Our IVF Journey in Hong Kong

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Our IVF Journey in Hong Kong

A page to record our IVF journey. Unlike most couples, our IVF journey began as early as I was a teenager. Adoption.

I was diagnosed with a dominant genetic disorder, meaning that there will be a 50% chance of passing it onto the next generation in each natural pregnancy. Through a blood test, a molecular investigation was performed and the exact point of mutation was detected. Through genetic councelling, I was told that I have a few options of having children in the future:

1. Try to conceive naturally and perform Chorionic Villus Sampling (CVS) or amniocentesis whenever appropriate. I can opt for an abortion if the fetus turns out to be affected.

2. Go for IVF with pre-implantation genetic testing.

3. Just a bit of background information, typically CVS is performed at 11 to 14 weeks of gestation, whereas amniocentesis at 16-20 weeks. It takes around 4 weeks for a full report, and this is what is needed to see if the fetus is affected or not. Depending on the position of the fetus and other clinical situations, CVS may not always be able to be performed, meaning that I stand a chance of having amniocentesis done at week 20 and aborting at week 24. At the beginning, we wanted to try Option 1 to avoid taking a large amount of injections as well as spending a lot of our savings on the treatment. However, the idea of having a 50% chance of abortion so long into the pregnancy was what made us make our first appointment with the IVF Specialist.

19/02/2024

Happy 7 months to our precious baby boy. Time flies! It really seems like yesterday that I gave birth to this little creature. Parenthood has been incredible so far, although it can be stressful sometimes.

If you asked me whether it’s worth going through IVF or not in order to be 95% sure that the baby isn’t affected by the genetic disorder that I have, the answer is, definitely! Pregnancy is supposed to be happy news for most couples. I could never ever imagine having to wait for weeks to get to know whether the fetus was affected or not through an invasive prenatal test. There is also a small chance that the test could lead to a miscarriage. What if the fetus was healthy and I ended up with a miscarriage after the test? On the other hand, in case the test result showed that the fetus was affected, would I really have an abortion that long into the pregnancy?

There are a number of factors which a couple needs to consider before going for IVF. First, costs. IVF treatments are expensive and the success rate isn’t as high as you think. It’s like a gamble. You may end up paying a fortune and not being able to go home with a healthy baby. I personally know a couple who has been through IUI and IVF for 5 years with no success. I wonder how much money they have spent to date.

Another factor to consider is time. IVF is very time consuming. You need to visit the doctor every few days before the egg retrieval and embryo transfer processes. It’s not easy to give an excuse to sneak out to the clinic that often during office hours. I doubt that anyone would ever say to her boss that, o I am doing IVF and so I need to go to the clinic every few days to monitor on xyz. O yes I could be pregnant soon and on maternity leave in 9 months’ time. To tackle this, you may need to find a clinic that is near your office and try to arrange an appointment during lunch hours.

As for the idea of having to inject yourself for around 10 days, I am sure you will overcome this if you know that the injections will bring you hopes of having your own child or children.

Despite all these positive thoughts about our IVF journey, there is only one thing that I wish I did very early on in my pregnancy. In Hong Kong, the chance of getting sperms, eggs or embryos mixed up is very very slim. I don’t know the exact probability but even if it’s a 0.00000001% chance, there is still a chance. I should have opted for a non-invasive prenatal DNA test to ensure that the fetus that I was carrying was indeed ours. The test is indeed costly compared with those postnatal DNA tests and may seem like a complete waste of money for outsiders. However, in my opinion, it’s better to know the bad news in early pregnancy so we could take action on this. I did think of going for a DNA test after the baby was born. However, my heart completely melted when I saw the baby. If we did consider adoption after a few rounds of failed IVF, does it really matter if the baby and I are blood related or not? What if we discovered that the lab did make a mistake? Would I really swap “our” baby with another couple? In a more complicated scenario, the baby could be blood related to me but not my husband, or vice versa. Perhaps it’s better not to know the answer.

#試管嬰兒 #人工受孕 #輔助生育

14/07/2023

Less than an hr before I entered the 38th week of my pregnancy, I started experiencing some sort of contractions. I was told by the doctor that I should head to the hospital when the contraction comes every 10 minutes so I started paying attention to it.

The pain became stronger and stronger and I wasn’t in the mood of doing anything other than lying on my bed. Although I couldn’t tell how frequent the contraction was, we decided to head to the hospital at 3 am.

When we reached the hospital, the nurse put some sort of equipment on my tummy to measure the fetal heartbeat as well as uterus contraction. There really was contraction every 10 minutes or so so she tried to check my cervix using her fingers. It hurt a lot! Unfortunately, my cervix didn’t dilate but still I was advised to stay there.

I hardly had any sleep overnight due to the pain. The doctor came in the morning and by then my cervix was only 1 cm dilated so she decided to wait for another 3 hours.

3 hours later, the contraction, dilation, pain whatsoever were still the same, so she used medication to ripen my cervix in order to induce labour. Unfortunately, it didn’t work and she said if there’s no miracle the next morning then I should go for a caesarean.

Having a caesarean has never come to my mind unless there’s a medical need as I thought that va**na birth is the best for both the mother and the baby. I was also scared of having an injection on my spine for anaesthesia and even if I went for a natural birth I would avoid having an epidural.

Unfortunately, there was no miracle overnight and so I ended up having a caesarean. I had to fast starting from midnight to minimise the chance of vomiting during the surgery. After I got changed into the surgical gown, I was taken to the operation room ready for the surgery. After having given an injection on my spine for anaesthesia and the doctor made sure that it was indeed working, the surgery started.

Although I didn’t feel any pain, I did feel the doctor doing something on my tummy. Shortly after that, I heard the baby cried. Our son finally came to the world.

I had to stay in bed for 24 hrs after the surgery and could only have liquid after 6 hrs. Once the doctor came the following morning, I had all tubes removed and could get out of bed, and even had the chance to see and feed the baby, as well as started having soft food.

I left the hospital 3 days after the caesarian section. However, the baby had to stay for a little bit longer for some medical examinations.

#試管嬰兒 #人工受孕 #輔助生育

15/05/2023

I do wonder how many people are actually reading this page.

Anyway, I am currently 30 weeks pregnant so not long to go until we can see our baby. For those who are interested, IT’S A BOY!!!!! Although we have always wanted a girl, a healthy boy is good enough already.

We have been going for prenatal checkups both in the public and private sectors. In Hong Kong, under normal circumstances, the public sector will only offer 1 ultrasound scan at around 11 weeks. If you wish to do more than that, you will have to go private.

We have been going for ultrasound scans almost once a month. In recent scans, we were told that our baby is bigger than his gestational age. His belly and head are around 1-2 weeks bigger, and legs are almost 3 weeks longer.

In Hong Kong, it’s a legal requirement to start your maternity leave at least 2 weeks prior to your expected date of confinement, i.e. at 38 weeks. Since it’s not uncommon for first time mothers to give birth later than the due date, I have always been worried that I might have to sit at home doing nothing from 38 weeks until 41 weeks. However, during the recent appointment, the doctor told me not to worry at all. It’s almost certain that I either need to have an induced labour or a caesarean at around 38 or 39 weeks as it’s unlikely that I can give birth in a completely natural way due to the baby’s size.

Apparently, labour induction hurts a lot more than labour that starts on its own. With scoliosis (a curvature on the spine), having an epidural might not work on me. I am so worried that I will have to experience hours of pain. More importantly, if the induction doesn’t work out in the end, I will need an emergency caesarean, meaning that I need to experience the pain from both the induction and caesarean.

On the other hand, having a caesarean is a surgery. I will have a wound and a scar. It will also take me longer to recover than if I opt for an induction.

We are going for a maternity shoot in less than 2 weeks. Hopefully my tummy will be big enough for good pictures.

#試管嬰兒 #人工受孕 #輔助生育

21/03/2023

It’s been a while since my last update. I am currently 22 weeks pregnant so it’s more than half way through the pregnancy journey now.

So… last time I talked about when and how I found out I was pregnant, and also a little bit about my IVF journey. Now, let’s talk about what happened in the next part of my pregnancy journey.

In week 10, we went for a Noninvasive Prenatal Testing (NIPT), which screens for Down Syndrome and some other chromosomal conditions.

In Hong Kong, there are 2 main tests available in the private sector: NIFTY and T21. In short, they are done by different labs. With these 2 tests, you can also opt for the basic or advanced version, and of course the latter one can detect more chromosomal disorders. The only drawback is that the advanced version tends to give more false positive results, which could lead to unnecessary worries for parents-to-be. Nevertheless, both tests can tell you whether you are having a boy or a girl.

As I already went for PGT-A during my IVF journey, in theory, I shouldn’t need to do this test. However, for safety sake, I still chose to do it, but only the basic version. The result came back in around 5 days. Everything was normal and we also knew whether we were having a boy or a girl.

In week 11, we went for another NIPT provided by the government, which is called the OSCAR (One-Stop Clinic for Assessment of Risk). For this test, an ultrasound scan was performed to confirm the gestational age and foetal size. Then, the foetal Nuchal Translucency and the skin thickness at the back of the foetus’ neck were also measured. Afterwards, my blood was taken for measurements of the level of Pregnancy Associated Plasma Protein-A (PAPP-A), and free beta-human Chorionic Gonadotropin (free beta-hCG). Software was then used to determine the risk of Down Syndrome. Since I wasn’t called back to the hospital regarding the results, I assumed that everything was fine.

In week 20, we went for the foetal morphology scan. This was done by an obgyn who specialises in maternal and foetal medicine. My appointment was at 9:30 am. The day before the scan, the nurse reminded me to ensure that I had breakfast before I arrived, or else the foetus could be inactive, which would make the scan even harder as foetal movement was necessary for a successful scan.

The results came back positive. The foetus was healthy and even 1 week bigger than expected.

So… Do you guys want to know whether we are having a boy or a girl?

Stay tuned.

#試管嬰兒 #人工受孕 #輔助生育

30/01/2023

Good News! I am happy to share that I am currently 15 weeks pregnant.

I am happy to share my journey and here are some frequently asked questions:
1. When and how did I find out I was pregnant?

As I was given a HCG shot, doing a pregnancy test too early would give me a false positive result as the test detects the pregnancy hormone (HCG) in your urine.

My doctor was rather open-minded about this. Instead of telling me that doing a home pregnancy test isn’t advisable, she taught me how to test out my trigger shot.

As I started doing pregnancy tests after my transfer, these were what I noticed:

a) The test lines got lighter day by day until 4 days after the transfer.
b) On day 5, the line seemed to have got slightly darker.
c) On day 6, the line got lighter.
d) On day 7 onwards, the lines were getting darker day by day.

Based on the above, I believe that the HCG from the trigger shot did stay in my system for around 11 days, which explained why the test line on my pregnancy test got darker on day 5 and then lighter on day 6, since the test detected the HCG from both the trigger shot and those produced by my body on day 5.

10 days after the transfer, i.e. 15 days post ovulation, I was called to the doctor’s office for a blood test. The result came back within a few hours and I was told by the nurse that I was considered pregnant based on the HCG level in my blood, but the level was a lot lower than average. It could mean that the fetus wasn’t growing properly, it might have been a chemical pregnancy, or there’s nothing wrong at all. As a result, I was told to take another blood test a week later to check on my HCG level.

Luckily, my HCG level was considered normal by then. I was given a transva**nal ultrasound to confirm that the fetus was indeed inside my uterus and wasn’t an ectopic pregnancy.

2. Did everything go smoothly during my IVF journey?

No. In fact, it’s been a roller-coaster ride.

Firstly, on the day of my ovulation, I was told that my uterine linen was very thin and it might not reach the optimal thickness on the day of my transfer, which would lower the chance of success. However, my doctor prescribed me some hormone supplements, and at the same time, with the help of chinese medicines and acupuncture, my uterine linen finally reached an optimal level after 4 days, ready for the transfer the next day.

Secondly, 14 days after my ovulation, which was when my period was supposed to be due if I wasn’t pregnant, I noticed some menstrual period-like discharge. As the home pregnancy test showed that I was pregnant, and that it’s unlikely that I would get my period in case I wasn’t pregnant due to the hormone supplements I was taking, I thought I was having a miscarriage.

3. Did I have to take a lot of medications? And for how long?

You may refer to the attached photo for the amount of medications I had to take from day 3 of my menstrual cycle, up until I was 12 weeks pregnant. I am not even kidding. These could have been more than what I have taken over the last 3 decades.

#試管嬰兒 #人工受孕 #輔助生育

17/12/2022

Embryo Transfer

As I planned to do my embryo transfer in this cycle, I had been doing blood tests to look for my LH surge in order to know when I ovulated.

After 3 blood tests within 3 days, the doctor finally figured out the day of my ovulation. As it was a day 5 blastocyst transfer, 5 days after ovulation would be my day of transfer. I was prescribed some hormone supplements to help thicken my uterine linen as well as given a HCG shot to induce my ovulation.

On the day of transfer, I arrived at the clinic at 9 am in order to get ready for my transfer at 9:30 am. Since I had to have a full bladder for the transfer process, I started drinking water from 8:30 am.

The transfer process didn’t hurt. However, it was a bit uncomfortable when the doctor put the equipment into my va**na. Apart from that, I also had to hold onto my p*e.

To start with, the doctor had to sanitise my va**nal area to prevent infections. Next, she put some sorts of equipment into my va**na and afterwards transferred the embryo into my uterus with a catheter. I could see the whole process via the ultrasound.

Unfortunately, the process was a bit uncomfortable and since I was desperate for the toilet, I wasn’t in the mood of watching the ultrasound or listening to what she said when she explained what she was doing.

After the embryo was transferred into my uterus, the embryologist took the catheter away and looked at it through a microscope to make sure that the embryo was successfully transferred and didn’t get stuck in it.

I went for a blood test for my progesterone level right away. As it was slightly low, I was prescribed some hormone supplements to go home with.

For the next few days, I had some sorts of mild period-like cramps and pinching feeling down my bikini area. I suspected that could be what people referred to as the implantation pain.

I started doing pregnancy tests the day after my transfer as I wanted to test out my HCG trigger shot. Since I was injected with HCG on the day of my ovulation, there would be HCG in my system. Without testing it out, it would be hard to know if my positive pregnancy tests later on mean I am indeed pregnant or they are caused by the injection.

Stay tuned to see what happens next.

#試管嬰兒 #人工受孕 #輔助生育

30/09/2022

About Us

Unlike most couples, our IVF journey began as early as I was a teenager. I was diagnosed with a dominant genetic disorder, meaning that there will be a 50% chance of passing it onto the next generation in each natural pregnancy. Through a blood test, a molecular investigation was performed and the exact point of mutation was detected. Through genetic councelling, I was told that I have a few options of having children in the future:

1. Try to conceive naturally and perform Chorionic Villus Sampling (CVS) or amniocentesis whenever appropriate. I can opt for an abortion if the fetus turns out to be affected.

2. Go for IVF with pre-implantation genetic testing.

3. Adoption.

Just a bit of background information, typically CVS is performed at 11 to 14 weeks of gestation, whereas amniocentesis at 16-20 weeks. It takes around 4 weeks for a full report, and this is what is needed to see if the fetus is affected or not. Depending on the position of the fetus and other clinical situations, CVS may not always be able to be performed, meaning that I stand a chance of having amniocentesis done at week 20 and aborting just before week 24.

At the beginning, we wanted to try Option 1 to avoid taking a large amount of injections as well as spending a lot of our savings on the treatment. However, the idea of having a 50% chance of abortion so long into the pregnancy was what made us make our first appointment with the IVF Specialist.

#試管嬰兒 #人工受孕 #輔助生育

30/09/2022

21 Sep 2022

I received a call from the clinic today telling me that lab results part 2 are ready and the doctor would like to schedule an appointment with me to discuss the next steps. As I was desperate for the results, I asked whether it's possible to let me know over the phone or not. However, this wasn't possible. As a result, I went to the clinic right after work.

Out of the 4 blastocysts, 2 didn't pass PGT-M and thus no PGT-A was performed. 1 wasn't able to perform PGT and may require re-biopsy. In other words, I only have 1 healthy blastocyst for transfer at this stage. I will need to call the clinic on the first day of my upcoming period to schedule blood tests and check-ups with the doctor and see when the transfer will take place.

Hope everything will go well as I only have one chance.

#試管嬰兒 #人工受孕 #輔助生育

27/09/2022

11 Sep 2022

After the egg retrieval process, my eggs were taken for lab work.

The day of the egg retrieval was considered as day 0 and we received calls from the lab on days 1, 2, 3, 5 and 6.

On Day 1, we were told that out of the 24 eggs retrieved, 18 were mature enough for ICSI (Intracytoplasmic S***m Injection) and 16 were fertilised in the end.

On Day 2, out of the 16 fertilised eggs, 15 developed into embryos, and gradings were given as follows:
5 of Grade 2 +
6 of Grade 2
4 of Grade 2-

The diagram below shows what the gradings mean (see picture 1).

On Day 3, we were given an update on the gradings of the embryos. 1 embryo was downgraded from Grade 2+ to Grade 2.
4 of Grade 2+
7 of Grade 2
4 of Grade 2-

On Day 5, out of the 15 embryos, only 4 became blastocysts. For the remaining 11, 3 were dead and 8 were kept for another day and see how they would develop.

For those 4 blastocysts, gradings consist of a number and 2 letters were given.
5BB
4BB
3BB
4BC

The number shows the degree of cavity expansion (see picture 2.

The first and second letters show the inner cell mass and appearance of trophectoderm layer respectively (see picture 3)

On Day 6, we were told that those 8 embryos which were pending development into blastocysts did not make it in the end. As a result, we only have 4 blastocysts in total. Biopsy was performed and the cells will be taken for PGT-A (to identify embryos affected by chromosomal abnormalities that will affect an embryo by chance) and PGT-M (to help prevent certain diseases or disorders from being passed on to the child from the parent). The results will be available in around 4 weeks.

We were surprised that out of the 24 eggs retrieved, only 4 managed to make it to this stage. Fingers crossed for lab work part 2 and hopefully I don't need another cycle of injection.

#試管嬰兒 #人工受孕 #輔助生育

27/09/2022

5 Sep 2022

My surgery started at 8 am today and I was told to arrive at the clinic by 7:30 am. That was extremely early as I had to set off from home by 6:15 am.

I wasn't allowed to eat or drink anything starting from 12 midnight. However, I had to take antibiotics with a tiny sip of water at 6 am.

When we arrived at the clinic, we had to sign some forms and once these were done, I was taken to the preparation room to do a Covid-19 Rapid Test to ensure that I wasn't infected.

Whilst waiting for the test result, I had to get changed into my surgery clothing and when I was ready, I was taken to the operation room.

The surgery was done under Monitored Anaesthesia Care. Medications were injected through the back of my hand and I fell asleep within 1 minute. My husband was told to collect his semen samples whenever he was ready. It might sound a bit sarcastic, but whilst I was being tortured by the doctor in the operation room, my husband was having fun watching porns and collecting his semen samples.

The surgery lasted for around 30 minutes and when I woke up, I was already in the recovery room. I wasn't in a lot of pain. It just felt like period pain, a level that I would need to take painkillers if I had to go to work. I pressed the bell for the nurse and she gave me a hot water bottle for pain relief and I was a lot better within 15 minutes.

I had to lie down for another hour and after that, I could get out of bed and walk to the waiting area to see my husband, ready to go home.

#試管嬰兒 #人工受孕 #輔助生育

27/09/2022

3 Sep 2022

I didn't have much to update after the last 2 follow-up consultations as the doctor only took a look at the sizes of my follicles to make sure that they were growing properly.

It was my 4th follow-up appointment this morning following the start of the hormone injection for super-ovulation. I am so glad that I am now ready for the egg retrieval process in two days.

Instead of having the regular injection tonight, I will be taking the trigger shots. There are two shots and I need to take one after one. I was given a specific time to take them and it is important that I do it within 15 minutes of the set time in order not to affect the egg retrieval process. The nurse reminded me to set an alarm as she does come across with patients who totally forget about this from time to time.

There's nothing I need to do tomorrow. All I need to do is to go to bed early as I need to set off to the clinic very early the next day.

#試管嬰兒 #人工受孕 #輔助生育

27/09/2022

27 Aug 2022

After having had the hormone injection for 4 days, I went back to the clinic for another ultrasound scan to see how my body is responding to the medications.

Unfortunately, the size of the follicles are not growing in the rate of what the doctor was expecting. They are still relatively small. However, they have grown in terms of quantity. Nevertheless, the doctor has increased the dosage of the hormone injection for the next couple of days and will see how things go a few days later. Hopefully by then I'll know when exactly the egg retrieval surgery will be done.

Fingers crossed!

#試管嬰兒 #人工受孕 #輔助生育

27/09/2022

23 Aug 2022

Our journey has begun

A few weeks ago we got a call from the clinic telling us that our "Workup before PGT" report was ready and we may start the hormone injection once my next menstrual period comes.

My period came yesterday so I called the clinic and scheduled an appointment with the doctor today. After having an ultrasound scan, we were told that there were 17 follicles. As for how many eggs can be retrieved in the end, it will depend on how well my body respond to the fertility drugs.

I had my blood taken for some hormone tests. After that, the nurse taught us how to administer the injection. It was a rather emotional moment. However, once I managed to give myself the first shot, I felt much better.

#試管嬰兒 #人工受孕 #輔助生育

27/09/2022

17 Jun 2022

We've made the decision!

We first visited the doctor in May 2022 and spent over an hour asking all of our questions and learnt more about IVF, as well as extra procedures we have to go through due to my genetic disorder. After having serious thoughts about this, we have decided to go for it and hence arranged another appointment to sign all legal documents as well as taking blood for some basic testings as well as a procedure called "Workup before PGT".

The basic blood test was to see whether we have any STDs such as Hepatitis B and HIV or not. As for the "Workup before PGT", it's only for me and this is necessary in order to perform PGT-M at a later stage.

For couples who do not need PGT, the women may start their IVF journey when they get their menstrual period after they have got the basic blood test results. However, for me, I need to wait for the report from "Workup before PGT"and this takes around 4-6 weeks.

#試管嬰兒 #人工受孕 #輔助生育

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