Prof PC Wong - IVF with Norethisterone

bbcripps, that's y made me more wondering what's the problem in me? So that I can improve and make it happen for the next round!
coke in middle of the night???!!! U champion! wahahahaha! me not that big fan as you lor! same same, cos of tcc, gota give up cold drinks and food... so tot wana make myself happy, deprived mah keke if cant find any cold drink, eat ice i oso can!

I also tot wana do in Dec cos quite a few holidays then dont have to take loooong leave again, causing unhappiness among colleagues *roll eyes* but only get to see prof mid dec... so don't know can start in Dec or not...

but must go scan everyday???
 


Miric, my previous gynae explained that sometimes implantation fails cos the body is very stimulated fr the jabs, not calm, so it didn't or couldn't send out the correct signals to implant n sustain the pregnancy. Which is where endo scratching supposedly can help, cos the scratching supposedly can trigger the lining to activate the signaling process. But end of day, according to her, most times, it's due to chromosomal abnormalities, the embryos just stopped growing beyond a certain point. It's nature's way of ensuring u only get perfect healthy babies.

If u want to do in Dec, I think u can just inform CHR on day 1 of your cycle even before u see Prof. He only need to scan u starting fr day 10. But u must count ok, assuming your AF starts today, n your cycle is 30 days, u will ovulate end of the month, so your 2ww is actually first half of Jan.
 
Hello girls
@duffy bear yes i asked a report cause i go to my Home country And want to show it to my doc There - Loh doesn t need it in any case i think its good to have this is a one page resume of your fertility story so that you put it in your file show it to doctors and no need to tell again your whole story !
@bbcripps would not have done better on the ovulation process ;) except that i thought ovulation was 24 to 36h positive test no?
Ok have a nice day girls
 
Sisters I called nuh to make appt to see prof in dec before stim but seems like no appt till jan. I need to arrange endo scratch. How ar. On 9 dec I see him is my stim n af week. Pls advise wat to do
 
mesara said:
Sisters I called nuh to make appt to see prof in dec before stim but seems like no appt till jan. I need to arrange endo scratch. How ar. On 9 dec I see him is my stim n af week. Pls advise wat to do
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Did you call women's clinic or CHR to make the appointment? See if you can make the appt for endo scratch via CHR and see what they can advise.
 
Hi ladies, went to see dr loh juz now. Agreed wif gigi tat hes a crazy guy! So funny lah this guy. When i asked him abt my empty follicles, he shook his head saying pc wong again ar? U are not the first one who ask me this question.

He explained as wat machobaby had said. Error in triggering, technique or timing. He asked me wats my trigger jab, whether its ovidrel? I said ovidrel was during my 1st ivf. 2nd ivf was suprefact. He was so shocked when he heard suprefact! Said " this man must be crazy! Mayb getting old! Suprefact only is used to trigger those wif lotsa eggs to prevent hyperstimulation! But not for pple like u, who have low reserve! Aiyoh!!" Mayb tats y i only got 2 eggs.

Asked him how come i got lotsa follicles but only got 2 eggs. He said might be prof saw wrongly. Sometimes the tubes might look like follicles since my tubes are swollen, so theres chance he saw them as follies. He scanned me & said he can see quite a number of eggs in my ovary so he cant see why i only got 2 eggs. Told me to try dhea & told me the same dosage as my low amh buddies. Hes positive tat he can help me for my 3rd round. Tat gave me some assurance. At least i still got hope..feel great wif him as he listens well & dun give me the impression tat he wants to faster chase me out of the room. Hope he can be my miracle doc ☺️ *crossed fingers*
 
Girls i want to learn chinese only for this "aiyoh" expression - i wish i could translate it properly in french - syrian i am really happy for you ! Did not Know you had suprefact :eek:
 
@ syrian i dont understand you mean Loh say follies not eggs right?? We produce only one egg month when not stimulated
@tsf i would have thought cyst And ivf were compatible cause pcos girls have cysts but honestly trust your doc no? Was it prof ? What did they say exactly?
 
@syrian - I had suprefact also..... Maybe that's why 12 follies and end result only 1 fertilized egg?? :(

@tsf0205 - what kind of cyst? I had a dermoid cyst on my right ovary early this year and unlike other cysts, dermoid doesn't shrink so I did a laparoscopy earlier this year to remove it before starting ivf. Good to discuss with doc.
 
Miric maybe like wat bb blues said we should call chr. Will call them tomorrow.

Syrian loh is good. He did my dermoid removal when in kk. Super experienced person. From scan can say it dermoid cyst when other docs didnt confirm. Maybe what loh saw was your afc is ir. Follicles n eggs r different right. Did loh said wat is better trigger than suprefact.

tsf I alsi have endo cyst but prof said can go ahead with ivf. Dermoid must removed.

But when my iui failed with him he told me to try ivf with kk thats why I went to prof.
 
Gigi, sorry typo error..yup wat loh meant is follies not eggs. :D

Mesara, loh said trigger shot will depends on the condition of the person doing ivf. If low amh gals like me, who produce lesser eggs, he will suggest ovidrel coz low chances for us to hyperstimulate. For those with many2 eggs, he will trigger using suprefact to prevent hyperstimulation. Yup i agree hes goood! He did a quick scan & can tell tat i got endometriotic cyst abt 2cm on my right, just from the scan! Coz i think if doc not experienced, they cannot tell wat type of cyst tat u have based on vag scan..right?

Tsf, it depends on wat type of cyst. If endo cyst, its ok to do ivf without lap.
 
Anie, Im also not sure how prof decides who gets what trigger shot? Have not gone for my post review yet. Will ask him abt it. My post review on 11 dec..long way more to go..btw u mean u got 12 follies during stim but only gotten 1 fertilised egg? u also low amh?

Ladies, did anyone asked for a copy of your blood test results report or the embryologist report from prof? dr loh asked me abt the embryologist report (i.e stating the embryo's grading & quality) but told him nuh didnt pass me anything except the embryo's pic after ET. I think we should all have a report, maybe the summary of wat we went through so that it is easier for the next gynae to visualise our situation. Especially if we switch gynae rite?
 
Ladies, actually which one will determine if our ivf is successful? is it more on embryo quality or healthy womb? Heard stories abt those ladies with satisfactory embryo but still manage to bfp:rolleyes:.

Dr loh said success depends on embryo quality. He even told me a story of this 40+ old women who had bad quality eggs. But when she used donor eggs, she managed to bfp! So this shows tat quality more impt.

But i think if womb condition not optimal, even the best embryo cant survive..btw he not in favour of me going thro endo scratching. Asked him abt it as i worry i might have implantation problem since 2x failed to implant. He said not likely & told me no need unless i want him to do it..hmm wonder shd i or shd i not? o_O
 
Syrian, good to know that you have a constructive review with Dr Loh.

Was almost choke with laughing when he say Prof Wong again huh. Think most of the ladies with the same prob here went to see him. He must be wondering why so many Prof patients. Lol.

What dhea dosage he recommend? He can't determine the quality of the embryo from your pic? He din ask for my embryo report but I did tell him how many cells during transfer and think he can infer from there.

Regarding whether is the embryo quality or womb conditions that determine the success, I remember attending Prof's seminar, he showed us a statistic that women of late 30s to 40s using donor eggs has the SAME success rates as a 20s women. I was totally amazed by this statistic. So yes, embryo quality is more important. Well, regarding the endo scratching, I would say why not, this is not invasive or risky, so just do it to have a ease of mind. At least one thing less to worry.
 
Gd morning ladies!

Bb_blues, so far if nt wrong, gigi & machobaby went to see dr loh. Not sure if u or nervous_babe went to see him. Duno somehow i got this feeling tat prof cant help pple like us wif low amh. Hes better wif the pcos gals.

I forgot to bring the embryo pics yesterday so cant show him. He recommended 25mg of dhea twice a day. Ordered from iherb last nite liao. Asked abt the payment, need to pay all upfront 1st den claim frm medisave. Need to save more $. *oh gosh!* no more holidays for me! Yikes!
 
@syrian - I'm a weird case la. :oops: My AMH is not low. It's 14.4. My AFC was 9 during first scan and prof counted 12 follies during last scan on Friday. On ER day was told I had 4 eggs. Lost 2 during fertilization. Remaining 2 embryos were 1 good (transferred) and 1 poor (discarded). No chance to ask prof cos didn't want to ask during ET and post review done by Dr Anu.
 
Thanks ladies. It's dr sadhana from KKH. Was seeking 2nd opinion. Had a more detailed scan tdy. Shall ask her again on wat type of cyst it is
 
Hi ladies

Bbblues this link is great for me! Thanks
Ok tsf have other opinion and let us Know
Dear dhea buddies I had my periods for 3 days now spotting for 3 days so weird you have that too?

Syrian I feel the same yes - for the report yes I agree we need one and I asked for it they gave me a single page resume it's fine
Annie angel if I was you I would ask for explanation definitely yes
Take care
 
Tsf0205: ya... Check out wat the cyst and decide wat to do abt it... For me, dr chew also saw something in my uterus and advise me to do the hysteroscopy before I do a FET.... He suspect tat my early miscarriage was due to the fibroid or polyp in my uterus.... :(
 
Has anyone AF cycle gone haywire after Ivf cycle? My AF did come 5 days after BT in oct. My cycle is normally 28-30 days. But now haven't come....
 
Good morning everyone, im new to this thread. I wish to know more about endo scratching. How's the process like? Painful? Anything to take before or during the process? I will be doing my 3rd round of FET once af comes, so thinking of doing endo scratching before that. Can we do in the same cycle?
 
tsf0205 said:
Has anyone AF cycle gone haywire after Ivf cycle? My AF did come 5 days after BT in oct. My cycle is normally 28-30 days. But now haven't come....
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tsf, it is normal to have late AF for the cycle after the IVF cycle. My AF was late for 12 days after my 2nd failed cycle. I think there are some hormones still left in our bodies hence it will take a while to flush them out. You should be back to your normal cycle days after 1 or 2 cycles later. Don't worry. :)
 
bb_blues said:
I don't really know. But if the dr can see fibroid during normal scanning, it should be inside the womb, right?
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Bb blues fibroids can be at the interior exterior or posterior wall and may not be inside womb. Chk with the doc. I have two fibroids on the wall of womb and docs said leave it alone
 
bb_blues said:
I don't really know. But if the dr can see fibroid during normal scanning, it should be inside the womb, right?
Click to expand...
Bb blues fibroids can be at the interior exterior or posterior wall and may not be inside womb. Chk with the doc. I have two fibroids on the wall of womb and docs said leave it alone
babythots said:
Good morning everyone, im new to this thread. I wish to know more about endo scratching. How's the process like? Painful? Anything to take before or during the process? I will be doing my 3rd round of FET once af comes, so thinking of doing endo scratching before that. Can we do in the same cycle?
Click to expand...
Babythots I read it's ideal to do endo scratch on d21 of previous cycle.
 
babythots said:
mesara, tks. Do you know if its painful? And will we be sedated?
Click to expand...
Babythots I have no clue how the pain will be. But won't be sedated. Some ppl say its like pap smear and 1-2 mins of discomfort. Hope wont be as bad as us sonogram or hsg. I have scheduled mine on 28nov.
 



Endometrial Scratch Biopsy Helps IVF Success


Endometrial biopsy - also called scratch biopsy or endometrial injury - is a new technique which is being used to help embryos implant more successfully during in-vitro fertilization (IVF) cycles. Innovative new research has shown that superficially injuring the lining of the uterus can actually stimulate the womb to be more receptive to an implanting embryo resulting in a welcome boost to take home baby rates. This technique is especially warranted when recurrent implantation failure is suspected. Pregnancy rates may improve by up to 70% when this techniques is employed in the cycle before IVF.

Causing harm to confer benefit is not a new concept in reproductive medicine. Drilling many tiny holes in the ovaries - called ovarian drilling - and taking slices out of the ovary - called ovarian wedge resection - have long been used with great success to help re-start ovulation naturally after a long period of anovulation. When my clients have undergone these seemingly barbaric procedures, remarkably, a month or so later ovulation has spontaneously resumed and continued for some time.

The scratch biopsy is a simple procedure that can be performed by an OB/GYN familiar with the practice - called a '4 quadrant uterine biopsy' - in a simple office visit. Physicians are familiar with using this technique to collect tiny samples of tissue from various surfaces of the uterus to check for pathological changes. The procedure may be uncomfortable but could be worth it for the results. So far, my clients have reported that although a biopsy is a little uncomfortable, the procedure is extremely brief.

Endometrial biopsy is becoming more main-stream now that a number of reviews have been published on the success of the procedure in women with implantation faiure. A British review and meta-analysis (7) published in Reproductive Biomedicine Online, 2012, pooled the results from seven studies on endometrial biopsy which were performed in the cycle preceding IVF and included 2062 women.
This huge meta-analysis demonstrated that performing an endometrial biopsy in the cycle prior to IVF makes it 70% more likely that IVF will result in a clinical pregnancy when compared to no intervention. The researchers note that:

"The evidence is strongly in favour of inducing local endometrial injury in the preceding cycle of ovarian stimulation to improve pregnancy outcomes in women with unexplained RIF (recurrent implantation failure)."

"This study suggests that in women with RIF (recurrent implantation failure), inducing local injury to the womb lining in the cycle prior to starting ovarian stimulation for IVF can improve pregnancy outcomes..."

Similarly, a 2012 review (8) from The Cochrane database pooled data from five trials including 591 women and concluded that:

"Endometrial injury performed prior to the embryo transfer cycle improves clinical pregnancy and live birth rates in women undergoing ART..."

Here follows a brief overview of some of the individual studies on this remarkable new treatment for implantation failure. A Chinese study (1), published in Fertility and Sterility, 2008, randomized 60 women to receive an endometrial biopsy while another 61 women did not. The women who had scratch biopsies had live birth rates that
 
Mesara, tks for the article. May I know which dr is doing the endo scratch for u? Someone told me its very painful so we have to be fully KO for this procedure.

Are your embryos consistently good but failed to implant? (My case) Or is there other reasons to do endo scratch? Hope u dont mind me asking so much!
 
Babythots this will be my first ivf n endo scratch so I dont knw also. My appt is with prof so wonder if he will do for me
 
Good luck to you mesara! So cd21 is the best time to do? Whats the reason? Can I do few days before my af comes? My cycle is pretty long and I would prefer not to waste 1 full cycle if can.

By the way any ladies have done endo scratch with dr loh? Heard he doesn't really endorse endo scratch.
 
Hi girls
Wong told me endo scratch can be done anytime except during menses
Loh said "useless for my case my problem is quality even tough nuh rated my embryo good quality"
He did not say he was not in favor

My point i wont do cause this is similar méthod to D&C they scratch your lining (of course less than with DandC ) but still am scared they would damage it again
Plus i Never ever heard about this before am against any invasive procédure (ivf is more than i can bear lol) And for sure it Will Hurt me ( every Time they Hurt me i have antroverted utérus they Never have the right size spéculum Time to fix it am super tensed its a nonono for pap smear HSG etc. Lol)
 
Gigi, thanks for the sharing. Im thinking would it be good to endo scratch on like cd6, just after af, then allow it to rest for 1 weeksbefore FET. Or must i really bleed the full flow after scratch then let it grow again. My thinking is that after af, the lining re-grows again then isn't it back to square one? Anyone has the explaination as to why some recommend cd 19 or 21?

Hey but strange why your embryo rating would differ so much between wong and loh? Shouldn't it have some way to grade it across the board?
 
Hi ladies! Didn't post for a while cos had a small cold. How's everybody doing??

Anie, when is your BT? Should be soon right? All the best babe!! :)
 
Hi bbcripps me too have a cold cant beleive it with all the vitamins am taking thought i was microbesafe lol
@babythots well Loh said
" rating is based on egg visual which is not accurate - its not because oui have 8 cells on day 3 all similar that grade is great - the only way to be sure is biopsy which is (i Didnt Know) not allowed except for couple with genetic diseases
He says ivf failure is big most of the time due to egg quality not implantation proof is a woman over 40 with egg donor of a 25 yo has as much chance of pregnance as a 25 yo
Egg matters not the womb"
Hope its clear?
For your date question you re not back to square one after scratching it Will leave a scar - dont think the date matters of course day 21 your lining Will be ticker but no idea what relates to what
Bye
 
Hi nervous babe
Well i dont Know for me any surgery is invasive am completely scared by those procedures o_O This is lmy only view of course ! Bye :)
 
@bbcripps - today is 10dp3dt and I'm going crazy with anxiety!! The waiting has been sooo hard! BT on Thursday. Praying hard that my lone warrior is still fighting all odds! :p
 
Bbcrips n gigi am also down with bad flu. Cycle starting soon. We all shud recover soon. My cramps are all over abdomen back n thighs n i have been taking loads of painkillers. Wonder I will fully recover for endo scratch.

Anie all the best to you. Be strong n positive. Waiting for yr babydusts.

nervous babe hope the scratch is not as painful as us sonogram
 
Babythots you may want to consult prof on the procedure dates. Am not sure n i made my own appt for endo scratch. If he says I cant then I won't.

Gigi did u experience alot of pain during hsg n us sonogram due to anterverted uterus. I experienced tremendous pain n was thinking cud tat be the cause .
 
good da morning ladies...
me just recovered from flu too... and was quite occuppied attending to my furkid...

Anie> All the best to your BT on Thur! :D

Meaning if it is not egg issue, then it is womb issue? like my case? haiz... called Acu Dr that I'm BFN, she was shocked too... well... I just gota wait to see Prof in Dec...
 


Hi girls
@miric why you think its not egg issue ?
@mesara i had no pain during ET first Time ever a doctor insert properly the spéculum with me ! HSG lots of pain yes us sonography what is that?
 
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