The problem of infertility in the second pregnancy. Dr. Chun-I Lee will answer the question for you
- What’s the main reason for wanting to have a second child but cannot due to infertility?
Some patients already have polycystic ovary syndrome or endometriosis. What happened was when they are pregnant with the first child, everything was normal, but afterbirth, advanced age plus fatigue, diet and other reasons may have exacerbated the symptoms and cause abnormal ovulation. Reasons such as caesarean section, ectopic pregnancy, and other, may have caused adhesion, fallopian tube obstruction, thus affecting fertilization and embryo implantation. Moreover, many men think that men have a strong reproductive ability where it is not difficult for them to have a child at the age of sixty or seventy, they also have the idea that when they already gave birth to a child, and the sexual function has not changed, then naturally there should be “no problem.” Although the speed at which men's reproductive function deteriorate is slower than women’s, if their lifestyle habits are not good where their habit of smoking and drinking have not changed, then spermatogenesis will also be affected, and the quality of the sperm will decline, which of course will affect the chance of conception. This is especially apparent as one ages, maybe the body is beginning to have chronic diseases, such as high blood pressure, diabetes, hyperlipidemia, and so on, which may all affect sexual desire and fertility. Therefore, one should put all the blame on the wife for their inability to conceive.
Modern day females have late childbirth where they have their first child at a too old and age. Thus is becomes relatively more difficult to conceive a second child.
- How to prepare a fertility plan?
- What tests and treatments should I do if I am really infertile?
- What technology can assist advanced maternal aged couples to conceive a baby?
As for the rate of miscarriage, it is even higher. The rate of spontaneous abortion among pregnant women aged 20-24 is 8.9%, and the proportion for pregnant women over 45 years old becomes as high as 74.7%. This is coupled with the problem that for the advanced maternal aged, when their sperm and egg are fertilized they are more prone to autosomal abnormality. Thus their probability of giving birth to children with abnormal chromosomes increases significantly. If when carrying out with IVF, before the embryo is implanted, the two technologies, that of pre-implantation genetic screening (PGS), and embryoscope time-lapse system, are used, then the above-mentioned problems faced by the advanced maternal aged women can effectively be solved. Before embryo implantation, pre-implantation genetic screening is performed before the fertilized egg is implanted into the uterus, whereby 5-6 cells are taken out for chromosomal examination in order to select a normal embryo for implantation into the uterus, thus improving the conception rate. This will increase the success rate of the original implantation of an embryo from 20% to 50%, and the implantation of two embryos will also increase from 30%-40% to 85%. This is different from the prenatal genetic test done by the general advanced maternal aged women or mothers with special pregnancy.
Prenatal genetic testing extracts the amniotic fluid or chorionic for carrying out chromosome testing after pregnancy. Before embryo implantation, genetic screening needs to extract the cells from where the embryo develops into the placenta, and have to avoid the place where the embryo develops into a fetus, so as not to hurt the fetus.
This is the key point to this technology. The big data artificial intelligence provided by the embryoscope time-lapse system is a bit like applying time-lapse photography to the observation of embryo, where the machine can observe the growth of embryo non-stop 24 hours a day. This is because in the process of embryo development, development that is too fast or too slow is not conducive to the subsequent pregnancy by embryo implantation. The time point of changes in embryo development is a reference basis for observing the quality of the embryo, and remedies the inadequate past technology of observing the appearance of the embryo at fixed time period. Through the microscope head of this machine, the development process of each embryo can be observed, including areas such as the appearance of the embryo, the dynamics of the division, the presence or absence of debris, and so on. It take pictures every ten minutes and make it into a continuous image slide show, so that researchers can quickly and accurately grasp the big data and make analysis from it. They will find embryo developmental defects from these images, and then select the best quality embryos with normal chromosomes for implantation. This will significantly reduce the miscarriage rate and increase the pregnancy rate.
Another situation faced is that women nowadays get married late and give birth late, and when they are older, they may be faced with ovarian failure. For many women over the age of 40 have multiple failed IVF treatments, or young women in their 30s undergone radiotherapy and chemotherapy due to cancer, or have had ovarian surgery when they were young which affected their ovulation, or having difficulty to conceive or is infertile, or having family genetic diseases, will adopt the method of donor eggs to achieve conception. For those who have reached the age of 35 but are still without a partner, or for couples who have no fertility plans, or those who have already gave birth to a first child but are still uncertain whether or not they want to have a second child, in order to avoid the situation where you may want to give birth in the future but is unable to, we also recommend that you freeze the eggs as soon as possible, so that at the time when you want to give birth in the future, you will have a better chance of having a successful childbirth.
- What is the doctor's suggestion about the problems that may be faced when giving birth at an advanced maternal age?
Speaker : Dr. Chun-I Lee, Lee Women's Hospital
- Reproductive endocrinology and infertility doctor of NTUH
- Attending Physician of Reproductive Endocrinology and Infertility, Chung Shan Medical University Hospital
- CEO of Lee Women's Hospital
- Director of enetic inheritance of Lee Women's Hospital
- Infertility medication and surgery
- Egg Freezing
- Egg Donation
- Obstetrics and Gynecology