Posted by
Kikidee
18 yrs ago
I'm doing a test tomorrow but I'm pretty sure my first IVF attempt has failed. We have quite a few frozen embryos so will try a FET first. Do you know how long I'll have to wait before we can try a FET? If that fails I'd be keen to do another fresh IVF cycle asap.
Our problem is poor sperm quality... which is treatable with ICSI but I know that our chances are going to decrease as I get older (I'm 32) so I want to get as many good quality frozen embryos now whilst I'm still relatively young. Whilst I have a lot of faith in our RE, I'm worried that they always play down any risks associated with IVF so I want to get some views from people who've actually been through this. Is there anyone out there who's done 2 or more fresh cycle IVFs within a short period of time? How did it impact your health, in particular your ovaries?
Many thanks for any opinions.
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Kikidee, keeping my fingers crossed that your test will turn out to be positive!
After my failed first IVF attempt, I went straight for an FET cycle and that one succeeded (approx 2 years ago). Have used the remaining frozen embryo's a few months ago and am now almost 12 weeks pregnant... so hopefully, like me, you will not have to go through another fresh IVF cycle for a while!
Am not sure about long-term effects of IVF cycles - as per a quick Google, there does not seem to be any evidence of negative effects so far. But perhaps others have a different experience...
Good luck
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Thanks for the reply Lena HK. When you say you went straight for an FET, do you mean you did it the month after the fresh cycle? Do you have to wait for your cycle to get back to normal before doing an FET? I guess I'm also worried that if we are fortunate enough for a FET cycle to work, by the time we're ready to do another cycle for baby number 2 I'll be that much older. I suppose I shouldn't worry about that when I can't even get pregnant with baby number 1!
I'm feeling really down about this cycle. I cheated and did a test this morning (a day early) and it was negative. I know you're not supposed to do that but I'd rather be prepared and deal with it now than have anticipation build up over the last few days. I had some bloating after the egg retrieval and the RE said that it would get worse if the cycle is a success because the pregnancy hormone makes it worse. Well, it hasn't gotten worse. It's gotten better and there are no other indications that I might be pregnant.
We'd always wanted 4 children and it's just devastating to be faced with the prospect of not being able to have any.... but then I guess everyone going through IVF feels the same. Planning what to do next makes me feel a bit more positive. All hope is not lost I keep telling myself.
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Kikidee, try to keep your chin up - you are still young! Many of the women here only started IVF in their mid/late thirties... I was 35 when I had my son, and will be 37 when the twins arrive. So we're having 3 kids in 2 years - who knows where you will be in 5 years' time ;-)
I did not have to wait for a month after the fresh cycle, really went straight for the FET cycle. Felt much better - no bloating, no egg retrieval, less meds, all in all less invasive.
By the way, the bloating after egg retrieval is normal - each egg is approx 2cm! - and COULD get worse when you are pregnant, but that does not always happen. Even better if not, because you might be at risk of overstimulation if it does get worse.
Take care, keep faith!
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Thanks Lena, you've made me feel better. I think I'm just panicking it may never work because there was no obvious reason for it to fail this time. I'm sure a lot of you out there have been through the same emotions.
This cycle went smoothly and the RE has been making encouraging noises throughout. My eggs were good quality, the embryos were good, my lining was good.... but into the second week of the two week wait I just knew it hadn't worked (had my fears confirmed this morning). The only thing I was surprised about during the cycle was that they did a day 2 transfer (egg collection on a saturday and transfer on a monday). I had thought that day 3 or day 5 were more usual. Perhaps if they'd been given an extra day we'd have had more chance of picking out the best embryos? My frozen embryos were also frozen on day 2. Any thoughts?
Do you mind me asking who you went to for IVF? Did you go to the Sanitorium? I'm thinking of trying them for a fresh cycle next time if FET fails.
I'd also be interested to hear of anyone else out there who's failed first time around but succeeded on FET. I need to get some positive vibes going. It's also my birthday today... and don't really want to spend it locked in misery and self-pity!
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Dear Kikidee, Happy Birthday
I have done 3 fresh and one FET transfer (all at Santtorium) and am finally preganant on on my last fresh attempt. I also got preganant on my FET but miscarried.
We have a problem with sperm quality and used ICSI but also my age is a big issue.
You can do your FET on your next cycle, ie not this period but the next if you feel emotionally up to it.
I felt personally that the fresh cyles did not effect me too much phsyically but I had a short break before my last attempt because emotionally it was getting on top of me. Also because of my age I use a short proticol so that may be easier on the body as well.
My fozen embryos have been either frozen at 5 or 3 days usually dependent on the number and quality to start.
Good luck I am nearly ten years older than you so keep the faith
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Hi Rose1234, congratulations!
Did you do anything different on your 3rd fresh attempt? I'm about to do my second at the end of this month so was wondering if you could give me some advice so I can avoid no.3. I'm about the same age as you and have no sperm problems.
Hope all goes well
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I second the congratulations, Rose1234!... and thank you for the birthday wishes. I celebrated with a glass of wine and a nice selection of soft cheeses!!!
I spoke to the nurse at my clinic this morning and she seemed to be suggesting that we could do an FET this next cycle and to phone her back once my bleeding starts. Obviously, I'm desperate to give it a shot but the sensible part of my brain is thinking less haste may result in more speed. I just want the best chance of success so can't make up my mind whether or not to wait a few months. English is their second language and my cantonese is non-existent so I never really got an answer to my question concerning whether it's best to wait a while. What do you girls think?
Also - a question for 'longing', 'Rose1234' and anyone else out there with experience: After your IVF failures were you able to get any extra investigations done to look at sperm and egg quality? My thoughts are that although IVF can be a luck thing, if there are recurrent DNA problems with either the sperm or the egg, from a cost perspective if nothing else it would be good to know what the problems are. Otherwise I could end up throwing money at IVF month after month with no chance of it working out. Surely it only makes sense for me to try my chances again and again if all possible investigations have been done. I don't want to sound overly negative 'longing', especially with you about to do your next IVF attempt. My concern in my case is more about sperm quality which isn't an issue for you. The embryologist said that my husband's sperm was so bad we wouldn't stand a chance without ICSI and she really had to search for some good ones. If this is the case, I'm wondering how normal the ones she used could have been. They may have looked ok, but how do we know they weren't actually defective?
I wish you all well - seeing as it didn't work out for me this time, statistically it means it should work for someone else this cycle!
Kiki
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Thanks Longing,
On my last two attempts they used assisted hatching - that's again because I'm older -in very basic terms they scratch the side of the embryo before they put it back. The only thing I did differently was live my life normally. Previously I had got really stressed out cancelling work trips so as as not to fly during my 2 week wait. This time I went to india and Korea, personally I think you do whats right for you if I didn't work I probably would have put my feet up for two weeks.
Kiki, my understanding is that there is no difinative test for egg quality. The sperm get rated as you know for each sample. It is possible to get your embryos genetically tested but I am not sure if they do it in Hong kong and if they do I think what they test for is quiet limited?
Back to the sperm if the ones being selected are fertilising the egg then they can at least do the job. My doctor seems to think if they can do the job then the rest is up to my eggs and my body of course. Give the FET a go it's easier emotionally and financially.
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Hi Kikidee and thanks for your reply rose1234.
We're not sure what the problem is and none of the doctors I've been too have been able to work it out either. Done everything possible and have been trying for the last 10 years....nothing! I should consider myself very fortunate not to ever experience a miscarriage but sometimes can't help but blame myself for not being able to give my husband a child he so desperately wants....oh well!!!
I went to a public hospital for my first IVF so was not able to get further investigations although I think I will ask this time round to see what additional tests I can do. I think I might have done them all anyway!
You hear so many success stories on this site that you wonder whether it will ever happen to me but honestly we should never give up hope. Stay positive Kikidee it wll happen!!!
Afterall your egg only needs one sperm...
Lots and lots of babydust to you
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788
18 yrs ago
Hi Kikidee,
We have issues with failed IVF cycles because of bad embryo quality, which in turn can be caused by egg/ sperm defects. We have known that we have sperm issues but were also told that it can be bypassed with ICSi but had no luck twice. Our sperm morphology was quite poor(DNA tests were on target) 1% on Kruger scale. We had been told earlier that IUI's would not work at all. Anyway... we decided to go ahead with the varicocele surgery and the morphology has jumped to 7%- thats 3% above the min. in the 3rd month after surgery and the count increased significantly as well. We are very excited about the results because the dr. has even ok-ed IUI's in theory. Not sure what might happen in reality. I still haven't made up my mind what we should do now--- but this was how we decided to deal with the poor sperm quality.
I should warn you however, that all the reports I have read are sitting on the fence about this surgery- there is 50-50 chances of it not making any difference and the cost was much higher than any 1 IVF cycle. I remember foolonahill also had this surgery and the results started showing up only a year later if I remember correctly- which seems more of a norm from the research I have done.
Goodluck!
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Hi 788 - congratulations on the successful varicocele surgery. This is an option we are considering. DH saw a urologist before we started with IUI and IVF... and he seemed to suggest that the varicocele surgery could 'cure' the problem so we wouldn't need IUI at all. But then when we went to see Dr Lo he said that the Royal College of Obstetricians' advice in the UK is against surgery because it doesn't actually improve pregnancy rates. Then again, even without the varicocele surgery, ICSI should have overcome the problem of poor count, motility and morphology. Have we both just been unlucky? We've been told from day one that our problem is the sperm's inability to fertilise the egg. ICSI resulted in good quality embryos so in theory we have overcome the reason for our infertility and I should now be pregnant! It's so confusing, especially when urologists say one thing and the RE says another.
It's annoying that male infertility is such a neglected area and very little seems to be known about it. A form of sexism I suppose - it's always the woman's body that has been studied when it comes to infertility.
My feelings are that if there's a chance the surgery can improve things enough so that IUI is an option, it's worth doing. We can't keep doing ICSI indefinitely whereas you can at least make repeated attempts at IUI. Even if it takes a year to improve things and I get pregnant in the meantime with FET or another fresh cycle attempt, it would be nice to know we might have an easier time of it when trying for baby number 2.
As for the cost of varicocele surgery, my understanding is that it's far more likely to be covered by standard insurance than IVF. My husband's insurance coverage is really basic yet when he enquired about the varicocele surgery they said it was covered.... I guess it's because the surgery can be justified on a general medical level, not just because it's causing infertility.
Sorry to rant on. You've probably noticed I'm confused about the whole thing! I suppose I'll give FET a try but not hold out too much hope. I'll work on convincing hubby to do the surgery in the new year.
Thanks for the comments - I'm starting to feel a bit more positive with a plan of action!
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Hi Kiki - how many frozen embryo's have you got left? I know we probably got lucky that both FET's have worked out - but I also believe it helped we did a day-5 transfer with blastocysts. We had enough fertilized eggs to take the risk to wait until day 5 - we did lose almost 60% of them in the process (apparently that also happens in utero) but the ones that made it had proven their quality.
We also did ICSI and my theory is that our chances of getting pregnant because of it are actually higher... Since there is not much 'wrong' at my side, all we have to do is get assistance in fertilizing the eggs through ICSI, and the rest is up to nature... (sounds easy huh?!) Don't forget though that even in 'normal' situations, most couples don't get pregnant right away - there is only a 25% chance that everything goes well and sex ends up in pregnancy! :)
Anyways - I would say, if you feel up to doing the next round right away, go for it... According to my Dr it was not a problem at all - he just monitored my lining. It made me feel so much better to know I could try again, and the FET cycle was so much easier physically and emotionally. I did put my feet up for 2-3 days and took it easy - that seemed to make a difference.
Good luck!
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Hi Lena HK - I think I'm definitely just going to go for the FET. Waiting around for a few months doing nothing would be more stressful than actually doing the FET. Now that they are frozen is it too late to let them develop for a few days after the thaw? If I wanted to transfer a 5 day blastocyst, should it have gotten to that stage before being frozen? we have 14 frozen embryos left. 9 of them are grade 1 and the other 5 are grade 2 but seeing as they were frozen on day 2 I'm not really sure this means much! I am now a bit annoyed they just transferred on day 2 without giving us the option of leaving it an extra day or two, especially seeing as we had to pay extra for the lab to open on a public holiday! They could have just let them develop an extra day and then we'd have more of an idea of what the embryos are really like. If a certain percentage perish in the lab and in utero, what is the point of transferring the embryos early? Do more perish in a lab setting than in utero? I'd rather wait to see how they develop rather than just transferring early and hoping for the best. With an early transfer the embryos may stop developing early on yet you don't know that for two weeks. If it stops developing early in a lab situation, at least you know about it. Given that the two week wait is such a nightmare it seems best to wait a bit in my view. Do you mind me asking who you your Doctor was?
Yes there's only a 25% of success each cycle with 'normal' couples, but by the time you reach embryo transfer stage I understood that at my age our chances were a fair bit higher than this with ICSI. Half the job (ie fertilisation) has already been successfully achieved. Even though IVF's success rates are generally around 25%, the success rates are brought down when couples have to cancel a cycle due to poor drug response, failed fertilisation, poor embryo quality etc. Success rates with a fresh cycle are also supposed to be higher in couples that are fortunate enough to have good leftover embryos to freeze. I'm thinking that as I had good embryos transferred and no luteal phase problems, my odds should have been 50% or more. Well I suppose that still means 1 out of 2 are unsuccessful. Humph!
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Kikidee,
Do you mind me asking on what day your fresh transfer was done. Was it day three? I would think that they will let your frozen embryos develop to at least to day three before they do a transfer.
I would suggest you get onto your doctor and ask him some questions. I know every doctor is different but my understanding from my doctor was that given the number of good quality embryos you are getting they would try and get them to day five. The loss rate is higher but the blastocyst success rate higher as you say.
What lab are you using?
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On the fresh cycle they did the transfer on day 2. It's only afterwards I realised that most people seem to have the transfer on day 3 or day 5. I just don't understand why they did it on day 2, especially seeing as they had to open the lab on a public holiday for it and charge me an extra public holiday fee. When I was lying there after the transfer they told me that the sound I could hear in the lab was the process of my remaining embryos being frozen... so they'd already started freezing them without there being any discussion about whether they should be left to get to day three or day five. They must think it's better that way and I suppose they know more about it than I do.... but that still doesn't explain why it's more usual in other places to transfer on day 3.
The nurse is ringing me back today so I should hopefully be able to see the Doctor soon to get some answers.
So you think my frozen embryos can be allowed to develop a few more days once they've been thawed or is it too late now? Should that development process be done before freezing?
I'm currently at the ProlIVFic ART centre... (which is a bit of a mouthful). They're in the CNAC building on Queen's Road Central. I'm thinking of changing to the Sanatorium if I do another fresh cycle. I don't have any reason to doubt the abilities of Dr Lo or the staff at the clinic, but I'm starting to think there could be some communication issues. Perhaps it's my fault for not being properly informed and not asking the right questions. I also think that because IVF is never going to be an exact science, it might be just a case of us trying our luck somewhere else. They might do something slightly different that may work better for us. Then again, maybe I'd stand more chance of success if I stay with the same Doctor and clinic as they know our history and know how I've responded to their treatment in the past. It's so hard to know what to do for the best!
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Just to add to the general confusion, here's what I've found on the BBC news website concerning acupuncture:
http://news.bbc.co.uk/2/hi/health/7047431.stm
... which is a new study saying that acupuncture may cut IVF chances, and
http://news.bbc.co.uk/2/hi/health/1933901.stm
... which says that acupuncture 'boosts IVF success'.
Maybe I should give the acupuncture a miss next time round. I think I'll stop looking for information on the internet. It's obviously a path to madness!!
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Kikidee,
It's definetely not your fault you have to rely on the experts thats what your paying them for. That said you should ask as many questions as you need to and get answers that make sense to you. I would definetly want to understand the reasoning for the day two transfer, they may well have a good one but its generally day three or five.
I used Sanatorium and by the third go I was wondering how good the lab there was expecially after all my interent research - but we got their in the end.
The internet is great but too much information can make your crazy
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Just heard back from the nurse. They want to do a natural FET cycle first, rather than a medicated one, as I'm quite young. I asked about the development of the embryos and she said that they thaw them in the morning and will transfer them back at lunchtime/afternoon on the same day. She said that gives them enough time to know whether or not they're ok and are still developing. If you have good quality embryos she said there shouldn't be a problem with them surviving the thaw. As you know, my concern wasn't really about them surviving the thaw (I fully expect at least some to perish). I was more concerned about putting back embryos when they're between day 2 and 3 of development. It didn't sound like they could be very flexible but I suppose the nurse was just informing me of standard procedure and I can't expect her to know about the possibilities of letting them develop a bit longer after the thaw. There's also the language barrier to contend with. Looks like I'll have to save that question for the Doctor when I see him next week.
Thanks for the comments. It's so nice to know there are people out there who understand what it's like to go through this. Rose1234 - if it took three tries at the Sanatorium then maybe I'm being a bit quick to want to change doctors and clinics for our next fresh attempt. It's unfair of me to think after one failed attempt we might have better luck elsewhere, especially when I've no particular issue with the treatment I've received. I've just got to get used to the fact that there are no guarantees with IVF, no matter how good my case looks on paper. Of course, if I don't get a satisfactory answer on this day 2 vs day 3 or day 5 issue, I'll think again.
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Hi K
Thanks for posting this great thread. I like you have done 2 IVF cycles in Hong Kong. I think I am also about your age - if not a year older. My first Cycle resulted in 5 day 5 Blasocysts (from 20 eggs retrieved). I transferred 2 for the fresh cycle and then 3 for a Frozen Cycle (the month after the fresh cycle failed). It was the most devastating time for us as we were so hopeful that we would be successful - the Dr was very hopefull too and pleased with the retrieval and fertilization results overall.
So I decided to go straight for the 2nd IVF cycle a month or so after the FET failed. For that 2nd cycle I did everything that one should/or is told to do (which I didn't do for the first). I did accupuncture, TCM, I rested, I laid off exercise, I didn't drink so much and tried not to travel. This 2nd cycle resulted in less eggs of less quality and worse symptoms than the first time. For this cycle I got to day 2 and the Sanatorium told me that I had 3 grade 2 (which is the highest grade the Sanatorium gives) and 2 that were uncertain. I was told (or shoud I say pushed) to do a day 3 transfer. I didn't understand why, but have subsequently worked out that the hospital doesn't want to accept liability/complaints if one gets to day 5 and has nothing to transfer. This made me somewhat annoyed. I also did some reading and one of the top doctors in the US posted a thread on a US site that said that this practice is common and that we should watch out for it as day 5 Blastocysts are really the best and that he has never known of a case being successful where a patient did a day 3 transfer in the 2nd cycle if they were unsuccessful with a day 5 transfer in the first (exactly my situation).
I was very annoyed by this - and have spoken to another doctor - who confirmed that pushing a day 3 transfer wasn't really the best way to go in my case - as in the end I got 5 eggs at day 3 which were good.
The fresh 2nd Cycle transfer was unsuccessful and so I now have 2 (grade 2-) frozen babies and am torn between transferring them back and not. Its been over 3 months since my 2nd IVF fresh transfer failing and I can't seem to bring myself to make a decision.
Anyway, aside from that, I know your pain. I have seen a new doctor and discussed this and he will speak to the lab to see what went wrong in the 2nd cycle. He will let me know in about 2 weeks whether to go for FET or to go straight to another Cycle of IVF. This time he said that it may be a good idea to try another drug and/or monitor hormones (which my last DR didnt do). Apparently some people's progesterone spikes too soon on the Gonal F - so they don't get good quality eggs. Apparently it may be the 'issue' we are having, but then again, it may not. Who knows.
Like you, I have a sperm issue - its with 'morphology'. IUI is hopeless, so IVF is our only hope. It's one expensive 'hope' but hey, people get pregnant every day on IVF and one day its going to be you and me!
Hope this information helps you with your dilemma. Despite all that has happened, I still have faith. Rose 1234 and Havefaith on this site have helped me keep that in check.
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Hello Trying. It sounds like you've had a tough experience. What you said about the day 3 transfer has really shocked me actually. All they need to do is give us a full picture, all the information so we can decide what course to take. If they warn us about the risk of not having any embryos to transfer on day 5 and we know what we're getting ourselves into, why jeopardise our chances by putting the embryos back on day 3?! Do we need to remind them that our goal is to get pregnant, not just to have embryos to transfer! sounds crazy but that seems to be where we are. Given how much we invest in this financially, physically and emotionally we should really be given maximum opportunity to be involved and given information so we can make choices rather than have choices made for us.
I saw my Doctor the other day and he told me that I responded very well to the drugs and the result may have been that my hormone levels were too high and that's why the IVF cycle failed. Therefore my luck should be better on the frozen embryos. I'm not really sure what to believe anymore. You hear of people becoming pregnant even with quite bad hyper-stimulation so I don't understand why my hormones should have made that much of a difference. Also, the Doctor has been very positive about my chances at every stage and I'm still not pregnant so I don't want to place to much weight on his comments about my chances.
Still not sure if we're going ahead with the FET this month. Apparently my ovaries are being quite slow in producing a follicle and there are a few cysts from the IVF drugs so I've been told to reduce my carbohydrate intake. I'm going for another ultrasound in a few days and will see if things have improved. No point wasting one of my chances. Can I ask why you're hesitant about doing the FET? What would you have to lose by giving it a shot?
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Trying,
Sorry to hear about the dilemma you are going thru. It must be tough.
Wishing you lots of baby dust and faith that things will work out!
HF
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Just got back from a Doctor's appointment and I'm very upset. He again said my ovaries were being a bit slow so I asked if I should wait a few months for things to return back to normal. He then said that this is normal for me - I have PCOS and have always had it and then said that because of PCOS I'd be at increased risk of miscarriage if I do get pregnant. I'm absolutely furious because he NEVER mentioned this before. I'm sure there wasn't a problem before the IVF treatment. When I had my first ultrasound he said that everything looked pretty healthy. Even if he's right and there was a problem before I'm amazed that he never saw fit to mention it to me. When discussing the drug dosage with me he only mentioned the considerations of age and ovarian reserve. Surely if I had PCOS then he would have said so as women with PCOS are more sensitive to the drugs and more prone to hyper-stimulation. I'm stunned and am not sure what to do next. If I go for a second opinion they can only confirm if I have PCOS. They wouldn't be able to tell if I've always had a problem with it or if the IVF caused it. Anybody else had a similar experience? Might things improve if I leave it a few months? I'm beginning to think this just isn't going to work out for us. We've had bad news after bad news and I feel like I'm collecting up every infertility diagnosis in the book.
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Hi Kikidee
Sorry to hear about the PCO - but agree that its strange to hear about this now from the doctor!?! Sounds like you may not be responding so well to the injections - I gather you are on Gonal F? Don't worry if you are - its known to be the best drug to take - but some people apparently have strange hormonal issues associated and after effects. It happens in a small percentage of women, but its a known issue and your doctor should be able to help you through it.
I haven't decided about the FET as my doctor is going to call the lab to find out what went wrong in my 2nd Cycle before he advises whether to go ahead or not. The grading of the eggs is 2minus (2 being the highest grade the Sanatorium gives). This means that the eggs are either slow to grow and/or fragmented and that they may not be the best bet. I guess its a matter of weighing up the quality vs the pain and cost of putting them back. I am now very cautious about what I am told - particularly after my last disasterous IVF Cycle. I think I would rather go for a fresh 3rd Cycle then put back embryo's that are unlikely to develop.
On the doctor front, if your doctor isn't giving you the answers you need - then go for a second opinion. I am glad I did - if anything I feel more confident and my new doctor is willing to narrow down on possible infertility issues - rather than just put me in the 'unexplained' box and tell me just to keep trying. Its crazy to think the emotion, effort and money you spend when the doctor sits back and just says they don't know why it isn't working - when they could do so much more to help. With the advances being made in IVF these days - there is no excuse for these doctors to claim 'unexplained infertility' and sit back and do nothing. There is a lot that can be done!
My advice - research - read all the IVF sites of the US and Aus ones are good to. The Sydney IVF centre has good success rates and there is a clinic in Chicargo too that does amazing things. They are developing screening processes that are able to view all genetic material and embryo selection is getting better (as are the chances of success) in many of these places. I cut out articles and gave them to my last doctor - and when I realised he hadn't heard of any of these new things - I knew it was time to change.
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Trying! so good to see you back wish you were in better spirits. I also read that article by the doctor in the States and it really panicked me before my last transfer with my three day embryos. i am pretty sure it was you who cheered me up and now I have my 18 week check up next week. I am pretty sure that doctor also said not all labs are the same when it comes to getting embryos from 3 to 5 days. Good luck which ever way you decide to go you will get there you deserve it!
Kikidee, alot women on the forum suffer from PCOS and it is definetly not a side issue in the infertility saga. For your doctor to just drop it on you now makes you wonder about him. I know it's a pain but with all the money you are already spending I would definetly get a second opinion before you invest any more money time and heartache with whoever you see now.
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Hi Trying - if 2 is the highest grade the sanatorium gives then maybe a minus 2 isn't that bad in terms of quality? What does the lab say about chances of pregnancy with a minus 2 embryo? I know I've been told before not to get too hung up about grading as sometimes the embryos that aren't brilliant quality to begin with result in a successful pregnancy whilst other fabulous looking embryos fail.... and no-one knows why. Of course, every place grades differently etc so it's hard to compare. Depending on your Doctor's advice, if you decide to go for another fresh cycle then perhaps it would be good to keep the frozen embryos you already have for the future? With a bit more time to get over the emotional and physical trauma of the failed cycles you may start to feel that you could give it a go. You might even want to use them to try for baby number 2 a couple of years down the line! I understand your concerns about going through the transfer and the two week wait when the chances aren't optimal, but it is a lot less stressful than a full fresh cycle and you never know - it might work.
My FET is scheduled for Tuesday and I'm feeling more and more confused. Turns out the polycystic ovaries might be a result of the medication for the IVF cycle... at least it has become more noticeable as a result of the medication whereas before it wasn't really an issue. The Doctor doesn't seem to know if it will go away or not but he doesn't seem very concerned as I have no other symptoms and my egg quality has been good. If it doesn't work this cycle I'll go to another Doctor in the new year for a second opinion.
I now have to consider how many embryos to transfer this time. I have 14 frozen embryos frozen in batches of 2s and 3s ranging from grade 1 to minus 2 and another grade 1 embryo frozen on its own. I was thinking of transferring 2 but then I suppose there's always an increased chance of getting pregnant naturally this cycle because I've been stimming. I think I have 3 eggs coming up this month.... I don't really know whether I should just forget about the chances of natural conception seeing as the normal morphology of the sperm is consistently 3%. The Doctor says it could happen but I don't really believe it.
Good luck with the decision-making, Trying. Hopefully we'll both have something to celebrate soon, just like Rose1234!
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Hi trying
Day 3 vs Day 5 is an open debate - one which is not proved conclusively either way. I did 2 day 5 transfers in my first Cycle and was unsuccessful. I did a day 3 in my second and was unsuccessful - so who knows.
Sadly IVF is still a business model that has to work for doctors and they are unwiling to face disappointed clients when they come to day 5 and have nothing to transfer. So if you are getting enough eggs and they are pushing you to do day 3 - then that is strange (as far as my research can tell). If you are not getting many eggs and are being pushed to do day 3 - then that is the lab and doctor doing a "cover my butt" thing and pushing you to do day 3 in case there is nothing at day 5. All in all, from what I have read, Day 5 transfers are much more successful than day 3 on average (simply because the egg is much more developed and the doctor can select the best one to put back). At day 3 - there is still a lot of work ahead for the embie.
Either way - if you have good eggs, good sperm and your hormones are ok (all else ok too) then there is nothing to say IVF shouldn't be successful.
My new doctor is at least drilling for answers - and exploring avenues my last doctor didn't know about (or perhaps wasn't willing to do for a variety of reasons). If there are relatively cost effective ways (regardless of whether there is no conclusive research on the issue) to narrow down on issue - then I am all for having a try. Be wary of your doctor if he isn't - and yes - it is hard to change - but what have you got to lose?
Good luck!
T!
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From what I understood from both my Dr (Doo) and various articles, waiting until day 5 is only recommended if you have enough fertilized eggs to 'take the risk'. Both in IVF and 'real life', a lot of embryo's do not make it past day 4 (the morula phase) - for example, I lost 70% of my embryo's from day 3 to 5.
Apparently, it is not 100% clear if the lab environment actually contributes to this loss of embryo's - i.e. embryo's that do not survive day 4 in vitro, might actually make it in the natural environment of the uterus... which sounds logical to me.
I absolutely agree with Trying, Dr's will have business considerations too - but if you do not have that many embryo's, it might be worth taking a chance on day 3 transfer (and I know lots of cases where this was successful!)
good luck!
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I agree with Trying that doctors too have to consider whether there is anything to transfer on day 5 - from a business angle as well as from a medical angle. Kelly (Dr. Ho's nurse) advised me when I did IVF that there success rate for day 3 transfers have also been high. She reckons the success rate is more dependent on age of the woman than day 3 vs day 5.
I was not given a choice because I did not have many embryos. In hindsight, I think I feel I had a chance because at least there was a transfer.
Good luck to everyone! Lots of baby dust to you all!
HF
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Trying,
I am satisfied with the attention, the professional expertise and treatment I have been receiving from Dr. Ho and Kelly (who is a registered nurse). I have seen some postings here from women who have complained about the lack of attention from Dr. Ho. I am not sure if I have been luckier (or just not as observant). I have bumped into him in the reception area a couple of times and he has not only remembered my name but the treatments and day of treatment that I was on.
He has associated certain reactions to the S&E procedure last month to the same that happened last year (when I was not seeing Dr. Ho but I have advised him of since I have been going to him).
I also feel he is not as commercial and money grabbing as some of the other doctors in Hong Kong. When I first started seeing him, he suggested IUI instead of IVF (which my hubby was pushing for) based on the fact that I had conceived once naturally before.
HF
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Hi Trying
I agree with Havefaith. She thankfully convinced me to change doctors and am so glad. I go to Dr Ho. Have heard mixed views on him - but at least he is willing to try other things and I have thick skin now to be able to bear him being blunt with me. I won't say who I was with before - as he was really great and I really liked him a lot - but just did not have the experience of Dr Ho. The only thing so far that's hard is that he has a lot of patients and it took me weeks to get an appointment.
Good luck!
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Hi Trying! I understand why you don't want to say on a public forum. Could you possibly use PM to let me know which Doctor you were with previously as I'm thinking about which Doctors to see for a second opinion on my case? I want to make sure I don't choose a Doctor who lacks experience!
I've heard great things about Dr Ho - the only things that put me off seeing him at the outset were his popularity (hence difficult to get an appointment) and cost.... but it sounds like he's really willing to do individualised treatment rather than a 'one size fits all' approach so he may be worth every penny!
I have been very happy overall with Derek Lo... and I now think that the issues I have had are just to do with the way things are done here. From what I've heard from other people seeing different doctors I don't necessarily believe I'll be better off with someone else. It's just a case of getting a second opinion to get a second opinion. His costs are very reasonable. He definitely isn't the money grabbing type. I've been told that the total cost for my Frozen embryo transfer will be under $13,000. That said, I'm not pregnant yet so maybe it's a false economy.
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Thanks for the PM, Trying! Fantastic advice and the article was very interesting.
I actually had my FET today. It had been agreed that they would thaw and put back 2 embryos but 1 of them wasn't doing very well so they thawed an extra 1 and put 3 back. All very well except that they thawed the extra 1 without asking me whether or not that was what I wanted to do. I only found out immediately before the embryo transfer that they'd thawed three and were putting all three back. I'd already been there for over 30 minutes and no-one had said anything about this so it was a bit of a shock. I had asked someone about the grading when I was waiting for the procedure but there was no-one around with information who could speak to me. They just said that if there had been a problem someone would have telephoned me in the morning.
I then lay there for an hour after the FET with no clue as to the grading of the thawed embryos. Had they put 3 back because they weren't very good? What if I ended up with triplets? I tried to ask before I left but there was no-one around who could give me any information so they said they'd call me back later. By the time I left the building I was upset, stressed and very angry that they'd just made a decision without phoning me or making any attempt to tell me what the situation was. Not a good start to the two week wait.
They called back this afternoon and said that my chances wouldn't have been very good with only the one good embryo and that's why they'd thawed another one. I know that in the UK they're actually considering changing the law so that you can only put back 1 embryo each cycle to avoid the risk of multiples so surely my chances couldn't have been that bad. Also, as far as I'm aware, in the UK they're not allowed to put back more than 2 embryos with someone my age... I'm not sure if this is just for fresh cycle though.
In any case, the point is, if I had actually been asked what I wanted to do I would have said to just put the one embryo back and see what happens. I would have been against thawing another embryo. My reasons are that as this cycle has progressed I've been thinking that perhaps I'm not fully recovered from the fresh cycle so my chances might be a bit better if I waited a few months. Also, I would never ask for 3 embryos to be put back because I don’t want to risk triplets. Unfortunately for me they’d already thawed them and I was faced with the dilemma of putting all of them back or wasting one. Actually I didn’t even have much of a dilemma because they just told me they were putting 3 back. They didn’t ask me!
I tried to tell them that deciding to thaw another embryo was not their decision to make but they didn't understand me. It's like they just couldn't understand why I was annoyed.
Am I being unreasonable?
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Hello girls,
I have been seeing Dr Doo and went thru 2 cycle (July and Sep) with one IUI (not responding well to Gonal so eggs not growing at same rate) and 2nd time with only 7 eggs large enough to retrieve. 1 not good after retrieved, so I ended at the end with 5 embroys. Due to my age which is 40, we did PGD, all 5 is not healthy so I did not have any transfer at the end. It was so disapointing but the nurse at Sanatorium IVF centre said, this is common for women of my age.
My questions are what can I do to improve the quality of my eggs and how to increase the good size eggs.
Dr Doo is very nice but the problem I had with him is he is extremely busy and expensive. My 2nd cycle cost us about HKD120,000 (incuding all medicine, consultation, IVF Centre charge and all the blood tests). I saw in the forum that Philip Ho is charging about $70,000 and Queen's Mary private is $50,000, can someone advise?
Anyone heard of William So? I want to have second opinion with how to increase my eggs production. I am thinking to start again this month.
As for Kikidee, you should not feel too upset as I think you will get better chance with 3 than 2. Good luck to you!
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Hi Kikidee
Totally understand your annoyance. There is no excuse for lack of information or lack of consent on the process. You should have a word to your doctor. I would be very upset too. It is inexcusable for the doctor to not be there and talk to you both before and after the procedure.
On the positive - I have known of people who had 3 put back and one has taken successfully. I really hope that that is you too and that this all turns out for the best!
Good Luck K. Stay positive, watch loads of funny movies and enjoy being pregnant, 'cause arguably - you already are - so enjoy the 2ww.
T!
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Hi Kikidee
I understand why you feel upset - you're right: it should be your decision how many embryo's will be transferred.
Still, don't try to worry too much - the chances of triplets are very low and you will probably have a better chance now than with just one. I had 3 transferred (they were frozen in one straw and I did not want to re-freeze one and damage its quality) and am now pregnant with twins.
Good luck with the 2WW!
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Thanks for the support. I'm way too negative - I was already assuming it's not worked.... but you've both made me feel more positive.
Graceful - I'm really not sure what you can do to improve the egg quality... but I had heard that eating lots of protein and reducing exercise whilst you're stimming helps to produce good eggs. This is because the protein helps with the formation of the eggs and if you exercise your body is using up the protein and energy to repair muscles rather than forming eggs. I'm really not sure if any of this will help in your case because of the age factor but it's worth a go. As for saying I shouldn't be too worried, I take your point and have calmed down a bit since yesterday. I do think that it was wrong of them not to give me information though - especially as I was stressed after the procedure (which won't have helped my chances!). I think there may be a cultural difference in terms of how things are done here. I was expecting to be consulted about my treatment every step of the way, whereas here I feel I'm having to push for information and decisions are being made without me. Are patients generally expected to hand themselves over to the medical profession with a "Doctor knows best" attitude?
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Dear Kikidee,
Yes, local culture is "Doctors know best" for most doctor. Before going to my current doctor, I have tried 2 other female doctors (I was dreaming that female doctor will be more understanding, caring etc..) and their attitude are so "they know best". My first lady doctor was my first pregnancy last year (naturally) that tested chromosome problem. It was very late at 5 months that we needed to terminate the pregnancy. We had an aweful experience at a very sad time. I changed doctor to my current to do the termination.
Another friend recommended another female doctor for second opinion concerning IVF, she refused to give me any written information and tell me to follow her verbal instruction. ???
Anyway, we have very good experience with our current doctor but he is extremely busy and expensive. Any recommendation of doctor? I heard of name like Philip Ho (around $70,000), Queen Mary (around 50-60,000)... Anyone knows of William So?
Take care and good luck! Thanks for all the tips about protein and less exercise.
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788
17 yrs ago
graceful, sorry to hear about your loss and experiences with the drs. It is already hard, some of them can make it unnecessarily harder.
I have heard of Dr. So. In fact I went to him when I first arrived here in HK to look for any uterine fibroids. He had been recommended by my endocrinologist in NYC. Cornell (a top ivf places in the US)was going to open a clinic with him and it did not work out for some regulatory reasons. I hear he is huge in the Japanese circle/ Japan- people come to him from abroad. He was very nice and his staff is very helpful too. As far as why I did not go to him- my criteria for all my drs has always been that I need a personal recommendation, specially for a fertility specialist. Being new here, I did not know anyone who knew him personally.
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Thanks 788.
I have an appointment with Dr So this coming Monday and will let you know how he is.
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Hi 788
Sorry to report so late.
Dr So was very very good!! He spent a lot of time explaining and personally, I like his way. I think he is very on top of his knowledge and very compassion. Highly recommended. We will start our IVF cycle again in Jan 2008. Crossing my fingers...
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