:(

Belum rezeki saya lagi. Just came back from clinic and doctor confirmed that no hearbeat found and the sac does not grow much.

I can't explain how I actually feel. Tolong jngan ada orang tanya "r u ok?", memang saya rasa nak sepak terajang je orang tu. This few week adalah seperti hari2 yang penuh emosi roller coaster. Sekejap di diatas sekejap dibawah. Siap ada symptom2. Seperti dipermainkan perasaan ini. Astagfirullah.

Of course I am sad because is something that no one can understand if that person doesn't past per the same problem. But I know that I have people who are there to support me. Thank you all.

My husband currently works outstation, my parents are now in UK . I'm alone and I don't know I just think it's ok. I guess I just need to give myself plenty of time and space.

Symptom?

Pengalaman mengambil injection Proluton Depot. Saya dah amik banyak injection, tapi sor far ini la yang paling sakit. Pain and irritation at the injection site mmg agak lama la. Kebas untuk jangkamasa 2 jam.

Side effects I've had is that I am over sensitive about alot of petty details. saya perasan ni sebab lately bila sya tengok movie, drama etc, saya senang sangat mengalirkan air mata. Tengok anak wayang or Pilih Kasih, peserta terkeluar pun saya menangis gila2. Hmmm parah juga tu.

Kalau menangis macam orang ni, mantain cantik ok la jugak kan?

Oh nak update symptoms yang saya alami sekarang. I dont know if it's because of medicine that I take, or it's the symptoms of early pregnancy (amin). Selagi tak nampak heartbeat saya tak berani kata apa2.

1. loya2 pagi tapi tak muntah
2. breasts swell and tenderness; on and off
3. I have to urinate more often.
4. I feel tired.
5. I have headaches; morning and night
6. mood swings; feel angry, sad, or happy for no reason.
7. belly itchy

bersambung...

While waiting

According to an article that I came across yesterday (I googled too much, not so good you know?):

"The gestation sac size in pregnancies resulting from in-vitro fertilization (IVF) and embryo transfer have been compared with those in spontaneous pregnancies. Small-for-dates gestational sac sizes were found in 36% of the IVF pregnancies. This proportion held for both singleton and multiple pregnancies. With increasing gestation beyond 8 weeks the gestation sac volume increasingly approached normal. In contrast to spontaneous conceptions, IVF pregnancies had a low rate of pregnancy loss once fetal heart movements were demonstrated, when the gestation sac size was small-for-dates. Small sac size in an IVF pregnancy may lead to the misdiagnosis of a failed pregnancy."

Source: here

Maknanya:

1. it is common for IVF pregnancies to have small sac sizes, and
2. they do tend to catch up after the 8th week, and
3. the risk of pregnancy loss due solely to a small sac size is greatly decreased once heart activity is visualized.

Saya google hanya looking for success stories of cases with similar situation to me. Ini lag i baguskan dari saya susah hati sementara menunggu next scan.

6 weeks 2 days

Baru balik dari clinic. Doctor said I'm at 6 weeks 2 days. Biar saya start dengan good news dulu.

Did an ultrasound and doctor said there was a yolk sac and a sign of a baby present there. Dan bukan ectopic pregnancy for sure.

Yang agak menakutnya, doctor was a bit worried coz I'm still spotting. And still belum dapat detect heartbeat and the sac size is a bit smaller than it should be. My sac size is 9mm dimana sepatutnya sizenya 15mm. The doctor kata 2 possiblities:

1. sebab beta hcg saya memang start rendah (20, 40, 100, 253), so the development a bit lambat.
2. the embryo ada cromosom problem and later on will misscarriage

Yeah mine looks small and doctor kata just wait and see if it progresses or if I will have an early misscarriage. I think it's pretty standard for doctors to warn that it is possible in the early stages when dates aren't measuring up. Apa2 pun saya harapa sangat ianya kerana yang no. 1.

Will be going back on the 30th July so I'm hoping to see something more. So saya kena ambil injection proluton depot 2-3 hari sekali sampai next appointment and teruskan ambil ubat2 lain.

Follow up tomorrow!

Sorry lama tak update. My beta hcg on 22 dpo (day past OPU) was 253. Masa 19 dpo the number was 100. Biarpun my hcg beta mula dengan angka yang rendah, saya sentiasa berharap ianya adalah kerana late implantation. My number is rising, remember?I always thought the numbers should double every 24/48 hours, but I found online said 72 is average. So kira ok la tu my number?

So sekarang no more heavy bleeding. It stop on 21 dpo but still I sometimes I had a little bit of spotting lepas masuk kan utrogestan. Saya agak ia tak begitu bahaya, sebab dah melalui lagi teruk darinya untuk IVF kali ni.

I'm going to clinic tomorrow. I am not sure if they are doing just bloodwork or an ultrasound too, but I hope I will see some sign tomorrrow. I am just hoping if the do bloodwork the levels will rise good.Jika ultrasound, kalau preganant dah boleh nampak katung.

Saya tak boleh tidur, saya sangat gelisah. Wish me luck people.

Day 20

Tadi pergi clinic ambil Pruloton Depot injection. Still kena ambil selagi bleeding or spotting. Lepas amik injection I asked my nurse what my odds were. She said that I shouldn’t give up hope yet, but that I shouldn’t let my guard down either. Dia cerita ada patient lain baru call, had same bleeding tapi positive (something similar with my situation), BUT she had an history of 2 extopic pregnancy. Hmmmm. I really hope mine is not kandungan luar rahim. I only have 1 tube and I can't iamgine not having any. Nauzubillah.

Btw, anyone know of success stories of low betas and bleeding heavily macam kes saya ni?

Oh to my hubby and people out there who are wondering the beta range, just have a look at this chart of Beta Scores For Successfull Pregnancies k? Maybe we still have hope http://www.betabase.info/showBasicChart.php?type=Single

Beta HCG 19DPO

At 16 DPO (day after OPU) , my HCG was 42.6. I still had bleeding and cramping going on but the cramping was on and off.

Today, at 19 DPO my HCG was 100 and cramping was pretty much gone tapi still have the reddish spotting. My doctor and nurse adalah seperti berharap hopeful based on the increase (nearly doubling every 48-72 hours), but saya adalah tidak begitu berharap since the numbers are a low. Since I read a lot, saya risau akan ectopic pregnancy. Nauzubillah.

My nurse said doctor would not recommend terminating the pregnancy at this time because there is still a chance it will be normal. Mana tau ada rezeki, IF my beta HCG meningkat ke 1,000 or more dalam masa seminggu ni (macam susah je kan?), something should show up on an ultrasound and I might be able to finally find out what's going on!

Doakan yang terbaik ye?

Beta HCG

I just got the blood test result and I am 14dpo (day post ovulation/opu) and it was only 20. The nurse says it is early and it could be that I have just implanted so we will test again in a 2 days time.

But 20 still mean BFP (positive, 5-200) but considered very low as they are expecting 50-150! Ni yang saya dapat dari google.

• At 14 DPO, the average HCG level is 48 mIU/ml, with a typical range of 17-119 mIU/ml.


• At 15 DPO, the average HCG level is 59 mIU/ml, with a typical range of 17-147 mIU/ml.


• At 16 DPO, the average HCG level is 95 mIU/ml, with a typical range of 33-223 mIU/ml.


• At 17 DPO, the average HCG level is 132 mIU/ml, with a typical range of 17-429 mIU/ml


• At 18 DPO, the average HCG level is 292 mIU/ml, with a typical range of 70-758 mIU/ml.


• At 19 DPO, the average HCG level is 303 mIU/ml, with a typical range of 111-514 mIU/ml.


• At 20 DPO, the average HCG level is 522 mIU/ml, with a typical range of 135-1690 mIU/ml.


• At 21 DPO, the average HCG level is 1061 mIU/ml, with a typical range of 324-4130 mIU/ml.


• At 22 DPO, the average HCG level is 1287 mIU/ml, with a typical range of 185-3279 mIU/ml.

I know it is easier said than done but WILL try not to read too much into the number. The fact is I got a positive test result so just enjoy knowing I'm pregnant and saya berdoa sangat2 that my numbers will continue to double every 48-72 hours.

Btw I'm still bleeding. Went to see doctor yesterday and day before. Dia kata womb lining (i think so) was thick, 9mm. So the bleeding part is still unexplainable and just wait for the beta hcg result.

Spotting after IVF

I was a little worried I had a brown spotting from day 4 to day 6 after embryo transfer, on and off. I called the clinic and they said that its common, but does anyone think it could have been implantation spotting?

So I google something informative, well at least it can cheer me up. It could be a couple of things.

1. The embryo starts to implant at 3dpt (day post transfer) and completes at 5dpt so you're in that time frame. It could be implantation bleeding.
2. It could also be the blood leftover from your retrieval and that the progynova (estradiol) you are on is causing some CM (I have no idea what this mean??) and it is flushing the blood out.
3. Also, are you an progesterone suppositories? If so, lots of gals experience an irritation from them causing them to bleed a bit. Call your nurses and let them know!

Doakan saya ye?

Update on day 4 post transfer

03/07/09 I got appointment with my doctor to scan to see the womb lining etc. He said everything was fine yedda yedda and ask me to take additional medicine, progynova. Progynova is the drug they give you to help thicken the lining of your womb. Adalah menakutkan bila saya baca review pasal progynova kat salah satu page ni. Tapi itu untuk org yang ada risiko breast cancer etc. Hmmm.

Oh we made him to scan me to check if I were born with 1 or 2 kidney ;) Syukur alhamdulillah I have 2 kidney ( my husband read somewhere that unicornuate uterus may have single kidney). :D

After the appointment, I found out that I was spotting very dark brown but it's only really noticeable when I go to the toilet untuk buang air dan basuh. I was only on my day-4 transfer. My nurse said it wasn't anything to be alarmed with if I had light pink or brownish spotting, as it may be implantation bleeding. Tapi bukankah implantation bleeding hanya selepas 7-8 day transfer?

Saya hanya mampu berserah.

I have my blood test 09/07/09 day 10 dan adalah tidak sabar menunggu proses penantian 2ww ini berakhir.

Embryo Transfer

I had egg retrieval on 24/06.09 and they ended up getting 7 eggs & 4 fertilized. I was very dissapointed to say the least, bebecause my 1st cycle I had 14 eggs and all 6 fertilized (but 3 of them were odd shape). Well what I learned was that all cycles are 100% different and it really is quality that matters over quantity.

I was assuming I would be doing a day 3 transfer sebab I tak tahu menahu langsung pasal kewujudan untuk transfer day-5 ni. Serious I have no idea. Masa ni dah bersiap sedia day-3 untuk ET. Pergi situ, doctor had discussion with the embryologist to see quality embryo and said that all of our 4 embies are still thriving and they are making it a 5 day transfer.

I was a little concerned because I was worried that not many of them would make it to day 5, the embrologist says not to worry way to much, usually at least 1 will survive! Eh of course I wish more to survive, eventho saya hanya boleh masuk 1 sebab ada unicornuate uterus, saya berharap baki embryo itu dapat difreeze, IN CASE this cycle doesnt work, memang saya bercadang nak buat FET.

Finally on 29/06/09 I had my day-5 embryo transfer. They call it blastocyst transfer. Syukur, out of 4 embryo, all survived! And 2 adalah grade 1 quality with 10 cells on day-5. So as agreed and discussed earlier, 1 embryo was transferred. LEpas 15 minutes tranfer, I was allowed to buang air hehe. Lega. And rest for 1 hour and boleh balik :)

Before the procedure nurse pesan, I need to keep drinking more water so that the bladder push the uterus down to make my cervix more straight. I was already very uncomfortable, imagine having to control a full bladder for an hour! The agony was really indescribeable.

So sekarang adalah 2WW waiting saya. Bersambung.

Egg retrieval - OPU

My experience in two IVFs I did was ok. Takde sakit apa2 pun masa procedure I mean. So jangan risau eh sesiapa yang nak buat OPU tu nanti :)

I retrieved 14 (1st ivf) and 7 eggs. Masa 1st IVF, saya buat di HUKM, saya sedar masa proses OPU tu, tapi tak sakit. Rasa mamai2 gitu dan separa sedar. Tapi lepas je proses OPU tu, saya ditempatkan di day-care-ward sementara nak sedar, time tu saya mimpi best dan buruk macam2. Takut gak. Dalam 2 jam camtu la baru sepenuhnya sedar. Agaknya tu la agaknya tujuan orang amik dadah, terasa di awang2an ye?

The 2nd IVF, in KL Fertility Centre, the OPU they gives me a kind of twilight sleep where I'm are out, but not "under". Korang paham ke maksud ni. Tido lena dan nyenyak la maksudnya.

The clinic :), tempat checkup, consultation. The procedure buat dekat KLSMC @ same building

During retrieval I don't feel a thing memang saya tak sedar apa2 pun coz I was fully asleep and saya dikejutkan (tepuk dibahu caranya) and then barulah terjaga, mamai skit2 and felt a bit crampy in stomach but that's it. Doctor said, if i have strong pain afterward, diri terasa berat je and terrific bloating, it may be signs of OHSS and I need need to contact doctor again, but other than that I will be fine. Expect some crampiness because my ovaries have had a workout, but that's about it.

Ditolak ke OT
Syukur saya takde la cramp yang melampau. Memang banyak telur kata doctor tapi banyak belum matang, yang matang hanya 7. Cukup la tu janji quality kan?

Lepas keluar OT, still unconscious

This is the best part :) Lepas sedar makan, nurse suruh minum light2. I ordered pasta. Sedap wooo. Tapi lepas makan muntah. Booooo.

Note : Do not eat for 6 hours before anesthesia and eating and drinking too soon after an anaesthetic may increase the chances of nausea and vomiting..

Bersambung..

Suprefact, Gonal-f & Ovidrel

I started my Suprefact on 13th May 2009, one injection in the stomach until the day of the retrieval, which could be another 2-3 weeks, that what I expected at first. Came out ianya adalah terlama skit gara2 period delayed. Doctor kata mmg suprefact ada effect menses. I did suprefact for approx 6 weeks, it is a long time and it seems like forever, but its down to the timing of Egg Collection.

Nak bagi period turun (my period delayed for 10 days masa ni) kena makan norcolut plak for 5 days. After 2-3 days baru period keluar (2+ weeks delayed). Some side effects of suprefact include hot flashes and loss of sex drive. No big deal, all for the greater good. The injection site bleed a bit when I took the needle out, again, no biggie. Things go on like normal until I get to do daily work eg. pergi kedai, keluar bayar bill etc, at which time, the site starts to sting and itch. I go to bathroom and there is a nasty ugly looking purple bruise at the injection site. This is going to be a fun process, and worthwhile in the end.

Got my period on 3rd June 2009. 11th June start with Gonal-f injection, started with 150iu.

Here are the chronology::

03/06/09 - Period day 1

08/06/09 - Blood test. Result the next day, positive (i'm not sure the detail).

11/06/09 - 15/06/09 - gonal-f 150iu

15/06/09 - scan

16/06/06 - gonal-f 50iu (i did the mistake)

17/06/09 - gonal-f 150iu

18/06/09 - gonal-f 300iu & scan

20/06/09 - scan

19/06/09 - 21/06/09 - gonal-f 225iu

22/06/09 - scan (ready for OPU)

23/06/09 - ovidrel (12.30am, must take 36 hrs before retrieval)

24/06/09 - OPU (12.30 am)

Semua injection yang diambil sebelum OPU ;)

Bersambung....