doing In Vitro Fertilization (IVF).

 


Inhibin B,
Inhibin B is a sensitive marker of ovarian follicle development and produced by granulosa cells in the ovary, is a heterodimeric glycoprotein suppressing synthesis and secretion of the follicle stimulating hormone (FSH). If the inhibin B on the third day of the period is less than 45 (pg/ml), it means that the ovary may not well respond to ovulation drugs. This hormone has great variability in the period, and it is recommended to evaluate on the second day to the third day of menstruation.

Antral Follicle Counts, AFC
At birth, a female fetus has 1 to 2 million immature eggs called oocytes inside her ovaries, which are all the eggs she will ever produce. By the time a girl enters puberty, about 200,000 of these eggs remain. Approximately 300 to 400 of the remaining eggs will be ovulated during a woman's reproductive lifetime.There is quantitative eggs are screened out in every cycle, but when it is ovulating, only one egg will win, and the other eggs will automatically apoptosis. Therefore, when the menstrual cycle comes, the number of follicles in the ovary can be checked by the transvaginal ultrasound. If the total amount of follicles on both sides is less than 4, it means that the amount of ovarian reserve is not much, which can be clinically correlates with AMH.

However, don't just trust the clinical values, because these indicators or the results of the test only present the status of the current ovarian function, rather than predicting the outcome of pregnancy. As long as we grasp the prime time of pregnancy and do not give up easily, I believe that the happiness in the future will not be too far away. 





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