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Egg Freezing SAFE Fertility Center

Eggs Freezing (Oocyte cryopreservation), New choice for Mother to be in 4.0 era

It cannot be ignored that a woman in this 4.0 era often gives work as the first priority, likes freedom life and loves being single. Also many people accept to be an old maid. Some people decided to get marry when the age is nearly 35 years old or more. Additionally, this situation leads to risk of pregnancy failure.

When a women‘s age increase, the quality of ovary is consequently decreased. It represents that the eggs is the key of the successful pregnancy as same as women that have risk of ovary failure condition. In a group of women who has passed the chemotherapy, operation, some of pelvic disease, or using medicine that might damage cells, these issues influence the failure of pregnancy or difficulties of having baby.

Hence Eggs freezing is new beneficial chance for modern age

Eggs freezing methodology’s starts with hormone injection in order to increase the amount of egg, then eggs collection is performed. Then those eggs will be frozen in nitrogen tank at -196 °C as bio-clock has stopped and keep it until the owner wants to have baby. Therefore, the owner can thaw her frozen eggs and fertilize with sperm and wait till the embryo’s cell divided and transfer back to uterus.

Each eggs collection – many eggs will be collected in order to prevent the error. The ovary’s stimulation is used to stimulate the ovulation. When eggs completely developed, the doctor will collect the eggs via vagina and those eggs will be frozen in the tank at -196 °C

When does egg collection should be performed?

If you purpose to have baby, earlier planning is the best answer to encourage the perfect pregnancy.
Therefore, the proper age gap of egg collection should be no more than 38 years old due to the increasing of age, the quality of eggs decreases.

The reason that women are interested in doing egg collection because the many risks during the advance maternal age pregnancy such as the chance of miscarriage and risk of abnormality of chromosomal number ( i.g. Down’s syndromes which leads to severe intellectual disability )
Most of women concerns about these risks therefore egg’s preservation is one of choice in their plan. This will help them to manage the instability of their future of pregnancy because they still have the perfect and strong eggs in the store as another options in future.

 

Eggs freezing are not only giving the opportunity of pregnancy, but it gives opportunity of having healthy baby.

The main point is similar to stem cell that we can keep it for future but this is the preservation for keeping own eggs for getting pregnancy. Because of these days the doctor confronts with the patient with advance ages. There is irresponsive to medicine and stimulation. Hence, instead of saving cost when the body is still healthy, strong and in the reproductive age, the patient spend more due to the time has passed. Furthermore, some patient needs to do several cycles. Thus, freezing their eggs might be prevention for difficulties of pregnancy.

According to the report, the success rate of pregnancy from frozen eggs is nearly to the pregnancy from fresh eggs
Eggs freezing may be a choice of woman who has health problem or single because she doesn’t know when she will meet a man that she wants to marry.

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ฟองไข่กับอัตราความสำเร็จของการรักษาด้วยวิธีเด็กหลอดแก้ว

Eggs and IVF Success Rates

How woman’s age, egg’s quality, number of retrieved eggs, womb, sperms and the method of embryo transfer affect IVF success rate?

  To determine the chance of getting a healthy baby, the key factors are woman’s age, egg’s quality, number of retrieved eggs, womb, sperms and the method of embryo transfer (fresh or frozen).  

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HCG and Day 2 embryo transfer

hCG and Day 2 embryo transfer

Human chorionic gonadotropin (hCG) is a hormone produced during pregnancy and is responsible in the preparation of endometrium for the implantation and the development of embryo in an early pregnancy. Once the fertilization takes place, the trophoblast cells which surround the developing embryo begin to produce and secrete hCG. hCG’s primary role is to keep the corpus luteum functioning, so that the corpus luteum continues to produce estrogen and progesterone. The presence of hCG can be detected in the maternal serum 7 days onwards after implantation.

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จะมีลูก ... ต้องวางแผนอย่างไร

Preparation before having a child

Preparation before having a child

Preparation before having a child

Preparation before having a child  

Having a baby or fulfilling your family starts with get ready for being parenthood which be able to look after your child with happiness. 

Acting parents can prepare yourselves after these followings:

1.   Physical Preparation Taking good care health of you and your partner. Having beneficial food and do regularly exercise. Including taking an enough rest, no smoking, no alcohol, and no drugs.  

 

2.  Mental Preparation Ones who wish to be parents should arrange your stress and emotion carefully. Always trying to being cheerful. In order to balancing your hormones and preparing for any changes could be happen in the future.  

 

3.  Financial Preparation As you might already know, having a baby costs so much money. Not only clothes, appliances, but also other utensils and toys. And they are needed in a lot of numbers. You should prepare yourselves for these expenses.  

 

4. Raise-Up Management Adding one or two babies in your house means your personal time might be disappear instantly. Because you could not afford to take your eyes off the infants. Then you should manage your schedule carefully.  

 

5.  Residential Preparation Normally, for 2 persons living in a condo or an apartment may not cause so much problems. But when comes to having a boy or a girl in the age of curious, you have to clear your space more and more.  

6. Consultation with Obstetrician For being safety pregnant and the health of mother and her children, consultant is necessary.    


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Chance of Pregnancy after IVF

Your chances of success with IVF

Your Chances of Success With IVF

Your Chances of Success With IVF

Why, after IVF procedure, some got pregnant and some not?

Patients often ask how many amount of follicles they have, if their follicles’ quality are acceptable, or what their chances of pregnancy are. The answers, to all these questions, depend on the ovarian reserve and the quality of ovary they have.

Ovarian reserve is a term that is used to determine the capacity of the ovary to provide egg cells that are capable of fertilization resulting in a healthy and successful pregnancy.

Ovarian Reserve Tests

Age Female reproductive aging is a process that follows the generally accepted theory that over time, oocytes decrease in quantity and quality and do not regenerate. In uterus, there is a rapid multiplication of germ cells starting at six to eight weeks. By the time the female fetus is at 16-20 weeks, she has a peak of six to seven million eggs. This number declines to one to two million eggs at birth, falling even further to 250,000 to 500,000 eggs at puberty. Every month, a certain number or percentage of immature eggs is selected for maturation. One of these eggs will ovulate and the rest will regress, die and be reabsorbed into the ovary through atresia. The number of eggs selected is dependent on the number of immature eggs in the pool.

 

Quality of Eggs The rates of abnormality in eggs are much higher in older patients. With the age lower than 35, only 10% of patients found to have abnormal eggs. As the age rises up to 40 years old, there’s a chance of abnormality at 30%, and continues up to 40% at the age of 43. By the time the number of age reaches up to 45, the chance is doubled up to almost 100%. Microtubules, known as a spindle, play a crucial role in egg developing; they pull and hold eggs’ chromosomes to complete the development of the eggs, making them to become matured. As the woman ages, the quality of microtubules declines; easier to be tear and destroyed. Therefore, the state called non-disjunction happens, followed by an abnormal embryo with trisomy 13, trisomy 18, or trisomy 21.

 

Medical History Women with history of giving birth, which indicates a good quality of eggs, have a high chance of pregnancy while unsuccessful pregnancy history predicts a less successful outcome.

 

Antral follicle count (AFC) is performed with high quality ultrasound equipment to evaluate a woman’s ovarian reserve by counting and measuring small follicles (about 2-9 mm in diameter). If the number of eggs is lower than 6, it is predicted the low function of ovary.

  • Advantage: Quick and easy, possible to know the approximately number of eggs before starting the treatment.
  • Disadvantage: require professional’s performance.

Basal FSH day 3 is a measurement of FSH hormone routinely taken on Day 3 of the patient’s menstrual cycle. A good quality of egg will resulted in high levels of estradiol and inhibin B hormones, and low level of FSH hormone. The signs of low ovary function include; levels of FSH hormone more than 10 mIU/mL and of estradiol less than 80 pg/ml.

Advantage: Quick and easy. Disadvantage: Level of FSH hormone changes in every month, and if a patient takes estradiol or progesterone pills such as birth control pills, the result might be lower than it should be.

AMH Antimullerian hormone (AMH) is a hormone produced by ranulose cells of growing preantral and small antral follicles.

Advantage: The level of hormone is stable and related directly to the numbers of eggs in the ovary, high in accuracy and reliability. Disadvantage: High cost and no global standard.

 

 

Dr.Kittawee Rattanawattanasin,

Dr. Kittawee Rattanawattanasin, MD

(Obstetrician and Gynecologist Subspecialty in Reproductive Medicine)

For more information

Talk to Dr. Kittawee

ขอสงวนสิทธิ์ตอบคำถามเฉพาะท่านที่ให้ข้อมูลที่สมบูรณ์เท่านั้น

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การส่องกล้องตรวจโพรงมดลูก Hysteroscopy

Hysteroscopy for Infertility

Hysteroscopy for Infertility

Hysteroscopy for Infertility

Why Hysteroscopy?

Hysteroscopy has become increasingly popular among infertility, although there has been an argument whether the procedure should be done before starting embryo transfer or after the failed result comes out.  A study issued in Reproductive biomedicine online, 2014, found that: “Hysteroscopy before IVF increases both the clinical pregnancy rate and the live birth rate”

CPR-Hysteroscopy

The forest plot shows the compared clinical pregnancy rate (CPR) between the groups of patients with and without hysteroscopy. The group with hysteroscopy has a greater clinical pregnancy rate than those without up to 44% (RR 1.44, CI 1.08-1.92).

Who is Hysteroscopy for?

  1. Patients with repeated failure of implantation
  2. Patients with suspected major uterine cavity abnormalities diagnosed by ultrasound such as;
  3. endometrial polyps
  4. Intrauterine adhesions
  5. Submucous myoma uteri
  6. Patients with good quality embryos with recurrent implantation failure (RIF), e.g., three times of unsuccessful pregnancy whether by fresh embryo transfer or frozen embryo transfer, with four good quality embryos to transfer at the least.

Causes of Recurrent Implantation Failure

From a study of 70 women with RIF (three times of unsuccessful embryo transfers at the least) diagnosed by hysteroscopy in 2015, found the possibility of chronic endometritis, which are:

  1. Small endometrial polyps
  2. Irregular endometrial lining and hyperremia

After the treatment with antibiotics, the treated group has significantly higher percentages of clinical pregnancy rate (CPR) (65% vs. 33%, p=0.039) and live birth rate (LBR) (61% vs. 13%, p=0.02) and lower tendency to miscarriage than the group with chronic endometritis. Chronic endometritis adversely affects uterine receptivity resulted in the decreasing of implantation rate. There are many causes of implantation failure, therefore, the complete diagnosis from medical history taking (e.g., abortion, ovarian stimulation, embryo transfers, and the quality of embryo) along with uterus scan and laboratory blood tests are needed to determine the cause of failure.

 


 

Dr. Nattharut Kulphaweesuwan, MD

Dr. Nattharut Kulphaweesuwan, MD

(Obstetrician and Gynecologist Subspecialty in Reproductive Medicine)

For more information please contact

Talk to Dr. Nattharut Kulphaweesuwan

May I reserve the right to reply to inquiries that provide a complete information.
ขอสงวนสิทธิ์ตอบคำถามเฉพาะท่านที่ให้ข้อมูลที่สมบูรณ์เท่านั้น

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Boosting your IVF Pregnancy and Live birth success rates

Boosting your IVF Pregnancy and Live birth success rates

Boosting your IVF Pregnancy and Live birth success rates

Boosting your IVF Pregnancy and Live birth success rates

Increasing your IVF success rate

An essential step for successful IVF outcome is the selection of high-quality embryos for transfer. With this thought in mind, we have been using the exclusive methods and the latest technologies for the better quality of your embryos.

Next Generation Sequencing (NGS)

NGS by Illumina

Next Generation Sequencing (NGS) – Safe Fertility Center

The human body is made up of several organ systems all working together as a unit to make sure the body keeps functioning. These organs are different in each person both in anatomy and functions due to genes and DNA. There are significantly differentiations between the sets of DNA in a person with and without Chromosomal abnormality. Next generation sequencing technology (NGS) is the latest technology developed to identify the abnormality in DNA which has been adapted for chromosome screening of embryo. Because of its accurate, effective and fast result, NGS can help improve the success rate of clinical pregnancy; especially in the cases of patients with repeated miscarriage, with age higher than 28 years old, or with repeated IVF failure.

Embryoscope

Embryoscope – Safe Fertility Center

Embryoscope

is an incubator that maintains the necessary physiological conditions required by a living embryo while they are in the IVF laboratory. It has an incorporated time lapse system that has a camera that continuously captures images and records them as a video of the embryonic development. With this information, the embryologist can select the best embryo for transfer. Furthermore, we have been using embryo glue and atosiban to improve the effective of embryo implantation, consequently, increase the success of your clinical pregnancy rate.

EmbryoGlue

EmbryoGlue consisted of Hyaluronic acid helps the embryo to implant by increasing the adhesion of the embryo to the endometrium. Compared to patients who transfer without embryo glue, those with EmbryoGlue have a higher rate of clinical pregnancy around 7% or 1.5 times.

 

 

Oxytocin Antagonist (Atosiban)

is an inhibitor of the hormones oxytocin and vasopressin. It is used as an intravenous medication as a labour repressant to halt premature labor which can to improve the clinical pregnancy rate significantly. Planning for treatment and embryo transfer depends on each patient’s problem and difficulty; therefore, it is suggested for the patient to consult carefully with the doctor for the best outcome.

By IVF PHUKET

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Lite IVF/ICSI

Lite IVF/ICSI?

Lite IVF/ICSI

Lite IVF/ICSI

What is Lite IVF/ICSI?

Nowadays, IVF/ICSI is considered to be the most effective treatment for infertility with its important method of follicle stimulation.

To get the appropriate amount and size of the follicles, Follicle Stimulating Hormone (FSH) containing drugs are used to stimulate follicles to develop and mature.

Variety of Follicle Stimulating Hormone (FSH) containing drugs will be adjusted for each patient whose, in some cases, dosage could reach up to 3,000-4,000 units per cycle.

At present, there are many studies involving minimal ovarian stimulation for in vitro fertilization in poor response group of patients. What they found is that there is no difference in quality and quantity of follicles whether high or low dosage was used, which resulted in the same successful clinical pregnancy rate. Therefore, with lesser dosage of drugs, poor response patients will benefit from better well-being in both body and mind, and also from lower cost of medications.

Moreover, according to the Fertility Sterility medical journal, August 2015, in a group of patients with young age and normal response to Follicle Stimulating Hormone (FSH) containing drugs, the use of low dosage resulted in similar pregnancy rate around 40-70% as in usual dosage.

However, the amount of follicles will be lesser in low dosage users than average (the average is around 5-8 follicles).

There are no complications such as Ovarian Hyperstimulation Syndrome (OHSS) to be found.

 

Which patients will benefit from Lite ICSI?

  • Age less than 36 years old
  • Body mass index less than 29 kg/m2
  • Anti-Mullerian hormone (AMH) more than 5 ng/ml
  • No pathology nor surgery of pelvis

“Lite ICSI is like a lite yogurt with its soft, low calories which gives you a better well-being. There will be less pain, less cost, and more successful pregnancy rate for infertile patients.”

 

นพ. มานพ จันทนพันธ์

Dr. Manop Janthanaphan, MD.
(Obstetrician and Gynecologist Subspecialty in Reproductive Medicine)

สอบถามเพิ่มเติม

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การตรวจคัดกรองมะเร็งรังไข่ (Ovarian cancer screening test)

Ovarian cancer screening test

การตรวจคัดกรองมะเร็งรังไข่ (Ovarian cancer screening test)

Ovarian cancer screening test

Ovarian cancer screening test

Ovarian cancer ranks fifth in cancer deaths among women, accounting for more deaths than any other cancer of the female reproductive system. The number of new cases of ovarian cancer is 5 per 100,000 women per year. Epithelial ovarian carcinomas (EOCs) account for 80 percent of all cancers of the ovaries.

More than two third of ovarian cancer cases are found too late when it’s very difficult to treat. Currently there are no reliable screening tests for cancer detection with high accuracy. However, in some cases, cancer could be found and treated with care.

Symptoms

  • Frequent bloating.
  • Pain in your belly or pelvis.
  • Trouble eating, or feeling full quickly.
  • Urinary problems, such as an urgent need to urinate or urinating more often than usual.
  • Expansion of stomach, or a sudden change in waistline.

Commonly medical history of patients with ovarian cancer includes:

  • No children
  • Have family medical history of ovarian cancer, breast cancer, womb cancer, or gastrointestinal cancer

Patients with a risk of ovarian cancer will be treated with additional examinations such as physical examination, internal examination, ultrasound scanning, and blood tests (CA125+HE4) for diagnosis and treatment.

Treatment

Surgery is the initial treatment of choice for ovarian cancer, provided patients are medically fit , under the care of a gynaecological oncologist. Treatment plan should be carefully discussed between doctor and young age patient for the best treatment towards the chance of pregnancy in the future.

 

นพ. มานพ จันทนพันธ์

Dr. Manop Janthanaphan, MD.

(Obstetrician and Gynecologist Subspecialty in Reproductive Medicine)

 

สอบถามเพิ่มเติม

Contact us for more information

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