Northern Taiwan

Final IVF Treatment Failed, Turn Into Egg Recipient Program
Final IVF Treatment Failed, Turn Into Egg Recipient Program

I was married at 32. Regarding pregnancy, I have always thought that let it slide, and the baby will come naturally when the time comes. But after 35, I still haven't been pregnant. Then, I went to the clinic for infertility treatment and worked at the same time. I was 37 years old when the infertility treatment officially started. After 3 years of treatment in Japan, three hospitals were also changed. My AMH (ovarian inventory) was only 0.02 which was about very low, and I just realized that the number of my eggs was not enough. I was told by this hospital: “If I don’t get treatment as soon as possible, I am afraid that I will stop ovulating soon. The treatment must speed up.” I was shocked at the moment and accidentally caused my family members to be affected by my anxiety and restlessness. There was no time to sort out my mood, and I went directly to various examinations and treatments. Because of my low ovarian inventory, I need to retrieve eggs every menstrual cycle, and only two eggs can be retrieved each time. I not only need to take injections for about two weeks every month but also need to go back to the clinic almost every day. It’s really hard to balance work and infertility treatment. Even though I continue to receive treatment, there have been no good results. I often cried at night alone. I think over “Am I really unable to get pregnant?” again and again. I also thought about adoption as well. There is a sound from the bottom of my heart that makes me couldn’t give up, “I want to give birth for my husband.” I found information about the “Egg Recipient Program” from Stork Fertility Center in Taiwan, and also visited their website. Attracted by their high pregnancy rate, I quickly decided to contact them. Their consultants could communicate in Japanese, and I got their reply quickly. Although, I felt a little bit anxious due to rare information about the “Egg Recipient Program” in Japan. But I still have hope and expectation. We followed the instructions given by Stork, prepared all the documents in Japan, and flew to Taiwan, visit the Stork Fertility Center. The overall impression of the Stork is very bright and clean. My uneasy emotions have been wiped out, and I am being treated in Taiwan without any suspense. Maybe I am not sure whether I can carry out the treatment and all my feelings are written on my face. No matter the doctor or Japanese consultants, they all have a smile, encouraging me and explaining the treatment carefully, so that I can take overseas medical treatment with peace of mind. The examination was only mildly painful, and it ended soon. For me, the treatment in Taiwan doesn’t affect work at all. Before the first implantation, the ERA examination found that my implantation window was different from others. Although it didn’t succeed the first time. But after the second implantation, there were two lines on the pregnancy test stick. I couldn't believe it. I confirmed the pregnancy test several times.I think I can get pregnant smoothly because the advance of the pre-check had done enough, that’s why I found the cause of infertility. At 41, I gave birth to my child successfully, and my husband’s family members are also very happy. The child looks so much like my husband. I am writing while the child is 1 month old, and I can’t help crying when I look at my kid’s angelic sleeping face. If I hadn't had a child, it would be impossible to taste such happiness. I would like to thank the donor and every colleague who works in Stork. Thanks! #Egg Donor Recipient Program#Patient Testimonial *This article only reflects the treatment status at the time of writing, and the actual situation should be discussed with the doctor.

#Artificial Reproduction
Hope Fertility & PGT Center——Clients from the USA with a thick medical record but with perseverance successfully got a baby
Hope Fertility & PGT Center——Clients from the USA with a thick medical record but with perseverance successfully got a baby

Hope guards your bliss over a span of 12000 kilometers Two-month old Lucas has black hair. He wields his fists in the air and giggles. Lucas’s parents are from Taiwan. For the sake of the father's career, they settled down in the USA. The wife worked as a teacher in a kindergarten, taking great care of a group of kids. She loved children so much that she wished one of them could be her own kid. However, her expectation never came true. The couple had consulted many specialists around everywhere yet in vain. Eventually, they heard about a Director Chan in Taiwan who might offer them good news. This journey covered a span of more than 12,000 kilometers. Nevertheless, they were willing to undertake anything as long as they could fulfill their dream. This journey proved to be a most precious short cut. Lucas’s mom still remembers vividly the first time she came to Hope Fertility & PGT Center. Director Chan spent a great deal of time discussing with them. She remarked, " Director Chan was the first obstetrician that spared no trouble looking into all my medical record at great length." At that moment, she was determined to seek the help of Doctor Chan and tried again. The thick medical record exemplifies her painstaking experience in numerous medical treatments attempting to conceive a child. She has immune system related diseases which affect the implantation of embryos. When the immune system judges that the embryo is a foreign substance, it will resist it, making it difficult for the embryo to implant and stay in the uterus. The couple chose to undergo chromosome examination and faced every opportunity with caution. In October 2022, with the efforts of Hope’s professional team, the embryo was successfully implanted. All the endeavor brought about sweet fruit. As the pregnancy was stable, Lucas’s mom went back to the USA to labor. Despite being separated by the Pacific Ocean, Hope's concern never failed. Our consultants regularly monitored the conditions of the mother-to-be. In July 2023, after 38 weeks of pregnancy, she gave birth to a baby in the USA. To our excitement, Lucas was a healthy baby that weighed 4,345 grams. Both the mother and the child were in great physical condition. Hope Fertility & PGT Center extends a cordial welcome to couples who desire kids. Let Hope function as your initial step in parenthood and accompany you and your babies throughout the whole procedure. Hope Fertility & PGT Center will always stand here as a guardian for your happiness.

#Artificial Reproduction
【Taipei Fertility Center】Celebrating the First TFC Patient's Successful Parenthood After Border Reopening!
【Taipei Fertility Center】Celebrating the First TFC Patient's Successful Parenthood After Border Reopening!

🦁 Auspicious Lion Brings Blessings, Life Continues to Flourish!😄 I am grateful for the divine intervention that made all of this possible! I extend my heartfelt appreciation to the dedicated team for their contributions and efforts. This fills my heart with immense joy!o:p>/o:p> In the first half of 2022, after the reopening of borders, TFC welcomed its first international patient! After enduring hardships, she successfully gave birth to this beautiful, healthy, and adorable baby girl in April 2023!o:p>/o:p> A few years ago, they sought treatments at a renowned reproductive center in Thailand but it failed. Later, through a friend's recommendation, they traveled all the way to Taiwan for the IVF treatment, but the pandemic caused an additional delay of over two years.o:p>/o:p> After long-awaited anticipation, they finally arrived in Taiwan following the border opening, and the first embryo transfer brought great news! We successfully overcame challenges related to chromosomes and sperm issues. Through two cycles of egg retrievals, we obtained embryos with normal PGS results.o:p>/o:p> I am deeply moved by her trust and patience over these past two years, coming all the way to Taiwan to seek treatment with me. Our entire team has constantly motivated and supported each other, hoping to fulfill their dream of becoming parents!o:p>/o:p> During her stay in Taiwan, she painstakingly handcrafted a needle felting featuring an auspicious lion, symbolizing blessings and life's continuous abundance. I received this gift with overwhelming emotions, feeling both touched and delighted!o:p>/o:p> I am thankful for the patient's faith in our abilities and their unwavering commitment to this journey. This experience has been a true testament to the power of hope and perseverance!o:p>/o:p> The story of this precious new life, brought into the world through our collective efforts, shall forever inspire and motivate us to continue making dreams come true. May this beautiful baby girl bring boundless joy and prosperity to her family, and may the spirit of the auspicious lion continue to bless us with life's endless possibilities. This miraculous journey has enriched all of us and reaffirmed our belief in the miracles that unfold when hearts and minds unite in purpose and determination.o:p>/o:p> Together, we shall thrive, overcome, and create a world where hope, love, and miracles never cease to exist!🌟 o:p>/o:p> Successful Case Video:https://youtu.be/L2ewt3tW0KQ Introduction of Dr. Lin, Shyr-Yeu:https://www.tfcivf.com/en/doctor/content/15o:p>/o:p> Clinic Hours:https://www.tfcivf.com/en/doctor/content/15o:p>/o:p> 📍Phone number: +886-2-2725-2333 📍WeChat：tfc_ivfo:p>/o:p> 📍WhatsApp：https://wa.me/886928651058 📍E-mail：admservice@tfcivf.como:p>/o:p> For making the appt, please download TFC APP and register:o:p>/o:p> iOS Download:https://pse.is/3pj328o:p>/o:p> Android Download:https://pse.is/3ppxzz#o:p>/o:p> Doctors & Appointments https://www.tfcivf.com/en/doctor/list/doctor Updated Clinic Hours https://www.tfcivf.com/en/outpatiento:p>/o:p>

#Artificial Reproduction#Medical Tourism
Taiwanese Medical Expertise Shines! Jordanian Boy with Apert Syndrome "Give Me Five" Reborn
Taiwanese Medical Expertise Shines! Jordanian Boy with Apert Syndrome "Give Me Five" Reborn

The Department of Reconstructive Surgery at National Taiwan University Hospital Hsin-Chu Branch successfully performed a groundbreaking two-stage surgery to separate the fingers of a Jordanian boy, who was less than 2 years old and diagnosed with Apert Syndrome. The skilled medical team, comprising surgeons, anesthesiologists, nurses, and specialists from various disciplines, worked tirelessly to achieve the remarkable outcome of separating both hands' five fingers. The boy's parents expressed profound gratitude for the exceptional care and treatment provided by the Taiwanese medical team, and the hospital celebrated the boy's new lease on life with a grand cake-cutting ceremony, looking forward to his bright future and being able to give others a "high five." Dr. Huang Bo-Cheng, Head of the Department of Plastic Surgery at National Taiwan University Hospital Hsin-Chu Branch, explained that the young boy, Eyas, was of Jordanian-Palestinian origin and was born with Apert Syndrome. The condition manifested with craniofacial deformities due to premature fusion of the skull sutures, cleft palate, and syndactyly (fused digits) of the hands and feet. In July last year, the boy's mother, a student on exchange at National Chiao Tung University, sought medical advice, well aware of Taiwan's excellent medical expertise. After consulting with Dr. Huang and Dr. Hsieh Meng-Hsiang, Head of Pediatric Plastic Surgery at National Taiwan University Hospital, a treatment plan was devised that involved multiple surgeries to address the various symptoms. Given the limited time in Taiwan, the parents opted for a phased approach, starting with the separation of the fused fingers. The first surgery was conducted in August last year, with evaluations of cardiopulmonary function by Dr. Fu Jun-Min from the Pediatrics Department, brain structure assessment by Dr. Hsu Chia-Jui, and pre-operative evaluation by Dr. Kung Chia-Chi from the Anesthesiology Department. Under the guidance of Dr. Hsieh Meng-Hsiang and the skillful hands of Dr. Huang Bo-Cheng and Dr. Zhao Song-Quan from Pediatric Plastic Surgery, the separation of both hands' fifth fingers was successfully completed. Post-operative care progressed smoothly, and the boy was discharged at the end of August to return home. Satisfied with the medical standards at National Taiwan University Hospital Hsin-Chu Branch, the boy's parents returned last month for the second surgery. Dr. Huang Bo-Cheng successfully separated the boy's second, third, and fourth fingers of both hands. Following meticulous care in the Pediatric Intensive Care Unit by Dr. Fu Jun-Min and Dr. Liu Hsin-Ming, the boy was transferred to a regular ward, where the wound healed steadily. With the assistance of the medical team, he was discharged in good condition and is currently undergoing follow-up treatments at the outpatient clinic. Dr. Huang Bo-Cheng explained that Apert Syndrome is a rare congenital condition with a prevalence of one in twenty thousand births, caused by an autosomal dominant genetic mutation. It equally affects both males and females and is mostly the result of new mutations. Prenatal chromosome diagnosis can be employed to prevent the birth of another affected child. Apert Syndrome may lead to craniosynostosis (premature closure of skull sutures), resulting in flat head, midface retrusion, proptosis (bulging eyes), syndactyly (fused fingers), and improper teeth occlusion. Other internal organs and structures may also be affected, and cognitive development can be impacted. While the syndrome cannot be cured, surgical interventions can correct the appearance. Treatment typically involves cranial reconstruction to relieve pressure before the age of one, forehead and upper orbital osteotomy, sequential finger separation surgery before the age of three, midface advancement surgery before the age of seven, and orthodontic and maxillofacial surgery in adulthood. Rehabilitation, psychological support, and physical therapy are essential components of the treatment. Dr. Hung Kuan-Yu, the hospital director, emphasized that the treatment for syndactyly aims to restore both functional and aesthetic aspects of the hands. Thorough pre-operative evaluations, precise planning of vascular and neural distribution, and designing the configuration of skin flaps between fused fingers are crucial to the success of the separation surgery. Additionally, post-operative wound care, infection prevention, and rehabilitation are key focus areas of the treatment. This heartwarming case highlights the exceptional medical expertise and compassionate care provided by the medical team at National Taiwan University Hospital Hsin-Chu Branch, bringing new hope and a brighter future to the young boy with Apert Syndrome. The hospital remains committed to providing top-notch medical services to patients from around the world, truly embodying the spirit of "Give Me Five" as a symbol of triumph and success.
#Artificial Reproduction#Medical Tourism
Reunion with Japanese family!
Reunion with Japanese family!

A Japanese couple who is working in Taiwan came back with an eight-month-old baby who was a successful case last year. They are ready to do embryo implantation once again at BRC. Looking at the picture of the happy family of three, we are really happy for them! Thank you for choosing us, and have faith in Becoming Reproductive Center. We wish your family good health, happiness, success and prosperity.
A Gratitude from a Burmese Patient who had a Total Knee Replacement
A Gratitude from a Burmese Patient who had a Total Knee Replacement

A Burmese patient, KHIN NIN KYI, expressed her gratitude to Dr. Jen-Hui Zhang, chief of the Orthopedics Department at Cardinal Tien Hospital who performed a total knee replacement and relieved her long-standing left knee pain. According to her, Burmese people usually seek medical treatment or surgery in Thailand due to geographical proximity. Because her daughter was a patient of Dr. Zhang and she received an excellent medical care and treatment; therefore, the whole family trusted Dr. Zhang and the medical team of Cardinal Tien Hospital. KHIN NIN KYI specifically came from Myanmar to Taiwan to have a total knee replacement surgery at Cardinal Tien Hospital by Dr. Zhang. After the surgery, KHIN NIN KYI recovered without any complication and was able to walk normally. During the follow-up visit, she happily mentioned to Dr. Zhang that she cannot wait to go to the beach for a vacation. She expressed her great appreciation to Dr. Zhang's excellent medical skills and all the medical team at Cardinal Tien Hospital. (Left picture: postoperative follow-up after 3 days)(Right picture: the follow-up after 2 weeks) Should you get an artificial joint replacement for knee pain? Q&A about Osteoarthritis What is osteoarthritis? Who is more likely to develop it? Osteoarthritis is caused by cartilage wear and tear, making the knee joint cavity narrow. In more severe cases, the joint cartilage can completely wear away, causing direct bone-to-bone friction, leading to severe pain, deformity, and difficulty in movement.o:p>/o:p> The prevalence of osteoarthritis of the knee is about 15%, mainly occurring in elderly people aged 65 and above, with a higher incidence in women. Risk factors include being overweight, older age, heavy work, muscle weakness, a history of arthritis, congenital hip joint malformation, genetics, etc. How to prevent and treat degenerative joint disease? Is it necessary to replace the artificial joint? To prevent degenerative joint disease, besides aging which is an irreversible factor, it is necessary to adjust correct sitting and standing postures, avoid crossing legs, prolonged standing or sitting. Additionally, maintaining a healthy body weight and muscle strengthening can improve joint stability and delay the occurrence of degeneration.o:p>/o:p> For early-stage joint degeneration, physical therapy and oral joint health supplements, including glucosamine or non-denatured collagen, could be considered. For patients with mild to moderate joint degeneration, hyaluronic acid, PRP injection therapy, or arthroscopic debridement and cartilage regeneration surgery can be performed. For patients with moderate to severe joint degeneration, high tibial osteotomy or knee joint replacement surgery should be considered. How to choose an artificial joint for degenerative knee joint disease? Currently, most artificial knee joint replacement is good for 10 to 15 years at least. But if the patient is financially well off and she wants a self-funded artificial knee joint replacement, the usage can be extended for a longer period of time. However, the cost of a self-funded artificial knee joint replacement is more expensive than that is covered under national health insurance. Patients can freely choose based on their own age and their financial situation.o:p>/o:p> During artificial joint replacement surgery, a drainage tube is place at the operative side for a few days, which will be removed after another two to three days depending on patients’ clinical condition. When the patient feel better he/she can use crutches or walkers to practice walking, and the doctor will teach the patient how to do rehabilitation exercises.o:p>/o:p> Under the leadership of Dr. Jen-Hui Zhang, Chief of Orthopedics Department at the Cardinal Tien Hospital upholds the purpose of "Love God and Love People, Respect Life, Medical Service for Love, and Promote Holistic Care”. The surgical procedures advances in many aspects, including artificial joint replacement, trauma, sports medicine, spinal surgery, pediatric surgery, and has established a good reputation, being recognized by the public. Currently, we are actively establishing Regenerative Medicine and the latest treatment methods, such as: 1. Stem cell therapy, 2. Mosaic chondroplasty, 3. Biphasic Cartilage Repair Implant, 4. Robotic arm-assisted joint replacement surgery, etc. In the future, in addition to the improvement of technology and treatment methods, a knee joint rehabilitation center will also be established to help patients return to work as soon as possible after surgeries and improve their postoperative quality of life. Patients who have any querieswith orthopedic-related problems are welcome to seek medical treatment and consultation at Cardinal Tien Hospital.

#Joint Replacement
[Egg Recipient Program] Premature Ovarian Failure at 30 Finally Pregnancy in Taiwan
[Egg Recipient Program] Premature Ovarian Failure at 30 Finally Pregnancy in Taiwan

I am 36 now. I recall the hardships I have experienced in the past six years, and finally I had my own child. Look at my sleeping baby, I would like to record this process, kind of to say goodbye to this trip. Premature Ovarian Failure at 30, only can rely on Egg Recipient Program I found I had premature ovarian failure at 30. My AMH result was only 0.06. It really shocked me, I couldn't believe it at first, and finally accepted it. And I started to see doctors around the country. I tried everything and had IVF treatment for 2 year. Due to my premature ovarian failure, it’s hard to get the oocyte, even the good one. Although I was successful once, the baby was found it’s unhealthy at 28 weeks pregnant. I just let it go. After the induction of labor, my premature ovarian failure was even worse. I couldn't bear it any longer. I once thought about giving up. I thought it would be nice to live in a two-person world. Watching the birth of a friend's child. I can't fool myself, I still want a complete life and family with children. In the end, I chose the Egg Recipient Program. The Egg Recipient Program was illegal at that time. I knew some couples faced the same issue and they consulted the black market. But I was worried. Even though it's convenient, I felt insecure about an unmanaged egg bank, so I ended up not going to the black market for treatment. Egg Recipient is legal in Taiwan, that’s why I went to Stork Later I learned that the Egg Recipient Program is legal in Taiwan. After getting to know and being recommended by friends, I finally chose the Stork Fertility Center in Taiwan. In 2018, I started to contact Stork and prepared all the documents needed. I flew to Taiwan for the first visit, and the most important, I began pairing with the egg donor. Soon, I paired the donor after a month. It's a pity that the pairing of Taiwan's Egg Recipient Program is double-blind. We can't see donors’ photos, we can only imagine what the donor's look like through the mouth of the consultant. It’s efficient. So I planned for my next check-up-ERA. That's to make sure my window of implantation opens at a regular time. They make sure everything before implantation, including thrombus indicators. And it found out my D-Dimer is higher. So I have to do heparin injection. Even though it's uncomfortable, I could do anything for my baby. It turns out why not go to Taiwan at the beginning, tossing me for so many years, and making me exhausted. I finished all the procedures in one year: visa, notarization, flight ticket, examination, pick the donor, ERA, implantation. Finally, I gave birth to a lovely baby, and completed my dream. I experienced different treatments between Stork and the hospital in China. There are many people in China, and it is chaotic and long waiting in China. Stork is totally opposite. From the doctor, nurse and assistant, I felt comfortable and pleased. Most importantly, it’s legal center, they follow the Artificial Reproduction Law, serious for every step and procedure. The donor must be healthy before the pairing. Everytime I see my sleeping baby, I always want to say You only have one cell that is not mine, the rest of the billions of cells in your body are all given to you by me. I have suffered all kinds of hardships just to have you, I hope you can grow up healthy, safe and happy. I love you. However, I got through all 6 years to have my baby. I still appreciate that I didn't give up, and I chose Stork. Thanks to the doctors and staff from Stork Fertility Center that complete my life and my family. *This article only reflects the treatment status at the time of writing, and the actual situation should be discussed with the doctor.

#Artificial Reproduction
My Challenging Journey of IVF at Taiwan
My Challenging Journey of IVF at Taiwan

I didn’t plan my future when I was young, is oocyte donation my only option? I've never heard of the concept of freezing eggs for future use when I was still young. Hong Kong people are known for their hard-working and high living expenses. However, working women are often spending time at work in the golden age for marriage and childbirth. They are often labeled as three-high leftover women (higher age, high educational background, high income). I've been there, no choice but to suffer in silence. Hong Kong looks like a modern, civilized, and open society, but it is still very behind in terms of constitutions such as bachelorettes freezing their eggs. In recent years, some HK celebrities have mentioned their egg freezing treatment overseas. It created some attention in the society of egg freezing. I waited until the age of 41 to come across the concept of egg freezing, embryo freezing. In the meantime, in Taiwan, most high school students learn about it in a science lesson. It highlighted the lack of sex education and moral education in Hong Kong. As for me, I started IUI treatment as soon as I got my marriage certificate. After a failed IUI treatment in Hong Kong, a friend of mine from Taiwan introduced me to a small clinic in Taiwan. I went through two egg retrieval surgeries and three implantation surgeries. Though we had culture 12# Day 3 embryos, the doctor convinced me the outer layer (trophectoderm) is fragile and freeze those instead of culture till day five. I felt like I hit the bottom of my self-esteem. Personalized IVF treatment collecting embryos With an adequate AMH index and decent response after injections, I am not ready to give up yet. At 43, I heard of Doctor O from Stork Fertility Center for the first time from a Shanghainese friend. He carefully reviewed my clinical history and agreed with us. At our first visit, he prescribed a long-acting injection and a few other injections for me to bring back to Hong Kong. I waited for my period to come. I used a long-acting injection on my period day 3, it will last about 4-5 days. unlike traditional IVF treatment, I don't need to do injections every day, it was much easier for me. The result of my first egg retrieval was 17# formed four blastocysts which were very comforting. But based on the fact that only one blastocyst has reached BB grade. And the result of PGS/PGT-A (pre-implantation chromosome screening) showed "abnormal chromosome". Thus I implanted the other two embryos without PGS test. It was like a gamble, and I lost. Doctor O suggested I undergo another retrieval surgery while my ovarian function was still ok. Aimed at collecting embryos. I got 6 BC-grade embryos at last. Some might say transferring BC-grade embryos is gambling with our bodies. But isn't life a gamble? Life's always been a gamble since I was young working overseas, the encounter with my significant half. Desperately, praying for a good pregnancy Considering all factors, I decided to implant four blastocysts at one time! On the one hand, I pray that the transfer will be successful, and on the other hand, I hope my 44-year-old body can be capable of twins or more. Everyone said that the two-week waiting is more painful than the injections and the postoperative. However, after four failed implantations, I was mentally prepared for everything that could happen. Maybe it’s because I didn’t put pressure on myself. I was lucky. I got a positive result for the pregnancy test. I am so thankful for the consultants at Stork. They were very supportive and reminded me of every little detail. I was calm when I saw the result. I was even suspicious while I was waiting for the time to take the ultrasound test. I was truly relieved when I heard the baby's heartbeat in the hospital. My 88-year-old dad shed tears ... It may be because God already knows what I have been experiencing for the last 3 years. He treated me well during the 10 months of pregnancy. I've been a good patient, I took my medicine as the Doctor told me. I experienced zero morning sickness. In my second and third trimesters, I was able to work at home due to the spread of COVID19. At 39 weeks, my baby came to this beautiful world with loud crying. The moment was surely amazing. It feels like a miracle. Stork Fertility Center helped me through the journey. *This article only reflects the treatment status at the time of writing, and the actual situation should be discussed with the doctor.

#Artificial Reproduction

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Northern Taiwan

Final IVF Treatment Failed, Turn Into Egg Recipient Program

Hope Fertility & PGT Center——Clients from the USA with a thick medical record but with perseverance successfully got a baby

【Taipei Fertility Center】Celebrating the First TFC Patient's Successful Parenthood After Border Reopening!

Taiwanese Medical Expertise Shines! Jordanian Boy with Apert Syndrome "Give Me Five" Reborn

Reunion with Japanese family!

A Gratitude from a Burmese Patient who had a Total Knee Replacement

[Egg Recipient Program] Premature Ovarian Failure at 30 Finally Pregnancy in Taiwan

My Challenging Journey of IVF at Taiwan