Interesting Cases at Metro IVF: Something to learn


Lesson 1: Madam M.L.

Madam M.L. and husband, from Australia were longing for a child since their marriage in 1996. Their many treatment attempts during the initial 8 years were unfruitful. The reason for their infertility was ovarian failure. She had her first IVF treatment with egg donation in Melbourne, Australia followed by second attempt in Hong Kong. She was introduced to Metro IVF in 2002 at 39 years of age, through a colleague. Detailed investigations at Metro IVF confirmed that she had ovarian failure and her ovaries have stopped producing egg. She also had 2 small fibroids in her uterus. Her fallopian tubes and husband’s sperm count were normal. She started IVF treatment with egg donation in September 2002. Her endometrium cycle was synchronized with the egg donor’s before the embryos were transferred on 13th october. On 31st of October she was confirmed pregnant and continued her antenatal check up and delivery (baby boy) in Australia.

 

 

Healthy egg with 1 polar body after egg pick-up

 

 

Lesson 2: Madam N.A. bt N.

Madam N.A. bt N. is 30 yr & had tried to conceive since her marriage 7 yr ago. Initial investigation showed that her hormone, uterus, ovaries and husband's sperms were normal & the couple was diagnosed to have unexplained infertility. She attended one treatment cycle of IUI before approaching Metro IVF for medical assistance. Different treatment options were discussed with her and her husband and finally they decided to have their first IVF treatment cycle at Metro IVF. Their IVF treatment was started in December 2009 and 3 embryos were transferred on the 9th of January 2010. 4 weeks later on 6th of February 2011, a single gestational sac with fetal heart was seen within the uterus cavity. At 20th of gestation, a detailed ultrasound scan by the sonographer showed the fetus was normal. On the 30th of August 2010, she delivered a healthy baby girl. Congratulations to Madam N.A. who finally has a baby of her own after 8 years of marriage.

Ultrasound picture of N.A.'s uterus with a healthy pregnancy sac (black oval shape) within it.

 

 

Lesson 3: Madam L.F. bt A.

Madam L.F. bt A. is one of the IVF patients at Metro IVF. She is a 35 yr-old-lady from Klang, Selangor, Malaysia and had tried to get pregnant for the past 6 years. She had 6 cycles of IUI treatment elsewhere before she came to Metro IVF for medical assistance. After repeated consultations and investigations, they decided to have IVF treatment. In the early January 2011, she started her down regulation (long protocol) at Metro IVF and on the 23rd of January, egg pick-up was performed. 3 days later, embryo transfer was performed, and 4 weeks later a single intrauterine gestational sac together with fetal heart was seen. Her pregnancy is going on well and at 18th week of pregnancy she felt the first fetal movement.

 

 

Ultrasound picture of L.F.'s uterus with a 6th week healthy pregnancy sac.

 

 

Lesson 4: Madam M. a/p B.

Madam M. a/p B., 35 yr old, from Subang Jaya, Selangor, Malaysia. She had been trying to conceive since her marriage 6 years ago and had sought numerous treatment options before approaching Metro IVF. Detailed investigations revealed that her FSH levels markedly raise and she has pre-mature ovarian failure (no eggs). Her uterus was hypotrophic (small) due to low estrogen levels. She and her husband finally agreed to undergo IVF treatment with oocyte donation. She was treated with cyclical estrogen to bring back her uterus to a normal size. This was followed by IVF programme in October 2010. Her endometrium was prepared and synchronised with the oocyte donor so that the endometrium progress was at the window of implantation when the embryos were transferred on 26th November 2010. On the 8th of December (12 days post embryo transfer), her B-hCG level was 488 iu/l. At 6th week of gestation, a single intrauterine gestational sac with fetal heart was seen. Her pregnancy progresses normally and on 26th of March 2011, a detailed ultrasound scan by the sonographer showed a normal healthy baby girl.

 

Lesson 5: Madam C.B.C.

Madam C.B.C , 33 yr old lady from Shah Alam, Selangor, Malaysia is married since 2008 and had been trying to conceive since then. She had hormonal imbalance and irregular menstrual cycles. She had two cycles of IUI without success and finally agreed for IVF treatment. She started her IVF cycle in June 2010 using short protocol. Controlled ovarian hyperstimulation was started on 25th of June, and egg pick-up was performed on 7th July and embryo transfer (3 embryos of Grade 1) on 9th July.  she came to Metro IVF for her first IVF treatment and her embryo transfer was performed on 9th July 2010. Her B-hCG level on 11 days post embryo transfer was 328 iu/l.

2 weeks later, 3 gestational sacs with fetal heart were seen. At 20th week of gestation, detailed ultrasound scan showed 3 healthy baby girls. At 29th week of gestation, the estimated fetal weights were 1.24 kg, 1.37 kg and 1.35 kg. At 32th week of gestation, the estimated fetal weights were 1.59 kg, 1.42 kg and 1.39 kg. She was admitted at 26th week of gestation for preterm labour and continued her hospitalization till her delivery at 36th week of gestation (3rd March 2011) by Caesarean Section. All the 3 baby girls (weighed 1.9 kg, 2.05kg and 1.95 kg) did well without neonatal support.

This ultrasound picture of C.B.C. shows 3 intrauterine pregnancy sacs

 

 

Lesson 6: Madam S. a/p A.

Madam S. a/p A. is the first patient of Metro IVF at KL branch. She was 36 years old, a teacher from Petaling Jaya, Selangor, Malaysia and had been trying to conceive for the past 4 years. Investigation showed that she had endometriosis and her husband's semen analysis revealed male factor. She had tried 3 clomid cycles and 1 IUI cycle without success. She had her first IVF with ICSI treatment done at Metro IVF using long protocol in June 2010. She had her embryo transfer on 15th of July and 4 weeks later a single intrauterine gestational sac together with fetal heart was seen.

Her pregnancy progressed normally and she had the Caesarean section done on 4th April 2011. Her baby girl weighed 3.4 kg. Congratulations to Madam S.A.

This ultrasound picture of S. a/p A. shows a single intrauterine pregancy sac at 6th week of gestation

 

 

Lesson 7: Madam T.Y.S.

Madam T.Y.S., 31, from Klang,Selangor,Malaysia and had tried to conceive for the past 3 years. Investigation showed that she had uterine fibroids and tube blockage. She had tried IUI and IVF. In April 2010, she did her second IVF treatment at Metro IVF and had her embryo transferred on 19 May 2010. After 5 weeks, a singleton gestational sac with fetal heart was seen. On 20th January 2011, she gave birth to a healthy baby boy. Congratulations to Madame T.Y.S for the healthy baby.

This ultrasound picture of T.Y.S. shows a single intrauterine pregnancy sac at 6th week of pregnancy

 

 

 Lesson 8: Madam W.S.T.

Madam W.S.T. was a patient of Metro IVF since 2006. She was a 31 yr old lady, from Klang, Selangor, Malaysia and had laparoscopic surgery done in 2008 for endometriosis. The reasons for difficulty in conceiving were endometriosis and male factor infertility. She returned in 2010 for IVF. IVF cycle using long protocol was started 0n 2nd March. On 30th March was done followed by embryo transfer (2 embryos of Grade 1) on 1st April.

4 weeks later, ultrasound scan showed 2 intrauterine gestation sacs with fetal heart. Her pregnancy progressed normally. At 20th week of pregnancy, a detailed scan showed 2 healthy babies (1 boy 1 girl). Caesarean Section was done on 5th December and the baby boy weighed 2.65 kg and the baby girl weighed 2.2 kg. Both the babies were well on discharge. Congratulations to Madam W.S.T and her family.

This ultrasound scan of W.S.T. shows 2 intrauterine pregnancy sacs at 6th week of pregnancy

 


Lesson 9: Madam C.F.

Madam C.F. was a 44 years old lady from Perak, Malaysia and have been trying for a baby since her marriage 13 years ago. She had 7 IUI and 3 IVF cycles before coming to Metro IVF. Detailed investigations showed that she had multiple uterine fibroids, poor ovarian reserve and male factor infertility. She was counselled for IVF with ICSI and egg donation because of the male factor and poor ovarian reserve.

She agreed for egg donation and IVF cycles which were done in April and August 2010. In August 2010, her endometrium cycle was synchronised with the egg donor and embryo transfer (3 embryos of Grade 1 and 2) was done on 29th September. 4 weeks later, a single intrauterine gestation sac with fetal heart was seen. On 14th December, first trimester ultrasound scan showed a normal fetus, 13th week size. The pregnancy is currently on-going well.

This ultrasound picture of C.F. shows a single intrauterine pregnancy sac at 6th week of pregnancy with multiple fibroids

 

 

Lesson 10: Madam Y.S.M.

Madam Y.S.M, 31 yr old lady, was trying to get pregnant since her marriage in 2003. Detailed investigations showed that she had tubal blockage, endometriosis and male factor.  She was counselled to have IVF treatment and her first IVF cycle was started in December 2009 which was unsuccessful. Her second IVF cycle was started in April 2010 using long protocol. Egg pick-up was done on 3rd of May and embryo transfer on 5th of May.

On 25th of May, a single gestational sac was seen, and on the 2nd of June, 3 gestational sacs with fetal heart were seen. At 20th week of gestation, detailed ultrasound scan showed 3 healthy baby boys. She was admitted 23rd of November at 30th week of gestation for preterm labour. She remained hospitalise till delivery at 35th week of gestation by Caesarean Section. The 3 baby boys weighed 1.6 kg , 1.85kg and 2.1kg.

All the 3 boys did well and the "3 Musketeers" continue their vaccination programme at public health centre.

This ultrasound picture of Y.S.M. shows 3 intrauterine pregnancy sacs at 5th week of pregnancy

 This ultrasound picture of Y.S.M. shows 3 intrauterine pregnancy sacs at 5th week of pregnancy