Friday, 21 July 2017

Ivf #2 FET #1 - The Plan

Assalammualaikum wbt,

Today is the day we met prof hashim to plan for our frozen embryo transfer. On our way to the clinic, we pass by prof before he enter his room, and he quickly recognize us! Hehe im glad we are nit just a pass-by patient to him. 

So this is his plan: 

Wednesday, 19 July 2017

Post OPU complication - ivf #2

Assalammualaikum,

I wrote this entry about 5 months afer opu procedure. It is because i was in a very uncomfortable situation at that time.

This time, although my opu procedure went well, and the eggs retrived was 13, only 5 survive after fertilisation because mostly the sack was empty. And only 4 made it to blastocyte with 2 in a good grade and 2 are average grade. And the worst part was, i had OHSS right after opu! It was so bad, my stomach was bloated like 5months pregnant, i had difficulty to breath, i cannot sleep lying in bed, i had to sit up straight the entire time and i was very exhausted. I had no appetite, eventhough sometime i felt hungry, i can only sip half a glass of water and i felt already full! If i ate or drink more, i will feel suffocated, like drowning underwater.

This condition last for about 2 weeks! Even during the day of my embryo transfer.

That day, despite all the pain, i push myself to feel excited and happy. We went to hukm 6 days after opu. They let us see the blastocyte, and prof suggest to transfer 1 good grade and 1 average grade. I had a feeling my body isn't ready for this. But we pray hard and tawakal to Allah.

7 days after tranfer we went to check for beta hcg and the result was below 2. This time i didnt feel sad much because all i think about was to feel better from all this ohss. It is so bad, at one point i beg my husband to bring me to emergency and poke my stomach to release all the water retent inside me.
I stop all my meds and i got my period the next day. Soon after that, all my OHSS are gone and i felt free again.

It was a traumatize experience for me. I do felt dissapointed but ohss is a bigger issue than being not pregnant. I dont know if i can bare another ivf after this or not.

1 month after that, we went to see prof hashim. He suggest for me to take antibiotic, tab azithromycin 500mg for 3 days every month for 3 months, to rule out any infection in my adhesion side, together with vitamin D3 to boost up my egg quality and diane 35 contraception pill to regulate my cycle. These meds is to be taken for 3 months.

So today is after 3 months, and this is my last cycle. I will be meeting prof tomorrow to ask if we can proceed with fet this month. I am so excited and optimist about this time as my mind and body is ready for another journey and adventure in TTC.

I hope all my friend and readers are still in a high spirit and energy to continue your treatment and ttc journey as this is the sweet bitter part of our life that Allah had given to us. If we had much sabr, inshaAllah He will reward us, maybe not here but in hereafter.

Love,
Asma'

Sunday, 26 February 2017

CD13 - Ivf #2 Oocyte Pickup Day

Assalammualaikum,

Today is the day that i fear the most. I know it is a simple prosedur, but i know the consequences it will bring me after that (speak from my previous ivf experience). 

To re cap, 36 hours before opu day, i had to jab myself with pregnyl 10000iu to ensure my follicles undergo the final process of maturation before retrival. Then i had to fast from food and drinks around 12am before the opu day. 

The morning of opu day, we woke up for our fajr. 
At 7.30am, we start to work for sperm retrival. 
7.45am, we get ourselves ready to go to the hospital.
8.30am, we reached hospital and we went straight to the mac clinic. By the time we arrived, there were already like 5 couples there. It is sunday and we never thought the clinic would be this busy. We went for registration, hand over our sperm sample and i have to empty my bladder. After saving goodbye to DH(he had to wait at the clinic waiting room), i went inside to change to their robe(or scrub robe i dont know) and waited for my turn. I think im the second one after this indian lady beside my bed. After like half an hour of waiting, they call my name to the room. I had to layback with my feet being put high above me(it is the positing of you giving birth). And the nurse gave me the sleeping drugs via injection line. After that, i saw prof enter the room and the light went blurry. 

The moment i almost wakeup, they still try to retrive my eggs because i can feel something inside my vagina! However im still half awake so i cant even tell. Then the nurse woke me up saying the prosedure was success and help me to stand. I asked the nurse how many eggs, she say 13. Alhamdulillah.

The nurse guide me to my bed, and i continue to sleep for about half an hour more. I woke up at around 11pm, with soreness at my vagina and stomach. I change my cloth and went to the waiting room. DH was there waiting, i was hungry that time and feel bloated. I ask DH to buy me a milo drink. After that the nurse call us. She ask DH to buy me extra medicine to ease my soreness and to prevent ovarian hyperstimulation syndrome (ohss). It is because my follicle were too many and they afraid it will getting worse after retrival. 

So we got 1 dose of carbegoline and 10 tabs of bromocriptine. 

The nurse hand us the bill we need to pay after 21st (usually you need to pay after the prosedur), she asked us to call them on thursday to updates on our embryos and expected to transfer them by saturday the 25th. Then she jab me with decapeptyl 1ml that i already bought last appointment.

Today's bill:
OPU prosedur: RM 1802
UKM K-health fees : RM 2332
Medicines : RM 49
Total: RM 4183

After the prosedur, you suppose to be headed home straight as the sleeping meds is still kicking in, however, we got a very important wedding to attend, so we drop by Kajang for a quick showup-our-face and went back home. I slept like a baby that evening and woke up with more soreness and bloatiness. It is like u ate or drank so much your stomach gonna blow!

However, the procedur went well and very satisfied with the number of eggs they retrived alhamdulilah. Hope most of them make it to blastocyte!


Saturday, 18 February 2017

CD10 - Ivf #2 Scanning day

Assalammualaikum wbt,

Today is the final scanning day. DH just drop me off because he had urgent matter to finish, so i arrived at hukm mac at about 9 am. And i got my turn after about half an hour. Embryologist look very please at the growth of my follicles but as they was so many of them, she cannot jot every size down and just focusing on anything above 14mm. Looks like they were more than 20s and most of them looks very crowded and squeezing each other, makes it more difficult for her to interpret. However she said that as long as there is one or two of big size, prof will be ok to proceed.

At that point, i really had a hard time to bent myself, and my abdomen, especially my uterus ovary area, felt so full and bloated. I also walk like a pregnant women haha.

After handing over the scanning sheet to the nurse counter, i waited for about an hour for the doctor. Luckily during my turn, prof was there and he suggest to do oocyte pickup(OPU) on sunday, 19th feb. i was thrilled and scared at the same time. The nurse, ms azmah was so friendly, she gave me proper instruction on what to do before, during and after upcoming OPU session. Here is the details:
2 days before OPU:
-to inject pregnyl 10000iu at 12am midnight. This to ensure the last prosess of maturation is complete.
-to make deposit payment of RM848 
12 hours before OPU:
-to fast from any food and drink starting 12am

OPU day:
-sperm need to be collected in the morning in the clinic or at home. We choose to do this at home. Easier for DH to take ghusl after that.
-not to wear any jewelleries
-arrive early before 8.30am
-remember you are fasting.

After OPU:
-medicine need to be bought later after opu is done. 

Dont worry if you panic and cannot remember all this on the spot, they provide us with the written list. Hehe

So today, i need to buy some medicine before heading home. 
2 box of pregnyl 
2 syringe of decapeptyl
Clarinase 6 tabs and aspirin 3 tabs

This is the bill for today
Medications: RM166.40
Ivf Deposit: RM848
Total: RM1014.40

I took an uber to ride home. 

Tips: if you had trouble to pay, actually you can still make negotiation with the doctor. In our case, we plan to have opu after 21st (that's when we will have our money ready), but since it will be too late to wait until that, prof let say pay the deposit on the day of opu and the rest of the payment after 21st. 

Wednesday, 15 February 2017

CD 7 - Ivf #2 Scanning day

Assalammualaikum wbt,

So today, after 6 days of menopur injection. We had our 1st scan. We came to the clinic quite late. Scanning at hukm is always in the morning before 11am, and we arrive around 10.50am. Luckily i was not the last person to arrive. I hand over my blue planning sheet, that everybody will have when they start their assisted cycle here, to the nurse counter. This sheet is very details about your fertility and treatment that you had and currently take. The nurse will later issue a green sheet for you to pay for today's bill. Follicular tracking is about RM53 for the whole cycle. This means that you only pay once for how many scan you have for that particular cycle. After payment had been made, the nurse will give you a waiting number to scan.  By the time i got the number, it is already my turn. 

 

The scanning lady is an embryologist called fazilah. I like her very much compare to others as she is friendly and always entertain my question. I was so nervous abiut this scan. Will my follicle response well to menopur?

Fazilah sat there beside me with the scanning device. Once she inserted it inside me, she was very shocked and excited as well (i think). She repeatly said,"banyaknya...banyaknya...(so many, so many..)". There i was relieve and scared too. This is the longest scanning session i had. She said she need to properly know the place of each follicle as there were so many and they are in layers. So, this is the result:

The blue sheet
There are about 15-20 follicles each ovaries! And the size are varries, some are ok for cd7, some are big enough to matured in a few days. No wonder i start to feel bloated and full. 1 thing i know for sure, menopur works wonders for me alhamdulillah. My endometrium lining also looks good (size: 6.5mm). And my ovaries location is assessible. This is also important as in my last ivf cycle, my doctor cannot reach the right ovary as it was very high. So only follicles at left ovary were being retrived. Below is the picture of my ovaries with follicles. 


After scanning, i handover the paper to the nurse at the counter, waiting for doctor to review my findings. Usually they just text my doctor if he is not around. After waiting for quite sometimes, finally the called my name. My doctor said to continue menopur for another 3 days as plan. So they wrote me an online prescription, and gave me syringes and needles. I need to collect the medicine at the NF pharmacy. We went to have lunch first at the hospital cafe near the emergency department because we knew the queue at pharmacy will be long, and it is already 12.30pm. 

Just as we thought, it was about 20 people waiting before my number turned up. 

This is the total cost of the injection: 
 Rm701 for 9 vials menopur. And always remember to bring along your cold box/bag with ice pack, as this medicine need to maintain its temperature. We head back home at 1.30pm.

Today's expenses:
Follicular tracking at clinic: RM53
3 days supplyof 225iu menopur injection: RM701
Valet parking: RM12 (for 3 hours)
Tolls
Total : RM53+RM701+RM12+

P/s: i will upload the reconstitution video in my next post as i am editing it a bit.
P/s/s: i am worried about ohss, as my tendency to get it is very high at this point. I have started to feel nauseatic a little. 

Wednesday, 8 February 2017

Cd1 - Ivf #2

Assalammualaikum wbt.

I got my period at 5pm 7/2/18. So CD1 will be counted tomorow, 8/2/17. Exactly 7 days after i stopped duphaston and proluton injection (i restrained my self from scratching the site of injection, so the lump is slowly not getting worse compare to last months').

On the 8th afternoon, we went to Medical Assisted Conception clinic (MAC hukm) to collect my medicine. I am prescribed 225iu menopur once a day for 10 days. However they will only supple me for 6 days as i need to scan on day 7. I bought the inj at NF pharmacy, which is a pharmacy that sell non-formulary items or for fully self-paid patient like me. I vial contain 75iu (RM77), so i need 3 vial per day. So can u do the math how much it cost me?
Haha that is the price for the medicine only. 

 1 vial of menopur 75iu with 1ml sodium chloride as a solvent. We need to reconstitute this ourselves. So DH is the pharmacist/nurse for reconstitution and i will do the injection myself (he insist to do the injection, but i dont trust him that much! Haha) I will record how he reconstitute this in the next post inshaAllah (he is sure very proud of his work of art)


 We only use 2 vial of sodium chloride for 3 vials of menopur. This is to reduce amount of reconstitution injected.

  And this is the final bill for 6 days injection. RM 1404.20

I wonder if menopur will shorten your menses. Today is only cd3, and my period is almost ended! This is very unusual. I got to ask my doctor during scan later. So, my scanning date will be on cd7, 13/2/2017. Wish me luck and hope my egg and follicles mature and has more than 10 each ovaries. Amin

Friday, 3 February 2017

Hai back blog! It's been a while.

Assalammualaikum wbt,

First, my apology to my blog and all my readers for not updating my ttc journey for almost half a year! I've been lazy and lack of thought ideas on what to jot down here. Huhu

Second, i will tell you guys what had i done in this past 2016. Basicly we were doing exactly what our doctor recommend us. Yes we still seeing Prof Hashim in HUKM up until now. So, the choronology was:

Mac 2016: 1st appointment with prof hashim. Started Diane 35 to regulate my period before starting any fertility treatment. I has to take it for 2 consecutive month

May-july 2016: start fertikity drug Letrozole (Femara) with self insemination (timing BD). BFN

Still no luck, then we take a break for about 2 month before starting over.

October 2016: i requested another HSG done. So we went to hospital tawakal for hsg with doctor fatimah. She was very friendly. This second-time hsg went very smoothly with zero pain at all! Unlike my first hsg, it was a nightmare, you can read that here [Hsg Experience] and here [Post Hsg Complication]. However the result was not not-ok, but not pleasing either. The dye successfully went through my womb, fallopion tubes and then out from there, but, they stay inside my abdomen cavity for quite sometime. So, doctor indicate some peritubular adhesion. This adhesion maybe at the fallopion tube-ovary cavity. In layman term, maybe my tube isnt directly connected to my ovary. Well, for fact, ovary is like floating balloon and it is not directly attach with the tube, even in normal condition. So, when egg is released, tube had to catch the egg with its fingerlike structure. However, the adhesion makes the connection much worse. So, prof hashim suggest us to try again for 2 more cycle before going to any other option. This time he prescribe femara+clomid for a month, and femara for 10 days (normal regimen will be 5 days).

December 2016: femara+clomid with timing bd. BFN

January 2017 : femara for 10 days with timing bd. BFN

So now, im tired. Our next option is IVF or adoption. My DH suggest we try another cycle of ivf. So today, we went to see prof hashim to discuss for ivf.

2 feb 2017: prof hashim agree for us to proceed with ivf, since he said it is very unlikely that any of the cycle is not a success. So maybe his theory about the adhesion is true. However he did gave us another option before starting ivf. He named it "rejuvenate cycles", where we suppress my menses for 3 month to bring my physiology to the state of before my menses first started. This is to increase receptor of the egg so that many egg will matured and release. He said from his 3 patient undergo this treatment, 2 of them pregnant naturally. So, after discussing with dh, we want to proceed with ivf and postpone rejuvenating my cycles, because it will took like 3 month (mac apr mei) then fasting month on jun, so 4 cycles to waste? I dont know. We dont know what is the best for us, but we are ready for ivf cycle this month inshaAllah.
So, we are now waiting for af to arrive, expected to show her face on 7th feb. prof already give me the names of meds for ivf. I will tell more in the next post inshaAllah.

That is all for my updates. See you guys in the next post.

Ps: consultation fees increase from rm50 in 2016 to rm100 in 2017!!! Gile. That's 100% increase!
Pss: i allergic to proluton. My injection site was red, itchy, and harden for more than 2 weeks! Oh my buttock😭 proluton basicly injected on the day i went for beta hcg, even before my result is positive (which is never was)