Stork Fertility Center

Showing posts with label Frozen Blastocyst Transfer (FBT). Show all posts

I am always thinking if we are doing IVF, how high the pregnancy rate will surprise you? 100% is never impossible, perfection does not exist.... if you saw some publisher promoting a 100% pregnancy rate, no doubts that is a lie.

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What do you relate when you see 80%? An 80% discount on high-end fashion makes you excited? Got 80% on exams will make as A grade, got 8 or above at NPS is worth recommending. But if you saw IVF with 80% pregnancy rate before, definitely a fraud.

I will get you through the average result of IVF by Health Promotion Administration(MOHW) of the last 3 year ( see figure 1). For 35-year-old at the transfer cycle, the pregnancy rate is 52.6%, the live birth rate is 41.9% with average 2.12 embryo, not a very outstanding result. much more the same in western countries, by that, we might need a transfer cycle to bring a baby home. Moreover, the result of over 35-year-old is miserable, the live birth rate significantly decreasing with increasing age. Take the group of 40-year-old, every egg retrieval, transfer result in 38.4% pregnancy rate and 23.8% live birth rate, that is what everyone thinks about IVF in the past 40 years.

How do we reach "80%" pregnancy rate? It's rather simple. Transfer an embryo with inner and outer beauty AND with the right time. Maybe you will ask, what is inner and outer beauty of an embryo and what is the right time?

Before answering the questions, let us take a look at how we do IVF in the past 40 years. Our stereotyped "goal" was to culture a good looking embryo, no matter itʻs a day 3 or day 5 embryo, and no matter the endometrium cells ready or nor, we use our " experiences" to do the transfer. With that formula and judging only by the appearance of an embryo, the best pregnancy rate you can get is 50-60 %, why can't we get better?

"Inaccurate" is the main reason! Appearance is not trustworthy, who would have known a pretty embryo is carrying Down syndrome? P4 data in the range, endometrium thickness reach 10mm, does that means the endometrium cells are ready? No! An even more stupid thing is we treat everybody the same, we apply the same formula for every transfer surgery.

The ‘invisible ‘ is more important than the ‘visible ‘, what can’t be seen under the telescopes will need a genetic test, it can see through embryo like the mirror on the wall. You might hear of IVF3.0 or IVF 3.5, IVF 3.0 is run PGS for embryos, to eliminate the possibility of having Down syndrome. Since the technology was out in 2008, the best we can do is the get the pregnancy rate up to 60-70%. As for ivf3.5, that’s very tricky, some insert a time-lapse camera to an incubator and called it AI incubator, use pretty words for marketing. In fact, both can’t achieve over 70% pregnancy rate using just words but not technology.

Once we had an agent form Beijing told us that some American clinics are able to get 80-90% pregnancy rate at IVF, ‘what about the chances of having a twin’ I asked with respect. ‘Around 50%’ she replied. ‘ transfer 2 embryos each time?’ I kept asking. She laughed and said yes. It is meaningful if we do comparisons under the same level and conditions, with IVF results, you have to know, how many embryo transfers are the talking about. Creating a higher pregnancy rate with transfer less number of embryo means you had the right choice.

Of course, you’re going to ask ‘ why’s the limitation of IVF 3.0?’ The problem is ‘are we doing it at the right time?’ The endometrium cells have a WOI (window of implantation), the endow needs to be open by progesterone, and won’t stay open for a long time, it closes between 12-24 hours. At the 90s, doctors run a pathological examination of endometrium cells of patients went through repeated miscarriages, tried to find out the secret of WOI. Die without being ill because it was time wasting and inaccurate.

But some say ‘ IVF 3.0 increases not pregnancy rate but miscarriage rate’ From proven medical science we can find 2 very important facts: “ biopsy only on an embryo with grading BB or above” and “biopsy cells control under by 5” the outcome depend on the two facts.

What if we still have doubts even with the rules? Many patients bring along their previous PGS report for reference, I was stunned, with so many AA embryos. I wonder why they failed after transfer those nice embryos. But with no proof of embryo photos, that only leaves me full of doubts.

Sometimes, patients are not happy about their embryo grading, complaining we grade many AAs. I say if you get our BCs to other laboratories, you can definitely grade that BB or above. It’s like a different teacher grading the same article, you get different grades.

Thanks to the big data and AI, a science study group in Europe, iGenomic, they published a lite version ERA(Endometrial Receptivity Analysis) using genetic technology. Stork Fertility Center introduced innovative technology in 2006. Combating PGS, we name it IVF 3.0+. Analyzing the data that we collected for the past 2years, we proudly announce that we achieve 80% pregnancy rate (see figure 2) with 1 BB(or above) grade embryo, multi-birth rate less than 1%, miscarriage rate under 5%. In other words, transfer embryo at the right time can increase IVF pregnancy rate 10-20%, third might be the best result so far in the fields of artificial reproduction.

IVF 3.0+ create 80% pregnancy rate is surely the peak of the moment, but what about the rest 20%? We might find the answer at ALICE (Analysis of Infectious Chronic Endometritis) and EMMA (Endometrial Microbiome Metagenomic Analysis) . These two examinations were introduced in 2018 in Europe. Use also genetic technology to evaluate the good and bad bacterias in endometrium environment. It is crucial to know whether the concentration of good bacteria reaches 90% or not. The endometrium is where the embryo will rest, don’t you think the environment will affect your sleep quality?

What if you’ve had IVF 3.0+ and failed? Maybe ALICE and EMMA is your answer. Make sure to eliminate the chances of Autoimmune rejection, thrombosis and the couples' chromosomes, whether have any balanced translocation or not.

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11
4/30/2019 05:07:00 AM
Stork Fertility Center

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Egg donation - The Giver and the Taker

There are some women are infertile due to the ovulation function failure, common reason include congenital under-developed ovary( e.g Tunner syndrome) ; premature ovarian failure (e.g due to infection, surgery, immune system or medication treatment, cause the premature ovarian failure). And some women are carrier of chromosome disease, for example hemophilia, using donated Egg can really help to slove the problems.

Where are the Egg come from ?

Most girl donating oocytes aim to help people, few of them are patients doing IVF, end up getting more oocytes that she need, so donation can be an option. Miss Y was doing IVF, but because of she suffered from Polycystic Ovary Syndrome‎(PCOS), end up getting more than 20 oocytes, more than she needed.So she froze the rest and donated to others.

Privacy

According to the Taiwan governments’ Assisted Reproduction Act, “Assisted reproduction institutions shall not provide reproductive cells donated by a single donor to two or more recipient couples at the same time” Personal information of the donor and the recipient shall remain confidential, we can only provide donor’s health condition, heigh, weight, blood type, skin color.. mainly objective description to recipient couples for reference.

donor `s criteria

women at least 20 and less than 40 years of age, has never donated Egg before.

the heath Evaluation

Other than hereditary disease from the family and chromosomal abnormality , history of epilepsy and hemophilia, we do blood test on infectious diseases, such as mediterranean anemia, diabetes, hepatitis B, gonorrhea, syphilis, AIDS, etc.

what do the donor need to prepare

After passing the blood test and checking the qualification with the government, donor can start treatment from menstruation cycle day 3, using medication for around 10 days, egg are becoming more mature. Throughout the procedure, we monitor the growth of egg using ultrasound and blood tests. Around cycle day 14, egg-pick-up surgery will be arranged, under anesthesia. The surgery last 10-15 mins, after 1-2 hours rest, treatment is completed.

Side effects of egg donation

1. Very few people ,around 1%, suffer from Ovarian hyperstimulation syndrome( OHSS) after the surgery ,symptom include : abdominal accounts, poor appetite, decreased urine, shortness of breath, vomiting, etc.

2. Young women have hundreds of thousands of egg available stored in the ovaries, and donating dozens of egg will not cause early menopause.

What do the recipient need to prepare

Doctor will arrange hysteroscopy（H-scopy）and hysterosalpinography(HSG) to make sure
the endometriumis smooth and no Edema at both fallopian tube. Then will start medication at day 5 of your cycle. Prepare the best environment for embryo to bed.

Will my kid look like me?

There are half gene of the kid are from the father, half are from the donor. As for the matching process, the priority will be the blood type. Then we will according the criteria that you make for the donor, try out best to find a perfect donor for you.

Can egg be frozen?

Positive. Vitrification is a common use technology at crypreservaion of oocytes and embryos. Vitrification is a cryopreservation technique that leads to a glass-like solidification. Oocyte, embryo and blastocyst freezing by vitrification method for cryopreservation have been used for many years beside sperms preservation. Moreover, the use of vitrification technology for ovarian tissue cryopreservation to freeze eggs offers such an elderly women who sometime find more difficulty in conceiving or in maintaining pregnancy till full term because of old age compared to relatively younger women who might get better chances to get a healthy pregnancy. Furthermore, vitrification helps cancer patients who are looking to preserve their fertility later on after completing their treatment.

ref：
Assisted Reproduction Act issued by Taiwan Ministry of Health and Welfare

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4
2/27/2019 01:06:00 AM
Stork Fertility Center

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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.

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6
12/26/2018 12:25:00 AM
Stork Fertility Center

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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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4
12/06/2018 10:56:00 PM
Stork Fertility Center

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Faith means believing the unbelievable.

When we are the freshmen of Stork Fertility Center, we have the training program.
One of the course is that we need to entering the examination room, listening doctor's treatment and how to communicate with patients in order to make our advisory smoothly. When the patients tell their own story about the desire of having baby, we more understand what they have been through, and how they want this treatment bring result as expectation. That's why each movement we do is assigned a responsibility. Moreover, this follow-up process will strengthen the establishment of empathy and the special emotional connection with patients.

One of my training program, there is one couple makes me impressive.

"Did you use the pregnancy test kit at home?" doctor asked. I think that doctor try to make examine room more relax to ask this question. The husband said " No, we are too nervous to test by ourselves." And the wife didn't say anything next to husband. As the doctor open and show that pregnancy strip test, ask the couple "Could you recognize the second line on the test kit?" Suddenly, the husband popped up and said " I knew it. I pray to God last night, and ask the priest. See! Look at my Line message. He told me so in this message." Compared with silence wife, husband looked to excited. They pray, pray a lot, pray sincerely. I could see their joy in their eyes. However, that's my first time and the only one to meet this joyful couple. And I kept the wife's name in my note.

In this electronic and internet generation, people could make friends without face-to-face. Reading all the medical record of this couple, it could tell why they come to Stork fertility center and how hard and serious they try to have the baby. After reading the paper of medical record, I think I become more familiar with them.

They began the treatment in Stork fertility center in 2015. After some examination, we are quite sure that tubal and uterus are no problem. However, due to their ages, they registered for oocyte donation program. we matched a young and appropriate donor soon, and we got total 12 mature eggs for this time. The donor gave us 19 mature eggs, and eight blastocysts derived. Two embryos were thawed, and they were graded as 4BB and 4BA. They would have started the first course of treatment, but due to the wife’s persistent bleeding, they decided to cancel after discussion with the doctor. They started the second treatment with transfer a 4BA embryo, but still haven't good news yet.

However, due to the last embryo, the couple were worried about if they still don't have the good news with second transfer, they will spent more time to match another oocyte donor. So we spent a little time to have second match. Soon and later, we got 10 mature embryos. In the same time, second transfer have been finished, and they still don't get the result they want.
We could tell how aggressive of this couple by read the schedule of treatment. And the third time transfer, also the final transfer with a best 4AB embryo. Now, they are about to have a baby, and finally almost graduate from this long journey. There are 15 lessons for entering examine room of training program. We could see people cry, people laugh with doctor's announcement in the room. They are the most excited couple I have ever seen with succeed result. From their talk, I know they are convinced Christians. They repeatedly said how hard they pray, and they believe that they will become the parents one day.

Faith, is all around the world. Seeing this couple even face some difficulties, but they haven't been defeated. I will share this story to my customers, and tell them "Faith means believing the unbelievable."

Stork fertility center hold the "Annual Stork Party" every year. The purpose of this dinner is to invite the parents bring their IVF baby by Stork. They could share the joy with doctor, and let we could how big babies are. Due to we see all these babies from egg to embryo, and now they are sweet babies. Also the parents could share some different life experience with baby. What's more, the party could remind us the original intention of work "Sweet baby, Sweet home".

Remember, please come back to our Annual Stork Party after you graduate from this long journey.

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0
5/31/2018 09:37:00 PM
Stork Fertility Center

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I have been to so many hospitals for taking IVF.

This time, I made up my mind to come here,

because I have heard that the oocyte bank at Stork Fertility Center was good.

I am 44 years now, and have no time to waste.

It's time to know the result of pregnancy test....

I did not want to do the urine test at home this time, because I was very familiar with the feelings of frustration and disappointment. My husband and I sat in front of the doctor's desk, waiting for the good or bad news.

"Congrats, the beta-HCG is 2000 mIU/mL. You got pregnant!"

My doctor smiled at me, but I was stunned then. Until we walked out of the center, I was just bursting with joy. We have waited for this baby at least 12 years. I even could not remember what I have experienced in the past years. Finally, I got my baby at 44 years of age after transfer only one single embryo. It was the miracle of the eggs, since these eggs were retrieved from a young woman.

Before taking the donated program, I have gone through so many cycles of my own IVF, but it just did not work. In the March of 2016, I have gone through cryotransfer with four Day3 embryos, and the outcome was as disappointed as usual.

I asked my husband,

"How can I do? I have no time nor money. Should we continue to try more (IVF)?"

The journey seemed endless, and full of tears.

After resting couple of days, I decided to use "others' egg," since mine were obviously not good. I found the iCryobank website through net searching, and called to the center directly.

The lady there sounds patient and professional, and we arranged my schedule smoothly. My doctor examined my uterine state after the first visit to the museum-like center, and encouraged us to take the donated program.

Soon, a young donor was matched to us. Thirteen eggs were retrieved, and five available blastocysts were cryopreserved. The process took around three months.

The doctor suggested us transferring a single blastocyst, because both the morphology and developing time of embryos seemed good. I was wondered about the success rate, but finally agreed with the prevention of multiple pregnancies.

This Day5 blastocyst has become our lovely baby now. My family has started here. I was still proud of myself, for the decision at that day and for my own encouragement during this journey.

Pregnancy code of donated program at Stork Fertility Center (P-code):

0
6/26/2017 02:29:00 AM
Stork Fertility Center

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The benefits of Frozen Oocyte Bank

We guarantee that the donor has stored at least 10 mature oocytes in our center. Also, these mature oocytes will be provided only for you and will not be shared by another couple.
By using the most advanced vitrification technology, the average survival rate after thawing in our center is about 90%.
The treatment is more flexible and based on your time. After we receive the permission from the government, we can thaw the oocytes and fertilize the egg right away!

According to our recent statistics, patients undergoing oocyte donation program have 50-60% chance of conception in average. The pregnancy rate and live birth rate of oocyte donation program are similar to the woman of using their own eggs at or below age of 35.

Our Achievement

The pregnancy rate and the live birth rate are highly relevant to the quality of oocytes and the age of oocyte retrival. According to the statistics of Health Promotion Administration (HPA), female fertility even plummets after age of 34.

Using oocytes from the donor is absolutely an additional option of happiness for couple who are eagering to become mother and dad in a short term.

Based on our statistics, oocyte donation program has great pregnancy rate (about 70%) and high live birth rates (nearly 50%).

Comparison between Frozen Embryo and Fresh Embryo

To preserve the oocyte, Stork Fertility Center performs highly efficient vitrification method published by Kuwayama et al. Based on our center’s statistics, frozen oocyte and embryo survival rates are 90% in average.

According to the recorded literature, the clinical pregnancy rates for frozen embryo transfers and fresh embryo transfers are comparable. Similar results have been obtained at the Center. The pregnancy rate for frozen embryo transfers has even surpassed that of fresh embryo transfers.

Frozen embryo transfer could be applied in women with irregular menstruation, asynchronous embryo development, or there’s further inspection needed.

Comparison between Fresh Oocyte and Frozen Oocyte Bank

As reported by our statistics, there is no significance between frozen oocyte program and fresh oocyte program including fertilization rates, good embryo rate, good blastocyst rate, clinical pregnancy rate and implantation rate. That is, vitrification method will not cause significant harm to the oocytes and embryos.

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0
9/09/2016 10:45:00 PM
Stork Fertility Center

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The percentage of Stork Fertility Center sperm donation cycles to the total sperm donation cycles in Taiwan:

*The sky-blue bar represents the percentage of SFC oocyte donation cycle, and the sky-blue plus apricot represents the total oocyte donation cycles in Taiwan.

The clinical outcomes of embryo transfer in the donated-oocyte recipients:

* BT= blastocyst transfer
* FBT = frozen (and then thawed) blastocyst transfer

1
9/08/2016 10:59:00 PM
Stork Fertility Center

Stork Fertility Center

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Stork Fertility Center

What! In-vitro fertilization with 1 embryo transfer can reach 80% pregnancy rate!

Egg donation - The Giver and the Taker