PP-IVF (Personalized Precision IVF)

About IVF:

In Vitro Fertilization (IVF) is an assisted reproductive method wherein oocytes are fertilized by sperm outside of the womb, hence the word in vitro.

Louise Joy Brown is known for being the first IVF baby. People who was born by IVF up to now have been more than eight million, and there are 80,000 IVF cases in Taiwan. Taiwan Health Promotion Administration’s statistics in 2017 shows that in Taiwan, 3 out of 100 newborns are IVF babies.

Stork Fertility Center started to provide IVF procedures to patients in 1992. In 1993, a time frame of just one year, we announced our very first IVF baby. In the subsequent 18 years of our practice, we have already delivered thousands of healthy IVF babies.

**There are 9 out of 100 IVF newborns from Stork fertility center in Taiwan.**

The first IVF baby	UK	USA	Taiwan	Stork fertility center
Year	1978	1981	1985	1993

IVF3.0 plus (Third generation IVF Plus):

PP-IVF (Personalized Precision IVF) is the core treatment in Stork. According to individual situation, we plan the most suitable stimulating treatment to retrieve the best eggs in every menstrual cycle and then choose a blastocyst which is both good inside and outside through PGS test, as we call it “Precision Choosing”. Furthermore, IVF3.0+ means “Precision Choosing”(PGS) plus “Precision implantation”(ERA). According to Stork’s statistics in 2017~2018, the pregnancy rate of transferring one chromosome-normal blastocyst above grade BB can be 80%, which is the highest IVF pregnancy rate so far.

IVF Process:

Follicles stimulation → Oocyte retrieval → Pre-selection and incubation for fertlization → Embryo transfer → Luteal function maintenance →Waiting period for announcement of pregnancy → Embryo implantation in the uterine lining → Pregnancy confirmed → Child birth/ Delivery

IVF involves ovarian stimulation through oral medication or injections in order to increase follicle development. Once mature follicle count is ideal, oocyte retrieval is done using a thin, ultrasound-guided needle to harvest egg cells from the ovary under general anesthesia. Sperm is collected, washed and pre-selected.

Depending on the maturity rate of the oocyte, usually within 3-15 hours, the best quality oocyte shall be selected in order to be incubated in the laboratory with the sperm to induce fertilization. These will be closely observed within 15-17 hours in order to check if fertilization is successful. If yes, individual embryos shall be continued to be cultivated into blastocyst stage (5th-6th day), then a special designed tube shall be inserted into the inner uterus in order to transfer embryos.

Suitable candidiates for In Vitro Fertilization (IVF):

Couples must be legally married and healthy. Wife should have a normal uterus and husband should have sperm production (low count is acceptable). Couples experiencing any of the below problems can also utilize IVF to assist conception:

1) Both fallopian tubes for the oocyte to travel to the uterus are clogged.

2) Mild to moderate emdometriosis.

3) Infection of the pelvic area causing internal organ adherence.

4) Male factor such as low sperm count, low forward progressive motility, abnormal morphology, azoospermia (no sperms produced).

5) Immune rejection disorder.

6) Failure after 3-6 times of undergoing Intrauterine insemination.

7) Unexplained infertility.

8) Failure to achieve pregnancy even after 2 years of marriage with regular sexual intercourse.

9) Above 35 years of age and desiring to conceive with poor ovarian function.

Individualized COS for Stimulation:

Stork fertility center plan individualized treatment according to individual’s ovarian function.

AMH: Anti-mullerian hormone, index for ovarian function.

AFC: Antral follicle counts.

Injections:

Long-acting injection- Elonva came into being in 2011. On the 2^nd-3^rd day of the menstrual cycle, getting one shot of Elonva, then additional short-acting injections are needed before the oocyte retrieval operation.

Insemination:

With regard to special patients who are senior, with poor ovarian function and performing egg cryopreservation, Stork usually defines precisely the timeline of the oocytes with spindle microscope to enhance the fertilization rate.

Implantation:

Medication for Implantation:

The pregnancy rate of women under 35 performing one-time IVF:

According to Stork’s statistic, the IVF pregnancy rate is related to “the quality of the blastocyst”. The successful rate of one-time blastocyst implantation for women under 38 years-old can reach up to 50~60%. That is, almost half of hundred couples can get pregnant by transferring only one time, and the other half of couples can realize their dreams by two or three more times transfer.

The IVF pregnancy rate depends on individual age, ovarian reserve, sperm quality, blastocyst quality, the way of implantation and the physical conditions.

Couples in Stork Fertility Center all perform blastocyst transfer, you can have high expectation if you have good-quality blastocyst with PGS test.

FAQ:

Will IVF result in fetal malformation?

There has been more than 8 million people born from IVF so far in the world. The deformity rate is almost the same as natural pregnancy. Most of the people who undergo IVF are advanced ages or with poor sperm quality, therefore they will bare higher risk than others. We suggest to do prenatal testing such as amniocentesis (at 16th weeks), and non-invasive methods, such as NIPT/NIFTY (at 10~12 weeks).

The possible risk and side effect of IVF?

Ovarian hyper-stimulation syndrome (OHSS) is the most common treatment-induced disease. Typical symptoms of OHSS include thirsty, abdominal bloating, feeling of fullness, nausea, oliguria, and shortness of breath. In order to prevent OHSS, the GnRH agonist as a latest trigger shot, and the frozen embryo transfer strategy will be performed to decrease the prevalence of OHSS near to zero.

Risks of multiple pregnancy:

The multiple pregnancy rate of IVF is about 20%, and most of them are twins. Customers in Stork fertility center usually transfer a single blastocyst with the best quality in the available embryos. In that way, we can decrease the risk of multiple pregnancy rate and also the twins rate can less than 3%.

Is it necessary to be in hospital after implantation?

NO need. Lying down for 30 minutes to 2 hours after implantation then take a good rest at home. Being in hospital and lying in bed all day won’t increase pregnancy rate which is related to the quality of blastocyst.

Post-embryo transfer:

- Balanced diet and food with abundant protein, calcium, and vitamins are recommended.

- Avoid doing heavy housework and abdominal-pressing posture.

- Avoid sexual activities before pregnancy test.

- Other activities in daily life are acceptable as usual.