Saya masih memilih untuk menulis di alam siber secara percuma walaupun sesekali ada yang mencadangkan agar saya menulis buku mengenai infertiliti. Sebelum mencedok atau memetik 'ilmu' dari laman ini, anda tidak perlu meminta kebenaran tetapi diingatkan membuat semakan sendiri terlebih dahulu dengan doktor anda atau guru anda sebelum mem'forward'nya kepada orang lain dan memikul tanggungjawab akibatnya. Pohon doa kesejahteraan dan limpahan rahmat Allah ke atas guru-guru saya dan juga pesakit-pesakit saya yang banyak mengajar saya bidang ini. (peringatan untuk diri sendiri) Segala pujian bagi Allah. Mudah-mudahan, taubat saya diterimaNya dan segala dosa saya diampunkanNya serta saya terus dilimpahi rahmatNya. Sekiranya ada kesalahan, pohon dibetulkan, saya terbuka kepada teguran.

Sebarang percubaan berbentuk komen atau soalan bertujuan mengiklankan apa sahaja perniagaan atau blog sendiri tidak akan disiarkan. Blog ini bukanlah untuk iklan menjual barang. Peace.....

Wednesday, 4 June 2014

IVF Forum





One-hour session.
We adhere to almost Swiss-time punctuality.
Registration : 8.30-9am
Session starts at 9am, GMT +8 for Malaysia time zone
I have to be specific when talking about time here :))
30-minute talk followed by 30-minute Q-and-A and free consultation.

(Only a small group of couples is preferred (20 couples). Don't worry, this is a monthly session. I take turn with another IVF specialist/fellow)


Either in Bahasa Malaysia or English.


As always, please allow time for possible traffic congestion (although unlikely as it is still during school holiday, but it's Saturday when people go out shopping and eating outside) and also time to look for parking space.

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So, what's news?

Apart from the usual IVF talk (why, when, process etc etc),



Come and listen to the explanation as to why we advocate

BLASTOCYST STAGE Embryo Transfer.

See the difference above?
The sizes, for example.





Even blastocysts have gradings.
Even blastocyst embryo transfers do not result in 100% pregnancy rate.
But still,
Blastocyst Embryo Transfer (Day-5 or Day-6) gives the highest pregnancy rate compared to
Day-2 or Day-3.





So, we transfer your embryo/s on Day-5 or Day-6 when they should have developed into blastocyst stage (the top embryo)

Two embryos (mostly, in >85-90%)
or
One embryo (sometimes, in 10-13%)
or
Three embryos (in a small selected group, about 2-3% ie in those who had had unsuccessful IVF attempts or if there is only 1 blastocyst while the other 2 are still behind blastocyst-stage)

Never four embryos with this approach




No more on Day-2 (4-cell embryo). This embryo still remained at cleavage-stage (blastomere) on Day-5.





Not on Day-3 anymore (6-8 cells). The same with this embryo although it was already on Day-5.




and preferably not at morula stage, unless necessary (if the embryos are still at that stage even on Day-6)





 Blastocyst, dear.....




Blastocyst......




(seru lagi)

..........'Blaaaaaaastocyyyyyyyst'....

  :)


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Embryo selection is very important.

EMBRYO SELECTION.



Apart from 'rezeki',

..... probably that is why our pregnancy rate has always been maintained at above 50% every month, this year (except for January when it was 44%). All in. Every patient who underwent/completed the cycle until ET was included in these statistics (all age group including those who had taken the medicine 'wrongly' not as instructed).

One of the highest (if not the highest) pregnancy rates in IVF centres in Malaysia, considering I do NOT do IVF/ICSI using oocyte donor or surrogate mother or sperm donor (expectantly the pregnancy rate should be higher if oocyte donor, sperm donor and surrogacy are included).

This is higher than the pregnancy rate in normal couples (15-25% per cycle).

- Nothing to boast around as this can also happen to any IVF centre that does blastocyst culture.
- Nothing magical.
- Nothing to do with me (as I am not God)

We need to have a good IVF lab and embryologist.
That is factor number 1 in determining IVF success.

No 2 : patient factor.
- Healthy eating.
- Ideal body weight.
- Do not smoke.
- Have faith and do not easily give up.


ICSI-blastocyst : the way forward for us.

Embryo Culture until Day-5 or Day-6 is already included in the package price.



Sekian.




Green Earth untuk hiasan (memandangkan gambar2 embrio biru sahaja).

Cekur. 
(Sila abaikan rumput dalam background, maklumlah Puan rumah ini 'rajin' berkebun)
Sedap daunnya dihiris halus dan dimasukkan dalam bancuhan cucur udang. Isi/ubi cekur pula ditumbuk dalam ramuan pecal ikan pari/terung.



Daun kaduk. 
Kalau malas nak buat 'mieng kam', makan sahajalah daun tu seperti ulam.



Se'lautan' daun pegaga yang tumbuh syok sendiri. Sedap dijadikan ulam begitu sahaja atau dibuat urap.
Siapa yang singgah, silalah petik sendiri.




Semua kenal ikan gelama ni kan?



Kenal ikan ini?
Ingat pantun yang ada ikan gelama tu?



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Betul! Ini ikan kekek!


Hmm......

Malaysia tanahairku

Summer all-year-round.

Hujan berlian rupanya.......

Terasa sangat kerinduan ini.....


6 comments:

  1. Semoga dr dikurniakan kesihatan yang cemerlang dan dapat membantu golongan ttc seperti kami..Ameen..

    ReplyDelete
    Replies
    1. Terima kasih atas doa.
      Aamiiiiiin :)

      Delete
  2. Moga dimurahkan rezeki dan diberikan kesihatan yg baik utk dr cantek agar dpt membantu ttcians yg lain.. ameen

    ReplyDelete
  3. Assalamualaikum.saya nak tanya pandangan dr. tentang situasi saya. sudah berkahwin, belum pregnant. tinggi 149cm, berat 40kg. period regular normally on 27-29 days cycles. kecuali ada only a few cycles yg sampai 33-34 days, normally bulan yg saya consume supplement i.e. EPO. . sya telah membuat TVS pada jan 2014, CD13 dan saiz folikel plg besar cuma 13.6 mm, ovari satu lagi 10.0 mm. yg lain sume kecik. Gynae sahkan saya PCOS. She refused to do progesterone level test on CD21/7DPO since she was sure that i will not ovulate. Sya & gynae agreed to give chance to my body to conceive naturally for 6 months, but still xde rezeki. Jun 2014, on CD11 sya buat TVS lagi, uterus lining 6mm, satu folikel 15.9 mm, satu only 10+mm. yg lain kecik & my gynae was not happy with the size so we decided that I need medical help. sya akan start consume diane for my next 2 cycles. since bulan puasa dah dekat, my gynae x bagi sya consume metformin takut saya x btenaga utk puasa. so only after raya baru saya start metformin, then baru teruskan dengan clomid. FYI, saya tempting (masa yg sama setiap hari, sebaik bangun tidur) & my BBT charts show biphasic pattern which show ovulation happened, my luteal phase around 13-15 days.
    Apa komen dr.? adakah saya mengikut prosedur/step yg betul? Adakah saya boleh disahkan PCOS hanya melalui TVS? Bolehkah saya mempercayai BBT yang menunjukkan saya ovulated monthly? Adakah saiz folikel 15.9 mm masih kecil utk CD11? acording to BBT chart, saya biasanya ovulate on CD13-CD15 untuk 27-29 days cycles.
    Thanks dr.

    ReplyDelete
    Replies
    1. Soalan tidak kena pada tajuk topik di atas, lebih kepada peribadi. Ruang ini hanya bersifat pandangan umum sahaja dan tidak menggantikan pendapat doktor anda.

      Delete