Anyone doing IVF in 2020?

fyz

New Member
Thanks! Yes, never give up hope. I remember I met a very nice nurse during my ivf days, she always encourage me whenever I'm depressed with the results. She will always tell me successful story of their patients even with only 1 follicle/egg. I will never forget what she told me "don't focus on the no. of egg, we only need one to see your rainbows" ❤ N so coincident, my FET fall on my wedding anniversary too, so I pray n told my little embryo, no matter what you must survive from the thawing. Daddy n mummy wants to bring you back home to celebrate with us and today we still find this is the best wedding anni gift we ever had. So I believe you will be receiving your best wedding anni gift too. Jia you!! Best wishes to you for your FET ❤
Hello dear!Just did my FET on Wednesday, a hatched blastocyst. May I know if you develop any symptoms during the 2WW?
 


fyz

New Member
Good luck baby dust. All symptoms are normal. Due to medicine effect. Some might be implantation symptom.
Thank you dear, feeling twinges every now and then on my left side. This 2WW is draining me Hope everything is good on your side
 

Cmf

Member
Hello dear!Just did my FET on Wednesday, a hatched blastocyst. May I know if you develop any symptoms during the 2WW?
Hi dear!

Yes, on the 4th or 5th day of my transfer, I feel cramp while I'm sleeping, it feel like menses cramp but next day woke up it get better. Then on n off will have slight cramp n bloating.

I have sore breast but before the transfer my breast already start to sore abit maybe due to those hormone medicine. But when days go by, the breast will get even sore n heavier.

Some days may crave for food and tired easily too.

I also having wet discharge maybe due to the crinone gel. Even till now, I still have discharge due to the gel.

But don't worry too much, everyone experience differently. Just enjoy your 2WW and get more rest! Congrats for your FET, jia you!!!
 

stjy86

New Member
Try to stay home, and not go out unnecessarily during this 2 weeks. Walk around in the house, but not extensive walk like going shopping. Limit any bending down movements too! Watch your favourite dramas or anything that makes you relax. Please don’t even think about work. Have enough rest, but don’t lie on bed all day!
 
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Anonymousjane

Active Member
Only weird thing I felt during TWW was getting up in shock while sleeping a couple of times over two days back to back..not sure if it was implantation over that two days since I had twins

Other than that minor headache. Not much symptoms
 
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fyz

New Member
Good sign! Don’t think too much, keep relaxing. Just boil some red date without seed +wolf berry +longan(portion depend on your preference) I don’t like sweet, so I put 15+15+5each. drink warm. I drink it everyday after fresh transfer. Symptoms wise is depending on different people. I got no much symptoms but last few days before blood test ,will feel mussels pain and cramping on and off Lower abdomen will feel like harder. Discharge is more on watery. Hope it will help!
Thank you for your kind sharing Currently, im drinking goat’s milk with dates. Other than that, Im just waiting day by day
 

fyz

New Member
Only weird thing I felt during TWW was getting up in shock while sleeping a couple of times over two days back to back..not sure if it was implantation over that two days since I had twins

Other than that minor headache. Not much symptoms
Wahhh congrats dear on having twins!Ya the only symptoms as of now is just cramping mostly on my left side and I get tired easily. Starting work back again next tues and Im an infant care teacher so that is something that I look forward to just so it can distract me off from this 2WW
 

fyz

New Member
Try to stay home, and not go out unnecessarily during this 2 weeks. Walk around in the house, but not extensive walk like going shopping. Limit any bending down movements too! Watch your favourite dramas or anything that makes you relax. Please don’t even think about work. Have enough rest, but don’t lie on bed all day!
Thank you for sharing dearSpeaking of work, I will be returning to work next Tues and Ive shared with other user as well that Im an infant care teacher so Im pretty looking forward to seeing my babies in school
 

fyz

New Member
Hi dear!

Yes, on the 4th or 5th day of my transfer, I feel cramp while I'm sleeping, it feel like menses cramp but next day woke up it get better. Then on n off will have slight cramp n bloating.

I have sore breast but before the transfer my breast already start to sore abit maybe due to those hormone medicine. But when days go by, the breast will get even sore n heavier.

Some days may crave for food and tired easily too.

I also having wet discharge maybe due to the crinone gel. Even till now, I still have discharge due to the gel.

But don't worry too much, everyone experience differently. Just enjoy your 2WW and get more rest! Congrats for your FET, jia you!!!
Thank you for sharing!Yes feeling tired easily too and yes the crinone gel is im sorry to say quite yucky when it came out as a clump of clay as part of the discharge. Also been having on off cramps on my left side that’s about it as of now. I will try to just let the days pass by with no worries and not having a feeling of anxiety❤
 
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Cmf

Member
Thank you for sharing!Yes feeling tired easily too and yes the crinone gel is im sorry to say quite yucky when it came out as a clump of clay as part of the discharge. Also been having on off cramps on my left side that’s about it as of now. I will try to just let the days pass by with no worries and not having a feeling of anxiety❤
Yes, I believe mood does play a part too. For my past ivf, I was quite stress n worried for the implant. But this round, I was totally enjoying myself, not thinking anything, just treat it as a staycation or holiday, eat, sleep n do your fav thing. N it really made me feel so different this time, your little embryo will feel it too. So don't think about it, treat it as normal days. Most importantly, don't carry heavy things when you back to work, if can do rest more. :)
 
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Luxee

Member
Hello ladies, I had my first embryo transfer, a hatched blastocyst on Wednesday.. and currently on crinone and progynona as well as folic acid. Does anyone ever encounter constant wet discharge after the transfer? Is it cause by the medication? Also been having on off migraine and mild cramps..Doc said that my uterus lining is very good and just hoping it will implant☺
Hi, i'm also having a lot of wet watery discharge with crinone gel. Sometimes it gets quite heavy that I feel like I peed my pants. Im almost at the end of my tww. Been having mild cramp and twinge on the right side of my pelvis. Not sure if it is normal to have 1 sided cramp. My beta blood test is in 2 days so I guess I will find out soon.
 
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fyz

New Member
Hi, i'm also having a lot of wet watery discharge with crinone gel. Sometimes it gets quite heavy that I feel like I peed my pants. Im almost at the end of my tww. Been having mild cramp and twinge on the right side of my pelvis. Not sure if it is normal to have 1 sided cramp. My beta blood test is in 2 days so I guess I will find out soon.
Hello dear! I did my research and they said implantation will happen 5 days post embryo transfer so currently nowadays I do feel the twinges and cramps especially if I get up from sitting or bending..Anyhoo I wish you all the very best and baby dust to you!❤
 

fyz

New Member
Yes, I believe mood does play a part too. For my past ivf, I was quite stress n worried for the implant. But this round, I was totally enjoying myself, not thinking anything, just treat it as a staycation or holiday, eat, sleep n do your fav thing. N it really made me feel so different this time, your little embryo will feel it too. So don't think about it, treat it as normal days. Most importantly, don't carry heavy things when you back to work, if can do rest more. :)
Thank you and yes I think keeping our mind relaxed does work wonders hopefully Me having to carry things at work are basically carrying my babies in school
 
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XxJiaxX

New Member
Hi all,

Me and DH (30yo & 32yo) have been to Thomson Fertility Centre for a Fertility Check and there wasnt great results. Though my blood tests came back fine, ultrasound scan show shadows in the uterus and the doc thinks that it could be Polyps. She recommended going for hysteroscopy for confirmation and removal if required. As for DH, his sperm count is very low <0.2 thus recommendation was IVF & URGENT (due to DH limited sperm count).

We want to have a 2nd opinion and would want to go the subsidied route if we really need IVF thus gotten a referral letter from polyclinic yesterday. I received a sms today saying that the appt is scheduled on 10 Feb, which is almost a month away.

I read in the past messages that some ladies were able to have ultrasound scan, pap smear and blood tests done on the first appt while some only had a '5 mins talk' for the first appt and have the scans/test/semen analysis scheduled for the 2nd appt. Given that we know what we want (which is ultrasound scan and semen analysis), any idea if it is possible for me to request to have it done on the first appt?

I also wish to bring forward the appt and considering whether to call and ask for earlier slots. But previously when I was at TFC, I was told that the ultrasound scan needs to be done within 2 weeks from menses. Is there the same requirement for KKH? If so, then there's no need to change the date since the scheduled date falls within 2 weeks from menses (given if I'm able to do ultrasound scan on the first appt).

Can anyone share their past experiences with KKH?
 

harriet07

Member
Hi all,

Me and DH (30yo & 32yo) have been to Thomson Fertility Centre for a Fertility Check and there wasnt great results. Though my blood tests came back fine, ultrasound scan show shadows in the uterus and the doc thinks that it could be Polyps. She recommended going for hysteroscopy for confirmation and removal if required. As for DH, his sperm count is very low <0.2 thus recommendation was IVF & URGENT (due to DH limited sperm count).

We want to have a 2nd opinion and would want to go the subsidied route if we really need IVF thus gotten a referral letter from polyclinic yesterday. I received a sms today saying that the appt is scheduled on 10 Feb, which is almost a month away.

I read in the past messages that some ladies were able to have ultrasound scan, pap smear and blood tests done on the first appt while some only had a '5 mins talk' for the first appt and have the scans/test/semen analysis scheduled for the 2nd appt. Given that we know what we want (which is ultrasound scan and semen analysis), any idea if it is possible for me to request to have it done on the first appt?

I also wish to bring forward the appt and considering whether to call and ask for earlier slots. But previously when I was at TFC, I was told that the ultrasound scan needs to be done within 2 weeks from menses. Is there the same requirement for KKH? If so, then there's no need to change the date since the scheduled date falls within 2 weeks from menses (given if I'm able to do ultrasound scan on the first appt).

Can anyone share their past experiences with KKH?
But if you already did your scan and semen analysis at TFC, why not just bring your reports to show KK doctor for second opinion and perhaps you won’t need to redo tests?

On my first visit the doctor did a quick scan in her office but she still scheduled me for pelvic scan on another day.

I recall the blood tests and ultrasound has to be a certain date from menses too. For myself, I could do blood tests on the same day as first appointment as it so happened the date was right. For semen analysis, you will also be scheduled another date for this as your husband needs to abstain for some days.

KK is Govt hospital so to be honest, expect a longer wait than at private clinics. I heard there is a queue for IVF at KK now too.
 

XxJiaxX

New Member
But if you already did your scan and semen analysis at TFC, why not just bring your reports to show KK doctor for second opinion and perhaps you won’t need to redo tests?

On my first visit the doctor did a quick scan in her office but she still scheduled me for pelvic scan on another day.

I recall the blood tests and ultrasound has to be a certain date from menses too. For myself, I could do blood tests on the same day as first appointment as it so happened the date was right. For semen analysis, you will also be scheduled another date for this as your husband needs to abstain for some days.

KK is Govt hospital so to be honest, expect a longer wait than at private clinics. I heard there is a queue for IVF at KK now too.
Hi harriet07, thank you for sharing! With the current results, Im pretty sure we will be recommended for IVF as well. I guess we are hoping for different results esp DH sperm count. The Dr has suggested some ways to improve sperm count such as taking supplements and changes to lifestyle. We have started to adopt them thus hope there are better results in the KKH tests *fingers crossed*. As for my possible polyps, I think Doctors will still do another ultrasound to see it for themselves before surgery.

Anyone managed to have semen analysis on KKH first appt because they happen to abstain within the 2-7days period?
 
H
Hi all,

Me and DH (30yo & 32yo) have been to Thomson Fertility Centre for a Fertility Check and there wasnt great results. Though my blood tests came back fine, ultrasound scan show shadows in the uterus and the doc thinks that it could be Polyps. She recommended going for hysteroscopy for confirmation and removal if required. As for DH, his sperm count is very low <0.2 thus recommendation was IVF & URGENT (due to DH limited sperm count).

We want to have a 2nd opinion and would want to go the subsidied route if we really need IVF thus gotten a referral letter from polyclinic yesterday. I received a sms today saying that the appt is scheduled on 10 Feb, which is almost a month away.

I read in the past messages that some ladies were able to have ultrasound scan, pap smear and blood tests done on the first appt while some only had a '5 mins talk' for the first appt and have the scans/test/semen analysis scheduled for the 2nd appt. Given that we know what we want (which is ultrasound scan and semen analysis), any idea if it is possible for me to request to have it done on the first appt?

I also wish to bring forward the appt and considering whether to call and ask for earlier slots. But previously when I was at TFC, I was told that the ultrasound scan needs to be done within 2 weeks from menses. Is there the same requirement for KKH? If so, then there's no need to change the date since the scheduled date falls within 2 weeks from menses (given if I'm able to do ultrasound scan on the first appt).

Can anyone share their past experiences with KKH?
Hi! I don't think can request for semen analysis on the first appt.. I went for my first Dr consultation last month and I did try to request but the nurse said cannot.

Polyps also discovered in my uterine lining so I'm scheduled for a hysteroscopy in Feb before I can commence ivf. Super nervous about it
 

XxJiaxX

New Member
H


Hi! I don't think can request for semen analysis on the first appt.. I went for my first Dr consultation last month and I did try to request but the nurse said cannot.

Polyps also discovered in my uterine lining so I'm scheduled for a hysteroscopy in Feb before I can commence ivf. Super nervous about it
Hi thedreamchaser, thanks for sharing your past exp. Seems like it's not possible to do SA on first appt. What tests have you n hub done so far and during which appt? How far apart are your appts? BTW, did you also have a quick scan on the first appt then scheduled another pelvic scan for the next appt?

I'm also somewhat anxious to get appts done quickly because I have leave to clear before end march. Though I uds that theres a queue at KK..
 
Hi thedreamchaser, thanks for sharing your past exp. Seems like it's not possible to do SA on first appt. What tests have you n hub done so far and during which appt? How far apart are your appts? BTW, did you also have a quick scan on the first appt then scheduled another pelvic scan for the next appt?

I'm also somewhat anxious to get appts done quickly because I have leave to clear before end march. Though I uds that theres a queue at KK..
I had pap smear, transvaginal ultrasound and a blood test to check for my blood count done on my first appt.. During the transvaginal ultrasound, doc discovered something thick in my uterus and scheduled me for a Saline Infused Sonogram (SIS) to check if I have polyps/fibroids. True enough, I have some polyps. The first appt to the 2nd is about a month apart as I have to call in on my first day of menses so they can schedule my SIS.

My hub has only done semen analysis test. Yeah, I'm quite frustrated with kkh long interval waiting time between each appointment. my hysteroscopy is only in end Feb even though I queried for an earlier date. Sigh.
 

risther

Active Member
I had pap smear, transvaginal ultrasound and a blood test to check for my blood count done on my first appt.. During the transvaginal ultrasound, doc discovered something thick in my uterus and scheduled me for a Saline Infused Sonogram (SIS) to check if I have polyps/fibroids. True enough, I have some polyps. The first appt to the 2nd is about a month apart as I have to call in on my first day of menses so they can schedule my SIS.

My hub has only done semen analysis test. Yeah, I'm quite frustrated with kkh long interval waiting time between each appointment. my hysteroscopy is only in end Feb even though I queried for an earlier date. Sigh.
Hi may I know for SIS is there any sedation required? I remember I also did HSG to check if tubes are blocked or not. I also went for progesterone blood test on D21 of cycle to check if I’m ovulating other than the usual blood test for blood count n AMH.
 
Hi may I know for SIS is there any sedation required? I remember I also did HSG to check if tubes are blocked or not. I also went for progesterone blood test on D21 of cycle to check if I’m ovulating other than the usual blood test for blood count n AMH.
No sedation.. But I took 2 paracetamol just in case because I had a very unpleasant experience during my HSG check. Thankfully the SIS was not that bad.
 

risther

Active Member
No sedation.. But I took 2 paracetamol just in case because I had a very unpleasant experience during my HSG check. Thankfully the SIS was not that bad.
Previously I had a polyp but I never do SIS. Went to remove it and seems like is back again hence I wondering if my doc will ask me do this to confirm
 

Anonymousjane

Active Member
Hi harriet07, thank you for sharing! With the current results, Im pretty sure we will be recommended for IVF as well. I guess we are hoping for different results esp DH sperm count. The Dr has suggested some ways to improve sperm count such as taking supplements and changes to lifestyle. We have started to adopt them thus hope there are better results in the KKH tests *fingers crossed*. As for my possible polyps, I think Doctors will still do another ultrasound to see it for themselves before surgery.

Anyone managed to have semen analysis on KKH first appt because they happen to abstain within the 2-7days period?
Hi I would say do a 2nd SA...my hubby's first turned out to be close to 0 and we were told to consider a sperm donor...and my hubby felt the sample he gave was not proper, his first time doing SA and he was not so sure.. he did it again in Mt E and it was normal range..he did it 2X after that, all normal range. Most probably first one, he did not give a proper sample
 

Pino

New Member
Anyone did FET? Any idea after period came, roughly which days will need go down kkh for scans & roughly on which day is the transfer itself?
 

XxJiaxX

New Member
Hi I would say do a 2nd SA...my hubby's first turned out to be close to 0 and we were told to consider a sperm donor...and my hubby felt the sample he gave was not proper, his first time doing SA and he was not so sure.. he did it again in Mt E and it was normal range..he did it 2X after that, all normal range. Most probably first one, he did not give a proper sample
Thank you for your response! Have scheduled appt with KKH for the check. Fingers crossed for better results! :)
 

Azasha

Active Member
Anyone did FET? Any idea after period came, roughly which days will need go down kkh for scans & roughly on which day is the transfer itself?
Do give KKIVF clinic a call for them to schedule your visit to collect the meds/scans/consult. Hope this helps!
 

Justanotherone

New Member
Hello! I’m undergoing my first IVF cycle and just had FET on Tuesday. I’ve been having light spotting-light bleeding (mostly pink or bright red) and mild cramps since Wednesday and missed a dose of endometrin (vaginal) last night. Today the bleeding is heavier, I would say a moderate bright red flow. Has anyone experienced this and know if missing a dose could jeopardise the cycle? My BHCG test is next Wednesday.
 
Yes, got a confirm BFP from BT. Yes you should call the clinic so they can give you extra support if you BFP, i got extra support jabs since i had bleeding and BFP. Good luck and baby dust ya
Hi, how long did your bleeding last? Even after confirmed blood test, is there still bleeding?
 

Bells25

New Member
Hi, after ivf transfer, for tww, isit the doc will give HL to us or we have to request? Coz I dont want to go to work during tww, coz of the stressful environment, i dont want to use up my own leave.
 

chimchim

New Member
Hi, after ivf transfer, for tww, isit the doc will give HL to us or we have to request? Coz I dont want to go to work during tww, coz of the stressful environment, i dont want to use up my own leave.
Yes, the doc will give you HL right after your transfer. Don't worry
 

Azasha

Active Member
Hi, after ivf transfer, for tww, isit the doc will give HL to us or we have to request? Coz I dont want to go to work during tww, coz of the stressful environment, i dont want to use up my own leave.
You will get HL roughly 19-21 days till your beta blood test day. All the best and rest well! ♥
 

Advika

Member
Hi,
Does any private hospital provide blastogen/ embrogen along with human growth hormone just like SGH?
Previously, I did 3 IVFs involving 4 transfers, all unsuccessful implantation..
Currently, I am 41 yrs old and the doctor points a finger at the quality of embryo, do not know how to proceed further.
 

roxyanne

New Member
Hi all. Anyone with NUH? FYI.. The lab will be closed for about 6 months from Apr or May onwards. So any fresh cycles still can proceed but for frozen will have to wait till they reopen, maybe Oct. The nurse hasn't given me the exact date yet. I had failed 3 transfers with NUH and will be moving on to another place as I don't want to waste time plus obviously their protocol doesn't work for us. We considered Dr Chew but after our consult with him, we didn't get a good vibe with him, he didn't even read our history or tried to change something, instead he wanted to jump straight to another transfer already. I don't want to transfer again without finding out what caused our past 3 transfers to fail? So I requested for more blood test but in his words - the blood tests is ordered only for recurrent miscarriage but I was never pregnant, the embryo never implanted, so he doesn't see the need to. But I insisted, so the blood test is ordered and now waiting for the results. Once we got our medical report we might change doctor. And since I have 2 more frozen embies, we did consider PC Wong too, anyone under him before?

For private, we are considering Dr Tan HH from Alpha, Dr SF Loh from Thomson, Dr Roland from Virtus. Anyone under them and has reviews to share? Appreciate it thanks!
 

hopefulmoms

Member
Anyone know how to increase thickness of endometrial lining? Other than eating red beans...
Does Red Raspberry Leaf Tea helps??

Today I did my scan and it was only 5.7mm after taking Progynova for 2 weeks..

Doctor prescribed me with Oestradiol to be taken vaginally and continue Progynova for 5 days more..
Just worry it won't work for me.. does anyone here experience a good result with this Oestradiol? did your lining increase?

Any tips would be helpful. :)
 

roxyanne

New Member
Hi,
Does any private hospital provide blastogen/ embrogen along with human growth hormone just like SGH?
Previously, I did 3 IVFs involving 4 transfers, all unsuccessful implantation..
Currently, I am 41 yrs old and the doctor points a finger at the quality of embryo, do not know how to proceed further.
My doctor blamed the embryo too and said "nothing to test already" after 3 failed implantation. Well in fact, there are so many things that can be tested or different drugs to prescribed but unfortunately I'm in govt hosp so it's quite generic. So we're moving on to private...
 

miraclesdreamer

New Member
Hi all. Anyone with NUH? FYI.. The lab will be closed for about 6 months from Apr or May onwards. So any fresh cycles still can proceed but for frozen will have to wait till they reopen, maybe Oct. The nurse hasn't given me the exact date yet. I had failed 3 transfers with NUH and will be moving on to another place as I don't want to waste time plus obviously their protocol doesn't work for us. We considered Dr Chew but after our consult with him, we didn't get a good vibe with him, he didn't even read our history or tried to change something, instead he wanted to jump straight to another transfer already. I don't want to transfer again without finding out what caused our past 3 transfers to fail? So I requested for more blood test but in his words - the blood tests is ordered only for recurrent miscarriage but I was never pregnant, the embryo never implanted, so he doesn't see the need to. But I insisted, so the blood test is ordered and now waiting for the results. Once we got our medical report we might change doctor. And since I have 2 more frozen embies, we did consider PC Wong too, anyone under him before?

For private, we are considering Dr Tan HH from Alpha, Dr SF Loh from Thomson, Dr Roland from Virtus. Anyone under them and has reviews to share? Appreciate it thanks!
Hi, is the lab closure confirmed for Apr/May cos didnt seem to hear anything about it when I went for review in Feb and have planned a frozen embryo transfer around the Apr/May period.
 

Toh SH

Active Member
Hi all. Anyone with NUH? FYI.. The lab will be closed for about 6 months from Apr or May onwards. So any fresh cycles still can proceed but for frozen will have to wait till they reopen, maybe Oct. The nurse hasn't given me the exact date yet. I had failed 3 transfers with NUH and will be moving on to another place as I don't want to waste time plus obviously their protocol doesn't work for us. We considered Dr Chew but after our consult with him, we didn't get a good vibe with him, he didn't even read our history or tried to change something, instead he wanted to jump straight to another transfer already. I don't want to transfer again without finding out what caused our past 3 transfers to fail? So I requested for more blood test but in his words - the blood tests is ordered only for recurrent miscarriage but I was never pregnant, the embryo never implanted, so he doesn't see the need to. But I insisted, so the blood test is ordered and now waiting for the results. Once we got our medical report we might change doctor. And since I have 2 more frozen embies, we did consider PC Wong too, anyone under him before?

For private, we are considering Dr Tan HH from Alpha, Dr SF Loh from Thomson, Dr Roland from Virtus. Anyone under them and has reviews to share? Appreciate it thanks!
What I have heard is even the OT in the IVF lab are closing for Reno too, don’t think fresh cycle can do also.

I was under prof P.C. Wong in 2017 and I gotta BFP for my first fresh cycle. I did another fresh cycle in 2019 but failed, maybe due to my age. I just did my FET last fri and hope i can succeed this round
 
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CL2021

New Member
Does anyone knows if Prof Wong will continue to be your Gynae until you deliver your baby? Or he will stop after you get pregnant for the ivf programme? Sorry but I’m new here! Thank you! :)
 

Angelica Cheng

Active Member
Yes pgs is not available in Singapore unless the couple has a genetic condition which requires screening and then they will need to seek approval from MOH. Nearest country this is available in is Malaysia but with covid currently, not possible at the moment I guess. Yes probably he will liaise with the Malaysian side though the fees for transportation of embryos etc can be hefty. So most of us end up not doing pgs at all and just transfer.
Hi there! Could you tell me where you did your PGT-A? Did you need to get special permission to do it?
Dear ladies, please see this article:

Genetic testing of IVF embryos (PGS / PGT-A) – what Singaporean patients should know

Recently, Ms Rahayu Mahzam, Parliamentary Secretary of Ministry for Health — reported that the pilot trial of genetic testing of IVF (In Vitro Fertilization) embryos in Singapore suffers from a high attrition rate of 72% (2nd March 2021). She stressed the need to proceed carefully as there is some risk to the embryo during testing.

This procedure, also known as Preimplantation Genetic Screening (PGS) or Preimplantation Genetic Testing – Aneuploidy (PGT-A), involves screening the embryos of IVF patients whom are not known to be carriers of genetic diseases, unlike the closely-related Preimplantation Genetic Diagnosis (PGD) technique, which specifically tests for known genetic defects carried by prospective parents. Hence, the pertinent question that arises is why is there such a high attrition rate?

Yet at an earlier parliamentary session on 25th February 2021, MP Cheng Li Hui, called for less restrictions to make PGS (PGT-A) more widely available to IVF patients, on the basis that this procedure screens for the correct number of chromosomes to improve the chances of conception.

Hence, Singaporean IVF patients should be made aware of the widespread controversy and accumulating scientific evidence against the medical effectiveness of PGS (PGT-A) in improving the outcome of fertility treatment in patients, whom are non-carriers of genetic diseases.

Currently, PGS (PGT-A) is readily available to Singaporean patients at most foreign fertility clinics, particularly those from neighbouring countries. Indeed, many Singaporean patients who travel abroad for fertility treatment, often end up choosing to do genetic testing of their IVF embryos, not only for sex-selection, but also to eliminate the risks of Down Syndrome in older women and improve success rates.

This is due in large part to aggressive marketing of this technique by foreign fertility clinics, which substantially increases the costs of fertility treatment from 30% to 50%. Hence, it is imperative to highlight the controversial issues surrounding this expensive technique, which Singaporean patients and healthcare policymakers should be aware of.

Currently, there is good evidence that the PGS technique is fraught with false positive misdiagnoses due to the frequent occurrence of ‘mosaic’ embryos in IVF treatment. These are embryos that have a mixture of genetically abnormal and normal cells. Recent studies have shown that such ‘mosaic embryos’ can often give rise to healthy normal babies.

To understand why this is so, imagine the human embryo as containing multiple layers of cells, with the inner layers giving rise to the baby itself, while the outer layers give rise to the placenta and umbilical cord. Indeed, many studies of normal births often detect genetic abnormalities in the placenta and umbilical cord.

This is because nature has an amazing way of correcting genetic defects during the course of normal embryo development, by gradually pushing and segregating genetically abnormal cells to the outer layers that give rise to the placenta and umbilical cord, whilst preserving the genetic integrity of the inner layers that will eventually form the baby itself.

The problem with the PGS technique is that it only extract cells from the outer layers (Trophectoderm) for genetic testing, because sampling cells from the inner layers (Inner Cell Mass that forms the baby)
incurs too much risk of damaging the embryo. Hence the high incidence of false positive misdiagnoses associated with PGS, which often lead to discarding of ‘mosaic’ embryos, many of which can in fact give rise to a normal healthy baby.

Consequently, some studies have reported that PGS in fact reduces rather than improve the cumulative chances of IVF success. Because older women and women with low ovarian reserves usually produce less embryos during each IVF treatment cycle, the discarding of ‘mosaic’ embryos could in fact have a more devastating impact on their chances of success.

For such patients with very few available embryos, every single embryo (including mosaic ones) is more ‘valuable’, and would count more to their chances of reproductive success. Just recently in Australia, a class action lawsuit was launched by patients against Monash IVF for misdiagnosis by the PGS (PGT-A) technique, which led to discarding of their viable embryos that could have otherwise led to healthy births.

Although the PGS technique is often touted to be useful for avoiding birth defects such as Down syndrome in older women, patients must be aware that it is not a foolproof means of screening for genetic defects despite its high cost.

Usually, PGS screens only for a panel of common genetic defects, which excludes many rarer genetic diseases. It is also useless for detecting more complex genetic conditions that involve interaction of multiple genes with various factors within the birth environment, such as Autism Spectrum Disorders (ASD).

Patients should also be aware that the vast majority of genetically-abnormal embryos often fail to implant upon transfer to the womb during the IVF procedure; and even those genetically abnormal embryos that do implant often spontaneously abort at very early stages e.g. biochemical pregnancy.

Hence, patients should consider more economical means of screening for birth defects, such as the new generation of Non-Invasive Prenatal Testing (NIPT), that can screen for genetic defects in fetal DNA extracted from the pregnant mother’s blood sample.

Additionally, patients must also be wary of the aggressive sales pitch and marketing gimmicks routinely used to coax patients to undertake PGS during IVF treatment abroad.

One example is how the concept of relative risks is being misrepresented to patients, to play on their fears of birth defects. For example if the risk of Down syndrome is 0.1 % at age 20, and increases to 1% at age 40 and subsequently to 4% at age 45; then another way of presenting the data would be to say that the risk of Down syndrome increases 10-folds from age 20 to 40, and 40-folds from age 20 to 45.

Hence, through a sly manipulation of words and figures, the risks of genetic defects can be ‘exaggerated’ to patients who are unfamiliar with medical statistics.

Another dubious and ethically-questionable marketing tactic is to manipulate and play on the patient’s biased preference for either a boy or girl child, which may be helped by the fact that PGS is currently the most accurate and reliable embryo sex selection technique that is available in the market.

Last but not least, patients should also be aware of the risks of damaging the embryo during the ‘highly-delicate’ PGS procedure, which involves extracting cells from the embryo after drilling a hole through the embryo shell (Zona pellucida).

The smooth performance of this technique is often highly dependent on the skill and training of the laboratory staff (Embryologist). Even with high levels of training and accreditation, there is still a possibility of human error, particularly in a very busy laboratory that handles several such cases a day.

In conclusion, there is increasing scientific evidence that cast doubts on the medical benefits of PGS (PGT-A). There are certainly good reasons why the PGS technique is so stringently regulated by the MOH here in Singapore at the present moment, which is exercising due diligence to protect the welfare of patients.

Singaporean patients traveling abroad for IVF treatment should be cautious not to be ‘pushed’ into undertaking PGS unnecessarily, by asking themselves why this technique is so severely restricted in their own country, even if it is deemed to be so beneficial by profit-driven private fertility clinics abroad.
 

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Toh SH

Active Member
Does anyone knows if Prof Wong will continue to be your Gynae until you deliver your baby? Or he will stop after you get pregnant for the ivf programme? Sorry but I’m new here! Thank you! :)
Hi, he will discharge you when you are 12 weeks pregnant. He is not a Gynae but Dr Stephen Chew is
 

Cmf

Member
Does anyone knows if Prof Wong will continue to be your Gynae until you deliver your baby? Or he will stop after you get pregnant for the ivf programme? Sorry but I’m new here! Thank you! :)
Hi
Like Toh SH mentioned Prof Wong will discharge you during week 12. Around week 8 or 10, he will pass you a brochure with a list of nuh Gynae and he will just select some of the gynaes for you to chose but he would not suggest which Gynae will be the best for you. So by then, we have to go back to do the homework. During the last appt with Prof Wong, we will need to inform him the choice of the Gynae we decide n they will proceed to help to book the next appointment with the Gynae you have chosen.
 

Annie Du

New Member
Hi everyone

I'm currently on 2nd IVF cycle. Have transferred 3 frozen blastocysts in the 1st cycle, 1 fresh, and 1 frozen in the 2nd cycle. All didn't implant. First cycle was under Dr Chua Kah Hee and 2nd one with Dr Sadhana, both at KKH. Also did an endo scratch and cervix dilation before the last transfer but didn't result in any good news. Was diagnosed w endometriosis by Dr Loh SF at Thomson Fertility Clinic in 2018 and we've been trying through ART at KKH (1 IUI, 2 IVF) since then.

I'm 32 and DH is 34. Doctors keep telling us that we're still young and not to worry. But noone can tell us why we haven't succeeded after so many tries :(

My question is, should we switch to private and transfer our remaining 3 frozen embryos? We've been contemplating the change but hesitated as we don't want to restart everything from scratch (all the tests and records are with KKH). Any ladies with similar experience here?

Thanks in advance!
 
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harriet07

Member
Hi everyone

I'm currently on 2nd IVF cycle. Have transferred 3 frozen blastocysts in the 1st cycle, 1 fresh, and 2 frozen in the 2nd cycle. All didn't implant. First cycle was under Dr Chua Kah Hee and 2nd one with Sadhana, both at KKH. Also did an endo scratch and cervix dilation before the last transfer but didn't result in any good news. Was diagnosed w endometriosis by Dr Loh SF at Thomson Fertility Clinic in 2018 and we've been trying through ART at KKH (1 IUI, 2 IVF) since then.

I'm 32 and DH is 34. Doctors keep telling us that we're still young and not to worry. But noone can tell us why we haven't succeeded after so many tries :(

My question is, should we switch to private and transfer our remaining 3 frozen embryos? Any ladies have similar experience here?

Thanks in advance!
There's no harm in seeking second opinion with a private specialist or change to another government hospital. It also depends if you still have faith in your current doctor and would like to continue with her.

I failed 2 IVF cycles in KK (2 retrievals and 2 transfers) and decided to switch to private (Alpha) this year. I still have a frozen blastocyst in KKH but didn't transfer it over. I did another retrieval at Alpha and currently waiting for my FET. Although private is more expensive, and we lose out on govt co-funding, we can still use our Medisave (provided we have not depleted the 15k Medisave limit).
 


Annie Du

New Member
There's no harm in seeking second opinion with a private specialist or change to another government hospital. It also depends if you still have faith in your current doctor and would like to continue with her.

I failed 2 IVF cycles in KK (2 retrievals and 2 transfers) and decided to switch to private (Alpha) this year. I still have a frozen blastocyst in KKH but didn't transfer it over. I did another retrieval at Alpha and currently waiting for my FET. Although private is more expensive, and we lose out on govt co-funding, we can still use our Medisave (provided we have not depleted the 15k Medisave limit).

Hi Hariet

Do you mind sharing why did you decide to go private and how did you come to choose Alpha amongst many others? I'm not sure if we've depleted the 15k medisave limit, having done so many cycles already. We thought of going to Dr Loh SF at Thomson FC, last consultation in 2018 it was in the range of 20k per fresh cycle.
 

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