Tuesday 22 December 2015

Post IVF Fresh #1

AF appeared today, 6 days after ER, 8 days ahead of schedule. I'm not complaining, because it means that I am one week closer to reuniting with my baby(s). I wish I can fast forward time.

The embryologist has called and reported on the status of my embryos. Out of 24 eggs retrieved, only 6 embryos made it to the freezer. I couldn't really hear him very well over the phone and I think he said something like this: some eggs were fertilised using the natural method, none got fertilised, the remaining eggs were fertilised via ICSI, 11 were fertilised but only 6 continued to grow, 5 embryos are grade 4 and 1 embryo is grade 3.

Doctor's review is scheduled on 16 Jan. I'm getting impatient already.

Monday 21 December 2015

Book Recommendation

A lady wrote a post in the forum recommended this book for reading:
It Starts with the Egg by Rebecca Fett



The author also struggled with infertility and she put her degree in molecular biology and biochemistry to good use to research on what lifestyle changes and supplements would help to improve her chances.

I don't think I'll venture into taking supplements. Maybe I'll start with changing my plastic containers to glass ones.

Wednesday 16 December 2015

IVF Fresh #1 Day 15

It's ER day for me today! I fasted since last night and slept early. DH and I woke up really early this morning (probably even earlier than our usual work days), got ready and head down to KKH. In the early hours, KKIVF is almost empty. Shortly after registration, a nurse brought me to the changing room. I put on the surgery gown and kept my clothes and belonging inside the locker. I had to change into their slippers too. Then, the nurse inserted the IV cannula into the vein of my left hand. The diameter of the needle looks big! It wasn't really pain, but I was still scared to move my hand too much. While I was getting ready for the surgery, DH was in another room busy providing his troops.

I was scheduled as the second patient for the day. However, the first patient was somehow not ready and I get to go for the surgery first. The nurse led me into the surgery room. It's my first time in such a place; my first time being put on general anesthesia. It was really cold in the surgery room. I was shivering as I was walking in. Thankfully, the nurse quickly gave me a blanket without having to ask for one. Once I lie down on the operating table, I was hooked up to the blood pressure and heart beat monitoring equipment. I also had an oxygen mask over my nose and mouth. Dr Sadhana had not arrive yet, so the team of nurses and I waited for awhile. The anesthesiologist arrived and introduced himself. Once Dr Sadhana walked into the room, every one got into action immediately. My hand was in pain when the anesthesia was pumped through the cannula. I managed to tell the nurse about it and she assured me that it'll be fine. Then, I was totally knocked out.

The next thing I know, I was wheeled out into the resting area. In my semi-consciousness, I heard someone tell me to shift myself over to the bed. I have no idea how I did it. I fell asleep again. Every time a patient gets wheeled in, I sort of got awaken for a brief moment. I have no idea how long I was there for. Finally, a nurse came along and gave me a pack of biscuits and hot milo. Although I wasn't feel very hungry, I ate them all up! At the same time, I was watching what's happening at the opposite bed. The poor girl was very much in pain and the nurse had to bring some painkillers for her to take orally. Soon, a doctor came in and made her rounds. After she checked on me, I was allowed to get out of bed.

The nurse accompanied me to the changing room, told me to pee and change back to my own clothes. In my mind I was thinking "I only drank a small cup of milo, how to pee?" But I still managed to! It was only later then I realise that it was the drip that was keeping my hydrated while I was unconscious on the bed. Another nurse removed the cannula and gave me the medical certificate for HL. She told me that I have 24 eggs retrieved and explained that I have more follicles because I have quite a high AMH. (I think she mentioned my AMH is 7, not sure if I heard correctly, not sure what the unit is.) She instructed me to drink more water and reminded me that all my embryos will be frozen.

DH was already waiting for me in KKIVF when I came out around 11.30 am. We went home, ate lunch (DH bought food back) and I slept till it was time for dinner. I couldn't really walk straight because of the bloated. The ladies in the forum suggest drinking isotonic drinks, so I bought two 500 ml bottles.

Monday 14 December 2015

IVF Fresh #1 Day 13

Some ladies in the Singapore Motherhood forum are really religiously feeding on egg whites to grow their follicles. (A case of 以形补形; eat eggs to grow eggs?). As for me, I'm getting complacent and I ate eggs only when DH brings me out for Ya Kun breakfast. Then, there's also other fertility superfood like avocado, brazil nuts, etc. I didn't eat any of those; I just don't have the discipline to follow through. I hope I wouldn't have any regrets later.

Anyway, I'm back at KKIVF for yet another scan. Today, DH couldn't take leave and this is the first appointment that I am going on my own. Although I have more than 12 follicles on each ovary, the sonographer only measured the biggest 12 on each side. After she's done, she made a final count under her breath. The largest follicle measured at 18 mm.

As usual, I had to wait to see the doctor on duty. When I was called into the room the first time, she asked me if I was feeling bloating. Then, she said that she needs to consult Dr Sadhana on my case because I have many follicles and is at risk of OHSS. So, I was sent outside to wait. Meanwhile, I was feeling distraught at the possibility of a postponed ET, which means that I would not have ET for this fresh cycle. I message DH about the news. The doctor called me back to the room and confirmed that I would not have ET and all my embryos will be frozen in storage. I'm really upset that it turned out like this! But DH thought about it and concluded that maybe this arrangement is better. He still trust Dr Sadhana's judgement. Well, not that I don't trust her, but I'm just really disappointed.

Tonight, I'll be going back to KKH 24 hours O&G clinic for my trigger shot. Typically, patients who go on to have their ET done in their fresh cycle will be given Pregnyl. I am given Lucrin instead. It would prevent me from getting OHSS, but at the same time, it would affect my uterine lining and therefore making it unconducive for embryos to implant.

My IVF fresh cycle timeline:
CD1Call KKIVF
CD3 / Stim Day 1Baseline scan. 300 IU Puregon jabs daily for 4 days
CD7 / Stim Day 5300 IU Puregon & 0.25 mg orgalutran jabs daily for 2 days
CD9 / Stim Day 7Largest follicle at 11.5 mm. Jabs with same dosage
CD10 / Stim Day 8Largest follicle at 13.5 mm. Jabs with same dosage for 3 days
CD13

Largest follicle at 18mm. Final 0.25 mg orgalutran jabs
Lucrine jab at night.
CD15ER
CD17ET cancelled due to risk of OHSS



My IVF injections. Puregon was injected using the fine pen needles, while orgalutran came in glass syringes.

Friday 11 December 2015

IVF Fresh #1 Day 10

Scan result of the day: largest follicle at 13.5 mm on the right ovary and another at 12.5 mm on the left.

My updated IVF timeline:
CD1Call KKIVF
CD3 / Stim Day 1Baseline scan. 300 IU Puregon jabs daily for 4 days
CD7 / Stim Day 5300 IU Puregon & 0.25 mg orgalutran jabs daily for 2 days
CD9 / Stim Day 7Largest follicle at 11.5 mm. Jabs with same dosage
CD10 / Stim Day 8Largest follicle at 13.5 mm. Jabs with same dosage for 3 days
CD13Visit KKIVF for scan

Thursday 10 December 2015

IVF Fresh #1 Day 09

I'm back at KKIVF for my first scan after starting on the injections. DH took leave and accompanied me just like every other appointments. As told, I brought along my remaining medication in a small cooler bag, with the small ice packs inside. (I'm not going to lug a "sweating" plastic bag and drip water all over.)

Today's ultrasound scan will tell how well I responded to the medication. And I anxiously waited for my turn, not knowing what result to expect. During my scan, the sonographer read out numbers to the assisting nurse, who will record them in my file. She measured the sizes of 20 follicles and obviously, I cannot remember all the numbers. However, I took note that the largest measurement was at 11.5 mm and there were 3 of follicles at this size.

After the scan, I waited to see the doctor on duty in either Room 3 or Room 4. The doctor said that it's hard to judge the growth rate of my follicles, because this is my first IVF cycle. This meant that I will have to make another trip here tomorrow for another scan. She gave me the prescription with the same dosage. When we went to the pharmacy to collect my injections, the pharmacist was nice enough to replace my "melting" ice pack with new frozen ones.

Friday 4 December 2015

IVF Fresh #1 Day 03

DH accompanied me to KKH this morning and we reached after 8 am. KKIVF was already crowded with patients. There's another 10+ patients before me, so we decided to go upstairs for breakfast. When we returned, the queue had moved quickly and it was almost my turn. While waiting, I watched the other patients stapling some papers to their queue numbers and leaving them in the white box outside Room 5. In my heart, I'm thinking "Did I forget some instruction mentioned during the pre-IVF briefing?" But I left my briefing folder at home! Indeed, I realised that I was suppose to write my NRIC on my queue number (for first visit) and leave it in that white box for the nurse to pick up before I go in for my scan. Anyway, my number was still called and the nurse didn't show any unhappiness that I didn't follow instruction.

After my baseline scan was done, we had to wait for reception to call for us (same queue number). Meanwhile, I was watching the patients and wondering which stage they are at. DH kept himself occupied playing game on his phone.

When we were called, the nurse gave us the Medisave forms to sign and handed over my prescription. We went upstairs to the pharmacy, collected my injections and headed back to KKIVF. This time, I had to take a different queue number and waited (again). Room 1 called, we went in and a nurse taught me with a demo on self-injection.Then, I had to do my first jab (300 IU Puregon) in front of her.

And we are finally done and can finally head home to rest! Next scan in 6 days' time.

By the way, the pharmacy put small ice packs in the plastic bag together with my injections to keep them chilled. (The injections have to be stored in the fridge.) On the way home, the plastic bag was "sweating". Now I understand why some other patients were carrying cooler bags.

My IVF timeline so far:
CD1Call KKIVF
CD3 / Stim Day 1Baseline scan. 300 IU Puregon jabs daily for 4 days
CD7 / Stim Day 5300 IU Puregon & 0.25 mg orgalutran jabs daily for 2 days
CD9Visit KKIVF for scan

Wednesday 2 December 2015

IVF Fresh #1 Day 01

AF is finally here! I called KKIVF as I was told and I'm scheduled for my first scan on CD3. I could go for my scan on CD2 (tomorrow), but DH would prefer to take leave on Friday (CD3) instead, so that he can enjoy a long weekend. We're looking forward to Friday!

Tuesday 1 December 2015

Annual Leave Day One

Today is the start of my long leave from work. I'm taking 2 weeks of annual leave for the first half of the IVF cycle. From what I've read online, there's quite a few mornings that I would need to go for scans. Problem is, it's really quite hard to pinpoint the exact scan dates. I want to avoid the stress of having to take last minute leave and being asked by my colleagues why I am going on leave so frequently. Also, I imagine that it would already be quite stressful for me to jab myself every morning. As for the second half, my absence from work will be covered by about 2 weeks of HL from ER onwards.

My colleagues do not know the real reason behind my absence from work for the entire month of December (only my boss knows why). They had been told the partial truth that I am clearing my annual leave, which will get forfeited next year if I do not use them.

Right now, I'm just kind of moping around at home and wondering whether AF is going to show up right on schedule today.

Tuesday 3 November 2015

IVF Briefing and Counselling

We went for our IVF briefing and counselling session today at KKIVF. It was such a long wait since our consultation with Dr Sadhana in September. We arrived early and had to wait quite awhile for the other couples to arrive. While waiting in the room, we were given a folder containing information and forms related to the IVF treatment. Once it's full attendance, the nurse begin to go through the PowerPoint slides to share with us about the IVF process. She mentioned that we are all going to be put through the short protocol. There are plenty of people writing blogs and sharing information in the forum about their TTC experiences (including IVF). Since I've been reading up online, I (kind of) knew what to expect already. I thought that the session was more of a briefing rather than counselling. I felt that there wasn't really any counselling involved at all. Before departing, we filled up and signed all the necessary forms. Next, it's waiting time again, till AF to show up in December.

Total cost for KKH IVF briefing and counselling session (including GST): $337.05

Saturday 19 September 2015

First Consultation with Dr Sadhana

Two rounds of IUI didn't work for us. Although Dr Chin had recommended trying IUI 3 times, I am quite convinced that the 3rd wouldn't work too.

And now we are at our last resort - IVF. We wait for about one month between my call to make the appointment and the actual appointment. Dr Sadhana is the IVF doctor of my close friend's sister, who became pregnant after her 2nd embryo transfer (1st frozen cycle). I brought along our reports and tests results from Dr Chin. Dr Sadhana had a quick look at them and passed them to her nurse to make a copy of each to keep in my patient file. We told her the treatments we had done so far and mentioned that Dr Chin recommended for us to visit the government hospital for IVF. After the consultation, both DH and I had to take some blood tests, which are mandatory before starting IVF treatment.

Today's bill:
Counsultation$158
Blood tests$415
TOTAL (including GST)$613.11

I'm scheduled for IVF in December. Can't wait!

Tuesday 28 July 2015

IUI #2

OPK showed two lines this morning! We quickly arranged to take leave from work and waited for Dr Chin's clinic to open at 9 am to give them a call. We couldn't do the IUI procedure tomorrow because the clinic is not open on Wednesdays. Thus, it was a mad rush this morning. Once I made the appointment, DH had to quickly produce his sample and we rushed down to Gleneagles to submit it to the lab by 10 am. However, the morning traffic wasn't good and the carpark was very full. We only managed to reach after 10 am. Typically, the lab would required 2 hours for the processing, but thankfully, the lab was willing to rush the sample for us. Dr Chin had to close her clinic early today and so we were told to go back at 12 pm.

When we return after lunch, Dr Chin did the same things like our IUI #1. This time, I have not ovulated yet and she could measure the follicle size, which was at 2.34 cm x 2.66 cm in my right ovary.

Today's bill:
Lab work$300
Consultation$90
Ultrasound scan$120
IUI$500
Duphaston$48
Clomid (standby for IUI#3)$10
TOTAL (include GST)$1142.76

Tuesday 30 June 2015

IUI #1

Yesterday (CD12), two lines showed up on OPK. This is two days earlier than my previous cycles and it kind of caught us by surprise. Nevertheless, I called the clinic yesterday and we're scheduled for IUI procedure today!

In the morning, DH produced his troops at home and rushed them down to the lab immediately. Then, we went for lunch. While we were having lunch, DH's troops were being washed. As told, we came back to the clinic at 2 pm. Dr Chin did a scan to check on my uterus condition and mentioned that ovulation had already occured. She also measured my lining and said that it's of a good thickness. After that, her nurse brought me to a room next door and Dr Chin performed the IUI. Then, I was left alone in the room to continue lying down, until a nurse came in around 30 mins later. We paid our bills and we went home. Dr Chin prescribed Duphaston to be taken twice daily for 14 days. Although my doctor says that I can do whatever I want after the procedure, I only got the mood to go home and sleep.

Damages for today:
Lab work$300
Consultation$90
Ultrasound scan$120
IUI$500
Duphaston$48
Clomid (standby for IUI#2)$10
OPK (standby for IUI#2)$35
TOTAL (include GST)$1180.21

Sunday 21 June 2015

Preparing for IUI

Just few days back, my girlfriends were chatting in WhatsApp and one of them shared the happy news of her sister's successful IVF after several months of TCM. Her physician has a really good reputation in fertility treatment and had many success stories.

Dr Su Chun Lin (苏群淋)
Fu Nan Traditional Chinese Medical Centre
Blk 152 Bukit Batok Street 11
#01-266
Singapore 650152
Tel: 6896 1618

Dr Su shares the clinic with another TCM physician (whom many say is her husband). Since their charges are lower, their clinic is always super crowded. When I went there yesterday, she happens to be on leave, so I did my registration and left. Today, I called the clinic at their opening hour to take a queue number. The staff on the phone gave me a good estimate of the time to arrive at the clinic, so I didn't have to wait very long for my turn. Dr Su took my pulse and said that my body is fine. I just need to improve the quality and quantity of my blood. It came as a surprise to me that Dr Su doesn't do acupuncture, the other physician at the clinic does. I didn't want to re-queue and wait so long for the acupuncture, so I left with the medicine, which costed only $54 for 2 weeks' worth of medication.

It might be a little late to start TCM now (since my IUI is likely to be schedule in less than 2 weeks' time), but I guess it's still better than doing nothing at all.

Wednesday 6 May 2015

HSG Result

DH and I are back in Dr Chin's clinic to receive the result of my HSG test. The report says "The uterine cavity is normal. Both fallopian tubes are not dilated or obstructed." Okay, so I'm fine. So, why am I still having difficulty getting pregnant?

Dr Chin suggests that we try IUI. I'll still be put on Clomid and once I get a positive on OPK, I get an appointment on that day or the next day for the procedure.

Today's bill:
Consultation$90
Ovulation kit (5 pieces x 2 boxes)$70
Clomid (5 tablets)$10
TOTAL (including GST)$181.90

Wednesday 29 April 2015

Hysterosalpingogram

What is hysterosalpingogram?

Hysterosalpingogram (HSG) is an x-ray of the uterus and fallopian tubes performed after the injection of a contrast material. In HSG, continuous x-ray and fluoroscopy are used. The contrast material used for this procedure can be water-soluble. It is administered to the cervix through a small catheter to help the radiologist view the internal uterine structures. HSG is primarily used to examine women who have trouble becoming pregnant. It is able to show the shape and structure of the uterus and the patency of the fallopian tubes.

{ Information taken from a hospital brochure. }

Today (CD8), I took half day leave and had my HSG done this afternoon. DH took the afternoon off too to accompany me. I reported to Dr Chin's clinic and her nurse issued the prescribed antibiotics and painkiller medication to me. Then, we proceed to the hospital side for the procedure. While waiting to be registered, I took the painkiller tablet, because Dr Chin mentioned that this test would be rather painful and her nurse said that I can take it before the procedure. After registration, I was led to the changing room and DH waited in the waiting area. Shortly, I was called into the x-ray room and instructed to lie on the cold, hard metal table. It was really uncomfortable when the radiologist inserted the speculum and catheter. I couldn't really feel the dye being pushed in but I felt some cramping in my lower abdomen. Then, a few x-ray images were taken, with my hip tilted to the left and to the right. The whole procedure didn't take very long and I was allowed to go off after changing out of the hospital gown (and after paying the bill of course).

Today's charges (inclusive of GST):
Antibiotics and painkillers$35.31
Hysterosalpingogram$244

Thursday 2 April 2015

Clomid Cycle #4

So I start this cycle with Clomid from CD2 to CD6 (as per previous cycles) and went back to see Dr Chin on CD14 (as told in my last consultation). The purpose of today's visit was to do an ultrasound scan. Well, Dr Chin reported that there's a good follicle measuring 1.63 cm x 1.54 cm, so it seems like nothing's wrong.

Today's bill:
Consultation$90
Ultrasound scan$120
TOTAL (including GST)$224.70

Next step: hysterosalpingogram test (if I still don't get pregnant).

Friday 20 March 2015

Third Visit to Dr Chin

The past two cycles with Clomid didn't help to get me pregnant, even though OPK was positive on CD15, so I told DH to get his SA done.

Today is CD27 of my 3rd cycle with Clomid, which means AF is due to appear tomorrow if it's BFN again. (No, I have no guts to use the HPT.) And today, we were back in Dr Chin's clinic again. We got DH's SA result and Dr Chin said that there's no major issue. She gave me another round of Clomid and told me to return to her clinic for a scan around CD14.

Today's bill:
Consultation$90
Ovulation Kit (5 pieces)$35
Clomid (5 tablets)$10
TOTAL (including GST)$144.45

I'm really desperate to get a SG50 baby and the next cycle would be our last chance.