Pergoveris

Have injected two days of pergoveris. The needle seems bigger and harder to poke through the skin. Coupled with the stinging medicine, that first breakthrough into the skin is quite a torturous experience.

Requirements. More items needed than all earlier jabs:

Step 1: Pair syringe with the larger needle and draw up the solution from the first vial.

Step 2: Transfer the solution into the second vial, where the powder is.

Step 3: Switch to the smaller needle, draw the mixture, and start poking!

The suprefact needle, in contrast now, is so much easier to use haha.

Anyway, point to note, don't exert too much effort on the pinch. Might end up like this:

Long protocol

Started on long protocol jabs 3 weeks ago. 

Suprefact jab in the morning, 50IU. From CD21.

Purpose is to suppress the hormones, in preparation for stimulation.

This is what is necessary for the daily jab:

1) swab

2) draw

3) inject 

CD34 first baseline scan. No period yet. AFC 13. E2 level was abt 3000. Couldn't start stims.

CD38 baseline scan again. Still no period. E2 level was abt 2000. Couldn't start stims.

CD41 still no period. But E2 has dropped sufficiently for prof to give green light for pergoveris. He mentioned E2 shd go below 200.

My loot:

Decided to be a little more organized with all the poking stuff:

one week after ER

Today's 3dp4dt :)

Going to withhold from checking on hpt till Friday morning ... day of the BT

Just 8 more days to go ...

Been having slight cramps on and off the past few days, but otherwise everything's normal

Embryo Transfer

ET happened in a blink. Definitely took longer than IUI, and a little more uncomfortable too.. But pretty uneventful, which is good! :)

And I like the photograph of the embryo given by the embryologist after the procedure. It's affectionately known as Smellie now.

Embryo Transfer Day

One word. BLOATED.

Embryo Retrieval

Did my Suprefact injection at 1230 this morning (last night), will head for acupuncture 9-10 am, before reporting by 1030 tmr morning

Been bloated ... and to my horror I realised I had put on 5 whopping inches on the circumference of tummy below belly button ... my bloated tummy is bigger than my hip circumference!

Scan 4

ER scheduled on Thursday!

And managed to steal a picture of my scan results haha

It's like my PCOS belatedly woke up ... my E2 value exploded over the past few days

Scan 3

Increase in number of follicles..

RHS has 11 now, cyst still present.. 14, 13.5 and smaller ones

LHS 8 follicles.. Heard a few "11"s

Lining is 10mm

Prof seemed pretty happy 

Cetrotide

Started cetrotide ... had to get DH to help me with all the screwing and unscrewing of needles ... longer and thicker needle ... a little issue with poking into the skin ... and because there's more liquid to be pumped in, it was more painful

And I'm more bloated today ... tummy is obvious now

Scan 2

Had second scan today ... made a boo boo ... remember I was told to go back tomorrow, but I saw on my appt card that it's today, so decided to follow the card ... turned out it is supposed to be tomorrow ... so the nurses had to rush around to find my file etc

Right side 6 follicles, 8 & 9 mm .. cyst is still there

Left side 7 follicles, 6 & 7 mm

Baseline scan on CD 3 (26 June)

Did my baseline scan on CD 3 ... AFC (antral follicle count) right side 6, left side 8 ... with a cyst on the right side .. something that was never seen before but since prof didn't say anything, other than commenting that there as no previous sighting of a cyst, i guess it's just a normal cyst that would go away

On Gonal-F 150 IU for these few days, till my next scan on 29th June

Surprisingly period is significantly lighter than normal despite the lengthening of the cycle. Physician Kuai said it could be due to duphaston. But also commented that it was a little out of ordinary.

Day one!

Period started yesterday!

Day two today ... going to have my baseline scan tomorrow!

PMS

Today is day 32 of cycle.. Started feeling cramps on day 30, which is normal for me. I usually start cramping a few days before the start of the period. Only this time, my period isn't going to come for at least another week.

So just got to bear with it.

Yesterday went to visit Phy Kuai, she remembers my hand haha.. And commented it probably pricked a vessel under the skin and a little internal bleeding took place. 

She said I should stop the chinese medicine already. Reason being the medicine she's been prescribing has been to 活血, plus acupuncture these few weeks to improve circulation.. And since my period is delayed, it will be a super heavy period, so it'll only get worse if I continue chinese med. 

Didn't display it, but was doing a happy dance because I can finally take a break from mixing bitter powder twice a day! 

And she also suggested that I cut down on vigorous exercise, because that causes 子宫 to 收缩 (uterus to contract) and might induce the period to start, or have more severe cramps. :(

Little mishap at acupuncture

Was at Tcm for my acupuncture session.. There was a needle planted between thumb and index finger.. The sensitive spot that we're supposed to massage if we have a headache.

So I was reaching out for my phone as usual, but this time round the acute "suan" sensation lasted longer than normal, so I decided to put the phone away and sleep.

After the needles were removed, I noticed that the sensation still persisted and I couldn't move my thumb without feeling it. Went back to the physician, she told me to apply pressure and iced the area. Then apply heat the day after. 

And this was the state of my hand few hours later.

Update:

Two days later.. A bruise is blossoming, but I do not wish to rub or engage that area as much as I can.

But at least the pain is not present anymore. 

Side effects of duphaston?

Waist line is literally increasing. Wondering if it's due to the med.

All the gas building up. Sigh.

Suspecting it's that because I've not noticed any gain at other parts of body but the abdomen area. And I've been extremely hardworking at my exercise regime and pretty cautious with my diet.

And there's an obvious increase in waist line. Apparent from my clothes. Tsk.

Or maybe I'm just finding excuses for the increase haha

IVF - the start

Today marks the start of my IVF cycle. CD 18 of current cycle. Start to take duphaston 10 mg, twice a day, for 18 days.

Was initially 10 days of the med. But because I have examinations in early July and to meet Prof Wong's schedule, he decided that I'll take the med for 18 days. And my stims are scheduled to start 26th June.

IVF seminar by Prof PC Wong

Attended the IVF seminar conducted by Prof Wong on 30th May.

DH and I noticed that almost all present appeared young-ish (20s, 30s) and looked healthy! No weight issues, good looking also. Made us wonder what is happening to young Singaporeans and their fertility.

It was very informative and I'm glad we attended the science seminar. Something which all teaching reproductive system should attend.

Some things which I remember from the seminar ...
- Strictly no exercise, including yoga during the 2WW
- Rest, but not bed rest
- Not necessary to have high protein diet. That is for women who are down with OHSS, as they suffer a loss of protein. Otherwise a balanced diet is sufficient.
- Prof Wong does not recommend supplements which have not been well researched on ... example DHEA, royal jelly .. He said he wonders why people would read on the forum or websites and believe other people and start popping stuff into their mouths without knowing what they are
- TCM is fine, can complement, but he doesn't recommend the continuation of medicine once the injections start

Anyway I strongly recommend anyone who is thinking of, or planning to embark on ivf journey to attend this seminar, which is organized every 5-6 weeks according to prof. 

Traditional chinese medicine

Back in 2006, I went to see a TCM and she helped with my condition then.

But I think it's simply asking too much of me to visit her twice a week, and for me to travel at least an hour each time, and goodness knows how long the waiting time is going to be every visit.

Stumbled upon the information that TMC opened a clinic at NUH. Decided I should give TCM a try in preparation for the IVF treatment.

As expected, she gave me medicine which was 燥热. As a result I was slightly constipated and some pimples popped. Increased my water intake to more than 2 litre per day to counter.

I was surprised at the number of needles used during acupuncture. She used 11 needles on the tummy, 2 needles on each arm, 2 on each leg and 3 on the head. As compared to my previous experience which was in total 3 needles (1 on each leg and 1 on the tummy). And for one hour, compared to half hour.



Update: I've the habit of taking warm honey water every morning, so the little issue of "fake constipation" (as I like to call it) is solved by adding one teaspoon of apple cider vinegar to the honey water. Probably it's the acid that's working. I remember when I added lemon in the past, I had very active bowels.

IUI (Cycles 6 to 8)

Prof put me on 100 mg of clomid from CD 2 to 6. NUH protocol is to have scan on CD 12.

Jan '15: 1 follicle, trigger CD 14, IUI CD 15

Feb '15: 3 follicles, trigger CD 15, IUI CD 16

April '15: 2 follicles, trigger CD 15, IUI CD 16

All 3 times, follicle sizes were ok (all above 18 mm) and lining were at least 9 mm.

Sadly, they were unsuccessful. So we will embark on ivf.

Private gynae vs Hospital

After the bleeding corpus luteum cyst incident, I met up with the earlier gynae. She said she would recommend that I go straight to IVF, but because she's at a private hospital, would be better for me to go to a government hospital so that I could have the co-funding.

Decided on NUH since they would have my records. And specifically Prof PC Wong.

At that point of time, I knew I'll be on study leave in 2015. Thought it'll be a good time for me to go for treatments as it would not be disruptive to my work.

However, after meeting prof, he said he wanted to see how I respond to IUI first before going onto IVF. More on that later.

But after going to prof and reading up on what the others mention on SMH forum, I realised the protocols that hospitals have are definitely more structured that what the private gynae I went to had.

If anyone were to ask me if they should go to a hospital or a private gynae for infertility treatment, I would say hospital definitely. I wasted over a year with the private gynae, and there were still details which she missed about me.

After going through the procedures in NUH, I would question my previous gynae:
- why did she not monitor me when I was on clomid to see if I'd actually reacted to the medicine?
- why did she assume that I was insulin resistant and put me on metformin for more than a year?
- why did she not monitor me when I was on puregon?
- why were there no blood tests done?

On CD 2 blood test, my FSH was 8.6 IU/L and LH 8.8 IU/L (ratio almost 1:1). AMH 33.7 pmol/L. Progesterone 2.2 nmol/L.