Sunday, May 31, 2015

The Unnecessary Panic

13 May 2015

Being a first timer pregnant woman, I had no idea what to expect.. I did my homework and do the readings, but when I found a little trace of spotting, I immediately panicked and saw my obgyn. Dr Andi Hudono was not available, so I went to see Dr Robert Alief, despite the nurses saying that it's normal and is a common sign of pregnancy.

So I went ahead and see Dr Alief and after he scanned my tummy, he said everything was ok and I should have some rest.

The Pregnancy Test

7 April 2015

Our appointment with Dr Andi Hudono to check the programme was successful. I couldn't even get myself to buy a test pack because I was too scared to find out the result. So we did the urine and blood test at the doctor.

It was a positive. My BHCG level was 1250.

And on our next appointment, we found out that there were 2 yolk sac. We're having 2 babies! Praise the Lord.


OHSS

30 March 2015

My tummy was as big as a 5 month pregnant woman's belly and I had severe diarrhoea. So I went to see Dr Robert Alief. Dr CL's nurses recommended Dr Andi Hudono as he is their main contact in Jakarta, but he was on leave that day.

After he scanned my tummy, he said I had OHSS - Ovarian Hyper Stimulation Syndrome, which is a side effect of the hormone injections I was taking before the OPU. It is common for women who have undergone fertility treatments. There is no medicine for it, the treatment is only by eating lots and lots of protein... which means 5 egg whites a day and whatever other proteins of my likings.

OHSS was a bitch, I couldn't sleep on my side because I could feel that something is inside my stomach and I went to the toilet for more than 5 times a day. Dr Alief said the good news is that it is normally the first sign that the IVF programme worked. Fingers crossed..... and fortunately the OHSS inconveniences disappeared after about a week.

Embryo Transfer Day

It has been a while since I last posted, so to pick up where I let off.

24 March 2015 was the schedule for the embryo transfer. We were scheduled for 11 am but Dr CL was late. So we waited there, with my full bladder, without any information on whether we have any embryo(s) to transfer. Tried asking the nurse but no one would say a thing. So we waited... and prayed... until 3 pm the nurse called me up to get a shot, to prepare myself for the embryo transfer. YAY! Meaning we do have at least an embryo. At that point in time, they still wouldn't tell us any info on the embryo.

Came 4 pm and we finally saw Dr CL. Turned out out of the 15 eggs, we had only 2 embryos, one super good and the other so so good. Dr CL scanned my uterus, checked whether everything was ok for the transfer and whether I had enough water in my bladder... hello, i've been holding it in since like forever. Btw, I was allowed to pee as much as a cup, at maximum. (Full bladder was required to make it easier for the transfer)

So then I was prepped and we went ahead with the embryo transfer. It took around 10 minutes for them to clean me up and 5 minutes for Dr CL to put it them in. Waited for around 1 hour in bed then we could go back to the hotel.

More praying and waiting until another 2 weeks, when we know whether any of the 2 sticks in my uterus. We stayed in Damansara for another 5 days and we flew home. Asked Dr CL whether it's ok to fly, he said it's fine, but at least wait for 24 hours. On day 7 after embryo transfer, I was back to work.

Monday, March 23, 2015

D3 embryos

My embryos are 4 days old today and I was very eager in knowing how they were. I tried calling the Alpha Fertility Center yesterday but noone was there (it's Sunday, d'oh). So I called again today but the lady who picked up the phone said the embryologist was very busy and they would call me back, which they never did. So we went there and fortunately met the nurse that has been helping us all the way, nurse B. She looked reluctant when I asked her to check how the embryos were but she did it anyway. Apparently, out of my 15 eggs, only 4 made it to day 3. They could not touch the embryos again until tomorrow so noone knew what their status is today. 

The clinic offers this technology

Just FYI if you are keen in knowing live updates of your embryo. For me, that would be too stressful.

Embryo transfer is schedulled for tomorrow. We can only pray that we will be given the chance to be parents soon. 

Saturday, March 21, 2015

Day 2 post OPU

I am happy to tell you that my bloating has gone away. Yesterday I still feel a little pain because of the constipation and gassy tummy, but today tummy is back to normal. 

Friday, March 20, 2015

Avani - day 2

Breakfast is available in sepoi sepoi and bila bila. They said menus are same in the 2 places but bila bila is more crowded because its location is nearer to most of the rooms.  So this morning we went to sepoi sepoi. 

The food varieties were not ample, the ones I remember are:
- egg bar; omelette and sunny side up
- noodle/kwetiaw soup; condiments are veggies and chilli to have with either chicken or tom yam soup - no meat
- pancakes and waffles
- steam egg
- chicken sausage
- fried noodle
- porridge; not sure what the condiments are but no meat either
- nasi lemak with chicken curry and sambal
- salad bar
- homemade bread with peanut butter and a selection of jams
- cereals
- fruits
Again, taste was so so.


The bread counter

Kwetiaw with chicken soup

For lunch, we again went to sepoi sepoi and had fish and chips. It was ok, the chips were nice; forgot to take the photo because we were too hungry already. 

In the evening I was craving for some skittles (bought some at the warung yesterday) so we thought we'd go out to get some. When we were near the entrance, there were few people walking in with plastic bags in their hands and looked like it was cans beer inside. They came from the left side of the entrance; so we thought we'd explore that side of the beach instead. 

The distance was further than the warung we went to yesterday, but there were more people at the beach. We walked passed by a warung similar to yesterday's called Bayu Malam which was bigger and we could see people queueing. We thought.. Nah, we wouldn't like it.. And we walked further and passed another warung called Senandung Malam which was even bigger with longer queue. A few tables have already been filled too. We were curious, so we checked out the food served on the occupied table. They looked and smelled good. So we decided to join the queue, which got longer and longer as the time goes. Here is what the queue looked like. 

We queued for 45 minutes to put in our order and waited another 45 minutes for the food to come. When the food came, the wait was worth it. We had kerapu bakar and sotong goreng tepung. The kerapu bakar was pretty spicy but the spices were sooo good and the sotong was one of the best I've ever tasted. However, I'd suggest to come earlier or order before you come. I saw two tables with food served on it but noone was at the table. Here's their business card. Recommended if you don't mind the place and cleanliness, but taste is much much better than hotel food. 

P.S.: I didn't get my skittles.. But I did buy some snacks :)

Eating in Avani - day 1

Avani has a few restaurants in the premises; sepoi sepoi, bila bila, stimbot and hai sang lou. 

This is the bila bila; which is next to their pool in the club house



Avani's entertainment at night is held at bila bila, last night they had live music and some dance performance. 

When we arrived, we went to hai sang lou to have some dim sum. We ordered the deep fried prawn dumpling with mayo, siew mai, steamed bean curd skin rolls and congee with fish fillet; taste is so so, don't expect too much. Price per portion is mostly from MYR 10-13 for 3 pieces per serve. 

We then went to sepoi sepoi to have some juice. I had the Avani exotic something with dragon fruit, mango, pineapple and something else. Husband had something orange. Both of the drinks are very sweet. So if you're not into sweets, ask the waiter for less sugar. 


Since the food at the hotel was kind of disappointing, we tried exploring (on foot) the beach outside Avani and turned out there are a couple of hawker food there. This is on the right handside of the entrance if you're facing outside. 

So after wondering around we decided to have early dinner at one of the warung called Bagan Nyiur Seafood. 

We ordered ikan jenahak bakar and sotong bakar. The ikan looks like this

Taste is as bad as the hotel food, even the rice tastes weird. The only thing I like was the soy sauce mix. The whole thing set us back around MYR 50 but I wouldn't recommend this place. 


Intermezzo - Avani Sepang Goldcoast Resort

While waiting for the judgment day we decided to get away to a resort in Sepang called the Avani Sepang Goldcoast Resort. It is around 1.5 hour drive from Ashley Hotel but can be more if traffic is bad. We went at 10 am on Friday and traffic was good.

The concierge at Ashley helped us arrange the transportation to Avani. They said sometimes metered taxi drivers drive round and round when passengers are not familiar with the area (this practice is common in Indonesia too). So we agreed for their "partner" taxi driver to take us to Avani for a fixed rate of MYR 180 per way. Don't know how fair it is, but it was safe and convenient. 


Here we are! It is school holiday time so Avani is pretty crowded with families. I suggest you to bring snacks, books or any kind of entertainment.. or someone who can entertain you :) because the resort is pretty much in the middle of nowhere and the items sold at their convenience store is limited. 

The room




The area

This was taken at around 5 pm, water level has risen.

This was taken around 1 pm

At the Avani Spa

People biking

They also have a shuttle to KLCC.

Haven't seen the gym but this is their spin room
And their pool

Thursday, March 19, 2015

AFC Third Visit

19 Mar 2015

Same as last trip
Flight: KLM
Transport: airport taxi of MYR 84 to hotel
Accommodation: Ashley Boutique Hotel

Since we will be staying here for a while, we bought ourselves local sim cards at the airport. There are several telco provider counters after immigration and we bought the Digi ones; for 1 month subscription with 1.5 GB data limit on 3G/4G and then unlimited with lower speed, price is MYR 41 each.

Our OPU was scheduled for this morning. After we arrived - no makeup, no deodorant, no feminine wash, no body lotion - we were called to the nurse's little room for her to take down the time I had my last meal, the time I took the Dulcolax tablet, my weight, body temperature and blood pressure. Then we settled the remaining bill and went to level 3 where the OPU room is. 

I was asked to empty my bladder, get changed to hospital gown (top) and a sheet to be worn like a sarong and went into the OPU room. Before entering OPU room, there was a little passway between the 2 doors, with holes on the wall that sprays some anti bacterial air onto you. 

The OPU was not performed by Dr Colin Lee, but a lady doctor and an anaesthetician. I do not remember their names.

There I was, laying on the table with my arms spread to the sides. Left one has my thumb clipped with the heartbeat detector (or whatever it is called) and the machine went beep beep beep. On my right arm, the needle for anaesthetic was jabbed into my hand. Then I was out...

Next thing I know, someone called my name and I was feeling very sleepy. Then I was taken out from OPU room to my room where I fell asleep again for a while. When I woke up, I felt very fresh but with pain in my lower abdomen. Fortunately I was not nauseous like what others might experience. But the needle was still stuck into me as precaution in case they need to inject something. 

They managed to harvest 15 eggs but I was not informed of size or quality *fingers crossed they are super ones*. Husband was asked to "release" sperm again because the first one was not enough *fingers crossed they are super ones too*.

After around 30 minutes, the nurse came into the room to explain what I need to do in the next 4 days. I need to take cyclogest 400mg every 12 hours starting tomorrow. Then I was released and we went back to level 2 to check whether there was any extra charge to take care of, and there wasn't. 


Note for you who do not do much research like me: bring some panty liners because there is some bleeding post OPU. 

It is 8 pm and my tummy still hurts. It is a combination of period cramp and gassy. The nurse said I can take painkillers if I cannot take the pain. So far it is still bearable. 

I feel like this process is pretty much like an American Idol selection process. We do not know if or when we will get eliminated. So far we have the eggs, that is I guess like the initial audition and now we are waiting for our ticket to Hollywood :)

Our invoice:
Cyclogest 400mg @ MYR 165
IVF balance payment @ MYR 5980
Total MYR 6145

Tuesday, March 17, 2015

The last injection

Here we go.. My last injection before OPU - Ovidrel 0.5ml, which needle is surprisingly very soft. Wish me luck!

Saturday, March 14, 2015

AFC Second Visit

12 March 2015

We're back!

Flight: KLM
Review: Price difference was not too much from Air Asia, paying the extra money was worth the comfort. Plus, we love KLM food! On top of that, from JKT to KL we took the Boeing 377-200ER, their newer aircraft, which business class has extra 8cm legroom. But for us economy-seaters, the difference is touch screen monitor, USB port, adjustable head rest... and the seat chat function

Accommodation: Ashley Boutique Hotel
Review: only a few steps away from AFC, clean and well maintained, definitely will stay there again if we need to

Transport: we bought the fixed rate taxi coupon at MYR 84, no problem there.

Appointment was at 10.30 am. We went there just in time and the waiting room was pretty full. Apparently Dr Colin Lee had to fly to Australia the next day to attend a conference, so all appointments were changed to that day. Waited for 1.5 hour.

Finally our turn, Dr Colin Lee scanned me and counted my eggs. He showed us the result of the blood test and both our Hep B Antigen and Antibody are non-reactive so he advised us to get the booster after the whole process is done. He is not much of a talker but he said my body reacted well to the medicine and we need to come back on 19th to have the Oocyte Pick Up (OPU).

Then we went back to the nurse's little room. So, there were 10 eggs on my right ovary and 9 on my left. Sizes are between 6-12, which is considered not big enough for OPU so I need to continue both the Buserelin and Gonal-F injections. Hopefully by OPU time all eggs will be big, fat, perfectly round and ready for pick up.

So now my daily injections change to:
- Buserelin 0.08 ml 2 first days
- Buserelin 0.10 ml the next 3 days
- Gonal-F 175iu for 4 days
- Ovidrel on the 5th day taken 36 hours before OPU is scheduled

Before the OPU, I need to fast for at least 6 hours (no food no drink) and take laxative after having my last meal.

This time around, the invoice is as below

Gonal F 300IU 1140
Ovidrel 250mcg/0.5ML 200
Dulcolax 5mg 2
Vaginal scan 350
IVF part payment 4000
Dr Colin Lee 350
TOTAL 6042

Crossing my fingers that everything will go well....

Saturday, February 21, 2015

Day 9 of injections

It has been 9 days of daily 0.50ml Buserilin - Suprefact jabs and so far what I think feel:
- I sleep so much better at night
- Some light hot flashes, unlike the ones my menopausal mom is undergoing. Sometimes I see her with sweat all over her face..
- Light bloating

Sunday, February 15, 2015

Period - 15 Feb 2015

I got my period today, which made my cycle 45 days this time. The clinic asked to be notified if I did not get my period until the 26th, so all good there. They also said that this period is going to be longer than usual, due to the injections I am having. 

Needles oh needles

14 February 2015

Back at the AFC at 8 am Malaysia time. Jabbed myself for the first time and everything went well.

In below photo, from top to bottom:
- Buserelin - Suprefact
- Gonal-F
- 0.5 cc syringe
- 1 cc syringe



Saturday, February 14, 2015

AFC first visit

13 Feb 2015

Appointment was made a month before.

Flight: Air Asia
Review: super cheap, on time, so I cannot really comment.

Accommodation: 9 Square Hotel
Review: old, walking distance from AFC, prefer not to stay there anymore

We arrived in KL at almost midnight and took a fixed fare taxi to Kota Damansara that set us back MYR 126. The normal cost is MYR 84 but they charged extra because it had passed midnight.

We went to the clinic at 8 a.m. and waited for about 1 hour before we were called into a small room for the nurse to take our historical data and draw our blood. Then Husband went to have his sperm tested. For maximum result, he was told to "release" his sperm 3 days before the test.

While waiting for the results, we went to have lunch at a nasi kandar restaurant "Di Naina" located at the opposite corner of AFC. We had the lamb leg and teh ais (always thought teh tarik is Malaysian, but none of the waiters understood me when I said teh tarik) which were very good.


Went back to AFC, waited a bit, and finally met with Dr Colin Lee. A very soft spoken man, we can barely hear him when he speaks.
Husband: sperm test result was not excellent but OK
Me: Dr Colin Lee looked worried about my 40-day-ish cycle and even more worried when he asked me questions that I could not answer because I have not cared too much about my cycle. In my defence, there is this app that records your menstruation dates and tells you stuff. It knows, so I don't really have to know by heart :) Anyway, I then had the scan and that wiped off the worried look from his face. Hopefully that means I have 5-star uterus LOL *fingers crossed* then he continued by saying that we could start the IVF program and we have 65% chance of success.

Our main purpose of going was actually to have a check-up only, but hearing what Dr Colin Lee said, we agreed to start the program.

We were then called back to the nurse's little room for her to explain the IVF process and teach Husband and I how to do the daily injections. So we were given:

- 2 bottles of Buserelin (Suprefact)
This needs to be taken at the same time every day; plus minus 15 mins is maximum, if more than that the clinic asked to be notified. I get to choose the convenient time for me to take the jabs and I chose 7 am Jakarta time. I was given 2 dosage of Buserelin; first 2 weeks is 0.50 ml then 0.08 ml the second 2 weeks

- 3 pens of Gonal-F
175iu for the last 6 days. 1 pen lasts for 2 days. Tips: do not worry about the big bubble inside the pen, it does not need to be taken out. When you finish a pen, you will see that there is a bubble inside, so that big bubble will not go into your tummy. The dose in 1 pen is enough only for 2 jabs of 175.

- 2 sizes of insulin needles; per 10 units and per 5 units
- alcohol swabs
- a letter for customs, in case they are wondering why you have needles with you
- a blue bag to store all the medicine and ice to keep them cold

After all the explanation and demonstration, we were asked to come back the next day to have the jab at the clinic under the nurse's supervision. I am scared of needles and now God has given me a way to overcome my fear...

Invoice of our first visit. I believe this might differ, so it might be useful to give you a ballpark figure

Suprefact 1040
Gonal F 300IU 1710
Semen analysis 120
DW1 95
DW3 140
High vaginal swab 90
Abdominal scan 100
Vaginal scan 235
Syringe 30
Dr Colin Lee 235
Dr's planning fee 1000
TOTAL 4795

Next visit scheduled on 12 Mar 2015 to check my body's reaction to the meds; i.e. follicle (egg) check



Why blog

In life, some people get what they want easily and others have to fight their way through. Unfortunately for us, we fall into the latter category when trying to conceive. I believe there are lots of couples like us out there, so I would like to share our experience. Hope you find it useful for your planning stage or just to compare notes.

Let me give you our background briefly. We have been married for almost 2 years but since both of us are not that young anymore, we decided to speed things up. We tried to conceive normally for 1 year and went on to have an IUI (Intrauterine Insemination) helped by Doctor Robert Alief in Jakarta Women and Children's Clinic. I peed on a stick after the 2-week wait and a faint line appeared. I then took 3 blood tests, first one showed higher than normal HCG level, second showed HCG level creeping higher but not as high as expected, third one showed lower HCG level. IUI failed.

Now we are undergoing IVF process, our second try, at the Alpha Fertility Clinic in Kota Damansara, Malaysia. Why Alpha Fertility Centre? 
- Dr Colin Lee is well known for his high success rate (fingers crossed we will add to it)
- Convenience. We can get off from work, hopefully stress free during the process
- The cost is similar to Jakarta; accommodation and flight excluded

A little note on Alpha Fertility Centre. Dr Colin Lee is the founder and Managing Director of TMC Life Sciences BHD, who then sold his shares to a Singaporean billionaire, who then opened his own clinic - Alpha Fertility Centre.

So here we go...