Monday, 13 June 2016

TTC @HUKM - Ultrasound CD13

Assalammualaikum wbt and ramadhan kareem everyone.

Today is my ultrasound day on cd13. Recap: i was on femara starting cd2-cd6 7.5mg daily. I arrived at clinic at 10.30am and the clinic was so quiet, and less people inside. I registered myself and ask am i late or something, the nurse said that less people prefer to have treatment in ramadhan month as there is no way they could do transvaginal scan or other procedur like iui or ivf.

So, i was in no queue at all. During the scan, the sonographer said she will be doing abdominal scan only as im fasting. So, as it is hard to see follicles using this scan, she had to push the scanner tool harder than usual on my stomach. And alhamdulillah, when she scan my right ovary, she easily spotted one big follicle measuring 23x18mm in her screen, while others in left ovary are very small one measuring only 7x7 each. Endometrium lining also looks good with thickness 10.1mm. After the scan, i went to the registration counter and an indian doc name dr prakash waited for me and look at my form. He said this is very good and we need to trigger this now. I was so excited as my follicle grew this fast and as prof hashim expectation. Alhamdulillah. So i trigger with pregnyl 2000iu at the clinic and will bd in the next 36 hours from now.

Also, i had started using opk the last two days, and today my opk is darker than yesterday, and i found out that my vaginal discharge also a little bit sticky and going to be egg white a little bit. I hope this is the month for us, inshaAllah. The best month for ibadah and du'a, and also a miracle soon inshaAllah. Do pray for us, and i hope for the best for u too.

Happy 8th ramadhan to all.

Thursday, 2 June 2016

TTC @ HUKM - Second attempt with femara

Assalammualaikum and good day everyone!

Looks like last month's attempt is a total bfn. Well it is ok, coz we didnt expect much on the 1st attempt right. Well let me recap what have we done last cycle.

We took femara for 5 days starting day 2-5. Then we had a tvs on day 10 with 2 potential follicle with size 10mm on the right ovary and 1 follicle with size 11mm on the left ovary. Then another tvs on day 13, but with only 1 potential follicle sized 18mm on the left. So after discussing with doc maiza (a phd student under prof hashim), we triggered with ovidrel the next day and BD 36 hours later. However, doc maiza noted that since i had questionable ectopic pregnancy on my left tube last ivf, maybe my tube is not healthy enough to done its job or worse, not function anymore. But doc maiza asked us to have faith and just try. We had our beta hcg done on 10dpo and the result is less than 2. Af came on cd32.

So, we just came back for another visit to prof hashim, and despite of the left tube issue, he is very satisfied with my cycle last month as my af came 14 days after i ovulate. So he said that im ovulating, that is the good news. I also asked him whether we need another HSG done for the left tube, but he said, if it is blocked, u still have another tube functioning. So, we postpone the HSG procedur to try for another cycle as we are very optimist about my body for now. 
O
Prof provide me with another femara, same dose 7.5mg, to be taken starting today (cd2-cd5) and come back for a scan on cd14. However since this month will be the month of ramadhan, tvs will not take place, just a normal abdominal scan will do. I dont know if the sonographer can actually sees the follicle grew using this abdominal scan. It is hard to see. Hurm..

Well, do pray for this cycle to be a miracle one! May this bless month give us hope and joy of ibadah and also, babies! Amin.. Happy celebrating ramadhan my fellow friends! Keep ttcing and keep praying for us too!!

Sunday, 22 May 2016

Medication review - Diane35 and Meftormin

Assalammualaikum wbt,

Lately i was thinking of starting a vlog, because i love to watch ttcian from all over the world documenting their journey through videos in youtube. However, i am a shy person, especially in front of the camera hehe. I also figure it out that no ttcian vlog are made from my country. Hurm, should i make it?

Back to the real topic for this post, it is about my medication for this time of treatment. As i mention in my previous post, my doctor, Prof Hashim from Hukmsc, presribed me with birth control pill, or oral contraceptive pill called Diane35. Actually diane35 is not a new drug for me. I was previously on this drug when i was 21, right after my first diagnosis of pcos.

Diane35 is an antiandrogen drug together with estrogen (cyproterone acetate 2mg and ethinyl estradiol 0.035mg). This drug is not solely use for contraceptive purpose only but also to prevent or reduce androgenic effect of the body such as acne and hirsutism. That is why this drug is suitable to treat pcos as we are high in androgen hormone. So as any other birth control pill, it consist of 21 tablet for a month supply and should be taken a tablet daily as a same time. Personally i dont really like this drug, well i Hate it!!! Haha. It causes me a lot of side effects that i cannot stand it any longer. Luckily i was on this drug for only 2 month before i start my fertility drug. These are some of the side effect that might occur to you when taking diane35:

    • Breast tenderness/pain*-especially towards the end of finishing the pill
  • Abdominal pain*
  • Nausea*-worse ever in me!
  • Oedema
  • Headache*-for me it is more like light headache when starting the pill
  • Skin rash
  • Itching
  • Insomnia
  • Depression - i dont know if this happen to me, but i do feel a little bit emosional
  • Changes in body weight*- i ate a lot and of course i blame diane35, hehe but i did not gain weight
  • Change in libido
*side effect that happened to me

After 4 days stopping diane, my period came like a hero (seperti juara!) . It was heavy for about 2-4 days and spotting for another 5 days. Huu. No severe abdominal pain during period time yeayy alhamdulillah. 

Ok, next is Metformin.

Metfromin is a type 2 diabetes mellitus drug, prescribe as a first line therapy. However, since pcos is link with insulin resistant and sooner or later we will develop diabetes as well. This drug presribed ia a low dose for pcos to regulate insulin by increasing its sensivity hence reducing insulin level in the blood and also help to increase glucose uptake. In simple explanation, it makes our insulin function properly. Pcos tend to have insulin resistant becouse pcos is an endrocrine disorder. This disorder disruption endrocrine hormones like insulin and our fertility hormones.

My doctor presribe me with 850mg metformin. At first i did not manage to complete a strip because i cannot tolerate it's side effects, however, after completed my 2nd dose of diane35, i continue taking it until now. It is because the side effect of metformin and diane is slightly similar and it making g much much worse for me.
The side effect of metformin are:
  • Nausea*- worse.ever.😷
  • Diarrhea*- after 5 hours of taking it (i usually take it before i went to bed to reduce the nausiatic effect) it woke me up in the middle of the night and rush we go to the toilet!
  • Flatulence and bloating*- they come like a package with before diarrhea. Imagine that! I barely slept at night because of this!
  • Metallic taste
  • Abdominal pain*- combo with diarhhea yeayy
However, all these side effect im having is slighly reduce after i start over meftormin again. And now im free from all those side effects!!! Alhamdulillah. It takes a while to tolerate with it (dont be like me), but you will get used to it. The best thing is, i didnt have a craving anymore! Usually before this, i MUST ATE AFTER 4 hours of meal. Gile x.? I think it's my hormone becoming haywired. And if i didnt ate, i will become grumpy and i feels like a hypoglycemic effect. Now, it didnt happen!.  Even did not feel hungry when it is time for meal. So, i manage to eat small portion without the 'starving' feeling anymore!.

Annndddd there is more! Metformin in conjuction with clomid or letrozole increase the chances of ovulation, then the fertility drug itself! Best kan?!! Cool isnt it?? This part i will talk about it in other post ok.

Orait that is all for now. I hope my writing benefits you. And feel free to share what is your side effects taking these 2 pills in the comment below. 

Bye..👋🏻

Monday, 16 May 2016

TTC @HUKM - 1st appointment

Assalammualaikum and good day everyone.

Today i decide to write in 80% english language. Another 20% will be in my mother's tougue language, which is Malay Language. It is because i want any information writen to be useful for all my friends around the world. *ntah ade ke pembaca dari omputih ni..kih3..biaq pi lah*. And also, i want to improve my english writing skills, so if there is any grammatical mistakes, please, do guide me ok.

It's been a while since my last entry. After about a month break from ttcing, we went to prof hashim's clinic at HUKM private wing. FYI, hukm provide 2 clinics for fertility, one in the Medical Assisted Conception (MAC) clinic, which is the government sector part, one in private sector at level 7. We chose to go to private sector since our record is already there, when we sought for a second opinion on my ectopic, and also to cut all the other procedur needed in MAC (well this one i didnt know much about, maybe they need you to do certain test or queue up or something).

The first visit was very simple and quick, appointment was made 1 month before the appoitnment date because Prof is going overseas for about half a month, so we didnt manage to see him before he go. Usually, if you are lucky enough, the 1st appointnment will be around 2 weeks. I was schedule to see him at 3pm. So we arrive at 2.30pm, register at nurse counter and i got number 5 out of 7 patient during 3-4pm session. Not bad. So we went for solah first, and wait in front of his room. The queue was rather quick actually. By the time i came back from solah, there is already 3 patients had seen him. So, i waited for about another half an hour and our name were called.

Upon seeing him, he smile at us and ask what is our plan. We said that we wanted to try again after the miscarriage and we will do whatever he suggested. He then said that the key treatment for pcoser like me is to regulate my period back. According to his experience, with 3 cycle of period, and proven ovulation, pcoser can get pregnant naturally. So he suggested for me to take diane for 2 cycle, and start fertility drugs in the 3rd cycle. We agree. He also put me on metformin 850mg daily for my insulin resistant, although i do not have this yet but pcoser tend to have this sooner or later, and metformin can improve my hormonal imbalance during fertility treatment. I will explain about this further in other post about drugs ok.

So no ivf this year i think. Just back to basic. Well, i actually relieve because i know we are in a care good hands. Prof Hashim is the head of MAC and had experience in consulting many couples and also teaching in UKM. As according to doc adilah, he is a practical person, he may not do what exactly the book said, but he knows how to apply them, and he knows what he is doing. Tq doc adilah for suggesting him.

Ok, some of you may worries on him being your fertility doctor since he is a male. Well, i will discuss this matter in other post ok.

Until then.. Byeee

Saturday, 13 February 2016

Post IVF #1- The review

Assalammualaikum wbt

Suspen x baca post ni..hehe..last post was 4 months back. So actually da mcm2 benda berlaku..jom sy summarizekan

5wks pregnant ivf #1:
No sac seen on tvs n abdominal ultrasound. Bhcg reading pun sgt rendah..

6wks pregnant ivf#1:
Still no sac seen on uterus, but something was seen on the fallopion tube!! Ade sakit2 jgk kat bhgian kiri rahim..aduiii..doc a da suruh admit takut ectopic. But we r very optimistic sbb pain tu xteruk sgt. Doc suggest amik second opinion di hukm dgn prof hashim. Went to prof hashim, he said nothing to worry about since the mass xbesar n baru 6wks..if die burst pun dlm 7 wks. To be cautious je. Prof suruh berhenti semua ubat luteal support sbb die yakim pregnancy ni xjadi coz bhcg rendah scan xnmpk pape. So benti semua ubat

7wks pregnant ivf #1:
Tepat2 masuk 7 minggu wooosh darah mengalir dgn jayanya.. 2 hari sblm tu keluar lendir2 putih telur. Ummi sy kate tu sarang baby tu, sbb xjd so xnmpk pape, die pecah terus. Heavy bleeding for 7 days follow by 30 days spotting onwards. Heavy bleeding tu jgn ckp la sakitnye mcm mane huhu..tu la contraction agaknye ek. Tepat2 30 hari spotting, sy period semula. Alhamdulillah rase lega sbb period lps miscarriage.

So i wait for another 2 cycle sblm jumpe doc a semula.

Jan 2016, we went for another fet since we had 1 frozen morula. Segala ubat2 fet beli ade dlm rm500. Then thawing day arrive, our morula seem did not generate well. Lps 3 hari thaw, die mati aka degenarate. Fet/ivf#2 was cancel due to morula didnt make it. So we plan to shift to hukm after this.

What actually happen:

After 2 fail ivf (1st one was chemical pregnancy until 7 wks, one didnt make it even in the petri dish), doc a conclude that maybe my gene or the embryo gene is not good enough for them to survive. Usually a women my age have a good quality of embryo of 2:3, means 2 out of 3 is a good embryo. But mine is very confusing, it is like my embryo langsung xbagus semuanya, thats why they didnt make it. I was so afraid that the problem is with genetic, doc kate kat tropicana ade tools utk cek gene of embryo tp cost about rm12k lg..so xworth, baik try again for another cycle.

We plan to shift to hukm mostly due to cost wise, pantai had a very good doctor and i really like doc a, however their cost is very unbearable. Tu belum tiba2 emergency kena warded la kan.. So doc a cadang ke hukm pulak.. Hukm xde doc perempuan, which this is my 1st priority in seeking treatment, but no choice sbb kepakaran is my 2nd priority, and it is suggested by doc a to seek prof hashim. So our next appointment will be on march 2016 inshaAllah, can't wait!!

Perasaan saya?

 Hurm, nangis mmg wajib la kan bg setiap perempuan hehe..but mostly im grateful to be in this journey this far! Im young, just turn 27 last november, i had about 13 years more to try for baby. So why be sad now? Im excited to try again n again until Allah permit us to have babies. We will never give up. I know His plan is better for us. Ingat kate2 ni if rase down:

If i ask Allah for something that i want, and He gave me, i thank him once, but when i ask him but he didn't gave me, yet, i thank him 1000x, because He knew what is best for me.

Kalau kate pasarnye, if kite keluar rumah dah jln separuh n baru teringat ade tertinggal brg kat rumah n kena patah balik, jgn merungut sbb mungkin Allah nk selamatkan kirpte dr malapetaka di tgh jln. Cmtu la lbh kurang..hehe

So sebulan without any treatment is my recovery month. Means no hormon yeayy..so i plan to take supplement to improve my egg quality. I bought royal jelly, coq10, fish oil, multivit n folic acid. InshaAllah nk mkn utk sebulan sblm jmpe prof hashim.

I google about prof hashim but xbyk yg tulis review treatment dgn die. Kenape ek? Anyone know or been his patient before? Just want to know a bit about his style before starting with him.



Friday, 9 October 2015

My IVF Journey - Progesterone and me

Assalammualaikum,

Seperti semua pesakit IVF, sy juga xketinggalan dalam memerlukan luteal support selepas FET. Luteal support ini ialah pengambilan hormon2 tertentu, terutamanya Progesteron untuk membantu proses rahim menyediakan medium yg optimum bagi bayi menempel. Dalam kes saya, doc precribe 2 jenis ubat iaitu femoston yg mengandunyi 2 jenis pils, sy perlu guna pil yg mengandungi progesterone shj, dan crinone, atau progesterone vaginal gel. Yes, vaginal gel means insert in your vagina, termasuk pil progesterone femoston tu.


ini juga kerana ovaries saya dua2 tidak aktif menghasilkan telur dan sepatutnya sarang telur atau corpus luteum yg merembeskan progesteron. So itulah sebab sy perlukan progesteron luar. Bila cerita benda ni kat mak2, diorg mcm blur plak..hehe..yela if undergone natural pregnancy, rase sy pun xambik kisah benda ni.

So, since the 1st beta smpai skrg, effect progesterone sgt ketara kat saya.. Sepanjang minggu ke 4, sy demam selsema sepanjang hari, teruk sgt, xleh kena kipas or aircond, mesti selsema.. Bdn sentiasa panas smpai skrg.. Masuk minggu ke 5, demam selsema terus hilang, tp bdn still rase panas dr biasa, dan, mula simptom baru. HEARTBURN! 1st time kena mlm sblm tdo, mula2 rase sesak nafas, ingat semput ke kan, then rase senak dada, sakit tekak terutamanya time baring, sepanjang malam xboleh tdo. Xpernah rasa mcm ni sblm ni, so esoknye google lah..tgk2 same simptom pedih ulu hati ni.. Bila progesterone da tinggi dlm bdn, ia akan relaxkan muscle esofagus dan menyebabkan asid perut naik ke atas..mlm ke 2 kena, pun teruk, smpai kena mkn gaviscon 2 paket baru boleh tdo, tu pun terjaga malam2 rase kena bakar je tekak ni..n lama2 tertdo sbb penat n ngantuk sgt.

Jadi, bile sy komplain simptom ni kat doctor, doc nasihat supaya kena kerap makan n amik early dinner so acid tu xkeluar mlm2. Doc pun precribe ubat femoston estrogen utk di mkn 3x sehari utk balance kan hormone.

How's progesterone effect on you? Do share it with me in the comment below.. Tq :)



My IVF Journey - Beta #3

Assalammualaikum wbt,

Beta kali ke tiga bukan dalam perancangan kami.

Harini 20dp5dt, predicted 5 weeks 4 days, hari appointment untuk scan kantung, but unluckily, xnmpk lg kantung. Doc kate mungkin sbb hcg rendah lg time 2nd beta, so harini cek lg beta ye.. Hati dah berdebar semula..aduiii..xjadi ke..but time scan tu doc ade tunjuk mcm tiny bubble kat rahim but doc kate it's still too tiny to tell, it maybe something else..so ambik beta utk 2 hari tgk die double n jmpe die semula minggu depan.

Dan result beta ialah......233! Alhamdulillah.. Tinggi, dan bila cek doubling time kat internet, perfect!..

Ok ape tu hcg doubling time? Bila kita pregnant, hcg expected utk double the value setiap 2 hari pada 4 minggu pertama pregnancy dan bila masuk minggu ke 6 & 7, doubling time jd makin pnjg ke 3.5 hari. Hcg akan mula menurun pada minggu ke 8. Menurut kajian, hcg value perlu double sekurang2nya 35%, cth dlm kes saya, if 1st value 19, 2nd value 32, doubling time ialah 2.7 days with 68.4% increase..ada paham ka? Haha.. If nk penjelasan lanjut bole tgk website ni: http://perinatology.com/calculators/betahCG.htm

So doubling time sy:

1st beta : 19
2nd beta : 32
Doubling time : 2.7 days with 68.4% increase every 2 days

2nd beta: 32
3rd beta : 233
Doubling time : 2.8 days with 64.3% increase every 2 days

So far so good..alhamdulillah..