IVF Success Rate in Taiwan
The Taiwan Health Promotion Administration (HPA) published the 2021 national report on ART in September 2023. The report reveals that nationwide, the pregnancy rate per embryo transfer cycle stood at 44.3%; the live birth rate per embryo transfer cycle was recorded at 32.8%.
One of the Top 5 fertility centers in Taiwan: Stork Fertility Center
Its "graduation" rate for ongoing pregnancies at 14 weeks reached 59.7% in the first half of 2023.
6 out of 10 couples successfully overcame the challenging initial 14 weeks of pregnancy and graduated from the clinic to maternity care on their first IVF 3.0+ transfer cycle.
Notably, the difference between their graduation and live birth rates is just 5%.
Reference:https://www.e-stork.com.tw/news/view/170 https://www.e-stork.com.tw/article/view/19566
To know a clinic's real IVF success rate, see their "graduation rate"
Pregnancy rate is often used as a measure of IVF success. However, for a more accurate understanding of the chance of a successful live birth, it is better to consider the percentage of individuals who have successfully graduated from the clinic and were transferred to maternity care.
While fertility clinics' pregnancy or graduation rates are defined by their own standards, general definitions are as follows:
- Graduation: Sustaining the pregnancy for a specific duration specified by the clinic (commonly around 8 weeks). Once the patient achieves this milestone, they can transition to a maternity hospital.
- Pregnancy: A significant increase in blood hCG levels or the identification of a gestational sac after embryo implantation.
IVF 3.0+
(The information is from the Stork Fertility Center)
IVF 3.0+ = Precise Embryo Choosing (PGS) + Precise Implantation (ERA)
The Third generation IVF Plus is built upon the core treatment - Personalized Precision IVF, with the addition of PGS (Preimplantation Genetic Screening) and ERA (Endometrial Receptivity Analysis).
According to the Stork Fertility Center's statistics in 2017~2018, the pregnancy rate of transferring one chromosome-normal blastocyst at or above BB grade can be 80%. The chances of having twins were less than 1% and the miscarriage rate was less than 5%.
The remaining 20% can be addressed through additional methods such as EMMA and ALICE, which are screening tests that evaluate bacteria in the uterine cavity. Other approaches include reproductive autoimmune screening and blood clotting tests.
The grade of blastocyst stage embryo
During the blastocyst stage, embryonic cells differentiate into two cell types:
- Inner Cell Mass which eventually develops into the baby.
- Outer Cell Mass (trophectoderm) which eventually forms into the placenta.
A blastocyst is graded on three elements, for example: 4AB
4→ Indicates the expansion and hatching status, numbered 1-6 (6 being the most expanded)
A→ Indicates the Inner Cell Mass quality, ranked A-C (A being the best)
B→ Indicates the Outer Cell Mass quality, ranked A-C (A being the best)
IVF 3.0+ Process
(The information is from the Stork Fertility Center)
Egg Retrieval Cycle:
To start the egg retrieval cycle, you will begin on day 2 or 3 of your menstrual period. The clinic will use Individualized Controlled Ovarian Stimulation (iCOS) to help the follicles in your ovaries grow. These follicles are small sacs filled with fluid that contain immature eggs. Once the follicles reach the optimal level of maturity, they will give you a trigger shot to stimulate ovulation. After that, they will proceed with the egg retrieval procedure, which usually takes place around day 14. The retrieved eggs will then be fertilized with sperm to form embryos.
Embryo Cultivation and PGS (Preimplantation Genetic Screening):
After 5-6 days of development in the laboratory, the embryos will be biopsied when they reach the blastocyst stage. The cells will be sent for PGS while the embryos are frozen.
ERA (Endometrial Receptivity Analysis):
By the third day of your menstrual period, a mock embryo transfer cycle can be performed to determine the window of implantation (WOI). This will help the clinic identify the specific timeframe when your endometrium is receptive to the embryo.
Embryo Transfer Cycle:
The embryo transfer cycle begins by the third day of your menstrual period. You will start taking medication to prepare your uterus for implantation. Once the uterine lining reaches a satisfactory thickness, the clinic will proceed with the embryo transfer during the implantation window, which typically occurs around day 18-20. After that, pregnancy can be detected 7-14 days after the embryo transfer.
Reference: https://en.e-stork.com.tw/page/ivf
Personalized Precision IVF approach
Choosing the right embryo and transferring it at the right time.
PGS helps select healthy embryos with normal chromosomes, reducing the need for multiple embryo transfers and decreasing the risk of miscarriages. This ultimately enhances the chances of couples achieving pregnancy at a faster rate.
ERA determines the optimal timing for embryo implantation by identifying when the endometrium is receptive. This ensures that the healthy embryo has the best chance of successful implantation.
IBR (Pioneer: Dr. Hsing-Hua Lai)
Implanted-Blastocyst Rescue
If a pregnancy doesn't progress as expected, even after PGT and ERA have been conducted, IBR steps in to save the baby.
Through the Reproductive ICU approach, called IBR, pregnancy indicators and maternal autoimmune changes are closely monitored, and appropriate medication is promptly administered to overcome obstacles and ensure the baby's survival.
You're not alone in experiencing this heartbreak; there are solutions out there for you.
Q: Have you ever experienced the unfortunate situation of having repeated pregnancy terminations at around 6 or 7 weeks, without your doctor being able to offer any solutions?
The embryo faces a challenging time during the first and second week after being transferred, and when the fetal heartbeat appears (around 6-7 weeks of pregnancy).
This is because the mother's immune system may see the embryo as foreign and attack it. If the embryo is harmed during this period, it can result in shallow implantation or a blighted ovum, where the embryo sac is visible on ultrasound but there is no fetal heartbeat.
To address this issue, the "dynamic triple detection" method, known as advanced immunological indicators, is used. This involves drawing blood at three different times: before embryo transfer, after embryo transfer, and on the day of pregnancy detection if the result is not ideal. By monitoring the mother's immune changes, this method helps detect potential risks.
There are five common embryo killers: white blood cells (WBC), tumor necrosis factor-α (TNF-α), blood clots, natural killer (NK) cells, and B cells.
In the event of elevated immunological indicators, medication is promptly given to protect the embryo from potential harm caused by different attackers. Stork Fertility Center pioneered this approach, known as IBR (Implanted-Blastocyst Rescue).
memo: insert linkhttps://en.e-stork.com.tw/article/view/126
It's important to note that the mother's immune status is dynamic, and the immune attack usually intensifies with "the number of miscarriages". IBR plays a key role in safeguarding the embryo's growth into a baby.
Reference:
Q: Have you ever had multiple implantation failures (negative pregnancy test results) and were always told that the main cause is genetic abnormalities in the embryo?
If you still have several frozen embryos without PGT, your doctor may have mentioned the option of continuing with embryo transfer until the right one is found. Another option is to undergo another egg retrieval cycle with PGT. The last option, which is not recommended, would be to thaw the frozen embryos and perform PGT to identify the ones with normal chromosomes.
To avoid this regrettable scenario, it is essential to consult your doctor for a comprehensive examination before starting IVF treatment. This ensures that the condition of both the mother and the embryo is at its best and ready for treatment.
With the IVF 3+ treatment, we can do PGT in the initial attempt followed by ERA to ensure accurate progress at each step. This approach eliminates the need to look back and regret any missed opportunities to do the right thing.
★Six Main Factors Behind Repeated Implantation Failure
Reference: https://en.e-stork.com.tw/article/view/24
(1) Embryos
Embryos with abnormal chromosomes are unable to embed or lead to miscarriage.
💡 Solution: PGT (Preimplantation Genetic Screening)
(2) Uterus: implantation window
30% of women have a displaced window of implantation.
💡Solution: ERA (Endometrial Receptivity Analysis)
(3) Uterus: abnormal uterine structure, polyps, endometritis
Abnormal uterine structure or inflamed endometrium is not suitable for implantation. Miscarriage may occur even if the embryo is embedded.
💡Solution: Examined by Hysteroscopy and treated by surgery or medication
(4) Fallopian tubes
Obstruction or edema of the fallopian tubes causes fluid to flow into the uterus and affects implantation.
💡Solution: Examined by Hysterosalpingography (HSG) and treated by surgery
(5) Hormones
Low estrogen and progesterone, low thyroid hormone or high prolactin etc. can affect embryo development and lead to miscarriage.
💡Solution: Treated with medication or injections, and tracked regularly.
(6) Autoimmunity
Maternal overactive immune systems can impact embryo development, embedding and can harm the embryos.
💡Solution: Treated with medication or injections, and tracked regularly.
Q: Have you experienced the frustration of facing repeated biochemical* pregnancies or miscarriages, only to be told by your doctor to stop the medication and try again next time?
If your uterine environment, fallopian tubes and hormones were all in good condition, and a chromosomally normal embryo has been transferred during the receptive time of the endometrium, but you still experienced a biochemical pregnancy or pregnancy discontinuation, it is possible that the embryo has been impacted by an immune system attack or blood clotting issues within your body.
Typically, a pregnancy test is conducted 14 days after embryo transfer. However, for individuals with autoimmune issues, neglecting to address those issues during this waiting period may end with an unsuccessful outcome.
To tackle this issue, the Stork Fertility Center performs the first pregnancy test 7 days earlier than usual. Moreover, they use "dynamic triple detection" which involves three blood tests for immunological indicators before and after embryo transfer, as well as on on the day of pregnancy detection if the result is not ideal. This approach aids in identifying any excessive immune response following embryo implantation and helps to detect potential embryo killers at different stages. Meanwhile, they consistently monitor pregnancy indicators every 2-7 days to make necessary adjustments in the administration of immune-related medication or blood thinners.
The Stork Fertility Center in Taiwan has pioneered this comprehensive approach known as IBR (Implanted-Blastocyst Rescue) to provide intensive care for embryos. They have assembled a team of professionals who are dedicated to assisting embryos in overcoming challenges during their development into babies. This team comprises experts in Reproductive Immunology and Immune Reproductive Medicine, a laboratory team with extensive experience in the Third Generation IVF Plus, an external team specializing in Advanced Immune Testing, and a state-of-the-art biochemical laboratory equipped with Real-time Reporting capabilities.
★Biochemical pregnancies:
A biochemical pregnancy is a type of early miscarriage that happens within the first five weeks of pregnancy. It occurs when the pregnancy hormone, β-hCG, initially rises but then either stops rising as it should or starts to fall. It can also be identified by the absence of a visible pregnancy on an ultrasound scan, even if the blood hCG pregnancy test is positive.
Reference:
https://en.e-stork.com.tw/article/view/129
https://en.e-stork.com.tw/article/view/37
https://en.e-stork.com.tw/article/view/126
https://en.e-stork.com.tw/article/view/131
https://www.e-stork.com.tw/article/view/18635
https://www.youtube.com/watch?v=5qRlTgdcp1M
Q: Did your doctor always present statistical data instead of addressing the specific issues that happened to you individually?
You might have heard doctors say "70% of implantation failures and miscarriages are caused by chromosomal abnormalities in the embryo".
While statistical data is useful for decision-making, the key to success lies in addressing the specific problems encountered by each individual.
The personal history of conception, including pregnancies, miscarriages and implantation failures, carries greater importance than general statistics or blood test results. Even if the blood test results are normal, it does not always guarantee successful outcomes.
It is crucial for your doctor to be aware of this and evaluate your past conception history in order to make necessary adjustments to your treatment and medication for better outcomes in future attempts. Every failure is important and provides valuable information for your medical providers to improve your next try.
Stork Fertility Center delivers "Personalized Precision IVF (PP-IVF)" treatment, an approach tailored to each individual's conditions and needs.
Reference:
https://en.e-stork.com.tw/article/view/25
https://en.e-stork.com.tw/page/ivf
Q: Why are people from Japan choosing Taiwan for IVF treatment?
In regards to the variety of treatment choices available, Taiwan outshines Japan in terms of accessibility for individuals requiring IVF with donor sperm or eggs. Moreover, unlike Japan, Taiwan allows PGS (Preimplantation Genetic Screening) to be conducted during the initial IVF attempt, increasing the chances of success. Furthermore, in comparison to Japan's regulations, Taiwan provides greater flexibility in treatment options, leading to a more efficient and effective IVF approach.
The cost of treatment in Taiwan is similar to Japan's self-pay care but you have a wider range of options that results in a more personalized care plan. This makes Taiwan a viable alternative for many individuals seeking IVF treatment.
In terms of convenience, Taiwan is geographically close to Japan, with just a 3-hour flight between the two countries. This makes traveling to Taiwan for IVF treatment relatively easy and accessible.
Furthermore, language is not a barrier in Taiwan as many fertility clinics can accommodate English and Japanese speakers. On the other hand, English language services are not common in Japan, which may pose a challenge for non-Japanese speakers.
