Ivf#2 FET#1 - Beta Day

Assalamualaikum wbt,

Today is 8dp4dt which is beta day. During this pass 2ww (well to be precise it is 1ww), there were plenty of pregnancy symptom aka progesterone side effect that occurs to me such as cramping, nausea, sensitive smell, flu and rising body temp occasionally (the feeling when you are going to get fever) and facial rash.


To be honest, we had done 2 hpt before this day, and both are negative. We try to be optimist and guessing it is too early to be detected using an internet cheapie hpt. So, at 11am, we went to the nearest BP lab, which is at glenmarie shah alam. After registration, the staff took my blood and the result will be ready after 3 hours. After that, i had a proluton depot jab on my buttock as a preparation for pregnancy.

3 hour suprisingly was not a long time to wait. From BP lab, we went for lunch at segamat rail, sek 9 shah alam while my husband meet his agent and after that we head off to putrajaya for a quick meet up with our client. Then the email popup on my notification. We both recite 'bismillah', and the mail opened.....

Ivf #2 FET #1- Frozen Embryo Transfer day

Assalammualaikum wbt. I wrote this entry using my samsung note 3. I find it is a bit easier to write using my phone instead of my ipad because Crome feature is a bit friendly than using safari.

Anyway back to our topic. Today actually is 2dp4dt. So let me take you back 2 weeks before.

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: 

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'

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!

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. 

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:

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. 

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 - 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.

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!!

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

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.