Unusual Lawsuit

First in the world to be sued by her own embryos!

Criteria for PGS Trial (& Stupid Comments on Facebook)

See what stupid comments some people wrote! So fuming angry to read those idiots writing like as if they are so wise! They are so ridiculously ignorant and still dare to judge people going for IVF! You morons better beware, even if it's not infertility that comes after you, karma will surely come around and give you a tight slap in the face!

Catching up on Medical Advances

For the past months, there has been rumours spreading in the IVF community that government hospitals could be allowing PGS (pre-implantation genetic screening) for more patients. Singapore tends to be rather lacking behind in offering newer technology because of the really long approval process, which is often due to the need to have enough evidences to proof its benefits and, in this case, due to the fear of abuse.

One thing for sure, this addition procedure will bring up the total cost of each fresh IVF cycle quite significantly, in the range of thousands. Would government provide more co-funding? Can the patient make payment using Medisave? If there's no co-funding and Medisave can be used, would there be a need to revise the current lifetime withdrawal limit of $15,000? Also, having PGS would mean that the embryo(s) will only be transfer in a subsequent frozen cycle, which again, is additional cost.

IVF Frozen #3 Day 35

HPT result on 16dp2dt: BFN
BT result on 19dp2dt: BFN

Back to square one.

IVF Frozen #3 Day 16

Here we go again.



One of my embryos got upgraded from grade 3 to grade 4 because it is growing well after the thaw. So, now they are both grade 4. Babies hang on tight to mummy!

My 3rd frozen cycle timeline:

CD1	Call KKIVF
CD4	4 mg progynova daily for 5 days
CD9	6 mg progynova daily for 7 days
CD13	Visit KKIVF for scan. Uterine lining 8.6 mm
CD14	Crinone gel inserts twice daily until BT
CD16 / 0dp2dt	ET. 2 embryos transferred. TWW begins! 4 mg progynova daily until BT.
CD34 / 18dp2dt	BT

Wish me luck!

News - First Time Mum at 63

Not as crazy as the Indian woman who gave birth at 70 years old. But still shocking enough to be features in newspaper.


(Click picture to go to website.)

Funny English

Impregnable doesn't mean (a woman) cannot be made pregnant.

Impregnable /ɪmˈprɛɡnəbəl/ adjective

1.	strong enough to resist or withstand attack; not to be taken by force, unconquerable: an impregnable fort.
2.	not to be overcome or overthrown: an impregnable argument.

Inconceivable doesn't mean (a woman) cannot conceive.

Inconceivable /ˌɪnkənˈsiːvəbəl/ adjective

1.	unimaginable; unthinkable.
2.	unbelievable; incredible.

Unbearable doesn't mean (a woman) cannot bear children.

Unbearable /ʌnˈbɛərəbəl/ adjective

1.	not able to be borne or endured

{ Definitions taken from http://www.dictionary.com }

A Heart of Syringes

(Click on image to go to article.)

Remembrance Tattoo

Found this article online and thought that the tattoo is really beautiful.


~ Joan Bremer's miscarriage remembrance tattoo ~

“Even though it was devastating to us, I wanted to be able to remember it in some way, while still healing and moving on.”

Happy and Sad

Earlier this month, I scrolled through FB (while lying on the bed just before bedtime) and found out that an ex-colleague is expecting her number 3. Viewing FB right before bedtime is really not a wise choice, but I just cannot resist being a busybody. For the longest time, I've been telling myself that I really shouldn't be going into FB too often, because I get a little upset whenever I see another pregnancy or birth announcement.

Yesterday, one of the girls in the IVF WhatsApp chat group shared her good news when we met for lunch. Then, today, DH's friends are at our house for a gathering and one of them announced her good news. Two BFP news one day after another. Haiz... sad... happy and excited for them... but sad...

When will it be my turn? If not for the miscarriage, I would be in my 2nd trimester by now.

Embryo Under the Microscope

Chanced upon this photo by zeiss_microscopy in Instagram:


This is how intra-cytoplasmic sperm injection (ICSI) is done by the embryologists in the lab.

IVF Frozen #2 Day 37

BT result: BFN. Devastated.

Post ET Herbs

I brewed my herbs last night. Due to my inexperience, it took longer than expected and I slept late. The instruction from Dr Lim is to boil the first batch of herbs from 3 bowls to 1 bowl, then add the second batch, bring to boil and switch off the heat. I used the slow cooker because the pot is made of ceramic. I wasn't comfortable using the stainless stain pot, even though it is generally deemed as safe for TCM herbs. After almost 3 hours, the amount of water in the pot didn't reduce much. So I opened the lid slightly, then I waited and waited. I didn't dare to leave it heated overnight, as I didn't want to risk the herbs drying up.




At the beginning of brewing my first batch of herb with 3 bowls of water:


Dr Lim prescribed 5 packs of these herbs, each pack cost $100. After brewing, I divide the liquid into 2 portions and drink 1 portion each day. Thus, 1 pack will last me for 2 days. On the 3rd day, I rest, no need to drink. Also, on the days I drink the brewed herb, I have to mix a pack of yellow powder medicine and drink it. I have no idea what is that and it taste weird.

IVF Frozen #2 Day 19

Today is ET day! Our appointment was at 8.30 am. Everything happened just like frozen #1, except we waited longer for our turn to go into the procedure room.



Here are my 2nd pair of embryos that thawed, survived and grew to 8-cells. Unfortunately, 2 cells in the top embryo died (and have turned dark in colour). The embryologist said that the chance of it becoming a pregnancy is lower, but if it does become a baby, the 2 cells that died wouldn't affect his/her health.

My 2nd frozen cycle timeline:

CD1	Call KKIVF
CD4	4 mg progynova daily for 5 days
CD9	6 mg progynova daily for 10 days
CD11	Visit KKIVF for scan. Uterine lining 8.9 mm
CD17	Crinone gel inserts twice daily until BT
CD19 / 0dp2dt	ET. 2 embryos transferred. TWW begins! 4 mg progynova daily until BT.
CD37 / 18dp2dt	BT

Dr Suresh Nair on YouTube

A sister shared the link to this video in our IVF WhatsApp chat group. It's a rather long video, but very informative.

IVF Frozen #2 Day 11

Status update: Uterine lining 8.9 mm. ET schedule on 10 Jun (CD19).

Perhaps, TCM medicine and acupuncture helped to improve my lining. Frozen #1 lining was 8.1 mm on CD10. For the past 2 days, I've been seeing Dr Lim for acupuncture and I just had a 3rd one in the late morning. Since, my ET is scheduled 1 week later, Dr Lim wants me to come back for another 2 sessions before ET.

Cost of each acupuncture session:
$20 (consultation) + $40 (acupuncture) = $60

In The News

(Click picture to go to website.)

Extremely unbelievable.

Public Forum: Pregnancy, Birth & Beyond

(Click for larger image.)

DH and I spent almost the entire afternoon at this event. We went there mainly to learn about miscarriages and twin pregnancy. It was quite fruitful but I wish they could give some handouts. I couldn't dot down or remember all the information.

Pre Frozen #2 Consultation

My appointment for a diagnostic ultrasound scan was at 9.50 am, followed by doctor's appointment in the afternoon. Actually, today's appointment was more of a miscarriage follow-up. But since the scan showed that all my old tissue is cleared from my womb and Dr Sadhana gave the green light to proceed with frozen cycle #2, I consider today's review as a pre-cycle consultation session too. I'm all good to go for a second ET.

The quiet Clinic D at 1.30 pm:

Panda Mating Season

Even Kai Kai and Jia Jia are doing IUI.

Jealousy vs Inspiration

Saw this on FB while on the way to work. Share it with the ladies in IVF WhatsApp Group. I felt jealous, because I just went through a miscarriage. Some of the ladies felt inspired by her.

I hope I can get lucky the next round.

The Miscarriage

Our happiness was very short-lived. Even before I could get scanned at week 6, I starting bleeding on day 6 after BT. DH had to rush me to KKH O&G 24-hour clinic. The doctor on duty did a scan and found my baby at an unfavourable low position in the uterus. He ordered a progesterone jab and sent me home. The bleeding stopped, but only for 2 days. When we visited KKH O&G 24-hour clinic the second time, our baby was gone. I cannot understand why all these happened when I had high beta-hCG reading and had no cramps or pain. There was no signs that a miscarriage was going to happen.

The problem with KKH is that we cannot make urgent appointments to see my doctor in-charge. So, between the two visits to KKH, we went to Gleneagles to see Dr Mary Yang, who is the partner doctor of Dr Lisa Chin (who happened to be on leave that day). She did a transvaginal ultrasound scan and pointed out to us that my baby's heartbeat can already be detected and seen on screen. On hindsight, I was really glad we made this visit; at least I got to "see" my baby for the first and last time and got a "picture" of it.



After the miscarriage, I stayed over at my parents' place for 1 week and did a mini confinement. My mum didn't let me drink plain water and only allowed me to shower with the herbal water twice. She made red date longan ginger tea for me to drink throughout the day. Oh man, how I hate ginger, but I just had to force myself to drink.

I still went for my doctor's appointment as scheduled at 2 weeks after BT on 1 April, except that the purpose was a different one. Dr Sadhana did a scan and put me on antibiotics for 1 week (to prevent infection) and norethisterone for 2 weeks. After I've finished my medications, AF is expected to return in 2 to 3 days' time. I am scheduled to go for another scan and review with Dr Sadhana at the end of the month.

Also, I went to see a TCM physician, a different one from the two that I've visited before. One of the ladies in the WhataApp chat group has been seeing Dr Lim. And she appeared in a TV show, in the episode that talked about confinement. She did the usual stuff (took medical history and took my pulse) and prescribed herbs (powder form) to help expel the old blood and tissue from my womb.

Dr Susan Lim Sor San (林素珊)
Time Enterprise TCM
12 Kallang Avenue #03-16
Aperia Singapore 339511
Tel: 6294 6880

Although Dr Sadhana (and any other Western doctors) would attribute my miscarriage to chromosomal abnormalities of the embryos, I tend to accept better the TCM's explanation that my body wasn't strong enough to support my baby(s). Dr Lim said that research has indicated that the most common reason for miscarriage is poor blood circulation. I just don't quite believe that both embryos, picked from among the 6 of them, have chromosome defects. Well, I could be wrong.

In the last week, every time I pick up my handphone, DH will give a disapproving look and order me to put it away. He even tried to hide the ultrasound scan photo from me. I guess he just wanted me to free my mind.

IVF Frozen #1 Day 31

I secretly used a HPT early in the morning before I head out for work yesterday. Looks like we can expect a BFP confirmation today!

Few days back, I actually tested with the Guardian HPT and there was only 1 line. Either the HPT is lousy or it was too early to test. Whatever the reason, it scared me to the point that I was Googling for 'early pregnancy symptoms' and reading almost every single website from the search result. I couldn't really focus on doing any work in the office. Seriously, early pregnancy symptoms is never ever conclusive nor helpful at all. I couldn't help it but let irrationalness overtake my mind.

This morning, DH and I made the trip to KKIVF and reached slightly after 8 am. I pressed the queue #3 button and waited for my turn. We didn't have to wait long. The nurse asked if I was feeling okay and proceed to draw my blood. She told us to expect the result in 3 hours.

Although tired (because we had to wake up early), we didn't go back home. We went for a good breakfast at Wild Honey located in Scotts Square and went window shopping to kill time while waiting for the result. Finally the phone call came. I nervously picked up the call and received a good news from the nurse! Happily, we went back to KKIVF.

This time, I pressed the #4 button for a queue number. The reception congratulated us and asked for my IC. Then, she gave me the prescription and forms for the next appointment in 2 weeks' time. We went to the pharmacy, collected and paid for the medications, then headed home.

Today's charges (including GST) paid by cash:

Beta-hCG blood test	$42.80
Medications	$156.97

I updated my close friends, the ladies in the IVF WhatsApp chat group and in the forum. With my beta-hCG at 2686.4 iu/L, some suggest that I could be carrying twins! Using the online pregnancy due date calculator, my estimated EDD (based on LMP) is 23 November.

Baby dust to everyone!

TWW Embryo Growth

Today is 2dp2dt. I took only 2 days HL and I'm back at work (because I have a meeting this afternoon). I wonder how's my babies are doing... keeping my fingers crossed that they are growing well. Anyway, I found several websites describing the day by day embryo development in utero. I have no idea how reliable they are, but it's nice to know what's going on inside. I couldn't find any on 2-day transfer, so I've made up my own.

0dp2dt	The 8-cell embryo is transferred
1dp2dt	The cells of the embryo continues to multiply
2dp2dt	The embryo continues to grow into a morula
3dp2dt	The cells of the morula continue to multiply, developing into a blastocyst
4dp2dt	The blastocyst begins to hatch out of its shell
5dp2dt	The blastocyst continues to hatch out of its shell and begins to attach itself to the uterus
6dp2dt	The blastocyst attaches deeper into the uterine lining, beginning implantation
7dp2dt	Implantation continues
8dp2dt	Implantation is complete, cells that will eventually become the placenta and fetal cells begin to develop
9dp2dt	Placenta cells begin to secret HCG in the blood
10dp2dt	More hCG is produced as fetus develops
11dp2dt	More hCG is produced as fetus develops
12dp2dt	Levels of hCG are now high enough to detect a pregnancy on HPT

References:

• http://www.essentialbaby.com.au/forums/index.php?/topic/927508-timeline-of-what-happens-after-an-embryo-transfer/
• http://www.bellybelly.com.au/forums/ivf-icsi-discussion-299/embryo-implantation-timeline-your-thoughts-181436/
• http://withgreatexpectation.com/ivf/three-days-post-transfer-plus-whats-the-deal-with-pineapple/
• http://www.bubblesandbumps.com/what-happens-after-embryo-transfer-day-3-day-5-transfer-calendar/

Socks Buddy

One sister in our IVF WhatsApp chat group shared with us about the socks buddy system in the States. I did a quick search on Google and found this website. Why socks? "The reason it’s socks is because during egg retrieval and embryo transfer you can’t wear anything under your sexy gown except a bra/vest and a pair of socks so it’s nice to take a pair that will bring you a bit of luck and positivity."

Interesting.

IVF Frozen #1 Day 14

Today is ET day! My appointment was at 8 am. On the way there, I brought along warm water in my thermal flask and sip throughout the journey. We managed to reach KKIVF before 8 am, took our queue number and wait for reception to call. The nurse took my ET form and asked me if my bladder is full. After a brief wait, another nurse led us into the procedure room. After I got changed (just the bottom only) and once Dr Sadhana arrived in the room, the procedure begins. From the TV, we were shown our 2 embryos in a petri dish (I assume they are in a petri dish) before they were transferred into my womb.



Out of my 6 frozen embryos, these 2 were thawed. They survived and grew from 4-cells to 8-cells.

My 1st frozen cycle timeline:

CD1	Call KKIVF
CD4	Collect medication at KKH (can be done before CD4 too). 4 mg progynova daily for 5 days
CD9	6 mg progynova daily for 5 days
CD10	Visit KKIVF for scan. Uterine lining 8.1 mm
CD12	Crinone gel inserts twice daily until BT
CD14 / 0dp2dt	ET. 2 8-cells embryos transferred. TWW begins! 4 mg progynova daily until BT.
CD31 / 17dp2dt	BT

IVF Frozen #1 Day 10

Went for scan today. Uterine lining is 8.1 mm. Felt like I just scraped through an exam because lining must be at least 8 mm to proceed. ET scheduled on 1 March at 8 am!

Disappointed

I thought I could start my frozen cycle. But, no! AF came this morning and I called KKIVF. I was told that I have to wait for the next cycle, as I have missed the cut off date for ET because of CNY holidays! Now, I have to wait another month. So upset!

Pre Frozen #1 Consultation

Today is my review day with my IVF doctor, for post-fresh cycle #1 cum pre-frozen cycle #1. As usual, I spent a great deal of time waiting outside the consultation room, but only a short few minutes meeting Dr Sadhana. Knowing that I do not ovulate regularly, doctor decided to put me on medicated frozen cycle.

So, the plan is as such:

• Call KKIVF on CD1
• Go to KKH to collect medication on or before CD4
• Start taking mediation from CD4 onwards

Difference between natural vs medicated frozen cycle:
(This is what I've gathered from the forum.)

Natural	Medicated
- No mediation	- Start progynova from CD4 onwards
- First scan on CD11 (or CD9 / CD10)	- First scan on CD11 (or CD9 / CD10)
- Follow-up scan (and BT*) until   (1) lining is at least 8 mm and   (2) ovulation occurs	- Follow-up scans until   (1) lining is at least 8 mm   (2) (no ovulation)
- Schedule for ET	- Schedule for ET

* Ovulation determined via BT in some hospitals.

Do's and Don'ts during TWW

One sister in Singapore Motherhood forum posted this today. It's probably going to come in handy, so I shall "bookmark" the information here.

• Eat healthy balanced diet. No extreme shifts in diet even when including foods suggested to benefit TTC.
• Drink at least 2L of water to keep well hydrated.
• Have ample good rest.
• Do light exercise like walking to enhance blood flow.
• Continue pre-natal supplements (min. 4mg folic acid or otherwise as per doctor's advice) and post transfer support meds.
• First week post transfer ie. hatching and implantation window, take things easier. Talk to and encourage your embie to attach, implant & stick! (If have, can listen to hypno/meditation cd for post transfer)
• Can take foods that support implantation as suggested by IVFers sisters on the forum - brazil nuts, walnuts, avocado, double-boil chicken essence (http://jewelpie.com/homemade-chicken-essence-to-relief-tiredness/)
• Ensure adequate protein to support growth, regeneration and esp. in fresh cycle, to prevent OHSS - e.g. Egg whites, fish, chicken
• Take fruits & leafy vegetables that are not too cold/cool - e.g. can take golden kiwi, broccoli, cai xin, etc.
• If not heaty, can take warming foods/ drinks, otherwise cut down (e.g. take less or do not take daily) or stop - e.g. longan red date tea, durian (signs of heatiness include heavy headed feeling, swelling tongue that is more red than usual, sweating too easily, very warm palms and soles to extent of discomfort, constant thirst; don't let heatiness escalate to constipation)
• Avoid cold and raw foods - e.g. NO papaya, banana, watermelon (any melons), sashimi, salads, ice-cream
• Avoid pineapple which may cause uterine contractions
• Avoid dairy foods esp. if you hv phlegm-damp constitution (see http://www.maryzhang.com/food_function.htm)*
• No unpasteurised milk which causes risk of listeria infection
• Avoid eating mould-ripened soft cheese, e.g. brie and camembert, and blue-veined varieties, such as stilton or Danish blue, etc as these are usually made with unpasteurised milk.
• Limit soy foods (GMO corn crops very prevalent in soy foods; also very high in phytoestrogen so higher risk of excess)*
• Avoid seafoods high in mercury, e.g. mackeral, shark
• Avoid spicy stuff esp. even more so for those with poor digestion
• Avoid caffeine - no coffee, tea, chocolate (caffeine is not good for blood flow and may restrict absorption of nutrients)
• Avoid alcohol - may affect kidney function and hence metabolization of meds, affects fetal growth & health.
• NO soaking in hot baths, no sauna, no massage, no spa.
• Avoid smokey/hazardous areas.
• If red spotting or bleeding during 2ww, no need to panic, just call clinic & follow advice.
• In case of constipation, can take some prune juices along with daily intake of vegetables, fruits and lots of water. If no improvement, check with clinic/ doc for advice and before taking any OTC laxatives.
• Keep feet warm - can wear house slipper / socks
• Laugh a lot!
• If in doubt, take the path of least regret.
• Breathe, be positive and hang in there.

* It is ok to have a bit of milk or tofu sometimes. We don't usually eat these excessively so it will be fine. The key is overall healthy balance diet, adequate hydration and rest so that our bodies function optimally.

SMH Forum WhatsApp Group

One lady in the Singapore Motherhood forum suggested starting a WhatsApp group chat for IVF-ers cycling this month. When I saw her post in the forum, I wanted to join but was rather hesitant. What if I meet someone I know in the chat group? It's the same fear that I'll bump into someone I know whenever I visit KKH. I sat on it and pondered. In the end, I still decided to join. When I was added to the group, the first thing I did was to check through the list of participant. It was a great relieve that they are all strangers.