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. 

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 - OPU day

Assalammualaikum wbt..

11/8/15
Suntikan orgalutron di awalkan ke 10am dan suntikan decapeptyl pada jam 11pm

12/8/15
Mkn 10mg bisacodyl utk proses pembuangan air besar jam 6pm dan start puasa penuh jam 12am

13/8/15
Sampai hosp kol 7.20am..terus pergi bhgian admission. Dlm kol 8 pergi masuk wad day care kat blok C tingkat brpe xingat sbb da berdebar sgt..rupenye wad sblm ivf unit je..masuk bilik terus salun baju OT..doktor bius dtg dlm pukul 9.30..then kol 10 jalan kaki dr wad ke OT ivf..power jugak ivf unit sini ade bilik OT sndr..dalam bilik OT tu aduiyai berdebar sgt even ni kali ke 2 masuk OT..doc A interview sket2 tnye bile suntik ubat..doctor bius sempat buat lawak lg time nk masuk line kat tgn..then lps 30min sedar ade bende kena tarik dr mulut..adui tu sakit sikit sbb tgh lalok lg..pastu sedar balik ade kat luar OT..terus tnye nurse da pukul brpe..nurse kate kol 10.30...oooo mmg 30min je ek..lps tu kena sorong ke bilik, perut rase senak n sakit sgt..nk tdo pun xbole even tgh lalok..kol 2pm br bole mkn..pastu doktor A dtg..doktor kate time mula2 masuk needle die ter poke arteri, so ade bleeding kat faraj..die da jahit tp takut ade internal bleeding..die scan perut sbb die kate time procedur telur kanan tinggi sgt..so kanan dpt amik sikit je. Time scan lembut je doktor tekan sbb mmg tgh sakit..lps doc scan, pergi toilet terus burse kencing..n lega sikit xsakit sgt..lps tu mkn sandwich n panadol..br lega sket..tp tiba2 sakit lg..terus g toilet lg n kencing..then lega.. Dlm kol 7pm doctor A call, tanye sakit lg ke x..die kate blood result ok xde internal bleeding..bgtau doktor sakit time nk kencing..rase bloated..doktor kate sbb ovary tu mmg rapat kat bladder so jgn biar bladder penuh nnt mmg sakit. Mlm tu makan cabergoline 1/2biji utk permulaan.

14/8/15
Owh sebab doctor nk monitor psl internal bleeding tu day surgery jd in patient plak..so terbang la RM400++ huhu. Harini doctor scan tvs kat klinik die. Alhmdulillah xde internal bleeding, tp ovary kanan da tinggi sgt ni..die betul2 rest kat bladder..dan size die 9cm!!! Normal size ovary 2.5cm je..n post ivf ovary ptt dlm 5-6cm..i punya 9cm!! Doktor tanye ade mkn supplement pelik2 x 6 bulan lps..sy kate mmg xde..nk mkn multivit pun mls2 huhu.. Doktor kate mungkin sbb besar sgt so slight movement pun bole sbbkn ovari teralih. So kena betul2 bedresr as if xleh duduk langsung..baring je..huhu..ok doc! Sbb klu pecah lagi bahaya..so harini dpt discharge alhamdulillah..

Owh lupe nk bgtau, doc ade wassup gmbr embryos. Alhamdulillah doc dpt collect 7 ovums and 4 of them da start membahagi..1 br nk membahagi harini, 1 lysed 1 xmembahagi langsung.

Syukur ya Allah...

Doakan embryo kami membesar dgn jayanya jd blastocyte sblm di frozenkan..