Want to meet you so bad!

After repeated implantation failure(I)

Do you have the experience of repeated implantation failure in IVF program? Or even though after pregnancy, still undergo miscarriage or fetal demise? In these situation, the most important thing to do is try to find out what factor is the "murder" of your child.

What's the most sorrow thing on the journey to get a baby?

Taiwanese celebrity汪用和 use fourteen years trying to get a baby. The other celebrity黃光芹 said "The hardship on the journey for getting a baby is like dying for several times ." They both decide to adopt a child in the end. And there are still a lot of people keep going on this journey. Such as super model 林志玲, celebrity 張秀卿 and the one who read this article without giving up. How can we do for next step to get to the happy ending?

Want to meet you so bad! It's OK that if you have a meeting with others but they cancel it at the very end. You can just rearrange it. However, what will you feel if they disappeared without saying why?

Friends that break their promise do not worth profound friendship. And what if this happen on your journey of getting a baby? Is it trustworthy to use the same treatment after repeated implantation failure without knowing the reason of failure?

Changing to another scenario. Getting pregnant every time after implantation but every fetus couldn't keep growing then get abortion is already miserable enough. When hearing a physician say "let's try harder next time" what will you feel? How can you bare this twice or even three times in a row?

If you run on the wrong road, you will never reach the end.

When you fail after two implantation or getting abortion twice in a row. It means "the murder" is still there. The most important thing to do at this point is to stop the pace and try to find out "the murder".

Everything happened for a reason. I always believe that you must have done something right to lead to success. In other hand, there might be something wrong lead to failure. If we find out the factor precisely and exclude it in next treatment, there's no reason that we will fail next time.  

Clients are our teacher. That's also why I like to use real stories to share with others. Following I'll take three clients that left our center with smile of success for example.

39 years old Mrs. A

When A came to our center for the first time, she already underwent two times of implantation failure. First time was IVF with preimplantation genetic screening(PGS). After failure, doctor suspect that window of implantation is not right. Therefore, she underwent Endometrial Receptivity Analysis(ERA). It turns out that she needs to take progesterone for one more day to get right implantation window.

For the second implantation, with the right time and prevention Heparin injection. She got pregnant successfully. However, the fetal heat beat stopped when it was 8 weeks. She remembered clearly that after first and second implantation, she got bleeding for both time. The blood test of autoimmune and Thrombosis were normal. Therefore, doctor declined the dosage of Heparin from two days a time to three days a time. Meanwhile add progesterone injections. Sadly, the baby is still gone.

The most painful fact is not miscarriage, but not knowing "who killed my child?''

·       We restarted the oocyte retrieval again, but there were no chromosomally normal embryos. Can mosaicism(embryos have both normal and abnormal cells) embryo be an option of implantation? How can we success with two-third of embryo chromosome abnormal rate at her age? With my own experience, if there is bleeding situation after implantation and before pregnancy test, it might because of Thrombus problem. We rechecked related blood tests and as expected they were weakly-positive. Therefore, we adjusted Heparin dosage to one time a day. Today, she is pregnant for14 weeks and 3 days. After hearing the heartbeat, it's time to say goodbye. Finally, She can be transferred to Obstetrician.

45 years old Mrs. B

Before Mrs. B came to our center, she already underwent three times of both oocyte retrieval and transfer. Fresh embryo transfer for the first two times and frozen embryo transfer for the third time. It's a pity that the embryos were all only cultured to day 3 early embryos. Which makes it hard to analyze the possible reason for failure. She was 44 years-old when she came to our center. Oocyte donation program should be a better choice for her. However, she rejected and choose to use her own eggs. She collected four embryos that was not proper to do biopsy and then transferred for the fourth time. She also did ERA before her transfer. However, she failed again.

Then she changed her mind to do donor program, to try for her fifth time. After transferred one chromosomally normal embryo, with ERA test, she still failed. Were there still other "murders" out there? 

We checked all her autoimmune and Thrombosis blood tests again. And found out her Nephelometry IgG result was higher than reference. The only difference between sixth transfer and fifth transfer is that we gave her Intravenous immunoglobulin(IVIG) injection three days before transfer. And started heparin injection one time a day from her transfer date. Now, she is pregnant for eleven weeks and one day. We are so happy for her.

45 years old Mrs. C

Before Mrs. C came to our center, she already failed for three times. She wouldn't want to try traditional IVF. Before our suggestion, she decided to do 3+ IVF( with PGS and ERA). She got pregnant after first transfer. Although she had some bleeding during her eighth week but baby heartbeat was normal at that time. With normal Thrombosis blood tests, progesterone injections and pills. When she came back after two weeks, the fetus is still growing. However, the fetus stopped growing next week unexpectedly. It was a real bolt from the blue that made her heart broke. Isn't it comparably safe after 10 weeks? Moreover, it is 3+ IVF this time!

My detective instinct told me it might be Thrombosis problem due to the bleeding situation after transfer. Therefore, I added two blood tests to be monitored this time. All tests were normal on the pregnancy test date. And there were no bleeding situation before fetal heartbeat check. We checked Thrombosis blood test for one more time and accidently found that one of the test became to abnormal. We immediately increased the dosage of heparin form two days a time to everyday. Now she is pregnant for eleven weeks and four days. Congratulations to her for finally finding the hiding murder and say goodbye to those misery days after failure.

Clients are our teacher

Mrs. A gave us two lessons.

• First lesson- please don't ask "should I do ERA test?" anymore.

• Second lesson- If there are bleeding situation during pregnancy, please beware that Thrombosis might be killing your child. Don't just think of taking progesterone injections.

Mrs. B also gave us two lessons.

•  First lesson- Over 43 years-old should choose oocyte donation program directly. Don't waste money.

• Second lesson-Infertility doctors should accept humbly that there are some people who have immune system problems that will lead to the system attacking embryos causing reimplantation failure.

Mrs. C gave us two lessons that's more valuable.

• First lesson- follow only one Thrombosis test is not enough. It is more accurate to test two at the same time.

• Second lesson- Today's result is not able to represent tomorrow's. The data of two Thrombosis tests were normal, and the fetal heartbeat also appeared as expected after 3 weeks. But why the Thrombosis test became abnormal? Our body situation is dynamic. If you are healthy today do not represent you won't get sick tomorrow.

 

Think about why these three teacher pay for sky-high price to learn these before success in their tough journey.

If you ask me where is the cheapest place to do IVF? I won't answer! Because there's always a cheaper place.

But if you change the question to "How to bring a healthy baby back home with the least hardship and most Cost-effective?'' I'll answer you without any doubt-- 3+ IVF! Because you can get 80% of successful rate with only one embryo transfer. We design your own personal precisely IVF treatment and every step is based on evidence. After failed unfortunately, we can also check from the very end to see is there any possible factors that become the "murder". Different from traditional IVF, using your own body to do "experiments".

Want to meet you so bad! Stork Fertility Center likes to choose a challenging path! This year is our 20th anniversary. We open a special appointment "Reimplantation Failure appointment". Please don't come if you like to chat or heard that Dr. Lai is not patient to clients. But for those who already traveled around the world and are longing to become parents as soon as possible, please come to join this journey. It's better that you believe in "precise treatment", knowing that everything happens for a reason and believing that you will only success when you are on the right track!

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What is Timed Sexual Intercourse (TSI)?

Will those eggs come in handy in my future?

She didn't want to fly over for ERA, so we transfer 1 normal embryo with the traditional format. Unfortunately, we failed. She did ERA at the next month, found that.....

Can we control our future? What if we can make plans for our life, what will your future like? 

Miss F from Nanjing, China, had follow her plan, fly to Stork for egg freezing at 32 years old. Her AMH data then was up to 3.81ng/ml, been through 2 oocyte retrieval surgery and cryopreserved 25 mature eggs.

Two years later, Miss F did the AMH test again and found it dropping to only 0.8 ng/ml. At that year, she meet her Mr. Right and tried to have a baby for a year, but no any good news came. She decided to come for thawing her eggs and went through IVF treatment at her 35, all the 25 mature eggs survived, after insemination, culture for 6 days, we created 9 embryos, and 5 of them graded 5BB and the other 4 were BC grade. Implantation fails or success, it really depends on whether the chromosome is normal or not, even if the grading are good. 

She chose IVF 3+ since she knew that embryo’s gradings are just for reference. 5 BB grading embryos were all biopsied and 3 of them sent for PGS test. Two out of three are with normal chromosome, one is with partial abnormalities. With younger age group comes with lower chromosome abnormalities, she is very lucky that she had chosen to freeze eggs at a young age. According to statistics, the embryos that created by the 32-year-old group can have almost 60% normal chromosome rate. These 3 embryos are suitable for implantation, form our experience, transfer 1 embryo with normal chromosome can achieve 60~70% pregnancy rate. 

As Miss F lives overseas, she didn't want to fly over for ERA, so we transfer 1 normal embryo with the traditional format. Unfortunately, we failed. She did ERA at the next month, found that the WOI(window of implantation) is different than others, intake progesterone for 96 hours, which is 24hours earlier than our traditional format, that might be the main reason why we failed the first time. 

Two months later, she transferred the last normal embryo with intake progesterone for 96 hours, after two weeks, her b-HCG data reached up to 10567! Three more weeks later, she checked the fetal heart beat! What a happy mother-to-be. 

How did we create such a perfect ending? The answer is “IVF3.0+”. Without PGS we won’t know whether the embryos are normal or not. Without ERA we won’t know the precise “WOI” for each one. Transferring a normal embryo at the wrong time is “waste”. Likewise, transferring an untested embryo at the wright time is “gambling”. All of these come to the same conclusion that high success rate can’t depend on appearance and fission speed, must be with PP-IVF (personalized precision IVF), we can make it work.

Life is full of uncertainty, we cannot control our future, but we can freeze our eggs for our future. About egg freezing, some might not understand how it works or near heard of it, worrying about it is not useable in the future, or the thaw-egg pregnancy rate. Afraid of missing put the optimal age to conceive a child, at the age 35-37, the cost-performance ratio is the best. It is proofed by science, after age 38, the quality of egg drops rapidly, which made the cost of doing IVF a lot higher compared to using frozen egg at age 35-37.

Stork’s oocyte bank use thawed egg for egg recipients’ IVF treatment, at 2018, we thawed 7,604 eggs and 7,206 survived. The survival rate achieved by 95%. The following fertilization rate 77%, embryo rate 66%. It's much likely equal to fresh eggs. Determine the technology level is not only by the freeze-thaw result. Appling polarized microscope to do insemination at the right time is also very important. As well as the embryo culture system, and can it apply PGS to determine whether the embryo is normal? If the answers are all YES, then transfer 1 normal embryo can reach 80% pregnancy rate.  This is the most important criterion to choose to freeze " Beyond Egg". It is only worth it if we can use the Beyond egg to create the highest pregnancy rate! Women can live their own life!

 You can subscribe magazine and software. What about happiness?

Take a 40 year-old woman as an example. Is it possible to receive a gift sent when 33 years old? The answer is Positive! The gift with late arrival is a pair of twins.

Isn’t this surprising? How could this happen?

For modern female, a dream of acquiring a balance between successful career and an attending family life is not that easy to fulfill.

The cover story of iVie 36 is quite impressive. It was the fourth year of our egg freezing service. A 33-year old single women from Shanghai froze her eggs for insurance. Egg freezing provide a chance for independent women to chase their dreams. She got a pair of twins years after, and we can’t imagine what it would be if she didn’t make that bright decision.

Presuming that she didn’t preserve 23 eggs at that time, at the age of 40, it’s likely that she would need to undergo the oocyte retrieval for at least 3 times. The cost might be triple with worse outcome. With the mature technology of ART, why do people still pay for useless treatment? None of the women aged over 43 would say YES to using the donated eggs. Why?

I have asked the question about “egg freezing” to a celebrity who did 22 oocytes retrievals. She said that she had actually heard of it 10 years ago. However, she didn’t have a boyfriend by then, and having a baby was not in her plan yet. Little did she know, she met the right person while she was 40. The urge of having her own baby instead of using the donated eggs cost her millions of dollars.

3 concern of egg freezing:

1. “I’m not sure if I will need these eggs in the future.”

This concern is actually unnecessary, especially for women aged over 35. For example, you might get married at the age of 38, and conceive at 39. After the child is born and resting for 1 year, your age comes to 40. If you want to get the second baby, you have to face the reality that successfully getting pregnant would be extremely hard. According to our experience, for women aged over 40, you need two attempts of IVF, which also imply that the cost would also be two times. However, if you did preserve your eggs at the age of 38, you would have a chance to get a better result.

2. “I’m concern about the post-thaw survival rate.”

According to our record in 2019, we thawed 9,869 eggs, and 9,403 eggs survived. The overall survival rate is 95%, fertility rate is 75%, and the good blastocyst rate is 61%. Of course, rare cases with relatively low survival rate (under 60%). However, it only takes 4%. In another words, 96 out of 100 clients has pretty good outcome!

3. “The cost.”

What if the cost of egg freezing is just a bit higher than the price of an iPhone? Would you rather exchange your iPhone or half of your monthly salary to a fertility insurance? Even if you are not planning to have a baby for now, there’s no guarantee that you won’t need it in the future. After reading the story in iVie 35, shared by one of our client from Japan, you will be impressed by her determination. Many of these Japanese clients have undergone IVF over 10 times before coming to our center.

To the reader of this article, you might still be young and single for now. Egg freezing might just an option for you “Nice to Have”. However, when your aged over 40, this would be something “Must to Have” if you want to have this happiness.

Please consider preserve a chance of happiness to the future you. Also, always be positive about yourself and believe in the hope of fulfilling the dream of having your own family.

We also provide the convenient APP for you. You can check the status of your oocytes anytime and anywhere you want. After a busy day of work, please lie down on a comfortable couch, check out your APP and give yourself a great pack on the back.