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..👋🏻

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 - Post OPU Complication

Assalammualaikum wbt.

Semlm, 18/8/15 merupakan temujanji pertama lepas OPU. Lepas warded 1 hari dan on Carbegoline utk 5 hari, so nk tgk result sama ada ovari masih bengkak atau tidak. Yes, salah satu komplikasi lepas OPU utk PCOSer is ovary lmbt surut. Alhamdulillah sign of OHSS xde lg. Since keluar ward haritu doctor mintk update kat dia 4 benda setiap pagi:

1. Ukur lilit pinggang
2. Berat badan
3. Input air
4. Output air kencing

So hari appointment tiba. Senak2 perut dah kurang, nk gerak pun da xbrape sakit. Nk bgn dr katil klu 1-2 hari lps discharge dulu pyh sgt, skrg da boleh, cuma kena push bdn guna tgn utk bgn..xbrani nk guna muscle perut. Alhamdulillah time scan, ovary sy yg 9cm tu dah surut jadi 8cm je..doktor kate lmbt jugak die respon pd carbegoline. Ovary 1 lagi masih 6cm. So, ubat carbegoline diteruskan sehingga next appointment 27/8/15, iaitu khamis depan.

So lepas scan tu, doctor tunjuk gmbr embryos day 3-6. Out of 5 yg berjaya fertilise aritu, 2 jadi blastocyte gred BB. Bb tu da cukup baik bg doktor sbb die kate by noon biasa die da jd AA. 1 masih stage morula. 1 masih stage 2 sel, 1 lagi byk fragmentation, which doc kate nmpk mcm sel tp sbnrnye bukan sel. Mcm cacat la. So end up freeze  blastocytes n morula tu shj.. Alhmdulillh.. That's good enough for me. Comel je tgk blastocyte tu..mmg tgk perfect je bulat n sel2 kat dlm.. Doktor beritahu yg biasa FET doktor mmg akan masuk 2/3 embryos..so doktor tnye nk brpe.. Kami tnye doktor balik ape yg terbaik..die kate dlm usia awak ni, 70% chances utk semua embryos survive implantation if masuk 3, so masuk 2 je la utk kurangka. Risiko multiple pregnancy.. Klu twin pun risky, lg la triplets. Sbnrnye byk soalan kami tanye doktor psl transfer ni. So sy listkn terus soal jawab ni:

1. Ape risiko mengandung twins?
Risiko untuk rahim xkuat. Klu die xsurvive time implant, tu mmg gene die xkuat, tp klu gugur time after 20 weeks, tu maknanya rahim xkuat. Biasa rahim xkuat sbb faktor umur, donor egg, donor sperm or surrogate mother. So in case awak, umur muda, dua2 sperm n ovum dr ibu bapa kandung, so probability utk survive tinggi.

2. Ape % live birth twins kat Pantai?
Dlm kes saya, setahun ade 36 kes twins, 3 gugur, so dlm 10% failure. Tp klu single pregnancy, ade dlm 50 lbh cmtu, 1 je gugur. Ni xtermasuk yg xsurvive implant sbb tu xkire gugur.

3. Ape umur baby untuk survive time lahir?
Bila berat baby dlm 1.5kg above, which dlm 7-8 bulan ke atas. Tp klu pregnant twins mmg kami akan induce birth dlm 8 bulan or early 9 mth.. Biasa 8 bln..

4. So nnt time FET semua akan di thaw kan ke or yg blastocyte je?
Itu bergantung pd embryologist jgk. Biasa 1 vial die letak 2 embryos. So kes awk ade 2 vials la. Paling cntik time FET tu blastocyte stage hatching, bukan da hatch, tp tgh hatch.

5. Mcm mane timeline utk FET?
Ok lepas ni habiskan norculut (norethisterone) untuk 12 hari, which rabu depan last dose, expected period mungkin dlm 1/9/15. Time tu da bole start ubat2 utk kuat dan tebalkan rahim. Ubat tu makan selama 3 minggu lebih kurang..so mungkin dlm akhir september lah FET.

So itulah lebih kurang. So skrg kena tumpukn kesembuhan ovary ku. Doktor still xbg gerak banyak, so mmg bedrest je la da hmpr 3 minggu..housechores semua husband yg buat, ok la sidai baju basuh bj, lipat je die xbuat lg so bertimbun2 baju dilonggokkan..haha..semput la die nk wat semua kje..baru tau penat jd surirumah smbil kerja.. Nnt time pregnant mmg kena cr pembantu la...die xlrt nk buat semua benda..huu...

Ok itu shj.. Bile la nk wat post kos ni..malas betul..huhu..

My IVF Journey - IVF medication review

Assalammualaikum,

Disini sy nk terangkan dlm bahasa mudah 2 ubat yang sedang saya guna setakat ni.

1. Pergoveris 150iu/75iu

Pergo ni terdiri drpn 2 jenis sintetik hormon:

150iu/11mcg follitropin alfa (mimik Follicle stimulating hormone aka FSH)
& 75iu/3mcg lutropin alfa (mimik luteinising hormone aka LH)

So back to basic, FSH tugas die membesarkan follicle yg akan meningkatkan hormon estrogen dan hormon ni akan bantu utk perkembangan telur dlm follicle yg plg besar. Bila estrogen byk, ia akan ransang perembesan LH pulak utk telur dilepaskan keluar dari ovari (ovulation).

Biasanya pergo inject pada S1-S8

Setakat ni lepas S4 inject br rase senak2 perut n sakit pinggang..

2. Orgalutron 0.25mg/0.5ml

Orga ni terdiri drpn ganirelix.

Ganirelix ni dia adalah anti-gonadotrophin releasing hormone. Secara asas gonadotrophin releasing hormone(GnRH) merancang perembesan LH. So ganilerix merencatkan LH supaya tiada ovulasi berlaku selagi xde saiz follicle yg optimum dgn jumlah yg diperlukan.

Biasa orga inject pada S5-S8.

3. Decapeptyl

Mengandungi bahan aktif triptorelin, iaitu same dgn fungsi luiteining hormone releasing hormon (LHRH) yg bertindak pd kelenjar pituitary di otak.
Ok secara kasarnya, Perembesan LH dan estrogen dikawal oleh LHRH ni, so bila LHRH aktifkn kelenjar pituitary, LH dan estrogen pun meningkat, dan decapeptyl injection menambahkan amount rembesan both hormon ni. But bila byk sht LHRH+decapeptyl, kelenjar pituitary jd desensitize dan akhirnya mengurangkan perembesan LH dan estrogen. Deca membantu dlm proses akhir utk pematangan telur

Decapeptyl injek 36jam sebelum egg retrival.


4. Carbegoline

Ubat ini saya makan selepas OPU. Ni untuk mengurangkan simpton OHSS. Pada dasarnya ubat ini utk treat hyperprolactemia iaitu byknye hormon prolactin dlm bdn, prolactin ni penting utk penghasilan susu.
But in my case, as decapeptyl is injected, so takut efek die xreduce lps opu, jd carbegoline act as inhibitor la kpd decapeptyl.

Saya da mkn 12 biji setakat ni since ovari sy still bengkak 8cm even seminggu lps opu.

Ok itu shj info ubat-ubatan.. Nanti dah start ubat baru sy review pulak.

My IVF Journey - S5

S5 means stimulation day 5.

Assalammualaikum.

Harini cek up utk tgk size telur in response to pergoveris for the past 5 days. Alhamdulillah ade 1 biji belah kanan yg size 15mm, 1 biji lagi 14mm belah kiri. Tp secara keseluruhannya doc xpuas hati tgk keadaan ovari sbb dua2 ovari penuh dgn telur kecik2. Patut la rase senak sejak semlm. Nk tdo pun susah.. Sbb semua telur tu berebut2 nk membesar same..huhu..but doc kate just nice with plan, mlm ni da bole start injection orgalutron pukul 11pm. Alhamdulillah..

Lepas keluar bilik doktor mood terus baik, sbb dpt good news alhamdulillah.. Padahal td muke punya la monyok sbb cuak bagai. Husband excited sgt..xsabar nk tgk embabies..hehe..sejak ivf start ni die rajin la gugel mcm2 istilah ttc.. 2ww tu ape, dpo tu ape..hehe..hari ni ajar istilah embabies plak..represent embryo + babies. Setiap mlm pun kami akan tgk video2 icsi, stage fertilization.. Nk bg attraction tu ade. Smpai husband angan2 la nk wat ivf machine sendiri..huhu..he and his robotic maniac.

So, cant wait for another appointment this coming monday, 10/8/15, on S8.

And doctor pesan xleh renyah2 dah skrg. Sbb takut telur ruptured. Solat pun kena duduk, xleh bongkok2.. Bersama pun xleh.. Tp air mani kena keluarkan n buang pd 9/7/15 nnt.

Ok baik doctor.

Doakan telur saya cantik membesar dan penuh dgn isi.

CD36

Assalammualaikum wbt.

semalam hari last on duphaston 10mg 3 kali sehari. amik selama 15 hari lepas. tp hari ni da CD36. last month period 10/7/2014.. so basically klu ikut kiraan org normal, saya da lewat 4 hari. tp sebab on duphaston tu yg xperiod2 kan.. semalam loya2 teruk smpai balik awal dr keje, n baring xsedarkan diri.. mlm muntah sekali baru lega.. pagi ni badan panas2 nk demam.. baru cadang nk ganti pose arini..mcm xtercapai je hasrat nk pose. perlu x cek upt, padahal br semalam last duphaston...arghhh..tiap2 bulan cmni..tensen betul..kan senang kalau period regular je.

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.

Duphaston Side Effect

Assalammualaikum wbt

i'm having moderate -severe duphasthon side effect..hari ni hari ke 3 amik duphaston untuk induce period. tapi baru hari ni dpt side effect tu which is nausea or in lay man term- loya..

but based on my reading and knowledge, ubat ni adalah dydrogesterone which selectively act on mucus membrane of female genitals, means die xkaco mane2 pathway utk nausea berlaku. tp xtau knpe ia terjadi juga..huaa..

ting tong dah kepala..dah la kne kerja arini.. T_T