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824127 tn?1290516842

Remove Intraumural Fibroids & Is Blastocyst more successful

I'm 39 years old.  I have been trying to get pregnant for last 2 1/2years, i did my first failed IVF jan 09 i had 6 eggs they transferred 3 eggs on day 2 and froze the last three.. we did a natural cycle to transfer back the other 3 remaining eggs when they thawed the eggs two of them changed 1 went to 8 cell and 1 went to 9 cell, the other one stayed at 4 cell..  I did not get pregnant.. all eggs were a grade 4 (1-5, 5 being best grading)

I asked the dr if the many fibroids i have may be my problem with getting pregnant.. he said i do have many small ones but that they are all intraumural i have one at the top of the uterus and two at the base of the cervix, he said there's no way of knowing for sure.  i asked him to remove the fibriods, he stated that it would be too difficult becuase since they are intramural in the lining- he would have to do open surgery to remove them and he feels doing all the incisions would weaken the uterus.. he suggest we try IVF again..  My question is should i have another opinion, maybe he is not expericence with doing the surgery, i live in singapore and am aware that they are not as advanced as in the US or Europe.. He claims he could easily do the laser surgery via laprascopy if it was in the uterus there fore not harming the uterus..  My question, should i try to remove fibroids before doing my third IVF or should i leave them and hope that we get pregnant..  He said another reason why he didnt want to take them out was because when they did my first ivf my hcg levels were high on the 5th day which showed the pregancy was taking and he feels that the problem with the second iVF is that the eggs just didn't stick..

I suggested doing blastocyst or having the eggs incubate longer, he said that it really does not improve the success rates transferring eggs on day 2, 3 day 4 or 5 and that you lose more eggs in the long run going to blastocyst stage.. he felt it was better to transfer on day 2 or 3.. after hearing him it is apparant that they do not do blastocyst often meaning they don't have much experience with it..

I asked him to increase the dosage of the Subcut puregon-originally he gave me a low dose 250ml and i produced 11 eggs 6 of which were good.. my antral follicle count is total of 37, he was afraid i would over stimulate if he gave me higher dose.. i read that if you give higher dose in first 5 days you can recruit more eggs, which would enable me to try to do blastocyst.. he said if i wanted to try to do this he would..he suggested that i could do a dose of 400ml or 600ml..he said since i do soo much reading he would let me decide what i want.. he normally would give me 400ml and keep it steady to see how many eggs we'd recruit..

i asked them to put more then three eggs in the most they can put back is 4, i know that i run the possibility of quadruplets but i'm 39 years old and so far really feel that i'll be lucky if i get one.. he also said he will try the assisted hatching this time and will do blastocyst only if i recruit alot of eggs this time otherwise he will leave eggs out 3 or 4 days if we want..

I need a second opinion.. the hosiptial is public hospital here they have the best success rate but i feel that they are not being agressive enough with my program..
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Avatar universal
Hi there, I'm in the same boat.
I also have fibroids as same as yours and my RE did not want to do surgery as same as yours doctor's explain.
I'm turn in 39 soon, and don't have many eggs.  However, my first transfer is day 3 with all 3 eggs and failed.  I went to the second opinion and change to him, both IVFs I got pregnant but ectopic ones which are nothing relate to getting pregnant.
He transfers day 3 with all 5 embryos, then 3rd ones with day 3 and also all 8 embryos.  He does not want to wait till day 5 because of lossing embryos in the process.
My RE said all things as same as yours but he's more aggressive to transfer up to 8 embryos due to my age and the numbers of IVF.
Getting second opinion does not hurt to try.
Wish you the best of luck.
Helpful - 0
185149 tn?1275225319
Hi there,

I am from Spore too. Also reaching 39.  still trying to have my 1st baby. I was diagnosed with the right tube blocked. Am scheduled to have another detailed test, at the same time, try to 'unblock" my right tube. Maybe I will have to go for IVF.

Really am curious how IVF works and its success rates. Can somebody is here to advise me along.

***@****
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824127 tn?1290516842
I will be doing my 2nd Full Cycle IVF..  The prices are different depending which doctor you choose, generally in singapore you can go to private dr (Thompson Medical, Glen Eagles, etc..)which ranges from 13,500sing-15,000sing  the public hospital's like KK Hospital will run from 7,000-10,000 sing.. i went to  KK Hospital, now if you are a singapore citizen or permanent resident you'll pay roughly what i paid 7,800 for my first IVF this includes freezing three embryo's.. if you are not a singapore resident add on couple more thousand to the 7m-10m for KK hospital.  NUH-another public hospital is 1m more then KK hospital.

my 2nd Frozen Transfer or remaing three embryo's cost me $1,200

I will be doing another full IVF cycle around July 4th..

Depending on your which doctor you choose they will have what's called a long protocol or short protocol...

Long Protocol usually takes two months- this is what i am doing: I am waiting for my period this month,

A. when it starts i count from first day of period, then start taking Lupron shots on day 21 of my cycle to rest the ovaries.. these shots i give to myself in my lower abdomen under my belly button.  I give this to myself for two weeks every day...

B. After 14 days of Lupron shots i go into dr for a scan and blood test, if everything is ok with my hormones and scan good then i start Follicle Stimulation which is another shot given under my belly button..usually this is with Gonal F or Puregon depending on Dr.. you will also have to take the Lupron shots in addition to the Follicle Stimulation shots (the Lupron shots make sure you don't ovulate -make sure not to miss these shots)

C.  After taking Follicle Stimulation shots for 7 days you will go in for a scan to see the Follicle size, usually you will take maybe two or three more scans depending on how quickly your follicles grow, once the follicles are greater then 12mm (can take 10-16 days depending on your response)

D.  once follicles are ready you take a Pregnyl Shot at night-you have to go to hospital for this one..

E. 2 days after Pregnl shot you go in for Egg Retrieval-i was put under, this is really quick-15mins you have anastetics so you are out like a light no pain!, you have to rest in recovery room for 2hrs and can leave same day- go home to bedrest for first day or so depending how you feel.. my uterus felt heavy like someone had taken something from it. but had no pain at all.

F. Embryo Transfer:  Depending on how many eggs you have and how they are developing they'll put back on Day 2, 3, or if alot of eggs over 15 they might try blastocyst depending how many survive to day three.

G.  You will choose before hand with your husband how many to put back in singapore you can put back up to three or four.. most dr.s are conservative here so for your first ivf they most likely wont put back 4.

H. The Long wait-17 days after you do embryo transfer you go back for blood test, in the mean time you will give yourself injections, take supositories  to support pregnancy.

On Short Protocol you will skip doing the Lupron shots for 2 weeks and start with your Follicle stimulating on Day 2 of your cycle..

Success Rates at 39 are 25-30% when you hit 40 they go down to about 17%..

Usually most women get pregnant after three full IVF cycles..

hope this helps..


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