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 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.

Thursday, October 20, 2016

A home-run and an additional Y chromosome

The result of pregnancy test made her extraordinarily happy — 100% positive. 

However, the following amniocentesis report turned her down immediately...

A real story was shared by the doctor of Stork Fertility Center.

She made an appointment for saying good-bye to me. The entire IVF progress was filled difficulties. And just like another temptation to her, God gave an additional Y chromosome to the transferred embryo. Although the risk existed, she decided to continue the gestation. She said,

"I prayed for a Y chromosome, but He gave me two. "

When she first visited us, she had two daughters already, but she still wanted to have a boy in her family. However, the expected third baby delayed to join their family, and finally she made an appointment with the fertility specialist. The hormone test showed that her ovaries was declining (FSH=24.6mIU/mL). She could not accept this diagnosis initially until underwent two consecutive failure in the IUI and IVF treatments. In that IVF cycle, only three mature oocytes were retrieved.

That's why she came to us and requested an IVF treatment. I refused her because she had two daughters already according to the record. After she told me the condition, I was hesitated. (To have boys and girls is a dream of most people.)
I started her stimulation in the September. The response in left ovary was poor, and only five mature oocytes were retrieved from the right ovary. Two of the four oocytes were normally fertilized (fertilization rate = 50%). While the embryologist reported the outcome of culturing, the unexpectedly lower fertilization rate turned her down. The development of embryos were not good either, so she decided to transfer a day 4 morula. The result was disappointed.
After two months for resting, she entered the IVF cycle again. Seven oocytes were harvested this time, but only one were normally fertilized. On day 5, only one early blastocyst was available to be transferred. Only one usable embryo twice made her quite frustrated. She had no confidence to the result. I encouraged her with all my efforts, and reminded her that the only embryo could be the best one.

On the day of pregnancy test, she was totally delighted by the clear "positive" result. A home-run was made by the only embryo. She kept this good mood until the amniocentesis report was released. She phoned me that the baby has mosaic 47,XXY/46,XY (mosaic Klinefelter syndorme). I tried my best to comfort her and made a referral to the related specialist.

Today, she came to my suite with her two girls. I already knew her decision from the smile face. In the end of this summer vacation, her family will welcome a baby boy.

Many people did not know that they have the premature ovarian failure unless they came to the fertility specialists. Most cases faced this problem with pessimism or passive attitudes. Some people just convinced themselves that everything was fine, and some pretended that they would not like to have kids. Fortunately, this case choose to solve the problem positively with an optimistic attitude. Perhaps she was already a mother of two daughters, she clearly knew what she need. And the last thing was how to meet the need.

It was a happy ending. As a sentence from Count of Monte Cristo, "all human wisdom is summed up in two words: wait and hope."
To all the friends who suffered the same problem, I just want to say,

"Yes, you can."

Tuesday, October 11, 2016

The last four tubes of frozen sperms

How to grasp the last chance? 

In a frustrated manner or an optimistic manner? 

A real story was shared by the doctor of Stork Fertility Center.

"For everything there is a season, and a time for every purpose under heaven: a time to be born, and a time to die; a time to plant, and a time to pluck up what is planted..." ~ Ecclesiastes 3, Bible.

As the King Solomon said, there is a beginning and an ending in everything, including the human body. However, most of us are not ready to face the end.

I met this couple at the clinic suite in a beautiful day.

The couple have been married for seven years. The husband was diagnosed as congenital bilateral absent of the vas deference, CBAVD. He has undergone MESA and TESE twice. In CBAVD cases, testes are able to produce motile sperms, but have no vas deference to transfer these sperms. Finally, the produced sperms would be metabolized and then reabsorbed by the surrounding tissue. Thus, the CBAVD cases can collected the available sperms through operation for IVF purpose.

The IVF program was not that difficult for the wife. She has undergone the program twice before, and was familiar with the stimulation injection and retrieval operation. As a 40-year-old woman, collecting 18 oocytes in a single cycle was a very good result. However, the result of TESE was not that good—few motile sperm were found. Moreover, the urologist told the husband that his testes could not tolerate the TESE operation anymore due to testicular fibrosis. The frozen sperms which have been collected before were their last chance.

Although the amount of oocytes was enough, the quality of sperms was not good enough. Eight embryos were formed after fertilization (all IMSI), and six blastocysts were cryopreserved. After two failed FBT cycles, they only had two frozen embryos and four tubes of frozen sperms. To increase the success rate of IVF, this couple decided to do IVF program again and create more available embryos.

Thirteen oocytes were harvested in the following cycle, and six embryos formed, and four blastocysts were stored. After another failed FBT, I transferred the last three embryos for them.

Fortunately, one of these three embryos was implanted. The amniocentesis 
report showed that they had a healthy baby girl.

I remembered that the first time I met them at the clinic suite. Both of them had warm smile and optimistic manner to the future program no matter how hard they have tried to have baby.

I knew they would reach a happy ending in this journey. And they really did eventually.

Tuesday, August 23, 2016

Across the sea, I stored my seeds (Part 2)

One of the differences between women and men is the attitude of making decisions.

Men are good at analysis, and women are good at observation.

While obtaining bountiful information,

most women encountered the mess of selection.

How to make decisions reasonably, not emotionally?

Calm down and do some calculations.

Shanghai, the city lightning all night, impressed people by the spring-up skyscrapers, population density and mortgage. At this transportation hub and financial center, people were good at calculations.

Wednesday, August 3, 2016

Across the sea, I stored my seeds (Part 1)

Two roads diverged in a yellow wood,
And sorry I could not travel both 
And be one traveler, long I stood 
And looked down one as far as I could
To where it bent in the undergrowth;
~ Frost Robert,1920

As most traditional Chinese kids, I was always a typical "good" student—organized, concentrated, and keen to study. My life should be like this—studying with good grades, graduation with a honored prize, and marrying to a perfect Mr. Right. I met the "one" when I was 17, and I truly believed that we would be together during the rest of my life.