A 43-year-old woman break through the predicament by IVF 3.0 Plus.

She's 47 years old this year. Only left one chromosomally normal blastocyst.

With great confidence and last transfer hope, her blood test for pregnancy is...

Written by Dr. Hsing-Hua Lai.

What will you do if you still want to become a mother when you are 43 years old? There are two options. One is as fast as high speed rail, you can hold your child after one year; the other takes 3 years of trying and cost 1.5-2 times of money. Most of people will choose first option without a doubt. However, her choice was different. It was not because of she want to cut off her nose to spite her face. Neither was she rich. It's because she didn't want to undergo oocyte donor program.

How hard is it to become a mother for a 43-year-old woman through IVF? According to a paper from 2012's Human Reproduction, a top European medical journal, the statistic showed that a 43-year-old woman need 120 oocytes to accomplish this goal. And under our experience, only 1/7 of the pretty blastocysts from appearance will be euploid (chromosomal normal) after PGS test. The pregnancy rate of transfer one euploid blastocyst is around 60-70%. Therefore it is better to collect at least 2 euploid blastocysts before transfer. But the question is, how do you collect 120 oocytes at this age? It is also very hard to collect two chromosomal normal blastocysts. Because her AMH was below 0.13. The average number of oocytes picked up every time would be 1-2. And she needed 42 oocytes to make it!

Jesus! How long would it take? She needed a lot of courage and determination to make this choice.

We used mild stimulation and natural cycle for her oocyte retrieval treatment. Because the quality was more important that number in her case. If we used strong stimulation, the number of oocyte might be greater but the quality might be disappointed. This kind of treatment design also helped her to save the medication fee for NTD$ 40,000-50,000 each time.

It took her one year to undergo 10 times of oocyte retrievals. 13 oocytes became 5 blastocysts after embryo culturing. There were 6 times that the oocytes couldn't reach the stage of blastocyst, no blastocyst could be transferred or be preserved. This kind of outcome is the fear why a lot of fertillity center are afraid of culturing to the stage of blastocyst. Because it is more challengeable.

Appearance will lie. Pretty blastocysts from the appearance is not equal to chromosomal normal. There were clients who waited expectantly after 15 days of transfer one "pretty blastocyst" but failed. When they asked doctors, the replies always came with a "Maybe". Maybe because of chromosomal abnormal, wrong transfer timing, autoimmune factors, inflammation...etc. Without finding out the truth, these answers could not help next implantation. It was like gambling, which brought more defeats until we give up trying.

The time after implantation until pregnancy test is the most pressuring. If the embryo is chromosomal abnormal, it is basically an invalid medical behavior. Why don't we choose a right embryo and transfer it at the right time?

She was lucky! 13 oocytes became 5 blastocysts. And the best part was there were two chromosomal normal blastocysts! This outcome apparently broke the medical reports and our past experiences!

When she was 45 years old, she tried to transfer one euploid blastocyst but failed. At that time, there was no examination to get the right implantation timing precisely. Global physicians can only use their experience to guess that all women were same. The implantation time was 120 hours after using progesterone. But the question is that is this really the right time for every women?

According to latest research, there are 30% of people have different timing. The implantation window might be 132 hours, 144 hours, 108 hours or even 96 hours. Which means 1/3 of women are exceptions. How stupid is it to use the formula for every women!

Since 2016, we start to do ERA (Endometrial receptivity Array). She accepted the examination after resting for one year and nine month. The result showed that her best timing to do implantation was after taking progesterone 144 hours. And this might be the main reason for her fail last time. With only one normal blastocyst left, she underwent the implantation when she was 47 years old. Fortunately, the pregnancy test was positive. Her βHCG was 2637. And finally gave birth to a healthy baby girl on Oct. 5th, 2018. After 4 years of hardworking, she finally got to hold her baby in her arms.

IVF 3.0 plus is the key point to make her dream came true. Imagine that if she tried second implantation without doing ERA, there was great chance that she would fail. In that situation, she might have to choose donor program or just quit. Therefore, PP-IVF (Personalized Precision IVF) is the solution!