Stork Fertility Center - iART building



What is IVF?

In Vitro Fertilization (IVF) is an assisted reproductive method wherein oocyte are fertilized by sperm outside of the womb, hence the word in vitro. It involves hormonally controlling ovulation stimulating increased follicle development, transvaginal oocyte retrieval and sperm collection, laboratory incubation for fertilization and zygote implantation into the uterus to establish pregnancy. After sperm retreival and successful fertilization, the embryo is implanted to the mother’s womb. This procedure is also known as Test Tube Baby.

The very first IVF pregancy was reported in 1978 by Patrick Steptoe (Dept. Of Obstetrics and Gynaecology, General Hospital – Oldham) and Robert Edwards (University of Physiology Laboratory - Cambridge), which resulted in the birth of the world’s first IVF babies. Their success was announced in The Lancet 1978, ii, p.366. In 1981, the Jones Team in Norfolk, Virginia, first American group to use IVF, further improved the procedure and developed their first test tube baby. In Taiwan, the first IVF procedure was in 1985.

Born in 1978 in Manchester, England, Louise Joy Brown – the world’s first IVF baby – is now, in the year 2008, 30yrs old. For the past 30 years since her birth, IVF has helped thousands of couples overcome infertility. Taiwan alone has succesfully produced a few thousand IVF babies. Current statistics show that in Europe, 3 out of 100 newborns are IVF babies; while in Taiwan, the ratio is 1 out of 100.

Stork Fertility Center (Lai’s Ladies Clinic) started to provide IVF procedures to patients in 1992. In 1993, a timeframe of just one year, we announced our very first IVF baby. In the subsequent 14 years of our practice, we have already delivered thousands of healthy IVF babies; with 80-100 successful births per year - a ratio which has been steadily increasing.

IVF Procedure

IVF involves ovarian stimulation through oral medication or injectibles 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 4-8 cells stage (2nd-3rd day), or blastocyst stage (5th-6th day), then a special designed tube shall be inserted into the inner uterus in order to transfer embryos.

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




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

Procedure guidelines and reminders

1) Prior to treatment

Couples should relax, continue with daily activity and exercise, regulate sleep to at least 6-8 hours every night, and make sure there is less pressure or stress in their lives. Trust in the expertise of the physicians and medical staff in the clinic. During the onset of the menstrual cycle, (prior to the desired month undergoing IVF), couples will need to visit the clinic for some preliminary examinations, which will determine which treatment is best based on specific conditions/problems.

2) Inducement of oocyte production and retrieval:

Short method – On the 3rd day of the menstrual cycle, follicle-stimulating hormone (FSH) injections will be prescribed by the doctor. Try to administer on the same time each day for 8 days. Dosages will depend on the individual’s conditions. At 35 years and below, dosage of 225IU FSH per day is normal. (Each injection pen and treatment package usually contains 2500IU)


After the 8th day, visit the clinic for transvaginal ultrasound to measure follicle growth, maturity and quantity. Blood tests will also be conducted to test hormone levels and determine if additional injections are needed. Centrotide shall be administered to get control of fast-growing follicles. For the slow-growing follicles, r-LH may be added.

Afterwards, clinic visits for progress examinations shall be required every 2 days. Usually around the 10th day to 12th day of injections, the oocyte will have matured. The physician shall then recommend the injection of hCG and at around 34-36 hours, oocyte retrieval shall be conducted. Sperm collection is also to be prepared at this time, awaiting the development of the retreived oocyte.

Long method – On the 21st day from previous cycle, the physician shall administer Supremon everyday. Supremon is a kind of medciation that down-regulate pituitary gland. Continue with this injection until the 2nd or 3rd day of the succeeding menstrual cycle. On the 3rd day, a clinic visit is required for blood test and vaginal ultrasound. If everything is in order, FSH shall be administered everyday starting from the 3rd day. Dosage shall depend on the individual’s conditions.

Afterwards, the procedure is the same as the short method above.

3) Luteal function maintenance

The patient needs to be administered a low dosage of hCG on 1st, 4th, 7th day after embryo transfer and supplemented with progesterone untill pregnancy test is done.

4) Ensuring better adherence of embryo to uterine wall

A low dosage of aspirin is prescribed to be taken everyday in order to improve the uterus conditions and blood circulation.

5) From the date of implantation until the announcement date, a period of about 16 days, the patient should refrain from any strenous activities such as extensive housework or stress-inducing work, exercise, sexual intercourse etc.

Pregnancy Rate

Today, undergoing one cycle of IVF yields an average success rate of about 35-40% (World Standards) This means, for every 100 couples, there are 35-40 pairs successfully achieving pregancy. The remaining 60-65% shall need to undergo a second or third cycle. Usually with confidence and patience, success is achieved in the second or third treatment.

Some of the most important consideration in the patients success rate are age, ovary conditions, semen/ sperm quality, embryo quality, the procedure of embryo implantation and health. For example, a 35-year old or below patient’s pregnancy rate is higher then a woman of a more mature age. Implantation of 2 top-quality embryos can increase the success rate to 50-60%.


Certified by the Taiwan Government Bureau of Health, Stork Fertility Center has a success rate of 55%, one of the highest in the country and far higher than the world standard of 35-40%. We believe our advantage is in our continous efforts to upgrade our medical equipment, technical know-how and professional experience. In fact, our success rate has been increasing steadily over the years.

Multiple Births

The chance of multiple births with IVF treatment is about 25-30%; with twins being the most common. If the patient has a possibility of developing triplets or more, the physician will recommend a decrease in the number to be carried to term.

Because the Stork Fertility Center has reached world-wide standards, we are exerting our very best efforts to ensure multiple births will be limited to twins at the most to decrease chances of any pregnancy-related complications. Also, we are promoting blastocyst transfer and cryopreservation in order to decrease the rate of multiple births.

Ectopic Pregnancy (Pregnancy outside the uterus)

Possibility of ectopic pregnancy is around 5% for IVF. In normal/ natural pregnancy, the rate is about 2%.

Miscarriage

Miscarriage chances greatly depends on the age of the patient. The possibility, though, is not more than 20-25%. A more advanced age increases the risk of miscarriage. For 40 years of age and above, the possibility is at 38%.

Psychological Effects

Couples who experience infertility and have been undergoing treatments for a period of time can have increased stress levels due to the pressure, either financially or emotionally. It is recommended for couples to relax and try to decrease their stress levels and try to avoid feelings of sadness, anger or disappointment.

Should any patient require clarifications which will help relieve some of the emotional stress, staff at Stork Fertility Center is more than happy to provide any explanations. The hotline number is +886-3-523-3355 ext. 205. Everyone is welcomed to join the Stork IVF association.

Birth Defects

Reports indicate that there is no correlation between undergoing IVF and increased chances of birth defects or abnormalities. There is no need to worry. It is suggested for patients to undergo amniocentensis and high-resolution ultrasound examinations.

Potential Side Effects to undergoing IVF

1) OHSS (Ovarian Hyperstimulation Syndrome)

OHSS is a possible condition that may arise from taking fertility medications and injections. There is a 5% chance of acquiring mild OHSS, but there is a small percentage (about 1%) that is severe. Severe OHSS cases need to be treated in the hospital.

Symptoms of OHSS may include the following: enlarged ovaries, abdominal bloating and feeling of fullness, nausea, diarrhea, vomiting, less and frequent micturate, excessive thirst, fullness or bloating above the waist/in the chest area, pain, and shortness of breathe.

Symptoms for mild cases of OHSS will dissipate in about 2 weeks so please do not worry too much.

2) Ovarian Cancer

According to some studies, long term usage and administration of fertility medicines and injections may increase the chances of ovarian cancer. This may be caused by long term anovulation of the ovary. However, there is a large percentage of medical practitioners who also feel more studies and tests must still be conducted in order to prove this point.

Hospitalization

There is no need for hospitalization. 4-8 hours after embryo transfer, the patient can go back home. Stork Fertility Center has a pregancy success rate of 55% without any hospitalization required.


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