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: 

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)

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!!

Start Over Again

Assalammualaikum wbt..

Maha Suci Allah yang sebaik-baik perancang.

Plan nk start treatment bulan 3 nanti terbantut. alkisahnya.....

2/2/14 - 1st day period selepas di induce by duphaston 10mg
11/2/14 - period end
13/2/14 - HSG done. heavy bleeding after that
15/2/14 - bleeding almost stop
16/2/14 - bleeding continue, almost like period type of blood
18/2/14 - called lppkn to consult doc about bleeding. dr hamizah ask to seek for local gp first before meeting her.
21/2/14 - still bleeding heavy. went to Hosp Umra Shah Alam for consultation, met Dr Getha. She was surprise to know that i'm undergone HSG without any doc scan me or asked about my history as she knows (according to my previous record there) i'm a pcoser. she said having a cyst is a risk to do HSG because the dye inserted can twist the cyst at the ovary making the placement of ovary altered or it may cause the cyst to rupture. She also said that HSg is not for everyone. the best soluton for cyst is laparoscopy. done physical check and TVS, Dr Getha confirm it is period bleeding as she didn't see any scar tissue or any baby inside. cyst also in normal size. Dr suggest to come back to LPPKN this monday as today will be my appointmnt to take the D21 blood test.
24/2/14 - called lppkn explaining about my condition, Dr Hamizah said to have to start over again in the next cycle. ( D2 adn D21 blood test for FSH) T_T

k that's it. agak sedih sebab mmg berangan-angan nk start treatment yg pertama bulan 3 ni. Tp Allah tangguhkan rezeki tu kan. xtau plak lps HSG tu adalah period. adei. maybe dye yg masuk tu mmg die tlg tolakkan yg tersumbat kot tu yg bleeding agaknya. hope lps period ni leh conceive secara normal dulu..aminnnn

P/S: Allah tangguhkan sesuatu nikmat utk bagi nikmat yg lebih baik di masa akan dtg kan..kalau bukan kat dunia, kat akhirat nanti inshaAllah...

Hsg experience

Assalammualaikum wbt..

13/2/14 yg lepas sy percepatkan appointment hsg sy yg pd mulanya nk wat pd 15/2 sebab beberapa reasons.. 1st sbb period suprisingly abes awal (hr ke 9 dah abes), then doc pmpuan xde ari sabtu tu..3rd parents nk dtg uma pulak. So mmg cntik la tuka tarikh tu..huu

Appointment kol 12 kat kpj shah alam .smpai sana tepat2 kol 12..pegi bhgian radiology dan wat pendaftaran..tunggu dlm 5 minit cmtu pembantu radiologi tu da panggil masuk bilik xray..time ni mmg dah dupdap2 je..gigil bdan..huu

Masuk bilik xray radiologist tu bg penerangan sikit psl prosedur dan sgt penting utk declare kite xpregnant utk kite sign surat yg diorg xkn bertggungjwb if kita didapati pregnant. Lps tu salin baju hospital and duduk kat meja xray..tunggu dlm 3 minit cmtu doctor adilah masuk dan perkenalkan diri..

Prosedur hsg

Baring dan buka kaki (mcm nk beranak tu..huhu) dan doc akan swap faraj dgn alcohol. Then doc akan masukkan semcm besi kot utk bagi laluan masukkan catheter getah...time ni sakit jgk la sbb even doc kate rilex, tarik nafas, jgn kemut..but bila ade benda masuk automatik akan kemut ok..huhu..sakit gak la bila kemut tu sbb beli keras kan..xsmpai 3 minit catheter dah masuk doc pn keluarkan besi tu. Lega sikit..then baring lunjur kaki..mesin xray tu akan diletak btul2 atas perut or rahim kita dan sesi mengambil xray pn bermula. Dlm 5 keping die flash dan xrasa pun bila cecair tu masuk..huhu. selesai dan doc pun tarik keluar catheter tu..siap!

15 min je prosedur. Nk mintk mc pun xsmpai hati..tp bos kate xyah masuk opis pun. Yeayy..hehe

Lps prosedur tu mmg rase cramp sikit dan darah flow byk jugak penuh 1 pad tu bila nk solat zohor..tp yg peliknya, dah 4 hari darah masih keluar..flow mcm period pun ade..risau jgk.. brpe hari darah ni akan stop ek?

Bil hari ni RM180.

gmbr hsg ceq..sapa reti baca habaq mai naaa...

2nd Appointment

Assalammualaikum wbt.

2/2/14 lepas saya period alhamdulillah..setelah segala kesakitan pms selama 2-3 hari sblm dan slps period di harungi. tu yg xsuka mkn ubat utk induce period, sakitnye xleh nk tahan. keras je perut. so, ikut jadual, kne g lppkn utk amik darah hari ke2-5 period. so semalam, 4/2/14 which hari ke 3 period baru berkesempatan pergi sana.

bertolak dr rumah pkul 2, dlm pkul 2.45pm dah smpai, amik nombor, kepilkan no pada kad temujanji dan tunggu nama di panggil. after 1/2 hour cmtu, nurse pun panggil utk amik darah suami dan isteri. isteri utk ujian FSH dan STD, suami utk STD shj (lelaki mne ade FSH lol). dah amik darah, byr kat kaunter. Bil hari ni RM110 shj termasuk untuk amik darah pada hari ke 21 nanti.

owh btw dah set appointmnt dengan KPJ Shah Alam utk prosedur HSG 15/1 ni. actually 15/1 ni hari ke-14 saya period, HSG kne buat dalam hari ke9-14, so nurse letak kan tarikh hari last skali sbb sy biasa period lebih dari 10 hari. tp nurse tu kate if period abes awal bole reschedule balik. mula2 hubby suruh buat kat kpj klang sbb kat situ xramai org, tp kpj klang xde doc pmpuan. so tuka ke shah alam. shah alam ade both doc laki n pmpuan n nurse kate tarikh tu setktk ni doc pmpuan tu ade. so better la kan..malu la nk mintk doc laki wat prosedur tuuuuu..selagi ade pilihan, selagi tu kita boleh pilih kn..bukan kritikal pun..ni kne byk praktiskan fiqh dlm perubatan ni..hehe

ok itu sahaja.

Apa itu HSG?

Assalammualaikum wbt,

sebagai persediaan saya untuk HSG bila2 masa sejurus saya period ni (masih belum period, esok last makan Duphaston..huhu), saya dengan takdekerjanya mencari info psl HSG. kebanyakkan sebelum ni sy bc sendiri pengalam ttcian dr blog mereka, but kali ni saya rajin menterjemah pulak.

Info ini saya translate bulat2 ke dalam bahasa ibunda kita dari laman web http://www.webmd.com/infertility-and-reproduction/guide/hysterosalpingogram-21590
Webmed ni antara reliable website utk baca apa2 pasal medical stuff.

Histerosalpingogram(HSG) adalah test X-Ray yang membantu kita untuk melihat dalam rahim dan tiub fallopio dan kawasan-kawasan sekitarnya. Prosedur ini dilakukan biasanya kepada wanita yang mengalami kesukaran untuk mengandung (tidak subur).

Semasa prosedur HSG, satu pewarna (contrast media) di salurkan dalam tiub yg kecil dan halus dan cecair ini akan dimasukkan melaui lubang faraj (vagina) ke dalam rahim (uterus). Atas sebab uterus dan tiub fallopio ini bersambung, maka pewarna ini akan masuk ke dalam tiub fallopio juga. Apabila pewarna melalui uterus dan tiub fallopio ini, gambar uterus akan diambil menggunakan X-ray. Gambar yang diambil membantu untuk menentukan masalah yang dihadapi di uterus sama ada terdapat kecederaan atau ketidaknormalan bentuk uterus tersebut, atau jika tiub fallopio tersumbat yg mengakibatkan telur (ovum) atau sperma tidak dapat untuk disenyawakan. HSG juga membantu untuk mengesan masalah dinding uterus yang menghalang penempelan telur yang tersenyawa.

Mengapa Prosedur ini dilakukan?

1. Mengesan tiub fallopio yang tersumbat. Ujian ini dilakukan untuk wanita yang mengalami kesukaran untuk mengandung. Jangkitan kuman mungkin menyebabkan tiub fallopio mengalami radang dan akhirnya menyekat tiub itu, lalu menghalang kehamilan untuk berlaku. Semasa ujian ini dilakukan, pewarna tersebut akan cuba untuk menolak sumbatan di dalam tiub itu dan membuka laluan di tiub fallopio.
2. Mengesan masalah di uterus (rahim) seperti bentuk yang tidah normal, kecederaan, polips, fibroid, rahim melekat atau terdapat bendasing di uterus. Masalah ini mungkin mengakibatkan sakit semasa haid.
3. Prosedur ini juga digunakan untuk mengesan jika pembedahan untuk mengikat tiub fallopio (untuk tujuan pemandulan) berjaya atau tidak.

Persediaan sebelum prosedur HSG

Beritahu doktor jika anda:

1. Sedang atau mungkin mengandung
2. menghidapi jangkitan kuman pada kawasan pelvik (pinggul) atau penyakit kelamin seperti gonorhea atau chlamydia.
3. Sensitif pada pewarna iodine atau bahan-bahan lain yang terdapat pada pewarna iodin tersebut. Selain itu, beritahu doktor jika anda menghidapi lelah (asthma), alah pada sesetengah ubat-ubatan atau pernah mengalami alahan yang teruk terhadap bisa ular atau dari gigitan lebah atau alahan makanan laut.
4. Pernah mengalami masalah pendarahan atau sedang mengambil mana-mana ubat pencair darah seperti aspirin atau warfarin (seperti Coumadin)
5. Pernah menghidapi masalah buah pinggang atau diabetes, terutamanya jika kamu diberi ubat metformin (seperti Glucophage) untuk mengawal kadar gula dalam darah. Ini kerana pewarna yang digunakan semasa prosedur HSG ini boleh mengakibatkan kegagalan buah pinggang pada sesetengah pesakit yang pernah menghidapi kegagalan fungsi buah pinggang. Jika anda mempunyai masalah ini, ujian darah (creatine, blood urea nitrogen) akan dilakukan sebelum prosedur ini dijalankan bagi memeriksa fungsi buah pinggang anda.

Sekian.

:)