PHASE II - STIMULATION STAGE - 28/06/2013 -D9 Appointment

I reached hospital about 7:15am and I saw many patient is already waiting. Today might be a long day I presume. I have lunch appointment with my dear friend. I just wanna chill out to relax my mind. I saw Dr Erda is back from her leave but unfortunately she will be around only until coming week since her practicing will be over and she will be back to Kuching Hosp. She has been so lovely and helping us through with the appointment and check ups. I managed to see Dr at 8:45am and this time they called my full name since the patient before me is having the same first name. once I enter the room, Dr Erda asked me about my husband and also who has accompanied me for the visit. I told her hubby only will be joining me this sunday, 30/6 and i took a cab alone to hospital. She then said am very independent. The scan shows my lining is 8.1mm and Dr Erda said I am over stimulated. What?? Really??? I will confirm the size with Dr later once she done with the scanning. Then Dr kannappan came in and Dr Erda updates him the number of follicles and the size. Then Dr Kannappan asked me to see him outside. I was blur and worried whats going on. He told me that my OPU will be on coming monday and he asked about my husband. I told him about DH plan to come down on sunday and therefore he will be there during the pick up. he needs to be there anyway to produce semen. Dr reminded me about the possibility of  OHSS and advised me to drink 2-3 liter of water and have high protein diet such as white egg 3 times a day, fish & chicken. If it is not treated, the fluids may effect the lung. He then advised me to do blood test tomorrow on D10, 29/06/13 to check on E2, LH & Progesterone. OHSS happen if high in Estradiol. Estradiol is the hormone boosting the follicle development. I hope I don't overstimulate but get worried also since Dr Erda said I have lots of egg. The Estradiol level will determine whether i should be taking Pregnyl 5000IU or 10000IU dosage of HCG injection. I need to do my blood test at Lablink again but not today but tomorrow. I asked Dr what was my follicle count and size. He came back with a piece of paper and mentioned there were 8 follicles on the right side with 3 follicles measuring 16mm. There were one extra follicle seems had appeared but left side reduced to 6 follicles which measuring 15.8mm and the rest are catching up. He said he is hoping for the 5 good size follicles to grow and mature. Dr reduced Menopur dosage to 75IU only and Suprefact to 0.1IU which I need to take for another one day only. He then asked me to fast from 12pm on 30/06/13 for OPU on 1st July. He then get me signed the concern form for pick up. Then I waited for nurse to prescribe me Pregnyl of 10000IU just in case if I need to use 10000IU depending on my Estradiol level. After I collected the medicine from pharmacy, nurse asked me to go for breakfast first then come back at 10am. when i return back at 10am, nurse asked me to go to O&G unit to meet Anesthesia. My height and weight details were taken and waited for an hour and half before meet the Anesthetist. Then I went back to Reproductive unit to be briefed by nurse on the procedures as follows:

29/06/13, Saturday 

9am: to take blood test at Lablink and inform results of Estradiol, LH & Progesterone. Nurse then will inform Dr for advise.

10pm: to go to nearest clinic and get Pregnyl injection.

30/06/13, Sunday 

10am: do UPT test to check for Progesterone level and inform nurse on the outcome. 

12pm: start fasting 

1/07/13, Monday 

7am: register at O&G and go to ward and inform reproductive unit which ward no. 

9.30am: OPU

After everything has been informed, I saw Dr Erda was there and she wished me luck and asked me not to be stress at all. Now am late for my appointment with my friend and I postponed my appointment at 1pm. Met her at Pavilion and had a short good time with her. I bought her jacquard printed pure Italian silk as her belated birthday gift and soft crepe material for her mum too. I went to supermarket and get some raw walnut as its contains omega 3 fatty acids and vitamin B that helps  implantation. Bought olive oils as I normally use for cooking and i found out avocados has monounsaturated fat which could improve fertility by lowering inflammation in the body. After shopping, I left about 3:30pm since my dry ice is melting already because its only last about 8-10hours. Then i rushed back home. I am having difficulty to walk since having bloated stomach and abdominal pain. I need to have good rest over the weekend. Can't wit for tomorrow's blood test. Hope everything will be fine. 

PHASE II - STIMULATION STAGE - 25/06/13 - D6 Appointment

I had my last fifth round of menopur injection together with suprefact but the dosage has been reduced to 0.1 mg. I have become an expert now after few days of using menopur. I had my favorite muesli for which my brother bought for me and I left house at 6:30am with cooler box. I reached hospital at 7.05am and my mind wonders what would be the follicles growth and blood test gonna be since my sister told me that i need to do blood test on Day 6 again. I never mentioned earlier that my sister is undergoing ICSI at the same hospital but unfortunately her cycle has been postponed next month due to hormonal issues. She went through until pick up earlier this year but the embies doesn't grow well so the cycle was cancelled. I am very much concern about her feeling since she was the one started the treatment about a year ago but I am on the track now. I really hope everything will be fine for her soon. 

I met Dr at 8:30am. I am a bit nervous this time. Think Dr noticed it so he asked me how am I doing. Scanning was done. I was trying to look at the monitor but I couldn't see anything since it was facing the other side. So I was eagerly waiting for the Dr to tell me the reading. Surprisingly the follicles has been increased to 15 which is 7 on the right side & 8 follicles on the left each measuring 11mm, 10mm, 7mm. Dr said I am responding well to the medication. He said some are over stimulated with the dosage. He added the OPU will be either on 1st or 2nd July 13 depending on my next appointment which will be on coming Friday, 28/06/13 at 7.30am. I feel so happy. Nurse called my name and passed me a prescription sheet to collect Menopur but the dosage has been reduced to 150IU with 2 vials & 1 ampule. Suprefact continues with 0.1mg dosage. I asked her about the blood test. She said no need. I feel so relieved. Then I went to pharmacy and collected the injection. Then I went to HUKM pharmacy to buy mask since the haze has effected terribly. I read somewhere that We shouldn't expose to pollution and haze during treatment. 

Then I took a taxi and came back home. I booked one way flight ticket for hubby on 30 June 13 as I think the OPU most probably will be on Monday, 1st July 13. My hubby told me that he needs to be back by 4th July because his associates will be coming down from Paris office until 10th July... Oh no!!! If everything goes well, my ET would be on the 4th July. I prefer my DH will be with me during the ET as I want him to see & witness our lil one, cutie pie being place inside her/his mum's uterus. Hope he can really arrange something to be with me. Next, hotel booking as we need private time for ourself until ET. 

I am praying hard for the whole process to go on smoothly. In the meantime, I am drinking lots of water to be more alkaline and the medication make me so dry. I  added for fruits in the diet. 

Lets hope my next appointment for D9 will be as good as well. I plan to meet my ex colleagues during lunch time after the appointment. Can't wait for Friday to come! 

PHASE II STIMULATION STAGE - 21/06/2013 D2 Appointment

I am the Early bird to hospital since I took cab early to avoid the massive jam in KL. Waited for an hour and half before my turn to see Dr. Scan was done and there were 6 follicles on the right and another 6 follicles on the left. So out of 12, don't know how many will contain eggs and out of that amount, how many will make it to become an embryo. I am not sure whether this is a good or just a OK number but most important, the quality of the egg is matter than quantity!

After follicles scanning, went to do blood test to check for E2, FSH, Progesterone & LH. Since I finished early at the hospital, I went to Lablink early at 8.30am but the diagnosing & analysis unit only open at 9am so they ask me to come back at 11am. So I went to have my breakfast. I come back to lab at 10am and the report is ready. I take a deep breath before opening the envelope and pray the reading should be ok to proceed to start IVF. I brought my previous month blood test to compare. Thank god my LH & progesterone level has come down. FSH is 1 point below the range but guess it should e ok. 

I return to hospital about 10.30am and gave the report to nurse and eagerly waiting for the next protocol. Nurse called me ar 11am and she subscribed me prescription to get it from pharmacy. I was blur and asked her 'so am I on for IVF?, nurse?'. She replied 'yes'. I am very happy even though I haven't started the procedure yet but to get green light to go ahead is a big achievement for me. Only those going through the same situation would understand my feelings. I am aware there are other important stages e.g ET which is more important.

I collected Menopur for 5 days course with 225IU dosage with 3 vials & 2 ampoules with 1ml solvent each. 

This  injection look rather complicated. I thought better take a video of the demo since its involve so many step. Nurse asked me to try break one of the ampoule myself. It's so tiny & made of glass material. I tried & broke it into pieces. Why this type of medication is so manual and not something ready straightaway for injection? 

My next appointment will be on Tuesday, 25/06/13.  

WAITING ENDS - 20/06/2013

I have been having abdominal pain past 2 days and I was expecting my menses to come anytime soon. It has been post 4days of OCP. As expected, I got my menses early morning and my flow is not heavy at all. my menses flow is getting very low and this make me worries. Thank god my hubby was around to discuss about flight & transport arrangement.  He unable to send me to airport since he tied up with trainings. He arranged one of his staff to send me to airport this afternoon. Thank god there is a fight in the afternoon. My hubby hugged me and I am already missing him. This is the first time I am making my own travel for the treatment without him. I hope my treatment continues beyond  blood test. I can't bear another postpone treatment due to high LH & Progesterone. I quickly made flight booking. Packed my luggage with Suprefact inside cooler box with dry ice which can last for 8-10 hours. Then I called the hospital to make Day 2 appointment. Everything settled. I went out for short shopping trip before come back and cook for lunch. 

On the previous post, I mentioned about me and my mum got upset over things and I don't know where to stay since my search for short term stay in KL was unsuccessful. My dearest friend is very kind to help me to look for one since his brother is working in the same hospital I am getting my treatment. To my surprise, my mum called me and talk to me like normal and I decided to tell her when I meet her personally soon. My mind wonders how about my in laws. I am in the state of whether to tell or not... It's just that we don't want to get stress if they keep asking about the status as we know IVF doesn't guarantee 100% success. In the meantime, my brother insists I stay in his house. Will keep it as an option. Nothing would be comforting compare to being around with hubby. Being around with family is good but sometimes we need our own privacy and need to go out meet our friends. I am already planned to meet some of my friends so that I can divert myself from stress and not thinking so much on IVF. 

Latest updates

I have completed 24 tablets of OCP on 16 June 2013. I should be getting my menses in few days time according to Dr. Since my menses is irregular, I am counting my days. Hopefully I will get it during this coming weekend so that it will be easier for me to make travel arrangement.

In the meantime, I have renewed my identity card, car servicing done and now just waiting for menses to come before I am flying off. 

We had a friend came down during the weekend and he showed us his daughter's video. We were amazed to see her video who is just 4 years old but so smarty and caring. Then our friend revealed she is a adopted child and her biological parents were doctors. Due to unavoidable reason they have to let her go. He admitted there are 7 adopted children in his family all together. Wow! Not everyone is willing for adoption! 

So we expressed our wish to our friend that we were thinking about adoption also. Meantime, we wanna try first for IVF and then go for adoption. Even if I conceive, we will go for adoption for 2nd child. It has been my dream since my secondary school that I wanna adopt a child and give a HOME for the child who really need it! There are many out there are without parents. I feel all child is my own child and never until now feel that am loneliness and must produce own child. I am doing this IVF treatment for my husband and his family. My husband has been very understanding on this matter. We can plan but God decide everything. I am already excited because I know somehow I will have a baby. I already start again going to Mothercare (I always go to check out new collection and buy cloths for my niece, nephews & friend's children). This time my visit to Mothercare was with an intention to look for things for our future baby. How exciting I was. 

We plan to not tell our family about IVF treatment due to the unnecessary stress we might get when they keep asking for status. As we are aware IvF doesn't promise 100%. After much consideration, we decided to tell my brother so that I can stay over at his house since his apartment is the nearest to the hospital and asked him to keep it secret from my mum. But anyhow she will be coming down to his house end of the month to babysit his child for a month. So I have no choice to reveal to her but I  plan to tell her when she is physically at brother's house. Knowing her she will share my news to others. Everything has been planned but all of sudden me and my mum upset over things and situation get worst now. I never had close relationship with my mum since I was young as I was brought up by my aunty since I was 1 year old. Guess am more close with my aunty than my own mum. 

So we decided I rent an apartment nearby to hospital some more my husband has to join me during pick up and embryo transfer. So now am sourcing for studio apartment. My friend is kind enough to help me to source for a place. I so glad have such a caring friend who I can trust her the most. In the meantime, my brother is keep asking me to stay with them. He has a smarty daughter and always make me laugh and I enjoyed her company very much. She is going to be 3 years old. It would be a good choice to stay there since I need to keep myself happy specially after the ET. I am now in very confuse state to decide. I just don't want to get stress during my treatment, I wish my hubby can join me for a month stay... Gonna miss him so much!

I will update next my Day3 appointment with Dr. My Suprefact injection is going on we'll. just feel pain every time I inject on my left side of stomach. I am hoping my blood test will be good to proceed for STIMULATION stage. Finger crossed!

PHASE 1 SUPPRESSION STAGE (Suprefact & YAZ)

In a natural menstrual cycle, hormones from the pituitary gland (LH & FSH) cause the growth of an egg within a fluid-filled space, or follicle, within the ovary. Although several follicles start to grow each month, in a natural cycle only one will become mature enough to ovulate following a surge of the hormone LH at midcycle.During the suppression cycle, we will be taking Lupron or Suprefact to prevent ovarian cysts and to block spontaneous ovulation during the stimulation cycle.

In contrast, during an IVF cycle it is desirable for several eggs to mature simultaneously. At the same time do not want an LH surge to trigger early release of these eggs. Therefore use a medication known as a GnRH agonist to temporarily turn off own LH and FSH secretion. This medication is usually started around day 22 of the menstrual cycle and continues through the stimulation phase. It is given daily, usually by nasal spray or occasionally by injection. Other GnRH agonist regimens or protocols may also be used in specific cases.

During the suppression stage of the IVF cycle, we will be taking a GnRH Agonist (Lupron, Suprefact, Synarel etc.) to suppress our ovarian function.

I am not sure how am I going to inject this. I just listen when the nurse explaining about the injection and I have to time to write down. Hope I remember to do what she asked me to do. Since I have to start taking the injection on 9th June, I tried with one sample and I wonder why they gave me 2 type of needle (blue and brown color) since there is only one type of medication I should take and not to be mixed with any other medication. I guess I will call the nurse to verify.

Suprefact with syringe and needles + alcohol swab
(To be taken until OPU)

24 tablets ~YAZ is a OCP

This cross over procedure scheduled as follows;

YAZ ~ 23/May ~ 15/June

Suprefact 0.25mg ~ 9/June ~ until OPU

I will be taking Puregon/Gonal F on Day2 or 3 depending on my blood result for LH and Progestrone are between the range. Otherwise, wait for another cycle? I really need God's blessing to go through the cycle without any delay again! 

First EEVA (Early Embryo Viability Assessment) IVF baby born in UK

Very impressed to read the first baby was born through Early Embryo selection which will identify the most viable embryo that will grows and become healthy baby. 

http://www.eevaivf.com/your-ivf-journey/optimizing-embryo-selection/

I wish the team and the couple all the best and hoping this technology would spread wide 

all over the world to benefit all the TTCians with IVF method.