The 2-week wait (for IVF #4)

Just like in my previous IVF cycles, the two-week wait (to know if I am pregnant or not) is one of the most suspense-filled weeks throughout our journey. After the embryos are transferred in my uterus, all I can do is to pray for a miracle to happen. And when I am praying, I am already claiming for my baby/ies. I am thinking of positive thoughts. I am dreaming of holding my baby/ies while breastfeeding.

Based on the current status of embryo development (refer to my previous blog entry: 2-week wait (for IVF#2)), I am trying to live each day by imagining how the embryos inside me grow, develop, and divide into multiple cells. I would caress my belly and talk to them. I would tell them how excited I am to take care of them. I would tell them to stick inside my uterus and hold on.. hold on until the end.. hold on and never leave me.

I also eat the recommended foods for implantation -- pineapple and nuts. I drink plenty of water, sleep early, and eat well. I am getting hungry easily because of the medicines that I am taking. My medicines are: Cyclogest 400mg suppository (3x daily), Progyluton white tabs (2x daily), Aspimed 75mg (once daily), Prednisolon 5mg (2x daily), and Clexane 20mg injection (once daily).

Five days after the embryo transfer, I was given Pregnyl and Progesterone injections. These medicines were recommended in order to boost my hormones to support the implantation and supposed pregnancy. Since I'm already used to receiving daily shots, Pregnyl injection doesn't hurt anymore. However, the progesterone shot does hurt because it seems like oil. After receiving the shot on my buttocks, it feels like one butt is heavier than the other! At night, I need to massage it and sometimes put hot compress so it won't feel solid and heavy. The bad news is that I need to take this injection every other day! Ouch! Anyway, I'm prepared to take anything just to have a positive pregnancy!

Eight days after the embryo transfer, I had light spotting (pink reddish) especially after inserting my suppository. I also experience minor cramping on my right side during the night. I often feel hot especially in the evening. I read that spotting is sometimes a good indication for positive pregnancy. It is called implantation bleeding. However, it may also be a sign that my period is just around the corner. But I try to think of it as implantation bleeding.

There were times that while touching my tummy, it seems like I'm feeling a pulse that I associate with my embryos' fetal sound. I know that they don't have heartbeat yet because it's still too early, but I just can't help but feel more positive that our embryos are growing and developing inside!

Ten days after the embryo transfer, I had my blood tested for pregnancy. We went to the clinic first thing in the morning and have to wait for their call in the afternoon for the result. I try to suppress my excitement and nervousness by diverting my time to other things and of course, by trying to talk to my embryos. I usually bring out the ultrasound copy of my transferred embryos and imagine them waving at me. At 6pm, my mobile phone rang and the Filipina nurse is on the other end of the line. She told me that my beta Hcg is 109 -- definitely a BFP (Big Fat Positive)!! Yey! Thank you Lord! I was told to continue to take the same medicines and next blood test will be after 4 days.

Four days later, I had my blood test again. This time, I was not nervous anymore because I am confident that the numbers will be good. Normally, the beta Hcg should double every 2 days. So I am expecting the result to be around 400+. The nurse called in the afternoon saying that my beta Hcg is 829! Yey! Super thank you Lord! It seems like the number is quite high so I got more excited as we might have twins!

Eighteen days post embryo transfer, my blood test resulted to a bHcg of 3,982! Wow! I am really pregnant! I am scheduled to have my ultrasound after two days. We are super thrilled to find out how many are there. Although having just one is more than enough for us!

IVF #4

We started IVF #4 in May after having a cancelled cycle (IVF #3) in February. We waited for two normal menstruation period before we decided that we're ready for our next IVF cycle. Going through our fourth IVF cycle feels like a routine already. The staff especially the Filipina nurses seem like old acquaintances. I was booked to a new doctor because my doctor's schedule is full. Since I already know the protocol, I agreed to see her.

The doctor performed an ultrasound scan and saw 3 small follicles on my ovary (a good sign!). I had my blood test and then received my first injection (Ceftriaxone antibiotics). I took home the Gonapeptyl injections (once a day for 2 days) because I want to take the shots at around the same time each day. I was also prescribed to take folic acid 5mg (daily) and antibiotic (Duradox 100mg 2x a day for 5 days).

I went back on Day 4 and saw my original doctor. We insisted that we follow the same medications as IVF #2 since that was the cycle when I had a positive pregnancy. My doctor agreed. I will start Pergoveris 300 IU injection on Day 5 and be back for appointment on Day 6.

If you haven't read my IVF #2 blog entries, Pergoveris is used to increase the number of growing follicles and stimulate their development. Follicles contain the egg cells. The aim of stimulating the ovaries in IVF is to ensure the simultaneous development of several follicles instead of just one in order to be able to collect several oocytes (immature egg cell) and to thus obtain several embryos so that at least one of them with a good morphology can be transferred back to the woman's uterus.

On Day 6, my ultrasound scan is looking good. Four follicles are seen, the biggest measuring 10mm. My endometrial lining is 6.3mm. My blood test results are also good. My doctor prescribed the same medicine (Pergoveris 300 IU) for 3 days.

On Day 9, 5 follicles are seen with the biggest measuring 14mm. My lining is 10mm. My blood test results are still great. It's good that we decided to stick with the same medication as IVF #2. My doctor prescribed the same medicine (Pergoveris 300 IU) for 2 days. I met with the anesthesiologist before leaving the clinic. They now require the patients to see the anesthesiologist before the Egg Collection procedure (also called OPU - Ooctyte pick-up). The doctor took note of my height and weight (if you're curious, I'm weighing 55kg that time). She also asked about medical history, etc.

On Day 11, 5 follicles are seen with the biggest measuring 17mm. My blood test is still good. My doctor prescribed the same medicine (Pergoveris 300 IU) for 2 days. 

On Day 13, 5 follicles are seen with the biggest measuring 19mm. I need to take one more shot of Pergoveris tonight and then the trigger shot (2 injections of Ovitrelle 0.5ml) will be the next day at 10:20 PM. 

The trigger shot is used for the final maturation stage of the follicles. I took 2 injections – left and right tummy. Timing is very important when taking this medicine. The OPU or Egg collection should be done 34-36hours after the trigger shot. Mine is scheduled on Sunday (Day 16) 10.20AM. I was advised to come to the clinic an hour earlier for the preparations before the procedure. Some precautions were also advised such as: no perfume, lotion, nail polish and feminine wash before the procedure and fasting for at least 8 hours before the procedure.

My OPU or egg collection procedure is the same as what I had described on my IVF #2 blog entry. I will leave out the details regarding the procedure so please refer to my earlier post for more information. The entire procedure is painless because I was under general anesthesia. Seven follicles were collected (this is a good number!). I was prescribed to start taking Cyclogest suppositories thrice daily. By the way, on the same day, my husband gave his semen sample in the clinic.

The next day, the embryologist called me and gave me an update. Out of 7 eggs collected, 5 are matured and out of those, 4 are successfully fertilized.

My Embryo Transfer is scheduled on Day 19. I was initially booked with another doctor but when my original doctor recognized my name on the list, she asked to be assigned to me instead. My doctor showed me the picture of my "babies" on the monitor while I was lying in the operating theatre. She asked me how many embryos do I want to be transferred. During my previous IVF cycles, they transferred 2 embryos only. But my doctor is saying that 3 embryos are still safe so that I would have a higher chance of getting pregnant. At that time, I was thrilled to have twins and very much okay with having just one; but the idea of having triplets terrified me! She said that the probability of having 3 is very slim. I never really thought that I would have to decide on this alone. Even if I wanted to consult my husband, I wasn't given enough time ask him. So, I gave the okay to transfer 3 embryos while praying that God will give us at least one but not all 3. I was prescribed with the same medications as my previous cycles - Cyclogest 400mg suppository (3x daily) and Progyluton white tabs (2x daily). Being aware of my previous miscarriage (after IVF #2), my doctor prescribed additional medicines that are believed to have helped other patients with similar case. So in addition to my usual medicines, I have to take Aspimed 75mg (once daily), Prednisolon 5mg (2x daily), and Clexane 20mg injection (once daily).

So, here comes the agonizing two-week wait (waiting till we find out if we are pregnant or not).

Before IVF #4

So after our cancelled cycle (IVF #3), I started spotting 12 days after our last appointment. It lasted for 4 days and didn't get heavy at all. So I don't think it is a proper menstruation period. My spotting was on and off on the next 3 days so I booked an appointment with my doctor. I had a blood test and ultrasound. My blood test resulted to negative pregnancy. (Although it is highly unlikely, they have to rule out that I am pregnant.) My doctor has seen some small dots on my uterus and suggested another scan by a radiologist.

After a second opinion from a radiologist, I was cleared. Though my scan still contained those small dots. My doctor suggested that I undergo hysteroscopy again so she can check my uterus first before starting the next cycle. My husband and I discussed about it first because it means that we need to take an additional expense again, not knowing if this will be beneficial to the success of the next IVF. So after thinking about it, we decided to risk it and proceed with the next IVF cycle without undergoing hysteroscopy.

My doctor prescribed Progyluton tablets so my period will be regularized. She said that as soon as I have my regular period back, we could start the next cycle. We decided to have 2 regular menstruation period first before undergoing IVF #4.

IVF #3

It has been a few months since I last created an entry. It’s actually good that the months flew by so quickly and before I knew it, we are back again in the IVF clinic for our IVF#3. 

When the nurses and assistants saw me, they thought that I have already delivered my baby. I told them about my miscarriage and they all felt sad. My doctor was also shocked when she saw me and she told me that I should have called her before. I actually thought on giving her a call but then after postponing (and hesitating because she seems to be always busy), I totally forgot about it. 

Just like my previous IVF cycles, IVF#3 begins with an ultrasound scan. On the first appointment, I had my trans-V scan and after checking my uterus and ovary, my doctor said that I could start immediately. For 2 days I will be injected with Gonapeptyl and then be back after 4 days for another scan.

After 4 days, I was back in the clinic. I had my blood test and ultrasound and then was prescribed to take Gonal300 for the next 4 days. Since we paid for the full package, we are getting all the medicines from them and my husband administers the shots on my tummy (after 2 IVF cycles, I am still afraid of seeing the needle enter my skin!).

We were back on Day 9 and only one follicle was seen. This is not a good indicator. The goal in IVF is to harvest more than one egg/follicle so that there's a greater chance of success. My doctor is still hopeful that on the next days, more follicles will grow and mature. I was prescribed to continue taking Gonal300 for the next 3 days.

On Day 12, there's still only one dominant follicle. My body did not respond well on the medicine. My doctor suggested to cancel the cycle as there is a lower chance of conception with only one egg. There is also no point of going through the complete cycle (the egg collection, fertilization, and embryo transfer).

Accepting the failed IVF #3 is easier that IVF #1 where we completed the cycle but resulted to negative pregnancy. We were of course sad of the outcome but still determined and looking forward to the next IVF cycle (IVF #4).

Since the cycle is cancelled, my doctor said that I will go through the normal menstruation period. She also said that we can start the next IVF cycle as soon as I get my period. We also asked if there's a way to boost my ovary so I can have healthier eggs. She prescribed supplements called DHEA 50mg (twice daily) and L-arginine 1g (daily) for a month.

A month after miscarriage: sanity check

It has been over a month now since baby Aedam passed away. My period has not yet arrived. I read that the next period would be delayed.. sometimes up to 6 weeks.. so I am not yet alarmed.

We had our follow up check with our OB last 23-Nov-13. The laboratory results of the pregnancy tissues came out to be normal. We still haven’t received the genetic testing. The doctor said it will be ready around 12-Dec-13. It takes a month for the results to come out. We discussed again what might be the cause of my miscarriage and how it will be prevented in the next pregnancy. My OB said that on my next pregnancy, she recommends me to take Duphaston 10mg (2x a day) and Aspirin (daily) till 24 weeks. A cervical cerclage is also advised after the NT scan (usually around 13 weeks). Additionally, she proposes Clexane 40mg injection till 38 weeks. We asked whether there are tests to determine first if I really need to take these medicines (especially the Aspirin and Clexane). She said that there are blood tests but they are not covered by insurance. These tests are: Antiphospholipid antibody, Anticordiolipin antibody, Lupus anticoagulant, Protein C, Protein S, and TORCH panel. My OB said that should we decide to have these tests, I should wait after I get my period.

My OB also required me to have an ultrasound just to make sure that all the pregnancy tissues are ejected. On 28-Nov-13, I had my ultrasound. We have originally scheduled that day to be our 20-week detailed scan (the time when the gender would be determined). It’s good that I didn’t cancel this appointment. The sonographer is a lady so it makes me more comfortable especially since she has to do a trans-V ultrasound. She said that my uterus and ovary are all back to normal. She also showed me my uterus and it indeed came back to its original sandwich state.

My OB said that we could have our IVF again after 2 menstrual periods. We’ll probably wait for at least 3. Therefore, we might be having it around end-January of early Feb. It’s just a few weeks from now so I am really looking forward to that! The holiday season is also keeping me a bit occupied. We’ll be celebrating Christmas and NY in Dubai with my sisters. We are having secret santa exchange gifts so I am pretty excited on that! I can move around freely as well. I started cooking and doing household chores. I am also into Clash of Clans and Plants vs Zombies 2 games lately. Hami bought me an iPad so I have been busy with it ever since. I am watching koreanovelas again, started reading novels, and am trying to do yoga and exercises. The weather has started to get cold as well. I had flu last week after coming back from Dubai. We went to Dubai on 28-29 November to celebrate my niece’s birthday. We watched Hunger Games (last full show). We also met (and grilled) her “suitor”. We had a fun time in Dubai that weekend. We also had a productive weekend last week when we went to Ikea (had breakfast there, bought some stuff, but mostly enjoyed window shopping). Then we went for a drive around Saddiyat Island. And then we went for grocery in Lulu Khalidiya Mall. Hami also went for a run around our compound. I didn’t go with him since I am still recovering from flu. We’ll probably try to have afternoon (before dinner) walks today and in the next weeks. J I know that Hami just needs some motivation and a little push from me so he could also run regularly.

I haven’t cried for the past 2 weeks now. I still feel sad when thinking about the failed pregnancy sometimes but my sorrow is overshadowed by my anticipation of our next IVF ahead. I had a dream (around 2 weeks ago) with God. I was alone in a forest when I heard His voice. I know right then that it is God who is talking to me. He told me never to lose faith in Him and that He will fulfill His promise.. I just need to have patience and trust in Him. I know that I have a lot of questions but when I heard His voice, I just fell down on my knees and tears were streaming down my face. After that dream, I feel so at peace. I am more determined than ever! I really believe that the next IVF will be a success.. that I will be pregnant right away! And that I will have a healthy and full-term pregnancy. And that we will have our healthy, normal and precious rainbow baby very, very soon! How can I not be excited when God has reassured me that He will fulfill His promise? Right now, I am just counting the days.. before I know it, we’ll be starting off with our IVF again! Yey! J