IVF with Dr L C Cheng

daylesford said:
Eat like granny ???

For my diet pre stims and for fet preparation, i still take carbo in the morning. Lunch i would usually take oats, flexaseeds/flexmeal with chia seeds. Dinner will be more in proteins (high fat fish, lean meat, eggs) , salad with a little carbo.

I cut out all caffeine while preparing for my IVF stims cycle, fet and even in pregnancy.

Only difference in my diet was after 1st scan during my stimulation where i had many follicles i progressively increase my proteins intake to 10egg whites per day till the day prior my egg retrieval. Otherwise, just maintain a protein rich diet will do.
Click to expand...

Daylesday, what is the purpose if eating egg white during simulation injections?
 


olivia_f said:
Hi,dear. Thanks for the information. ☺
I am same age with you. No gov fund. I have done two fresh ivf cycle in sgh. No ET yet. Have two freeze d2 embryo. May do FET at Nov. If i fail FET,may consider to chang to private hospital.
Click to expand...
Hi Ovilia_f , have you done your FET?
 
DKCH said:
Daylesday, what is the purpose if eating egg white during simulation injections?
Click to expand...

If you are producing many follicles then a protein rich diet will help the follicles grow better. Quickest way to take in large amount of proteins will be through eggs whites. Else there is no need to deliberately consume additional eggs. Just a balance diet will do.
 
Sweet_babysoul said:
Hi finesse9702,

Thanks for sharing your journey, I just had my blood test report and it's a BFN :( well..I didn't cry out loud (yet..) as I've prepared myself for this...

Has it ever come across your mind to change Dr after your 1st 2 BFN..? Do u mind sharing..wht changes after the 1st two round so 3rd and 4th got u BFP? Im sorry about the miscarriages but at least it's rest assure that u can implant. I like Dr Cheng and everyone but sometimes I just feel like changing some part of the puzzle might work magic somehow...but MEFT lab to me works better than my last one coz seems they were able to cultivate better embryos for me..

Saw Dr Shiela and she ordered some tests done for me next week during my menses. Hai...the meeting with Dr Cheng..they were disapppinted as well and he tried to ans every question I had i appreciate that, and the suggestion was to rest for a while, more for mental recovery than physical, and do the last embryo transfer in Jan, on a natural cycle. I just learnt that all the hormone pills might have effect on causing breast cancer which worries me even more...

I hope everything work well for u in Mar! It's your time! :)
Click to expand...

have you consider joining Pre-Implantation Genetic Screening (PGS) programme, which will start in early 2017 at the National University Hospital, helps detect chromosomal disorders in embryos
Read more at http://www.channelnewsasia.com/news...tudy-genetic-screening-of-ivf-embryos-7686640
 
daylesford said:
Hi sweet babysoul,
I saw the doctors out of clinic board at the registration counter at lvl 1 and it seems dr loh is out of clinic on 18Nov17.

For my 2 fresh cycle, i had 30 follicles but was left with a 4CB blast after 6 days. the ICM was C , i was skeptical that the embryo can make it or worse case implant and then causes MC at a later stage.

So i decided to go for a last shot and i was so determined to make any adjustments which can help improve my egg quality.

i took coQ10 - ubiquinol as well as swap tcm and also engage in a healthy lifestyle before my last stims.

Dr cheng also added saizen and pegoveris for my last stims and i Had 60+ follicles of which 47 were used to fertilize but as each day passed the knock out rate was just depressing (especially after but i am grateful to have 4 good ones to freeze and this baby that got stuck was a 6AA during ET. So whats more important is to get good quality blasts than having many lousy ones.

You may want to considering reading this book from amazon which i personally thought was a good read.

af4ab710229ee77a2df569868c695bf1.jpg
Click to expand...

Hi Daylesford, were you saying that the 4AA embryo eventually become 6AA when Transfer? Were they frozen?
 
Sweet_babysoul said:
She said my reports were dated in May this year and she need the latest numbers to diagnose me or sth. She asked me to do AMH too and E2 and everything. She said can't give me medicine before I got the results.

I just recover from BPF still having menses I also duno if the boood test reports are accurate...but just do lorrr
Click to expand...

What was your AMH level (the one done previously) ? Dr Loh actually asked you to do AMH again?
btw what BPF means?
 
daylesford said:
If you are producing many follicles then a protein rich diet will help the follicles grow better. Quickest way to take in large amount of proteins will be through eggs whites. Else there is no need to deliberately consume additional eggs. Just a balance diet will do.
Click to expand...
I forgot to eat egg whites/high protein diet during my last conventional IVF simulation.

This time for the mild simulation, i took 2 eggs every morning.
 
Anyone knows will follicles still grow after trigger shot?
My left is 15mm and right is 18mm.
Trigger shot tonight at 9pm.
I intend to go accupunture later to help the left one.
Can I still go accupunture after the trigger shot?
Egg retrieval is on Saturday
 
DKCH said:
Anyone knows will follicles still grow after trigger shot?
My left is 15mm and right is 18mm.
Trigger shot tonight at 9pm.
I intend to go accupunture later to help the left one.
Can I still go accupunture after the trigger shot?
Egg retrieval is on Saturday
Click to expand...

Will follicles still continue to grow after trigger shot?
 
DKCH said:
Do Dr order blood test before instructing the trigger shot?
Click to expand...

DKCH said:
Will follicles still continue to grow after trigger shot?
Click to expand...

There are different triggering shots (eg : ovidrel, lucrin etc) and depending on individual patient’s needs they have different reactions to our body. I had lucrin as i was at risk of OHSS.

Did not do any bloodtests prior the trigger jab as there wasnt a need to . The follicles were already suppressed with another suppressant jab to prevent any potential ovulation of the leading follicles.

Did you ask dr cheng if the follicles will continue to grow after ur trigger shot ?
 
Last edited:
daylesford said:
There are different triggering shots (eg : ovidrel, lucrin etc) and depending on individual patient’s needs they have different reactions to our body. I had lucrin as i was at risk of OHSS.

Did not do any bloodtests prior the trigger jab as there wasnt a need to . The follicles were already suppressed with another suppressant jab to prevent any potential ovulation of the leading follicles.

Did you ask dr cheng if the follicles will continue to grow after ur trigger shot ?
Click to expand...
He said it will stop growing after the ovidrel.
He agreed that I go for acupuncture.
Dr Tan said will help to increase the size.

I was actually given 2 choice as my follicles is 15mm and 18mm.
Wait 1 more day but risk that the leading follicles will rupture or take the trigger shot last night at least sure have 1 follicle to collect.
I chose the later.

What do I need to do after egg collection? Do I need to stay at home?
 
DKCH said:
He said it will stop growing after the ovidrel.
He agreed that I go for acupuncture.
Dr Tan said will help to increase the size.

I was actually given 2 choice as my follicles is 15mm and 18mm.
Wait 1 more day but risk that the leading follicles will rupture or take the trigger shot last night at least sure have 1 follicle to collect.
I chose the later.

What do I need to do after egg collection? Do I need to stay at home?
Click to expand...

You got the answers from the medical experts.

Depending on individual, some people are up functioning after a short rest after ER. Usually the more follicles extracted, the recovery journey is longer. You should already received the pointers to take note for ER and listen to your body.
 
DKCH said:
What was your AMH level (the one done previously) ? Dr Loh actually asked you to do AMH again?
btw what BPF means?
Click to expand...

My AMH level was above 2 so it was alrite, she just asked me to do again maybe coz I'd done several cycles so the number might be lowered..

I meant BFN sorry
 
Sweet_babysoul said:
I would love to! But duno if I'm eligible..coz my next option is probably PGS somewhere...aldy failed 3 cycles -_-
Click to expand...
I think you are qualified, need to send them an email and they will set up the appointment with the doctor. Better to meet up the dr to discuss what is the terms and conditions.
If you need the email I can pass to you but I need some time.
 
daylesford said:
You got the answers from the medical experts.

Depending on individual, some people are up functioning after a short rest after ER. Usually the more follicles extracted, the recovery journey is longer. You should already received the pointers to take note for ER and listen to your body.
Click to expand...

My 18mm follicles actually swell to 22mm.

Ive got a scare from my last fibroid surgery, thought it was an easy one, but 1st and 2nd day, I was so painful and I balloon to 3x times my size. Luckily I bought one sleep wear which doesnt look like one as I could not fit in my jeans and t-shirt or I had nothing to wear to go home.

Egg retrieval for me was easy for me as I have only 2 follicles.

Just got a good news this morning from MEFC. I have a Day 6 Blastocyst Grade 4BB which will be freeze today.
The other egg didn't make it. 100% fertilization and 50% blastocyst.
 
DKCH said:
My 18mm follicles actually swell to 22mm.

Ive got a scare from my last fibroid surgery, thought it was an easy one, but 1st and 2nd day, I was so painful and I balloon to 3x times my size. Luckily I bought one sleep wear which doesnt look like one as I could not fit in my jeans and t-shirt or I had nothing to wear to go home.

Egg retrieval for me was easy for me as I have only 2 follicles.

Just got a good news this morning from MEFC. I have a Day 6 Blastocyst Grade 4BB which will be freeze today.
The other egg didn't make it. 100% fertilization and 50% blastocyst.
Click to expand...

Hey congrats on that! It's a good news for the 4BB :) it could be just the strong one that will stick and stay！
 
daylesford said:
Yes... but there is an overlap btw an endocrinologist vs immunologist!

My endocrine is not bothered as long as my thyriod lvls are regulated. I was glad i got myself tested with dr shiela ... who detected my elevated thyroid antibodies and people who have elevated antibodies may potentially have NK Cells. she also mentioned that these antibodies may attack the embryo after transfer.
Click to expand...
After testing, what is the course of treatment?
 
I was on steroids but depending on individual, dr shiela would suggest different treatment based on individual’s condition.
 
daylesford said:
Usually the older we are, our egg quality will be compromised too. High FSH & low AMH means its diminished egg reserve but it doesn't necessarily equate to poor egg quality. For me, my egg quality was bad despite having low FSH and high AMH. And there is no way to know our egg quality till we do one cycle of stimulation. Anyway IVF is a gambling game... there is no one standard stimulation protocol which fits everyone. We just need a golden embryo & nice endometrium to make implantation happen.

For lifestyle change, i cut down alot of carbo and took more proteins and greens. Also cut down on sugary stuffs and eliminated caffeine, cold & cooling stuffs. Was also on a regular exercise regime to keep my weight at bay. Sleep early every night too.

Yes i was on CoQ10 - Ubiquinol before my last fresh cycle. I was also on TCM, acupuncture, blackmore conceive well ,5mg/folic acid & royal jelly.

We need to do our due diligence by researching on side effects on all these supplements which we buy online. Eg : royal jelly is not suitable for those ladies with cysts or growths etc.

Will recommend this book - It starts with the Egg by Rebecca Fett from Amazon. Its a good read on how we can improve our egg quality.

Yes if time is against u, u should consider doing time freezing / embryos banking prior 45. I had a friend also with dr cheng who did more than a cycle of stimulation and stored her blastocysts for subsequent usage. Shes now pregnant with twins too :)
Click to expand...

Hi Daylesford, how may embryos did your friend stored? How many times she did FET before BFP?
 
daylesford said:
Yes.. please do not go ahead with transferring your last blastocyst without establishing the root cause for the past failures.
Its heart wrenching to go through cycle after cycle without knowing the exact reason for the failures.

After going through rough patches for my ttcing journey since 2010, i have learnt to take more control over my recent ivf cyles as I am no longer young. dr cheng is definitely open to discussions on your suggestions.

Dr Cheng also recommended me Dr Koh from Mt E Orchard too. I saw Dr Koh for my acute Rheumatism a few years ago but I had my reservations when I saw him this time round.
I had a friend with Lupus and she recommended me Dr Shiela Vasoo who got her pregnant. I subsequently went to Dr Shiela and introduced another friend of mine with Dr Cheng to Dr Shiela and she got pregnant with twins under the care of Dr Shiela too.

Below are the tests which I did with Dr Sheila :-

Thyriod - T4, TSH, Thyroid peroxidase Antibodies - (TPO), thyrotropin receptor antibodies (TRAbs) and thyroglobulin antibodies (TGAb).

Liver Profiles - AST/SGOT & ALT/SGPT
Special Protein Studies - C3 & C4
Serology - ANA Screen, Anti-ds DNA & Index
Lupus Screening & Pupus Anticoagulant
Anti-Cardiolipin 1GG & IGM screening

With my hyperthyroidism, my T4, TSH & TrAB were within Normal Range but my TGaB & one of the Anti-Cardiolipin indicator were slightly elevated. I wasn't in time to do my NK Cells tests but Dr Shiela mentioned that the prednisolone she prescribed me would be able to counter any minor NK cells within my body.

Given my T4, TSH results, any IVF dr will claim that I will have no issues with my thyroid antibodies and I am not at all surprise as IVF drs are reproductive endocrinologists and immunology is not their forte. Therefore I decide to follow on seeing Dr Sheila Vasoo who specializes in immunologic sub-fertility.

Yes I spoke to Dr Cheng on Endo scratch too and he gave the same reply too but with multiple implantation failures, try to suggest to him that you want to do the endo-scratch for the next round. I am sure he is pretty open with the endo-scratch or other FET protocols given your history.

Meanwhile stay positive... and press on ! ...
Click to expand...

Hi Daylesford, which Dr Shiela's clinic did you go? She has 2 clinic if I am not wrong.
 
DKCH said:
Hi Daylesford, which Dr Shiela's clinic did you go? She has 2 clinic if I am not wrong.
Click to expand...

I saw dr shiela at her arc clinic. U can call any of her clinics and they can advise you on which clinic you should be seeing her.
 
daylesford said:
I saw dr shiela at her arc clinic. U can call any of her clinics and they can advise you on which clinic you should be seeing her.
Click to expand...

Thanks I have make appointment with her on 3rd Jan at ARC.

You must be feeling very excited now, baby due soon right?
 
daylesford said:
Cant remember the exact no... maybe 4-6. Why ?
Click to expand...

Age will affect the quality of the eggs.
Also this year is the last year I can collect
But it takes only one golden embryo.
But I also don’t know whether how times of FET I need.
Based on statistics for 40 age above, live birth is 18%.

May I know how old is your friend and how many times FET she did before she succeed.
 
Shes is in her early thirties and succeeded on first attempt.

Well, i conceived my no2 at 40.
Every patient have our own set of fertility problems and dont compare. have faith that things will work out.
 
daylesford said:
Shes is in her early thirties and succeeded on first attempt.

Well, i conceived my no2 at 40.
Every patient have our own set of fertility problems and dont compare. have faith that things will work out.
Click to expand...
I see, she is young so why she need to collect the eggs first?
Was she overseas?
I think my magic number is 6 too (min), enough to have 3 transfer.
 
Last edited:
DKCH said:
I see, she is young so why she need to collect the eggs first?
Was she overseas?
I think my magic number is 6 too (min), enough to have 3 transfer.
Click to expand...

Every couple have their own views and preferences on their IVF journey based on their fertility profile and i did not probe her on details.
 
DKCH said:
Thanks for the reply.

I am 43yr old and will be 44 yrs old in 4 months.
My test result is very negative.
AMH = 0.07
FSH = 11.5
AFC antral follicle count= only can see 3 follicles on each ovary, total 6.

I think my chances is super low. tomorrow will be seeing Dr Cheng for discussion.
I like to know :
1) are you using fresh embryos transfer or frozen embryos transfer?
2) Will all the frozen embryos survive during thawing?
3) each Egg collection and blastocyst and freezing of eggs is consider per cycle (without implantation?
4) Will they charge if Egg collection is cancel?

Thanks in advance.
Click to expand...
Hi. I m turning 43 in oct. We hv similar situation - AMH 0.5, High FSH 11 to 14. I had a ivf cycle in SG with sf loh in 2014 - 450iu puregon but only retrieved 1 follicle 1 fertilized & had ET. I had 2 rounds of ivf 2016 & 2017 in Manila (DH out post). 2016 - 4 eggs collected but 1 fertilized & had ET. 2017 - Retrieval but none matured for fertilization. 2018 - 1 ivf monash ivf, 4 collected but 1 fertilized. D3 transfer 4 cell grade c, now pending pregnancy test.

Took multivit, Co10, royal jelly for ivf 2016. Added DHEA & Vitamin D 2017 ivf. Added melatonin for 2018. (But is not working for me.)

I dont hv much hope once again. Trying to research in SG for a last try of IVF. I n financially & emotionally drained. I am considering mini IVF or natural IVF as i read online, works well for low responder. Any doctors to recommend/advice etc. Thks!
 
Ladies,

Am a patient with Dr LC Cheng and was blessed with 2 miracle boys through his help.

I will be returning 200 red eggs at Toa Payoh Shuang Lin Temple this coming Sunday (4Feb morning) to thank ZSNN for blessing me with my No2 who arrived in Dec17.

For those who are keen to collect the red eggs, you may go to the temple after 1230pm.

Once again spreading baby dusts to all of you and please do not give up and i wish that everyone here will carry your bundle your joy soon.
 
UnicornBB said:
Hi. I m turning 43 in oct. We hv similar situation - AMH 0.5, High FSH 11 to 14. I had a ivf cycle in SG with sf loh in 2014 - 450iu puregon but only retrieved 1 follicle 1 fertilized & had ET. I had 2 rounds of ivf 2016 & 2017 in Manila (DH out post). 2016 - 4 eggs collected but 1 fertilized & had ET. 2017 - Retrieval but none matured for fertilization. 2018 - 1 ivf monash ivf, 4 collected but 1 fertilized. D3 transfer 4 cell grade c, now pending pregnancy test.

Took multivit, Co10, royal jelly for ivf 2016. Added DHEA & Vitamin D 2017 ivf. Added melatonin for 2018. (But is not working for me.)

I dont hv much hope once again. Trying to research in SG for a last try of IVF. I n financially & emotionally drained. I am considering mini IVF or natural IVF as i read online, works well for low responder. Any doctors to recommend/advice etc. Thks!
Click to expand...

sorry just saw your message.

you meant you did your last IVF in Monash (Australia)?
how is your pregnancy result?
 
daylesford said:
Yes... but there is an overlap btw an endocrinologist vs immunologist!

My endocrine is not bothered as long as my thyriod lvls are regulated. I was glad i got myself tested with dr shiela ... who detected my elevated thyroid antibodies and people who have elevated antibodies may potentially have NK Cells. she also mentioned that these antibodies may attack the embryo after transfer.
Click to expand...

http://www.ivf1.com/natural-killer-cells-miscarriage-infertility/
daylesford said:
Yes.. please do not go ahead with transferring your last blastocyst without establishing the root cause for the past failures.
Its heart wrenching to go through cycle after cycle without knowing the exact reason for the failures.

After going through rough patches for my ttcing journey since 2010, i have learnt to take more control over my recent ivf cyles as I am no longer young. dr cheng is definitely open to discussions on your suggestions.

Dr Cheng also recommended me Dr Koh from Mt E Orchard too. I saw Dr Koh for my acute Rheumatism a few years ago but I had my reservations when I saw him this time round.
I had a friend with Lupus and she recommended me Dr Shiela Vasoo who got her pregnant. I subsequently went to Dr Shiela and introduced another friend of mine with Dr Cheng to Dr Shiela and she got pregnant with twins under the care of Dr Shiela too.

Below are the tests which I did with Dr Sheila :-

Thyriod - T4, TSH, Thyroid peroxidase Antibodies - (TPO), thyrotropin receptor antibodies (TRAbs) and thyroglobulin antibodies (TGAb).

Liver Profiles - AST/SGOT & ALT/SGPT
Special Protein Studies - C3 & C4
Serology - ANA Screen, Anti-ds DNA & Index
Lupus Screening & Pupus Anticoagulant
Anti-Cardiolipin 1GG & IGM screening

With my hyperthyroidism, my T4, TSH & TrAB were within Normal Range but my TGaB & one of the Anti-Cardiolipin indicator were slightly elevated. I wasn't in time to do my NK Cells tests but Dr Shiela mentioned that the prednisolone she prescribed me would be able to counter any minor NK cells within my body.

Given my T4, TSH results, any IVF dr will claim that I will have no issues with my thyroid antibodies and I am not at all surprise as IVF drs are reproductive endocrinologists and immunology is not their forte. Therefore I decide to follow on seeing Dr Sheila Vasoo who specializes in immunologic sub-fertility.

Yes I spoke to Dr Cheng on Endo scratch too and he gave the same reply too but with multiple implantation failures, try to suggest to him that you want to do the endo-scratch for the next round. I am sure he is pretty open with the endo-scratch or other FET protocols given your history.

Meanwhile stay positive... and press on ! ...
Click to expand...

Did Dr Shelia said Vitamin D will help borderline high NK cell?
Did she said borderline high NK cell caused blood to thicken?
 
DKCH said:
@daylesford, Do you remember how much is Saizen? and how many shots are required?
Click to expand...

Unfortunately i cant remember the exact costs of saizen but its definitely not as costly as pergoveris jabs. I vaguely remembered that i had saizen for a couple of days which included pre-stims and also during stimulation phase.

Are you ready for FeT or still doing blastocysts pooling ?
 


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