Saturday, January 1, 2050

IVF in Stork Fertility Center (IVF in Taiwan)




What is 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. 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.

(Know more IVF procedure at Stork Fertility Center)

(Know more donated programs at Stork Fertility Center)

(Know more oocyte-freezing programs at Stork Fertility Center)

Monday, February 20, 2017

Endometrial Receptivity Array (ERA)




Have you ever heard the phrase of personalized precision IVF?

Nowadays, the individualized medicine is more prevalent.

With the improvements in ART,

some patients still suffer by repeated implantation failure.

Why?

It's time to think about "personalized embryo transfer (pET)."




Embryo implantation is a highly complex process incorporating with a healthy embryo, a receptive endometrium, and a molecularly communicative dialogue in between. Until 2016, Stork Fertility Center has comprehensive applied individualized COS, IMSI/ICSI, blastocyst culture, PGS/PGD, donor gametes, and frozen embryo transfer for the cases with specific indications. Moreover, all patients would be requested to take the hysteroscopy, hysterosalpingograrphy, and cervical bacteria culture before entering the transfer cycle. However, still some patients failed after couple of transfers. 



Why? 



Except the quality of embryo and the physically normal observation of uterus and endometrium (EM) through ultrasound, a hidden culprit must exist in between—the dialogue for permitting implantation. Actually the human endometrium is a dynamic tissue, which undergoes changes during multiple levels in a menstrual cycle. The changes in histological markers, biochemical markers, molecular markers, and transcriptomics (Omics) have been reported in the previous articles. Generally, the period of EM receptivity is known as the "window of implantation, WOI," which opens during the cycle day 19 or 20 and remains open for 4-5 days. During WOI, the EM becomes functionally competent for the embryo implantation.


Using the assisted statistical tool, principal component analysis (PCA), hundreds of transcriptome (gene expression) during different phase of EM (proliferative [PE], early secretory [ESE], mid-secretory [MSE], and late secretory [LSE]) could be analyzed and clustered into four groups: proliferative, pre-ceptive, receptive, and post-receptive.




Through examining these transcriptomes in EM biopsies from different people, several studies found that the WOI is not fixed, as was believed before. It means that a fixed transfer protocol to all the patients could not be applicable. Thus several clinical approaches for detecting the receptivity of EM tissue were developed recently, and the endometrium receptivity array (ERA) was one of them. The ERA was used to analyzed the expression of 238 genes in an EM biopsy obtained from either an HRT or natural cycle. After priming of progesterone in an HRT or of LH in a natural cycle, the EM would be biopsied and analyzed. If the result showed receptive, transferring embryo at the same time in another cycle would be recommended. If the result showed non-receptive, transferring time would be adjusted according to the expressions of pre- or post-receptivity.





Based on the clinical trial of IGENOMIX, Spain, around 30% in the population had a WOI which is not located in the general frame (P+5 or LH+7), and four fifths of these non-receptive are pre-receptive (80%). The introduction of ERA has been reported to solve the problem in part of patients suffering with repeated implantation failure, and thus to increase the success rate in IVF.






At Stork Fertility Center, the indications for ERA is as below,


A. Repeated implantation failure after undergoing hysterosalpingogram, hysteroscopy and autoimmune exams


B. Repeated failures after transferring four Day 5 blastocysts graded over BB in accumulation

C. Repeated failures after transferring two euploid blastocysts in accumulation


Reference:

Monday, February 13, 2017

Love in Paris, Love in Stork Fertility Center






Another way to be a parent—


Although she did not know her,

She appreciated her precious gift;

Although she did not know her,

She gave her the most precious.




Picturesque perched villages between the sea and hills in Provence, undeniable scents of coffee along the banks of Seine, night views at the Eiffel tower, puzzling criss-crosses of Louvre Pyramids, and all of these describe the romantic name— La France.










As a tour guide, she always traveled around the world. Optimistic, talkative, and open-minded, are her unique characteristics, and many customers were just attracted by this charming woman. During a private vocation, she met her Mr. right in an adorable city, the city of flowers and love, Paris. This time was not for the temporary guide works, but for the permanent living.




Although they get married later in life, they were not anxious about starting family, and enjoyed the couple's life so much. Until the husband would like to have a baby, she suddenly found that the fertility capacity was significantly declined. At age of 44 years, both the quality and quantity of eggs were limited. 



She came back to her hometown for the fertility consultations. The specialist told her that having a baby at her age would be a hard and long journey. After discussing with the husband, they understood that the IVF success rate could be less than 5%, and it seemed very inefficient. They both agreed to register for donated eggs. During the matching process, she wanted to try autologous IVF for several times. If no available embryos harvested, they could use the donated eggs.

(More information about our Oocyte bank)





In the next 10 months, she underwent couple of IVF cycles, and one of the cycles was cancelled in the end. Since her husband must work in France, he cryopreserved sperms at Stork Fertility Center in advance. The specialist suggested her taking the accumulative strategy, which was collecting more blastocysts derived from multiple cycles. Until collecting enough embryos, two or three embryos could be transferred once to increase the possibility of implantation. 






Disappointedly, only two available blastocysts were obtained within the 10 months, and she still wanted to get a try. However, the thoughtful husband did not want to give her too much pressure, and thus decided to use the donated eggs first. 





The matched donor was a cute young college student with kind heart. She was very attentive to follow each step from doctors. The quality of her eggs were as good as her personality. Soon after, the recipient had a positive pregnancy test after transferring the developed embryo (single embryo transfer).







With great joy and expectation, the French husband applied for a long leave to accompany his wife. He helped her do the progesterone injections for luteal support every week. This couple would welcome their first baby in the most romantic country after another 10 months, and they promised the Stork Fertility Center to bring their baby back one day. 


According to the article in Fertility and Sterility in 2012, the cumulative live birth rate in the conditions of transferring five blastocysts were shown as below,



Tuesday, January 17, 2017

To have a second child? Preimplantation genetic screening is a good choice



"Excuse me, my oocyte pick-up is done,
 but my husband is still doing the sperm collection. Please tell him that I got to go."

She left in a rush, and I forgot to ask her name.






The day was as hasty as usual, scheduling for retrieval operations and gynecologic examinations. Every consultant at the counter of assisted reproductive technology (ART) department was busy for works, and I was checking the patients' ID and consent forms. 



Thursday, December 22, 2016

If I still have my periods, can I be pregnant?




"If I still have my periods, can I be pregnant?"


It is a common question at fertility centers. The specialist clarified that having periods does not mean having ovulations. Many women with advanced age thought that having periods equals to having potential to be pregnant. The fact is that older the age is, worse the egg quality is. That is why the women with advanced maternal age are harder to be pregnant.