21 April Embryo Transfer (ET)

Compare to KL Fertility, I feel that Sunfert manage their ET process more professional.
I know prior to coming, I shall not use any cosmetics or perfumes, & advised only shower with plain water, no shower gel or soup. I remembered there was two times Dr Helena from KL Fertility was on full eye make up when she did ET for me, one was with Dr Prasant & the other time, she did it on her own, half way through she asked me to release urine...thinking back, doesn't give me much confidence.

Somehow I don't know why, I have constipation, tired to push out prior to ET before 11am but it just doesn't want to come out! Ok ok, let it be, don't bother to worry too much any more.

As reminded by CT Ong, I reminded the nurse that I need the CT Ong mp3 to be recharged & rewind.

Next, the embryologist called me for counselling session.  They said they do it for all their client prior to ET. I didn't know about this, else could have asked hubby to be around instead of drop me off.


Result:
11 ovum extracted on 18 April 2014
8 fertilized with ICSI
Quality:
6 Good ( 8 -10 cells )
1 Average ( 6-7 cells)
2 Poor

She said overall the fertilization rate is good, as I have more than 90% embryo that I can use.
She said Dr Wong discussed with her, based on my previous IVF failure, Dr suggested I transfer 4 embryos.
If the event that I have more than 2 heartbeat, they will suggest fetus reduction, which is a process done at another clinic.
I wasn't sure to take up the proposal, called hubby, he said just follow advise, when stick, worry later, now most important thing is I need to get myself pregnant. Ok, make sense, no more hesitation, just follow advise.


ET on 21 April 2014
4 Embryos ( 8 cell, 8 cell, 8 cell, 7 cell )
Frozen: 3 Embroys ( 9 cell, 9 cell, 4 cell )

Hubby not allow in ET room, unlike KL Fertility.
There was a LCD screen on my right hand side, they project the embryo prior on LCD monitor and told em that these are the 4 embryos they are going to transfer.

Perhaps I was listening to the mp3 relaxation music, I feel the entire ET was superb fast & less nervous.

Done - just continue listen mp3 at rest room, cannot pass water until after an hour rest, unlike KL fertility, they let you pass water after 15 min of ET, and resting wasn't on a flat bed, but on a recliner sofa.
Rest was only about half and hour if I could remember in KL fertility.

Medication:
1. Dexamethasone 0.5mg tab ( 1 tablet, 2 times a day after food )
2. Glucophage 850mg ( 1 tablet, 2 times a day, half tablet each time after food )
3. Cardiprin 100 ( Aspirin 100mg & Glycine 45mg ) ( Half tablet a day ) - I remembered Dr Helena gave me this before after one of the ET cycle.
4. Progynova 2 mg ( 2 tablets at 8am (oral), 8am ( PV) + 2 tablets at 8pm (Oral), 8pm (PV).
5. Cyclogest 400mg  ( 1 tablet 11am (PV), 11pm (PV) )

Important when PV, need to ensure the entire index finger is deeply entered into vaginal, it is actually possible, initially I didn't insert deeply, worry about abortion.
On yes, it makes panties very difficult to wash, I used pad along the way, so need need to wash out the cyclogest/progynova or whatever vaginal discharged.

Prolution 250mg injection date ( I did it all mostly around 3-4pm)
22 April 2014
25 April 2014
28 April 2014
1 May 2014

Sunfert does it for free, & outside clinic charge me RM 20.

1 May 2014 night - saw minor brownish spotting, begin to worry.
2 May 2014 morning 1030am after breakfast, saw some extra spotting, called Sunfert, the nurse said since I had injection yesterday, the injection can last for 2 days, asked me to bed rest as much as possible, & go for blood test tomorrow.


Others:
Below is new to me, Sunfert Instruction to patient after ET, these are the fruit that I shall not take:
1. Banana
2. Papaya ( I love papaya, & have bought a few at home, too bad, all will go to hubby's stomach instead )
3. Pineapple
4. Watermelon
5. Honeydew

HypnoFertility Coaching Program

I was very anxious to go thru my fifth IVF cycle, back in my mind was what if I fail again?

I asked my hubby, what if this round fail? His reply: Try again.
As the days go near to ET, my insomnia comes back, I knew this is no good but somehow deep inside my heart, there is a strong fear of failure, despite I try to control my emotion.
Hubby advised me just focus on what need to be done & prepare for the best, & stop worrying too much.

I then suddenly realised there is this HypnoFertility Coaching Program which is part of the Sunfert package, but somehow it slipped my mind, hence I decided to enquire Dr Wong how to go about it.
Dr Wong issued me a letter, the letter attention to Mind Body Fertility & all I need is to go make schedule appointment with CT Ong at his office.
It was indeed, only about 7 days prior to my ET, apparently CT Ong was scheduled to go overseas on Thursday. I called on Saturday afternoon around 2pm after my visit to Dr Wong, and requested to scheduled 4 sessions in a row. Wendy, CT Ong’s assistance at the centre was really very helpful and with lots of to & fro timing scheduling, I finally manage to to secure CT Ong’s schedule on Monday, Tuesday & Wednesday, 3 days in a row prior to his departure.
He is also willing to do 2 sessions for me on Monday, which is a longer session compare to Tuesday & Wednesday, to make up of the 4 sessions. I was indeed very grateful despite very short notice.


Monday: 4 hours
Filled up a form & personal particulars & complete questionnaires. Introduction, background sharing
Tuesday: 2 hours
Wednesday: 4 hours
It was a busy one week intensive ‘training’ for me. He was indeed trying his very best to take the best approach that matches my personality to coach me, it is very time consuming, the coaching session then followed by hypnosis.
I somehow enjoy the hypnosis, it was more on he tells a story, I have a good sleep, fertility garden, uterus thickening, uterus is going to support my baby for next 9 months, providing all necessary nutrients and best environment, I am pregnant and it's the right time– it sounds so real, so relaxing and the world that I wanted to enter.
In the end of the session, I also realised something on my personality and character that making me very stress out, that in my fertility journey, I tried to control things that beyond my control.
He asked me questions that gave me a wake up call:
When was the last time that you feel relax? Deep inside my heart, it seems like long long time ago….despite I have left work for a year…
When will you feel relax?

Me: When I know I am pregnant
Are you sure you will feel relax when you pregnant? You will worry if the baby is healthy; you will worry about delivery; when baby is born, you will concern if baby is healthy, when baby grown up, you worries about your child’s education, child’s behaviour & etc. & it never ends when endless worries…

Just be a living being, live in present, don’t live in the past, don’t live in future…..

Yes, on second session after I walked out from his office, I decided I leave it to god to decide my faith, I am not god and I shall not try to be god anymore. Hence, the entire 2 weeks bed rest, I would say, despite me stay at home for first day, second day onwards I do go out for lunch & occasionally I have a slow walk at supermarket. I didn’t lay on bed for one week either, I cook & I do house work as per normal. I try not to think too much if the embryos were to implant, all I did was just focus on taking the medication on timely manner, that’s the only thing I can do, the rest, I can’t control, especially the result.

At night, when I sleep, I didn’t tell myself anything, neither I tell myself to sleep anymore. I just laid down on bed at 11pm after the Cyclogest PV. I just laid down on bed thinking nothing and eventually I sleep naturally. New way that I found how to sleep well..


Lesson learnt:
1. Schedule this HypnoFertility coaching session as early as you start IVF with Sunfert, if you believe this helps you. It was published in their website as part of the package but somehow I think the doctor & nurses are so busy that they might not remember to remind you on this.

2. The entire programme ( 4 sessions ), each session duration depends on individual, can range from an hour to four hours, is worth RM 800. You need a referral letter from Dr Wong Pak Seng in order to get the fees exempted.

3. Ideally each session should gap is about a week, as they are some homework that CT Ong will request you to do, such as listening to the music, self-hypnosis, and he will request feedback at each follow-up session. In my case, I didn’t have the luxury of time.

4. The entire coaching session is based on each individual personality, CT Ong is very skilful throughout the entire coaching conversation. I believe in order to reap the maximum benefits of the session, one’s need to have an open minded – to share & to receive feedback.

5. Believe me, once you are open and follow his advice, the outcome is different. After I walk out from his office after the 4 sessions, I realised what I need to change.

6. He pre-amp me that during ET, I can request to listen to his MP3 from the nurse. Make sure I requested MP3 in advanced, & the MP3 needs to be fully charged & rewind from beginning, as some patient has experience it started half way when they start to listen.

7. By listening to his MP3 during ET, I felt my entire ET was very FAST! & the process, was relaxing…

Sunfert: IVF Starts 8 April 2014

8 April 2014
Day 3 period, as usual, period about to stop.
Start IVF cycle, Menopur 225IU
The injection solution is totally different from previous experience.
To administer one injection, I need to mix two bottle of solution into 3 bottle of powder. I was a bit worry if I can get it right, luckily it was quite easy step in fact, plus a bit of fun to play around with the medication.
Technic:
Blue ace me, push back to open bottle
Pull water 1.5 ml
Push down, mix with powder
Slide bottle 45 degree, pull up solution
Repeat for second & third bottle


Prescribed medication:
1. Progyoval
Progyoval ( Oral ) 8am, 8pm & Progynova (PV) 11 am& 11pm ( Have to lie down for an hour after PV to rest & need to insert as deep as possible, best is whole index finger is inserted into vaginal so that the Progyoval is inserted into maximum depth, doctor said with some water on hand helps absorption)
2. Dexamethasone 0.5mg Tab : Once a day for 2 weeks ( I make a mistake, I took twice a day until 16 April 2014)



12 April 2014
Scanned, doctor said eggs are growing on track, lining also thicken.
Continue to administer Menopur 225IU same dosage till 16 April
Start Cetrotide 0.25mg 12 April – 16 April
Scheduled Intralipiq Infusion: initially doctor thought it only takes 2 hours, but apparently if 2 hours, my vein will be very painful, also by the time I manage to get a bed & admitted, it was already 3pm, as bed was full initially.
http://www.hah.co.uk/intralipid-infusion-therapy
4pm: Doctor came to visit
5pm: Intralipiq infusion starts
230am: Intralipid infusion completed
Thick white milky water – doctor said its soy based



13 April 2014
Morning 9am, doctor came, no allergic, discharge
http://www.hah.co.uk/intralipid-infusion-therapy


16 April 2014
Lining at 6.5 mm, short 3 lines
Blood test on Progesterone level
Prescribed medication:
Dexamethasone 0.5mg Tab, once day for 4 days
Administer SC Ovidrel 6,500 iu at 11pm sharp



17 April 2014
Commence tab curam 625 mg (antibiotics ) one tablet twice daily for 2 days
Take tablet Dulcolax (laxatives) two tablets at 11pm
Please DO NOT eat or drink after midnight



18 April 2014
Shower with water only, avoid use of soap, perfume or make-up
OPU process, scheduled at 11am
1045am: Empty bladder, escort inside the room at Sunfert, change to hospital cloth, walk into the operation room.
Unlike KL Fertility Center, I was on Light Sediation during the ovum pick up compare to full sediation in KL fertility center.
First they start with pain killer injection when doctor cleaning vaginal
Next they said a medication to put me into sleep, but doctor said I can still hear them talking.
Its something like doctor insert something into the vaginal with pressure, and I can feel the pressure, next was I heard beep beep sound from machine, and nurse said flowing flowing flowing , & stop & repeat almost in sequence, I was thinking, perhaps they are sucking out the ovum and ovum is flowing out from the sucking process.
The process was quite fast, they said about 10 minutes, and I was totally conscious & know what happens.
Next I was push to a rest place, I slept, just a bit uncomfortable at my stomach, then discharge.


Prescribe medication:
1. Progynova 2mg. Oral 8am, 8pm. & PV 8am, 8pm
2. Dexamethasone 0.5mg tab, 2 tablets a day for 3 weeks after food
3. Cyclogest ( need to chilled inside fridge ): 11am & 11pm

19 April 2014

Proluton 250mg injection @ Sunfert