Showing posts with label 2018. Show all posts
Showing posts with label 2018. Show all posts
The Key for Implantation - Endometrium Thickness
12/26/2018 12:25:00 AM
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.
[Patient Testimonial] Egg Donation, give my kid back
12/06/2018 10:56:00 PM
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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Register：Oversea Form Facebook：e-Stork FB Page E-mail：en_service@icryobank.com WhatsApp：+886-905-737-501Why do I have miscarriages over and over again?
11/25/2018 04:22:00 PM
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.
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.
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.
Register：Oversea Form Facebook：e-Stork FB Page E-mail：en_service@icryobank.com WhatsApp：+886-905-737-501The Grand Opening of our Branch in Taipei City - Stork 11
11/08/2018 01:54:00 AM
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
~wrote by Dr. Hsing-Hua Lai, Dean of Stork Fertility Center
Quality and quantity , Guide for transferring blastocysts
10/29/2018 12:28:00 AM
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"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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WhatsApp：+886-905-737-501[Patient Testimonial] advanced maternal age with Egg Donation
10/02/2018 11:07:00 PM
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
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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