TTC Journey

Nov 2013 – Nov 2014 (TTC Naturally)

I know it’s only been a year but at (then) 32 and having already tried for a year, we didn’t want to waste any more time… We didn’t want to wait until I was 34 to take action. So we decided it was time to get tested to see what was going on.

Nov 2014 – May 2015 (Dr. #1)

All standard blood tests came back normal for both myself and DH. Semen analysis was normal too. Next step is to do a hysterosalpingogram (HSG) to check that my tubes aren’t blocked – a very unpleasant feeling! Although they gave me a painkiller to take an hour beforehand, I could still feel a very blatant dull but strong ache in my abdomen, like a really bad cramp or stomach ache. It was pretty painful… This feeling is due to a thin catheter being pushed through my cervix into the uterine cavity. Contrast dye was then passed through it to fill my fallopian tubes whilst I lay very still on the ice cold metal table so that they could X-ray my tubes. We got the all clear. Great.

Now that it seems the hardware is fine, we were started on Chlomid. We did three rounds of it and one round of Letrozole. All were unsuccessful and we were still left with no real explanation as to why we were having trouble conceiving. So frustrating.

One of the things I was aware of was that I had quite a lot of follicles in each cycle and upon consulting with ‘Dr. Google’, it suggested Polycystic Ovarian Syndrome (PCOS). It wasn’t until we asked the doctor straight up that she said I had a minor case of PCOS. Well that was super annoying… I mean, if I hadn’t had kept myself informed and asked her straight up, she wouldn’t have informed us of it. Clearly, it was time to change doctors since she wasn’t able to give us any straight answers, plus she lacked basic people skills anyway. But at least we seem to be getting somewhere now.

Jun 2015 – Nov 2015 (Dr. #2)

Doctor #2 says PCOS is very common in women and is easily fixed. Women can still get pregnant with the right course of medication/treatment so it wasn’t a cause for concern. He assured me that it would be easy and straightforward as “I was still young”. He was so confident that everything seemed promising. GREAT!!

Did three rounds of IUI with Chlomid. Although we questioned whether this was safe as we had already taken three rounds of it with doctor #1, the doctor assured us that it was safe and nothing to worry about (even though doctor #1 and ‘Dr. Google’ had advised against taking it more than three times due to the increased risk of cancer). Ok…. Well, I guess we should trust the experts, right?

Learned through the process that I have a retroverted uterus which means that my uterus tips backwards instead of forward. Doctor #2 and ‘Dr. Google’ says it’s not a problem at all in getting pregnant; many women don’t have any issues getting pregnant naturally with a retroverted uterus so it’s nothing to worry about. Everyone’s different and it’s merely just a different shape, like how your boobs or feet are shaped differently but still function the same way!

All IUI attempts were unsuccessful and doctor pushes for IVF even though we still don’t know why we are having trouble conceiving/what the problem is. I prodded and asked if there were any other tests that we could do to see if we could delve deeper into the issue and find the source of the problem. The response was no.

We decided that this doctor wasn’t right for us due to his lack of concern for the continued use of Chlomid, his cookie cutter approach and the long wait time.

Dec 2015 (Dr. #3 )

Ready to take the next course of action – IVF. However, we are still in the “Unexplained Infertility’ category so we’re still frustratingly in the dark as to why this is all happening.

Doctor #3 seemed very knowledgeable. He is a Professor of Obstetrics and Gynaecology at HKU and a senior member at The HK Sanatorium. He took the time to answer our questions so we’re off to a good start. Again, I prodded and asked if there were any more tests that we could do to find the source of the problem. He replied no as well.

One thing that ticked me off was when he made the same damn comment about me being “still young” and that I shouldn’t have anything to worry about. Whilst I know he was just being positive and was “generally” speaking for my age range, by now, blanket statements like these do NOT help and clearly do NOT apply to us. Something’s obviously not quite right and he needs to look at our case in a different way…. Use a different approach rather than their standard cookie cutter textbook approach…! I need a doctor who can think outside the box!! Rant. Over.

Nov 2015 (IVF #1)

Stimmed for 9 days at 150iu/day Gonal F (usually they would administer 200iu but since I am at risk of developing OHSS, he reduced the dosage to be on the safe side. Apparently, OHSS can be dangerous, although rare.

My phone alarm was set for 4pm every day so I had to keep my injections in the fridge at work and run to the restroom when it was time. Luckily, I’m not too scared of needles so I didn’t have any issues jabbing myself in the belly. The downside was that I had to take almost daily blood tests which meant that I was constantly rushing between the hospital and work.

E2: 29,495pmol/L
P4: 3.1 nmol/L

The trigger shot (Ovidrel) was scheduled for 2.30am (just my luck) and I had already given DH the heads up that he would be doing the honours as I would be too woozy to. He was more scared than I was because the needle is significantly longer than the Gonal one!

26.11.2015 (Egg Extraction Day)

I was quite nervous today as it’s the first real surgery I’ve ever had. Luckily the nurses at the Sanatorium IVF centre were great and DH was able to stay at my bedside whilst I waited to be wheeled into the operating theatre. It’s also very efficient with about 5 nurses to one patient to handle all the paperwork, weighing, blood pressure checks etc.

The operating room was freezing but they cover you with linen and towels. The doctor said that the embryo had thawed well and that all was looking good. The anaesthetist sedated me and before I knew it, I was knocked out.

By the time I came to, I was back in the ward with DH beside me. Ah, that was a good sleep! 🙂 They had extracted 10 embryos and would update us on their progress the next day. I got a sick note to take the day off and went home to rest (apparently, I’d be fine the next day).

I went to work as usual the next day and everything seemed fine in the morning but by the afternoon, I was feeling a bit sore and quite bloated. I was also feeling super gassy which didn’t help as I was sitting in an open plan office!! I had to occasionally sneak into the adjacent photocopy room to find release LOL. By the evening, I called the nurse to advise her of the bloating and she asked me to keep an eye on it for one more day. It was still quite bloated but they wanted to see whether it would calm down by embryo transfer day.

We got a call from the nurse in the morning to update us on the embryos. Of the 10 oocytes extracted, 9 fertilised (4x naturally and 5x with ICSI). Great we thought!

The next day, we got another call to update us on the embies and this time it was to inform us that all had arrested except three and that they would immediately freeze the three grade 2 embies in case they’d die too. That would mean that none would make it to blastocyst stage let alone day 3, before being frozen.  It wasn’t looking good and it didn’t feel right – if the embies weren’t making it to day 5, isn’t that an indication that they’re not going to survive anyway? But the doctor insisted that the embryos have a better chance of developing inside the womb rather than outside in the lab.

28.11.2015 (FET Day – Cancelled)

We went to the hospital in the morning, got prepped in the operating theatre and waited for the doctor to arrive. As soon as he saw how bloated my stomach was, he cancelled the transfer. It would be too dangerous for myself and the embryo given my severe bloating as a result of OHSS. I felt a bit gutted but knew that it was for the best. I told work I’d work from home for the rest of the week as the bloating had become painful when I walked – I already looked 3 – 4 months pregnant and the discomfort was making me walk like a pregnant woman. How cruelly ironic!

Now we have to wait another cycle for my body to calm down and return to normal…

24.02.2016 (FET #1)

We debated whether we were going to transfer one or two embryos and at the doctor’s strong suggestion, we decided with one since with my age (yet again!), I’m more likely to have multiple births which really isn’t worth the risk. I’ll discuss the twins issue separately here.

Transferred one grade 2 (day 2) embie.

09.03.2016 (14DP3DT – Bearer of Bad News)

Got the call at work. HCG negative. Feel crushed. Buried my head in work so I don’t think too much about it.

29.03.2016 (FET #2)

This time we were adamant on transferring the remaining two embryos. This was going to be our last shot as we would have nothing left in the freezer and would be back to zero if this didn’t work.

12.04.2016 (TWW)

The TWW actually passed pretty quickly… Got the call at work again. HCG positive! Woop woop, finally some good news! Feeling a bit numb… DH was away so I couldn’t wait for him to return to give him the fab news. He has been pretty stressed out and down about some setbacks at work lately so to give him this news would be so amazing. And it was! As soon as I told him that we were receiving this little present for Christmas, his face just lit up and he smiled for the first time in weeks. He embraced me and said “I’m so happy, that’s all that matters now”.

27.04.2016 (Our First Scan)

We went for an ultrasound at 6.5 weeks and there it was! Our lil baby measuring 6.5mm with a very visible heartbeat beating away! What a positive sign! We got the ultrasound scan as a souvenir and arranged to see the doctor at 8 weeks again. When we got home, I placed the scan next to DH’s bedside table.

08.05.2016 (Mother’s Day)

Had a joint celebration with both mums and wished so much to be able to tell them the news. It would be their happiest Mother’s Day ever. But I had to bite my lip and hold it in as we wanted to wait to be within the safe zone of 12 weeks before announcing it to anyone… Even family.

16.05.2016 (8 weeks Scan)

This time, the ultrasound was very different. It felt awkwardly silent as the doctor probed around and I had a naggy feeling that something wasn’t quite right. Why was it taking so long and why wasn’t he saying anything? I finally broke the silence and asked if everything was alright.

“I can’t find the heart beat” he said without looking up at me. He looked for a bit longer and then stopped. I looked up at DH and he looked crushed. Just so disappointed. I got changed in silence and we went back to the doctor’s office.

He explained that I had had a missed miscarriage (sometimes called a silent miscarriage) and that the baby hadn’t grown much since the last scan. My body hadn’t recognised that the baby had stopped developing so was still harbouring it and I didn’t bleed. Overwhelmed and shocked, I began to sob. The doctor looked down and the nurse passed me the tissues as DH silently put his arm around me.

Our doctor advised us to take medication (basically an abortion pill) to terminate and push the fetus out. However, we wanted to wait a week and do a last ultrasound in case there was a mistake. Maybe they just couldn’t find it today I told myself.

The following week we went back to confirm the scan and as expected, there was no miracle heartbeat. I finally gave up hope and agreed to take the medication.

That night, DH placed the scan (that had been propped up on his bedside table), inside the drawer and closed it.

20.05.2016 (Abortion Pill)

It didn’t take long for the abortion pill to kick in. Even with super strength painkillers, I started feeling contractions which got worse very quickly (think 10 times a bad period pain) and I just couldn’t find a position that would relieve me of the pain. Oh my! Are these the type of contractions that women in labour go through?!?! Finally, I went to the toilet and it all came flushing out. I’m not going to lie… I did try to look… but the water was just too red to see anything.

When I returned to work, I was still quite upset but thankfully things got really, really busy and helped me keep my mind pre-occupied for the whole week. However, as work calmed towards the end of the week, I started to feel emotional and began sobbing before sleep again. Of course, I also declined a baby shower invitation for that week.

At a follow up doctor’s appointment to make sure that everything had passed out, we discussed our next steps. The doctor suggested we try again with an adjusted stims dose due to my OHSS. I also prodded him to find out why he thought our embryos started dying off so quickly. I mean, if they weren’t going to make it to day 5, doesn’t that mean they were no good to start with? He responded that it could be a chromosomes issue, as was the MC.

I asked our doctor if they did PGD (Pre-implantation Genetic Diagnosis). Again, I heard about this test through ‘Dr. Google’. PGD is the process of removing a cell from an in vitro fertilization embryo for genetic testing before transferring the embryo to the uterus. It helps to identify and filter out chromosomally and genetically abnormal embryos, thereby increasing the chance of having a viable pregnancy to term.

The doctor asked why I was asking. I replied that clearly the embryos weren’t very healthy and I wanted to explore the option of doing this test to increase our chances of getting pregnant and having a healthy baby. I also reiterated that I did not want to experience another miscarriage and that this test could help to reduce that chance. He informed me that the Sanatorium does offer the service, but on a strictly case by case basis. Each case would have to be assessed by two independent doctors as well as my own doctor (so three doctors in total) and I’d have to meet certain criteria including being 38 years of age (I was 34 at the time), must have miscarried several times already and had several failed IVF attempts under my belt to qualify. WTF?!! Why the fuck would you make couples go through this emotional and financial rollercoaster before offering it?!! And as we all know, our egg quality deteriorates with age, making it even harder to conceive so why wait?! He asked the nurse to give me the information and I made it clear that if we decided to do IVF#2 with him, I’d want the PGD assessment done even if I didn’t meet the age. Time to consider other options…

For the next few days, I ate whatever the hell I wanted. I went on a parma ham, cured meats, cheese (lots of it!) and ice cream binge, not to mention a few glasses of wine. Basically everything that I had been staying away from prior to the MC! Don’t hold back! It makes you feel better! 🙂

That weekend, I went to see my Chinese doctor for some herbal medicine to re-nourish my body. Apparently, having an MC and aborting is similar to “giving birth” and the body will be fragile. I couldn’t help but sob again when I told her what had happened and she very mumsily held my hand and comforted me. She also mentioned that she had clients who had done IVF successfully in Thailand (Jetanin) and let me take a photo of a leaflet that she had lying around.

August 2016 (Priorities First)

The busy period at work continued for the next 3 months and I found myself working under pressure til 9/10pm every night and sometimes 12/1am due to lack of resources. Work had promised to recruit more people for my team but the recruiting process was taking forever. After I finished a major project, I took some time to reflect and decided that I needed to get my priorities straight. We had several large scale bids in the pipeline and given the under resourcing, it would continue to be a very stressful time for the rest of the year which is the last thing I need if we were to do another round of IVF. Plus, by now, we had decided that we were going to do IVF#2 in Bangkok, meaning I’d need to take a lot of time off work.

Although I enjoyed my work and liked my colleagues a lot, it just wasn’t worth the stress so I decided to resign. I was pretty gutted about it because I was worried I’d be forfeiting a good job. My boss didn’t take to it very well initially… In fact, his initial reaction was “fucking hell” and went bright red in the face. The company had been through some restructuring so the last thing he needed was another leaving. When he calmed down and asked why, I told him the truth (I wasn’t actually going to but it just came out and by that time, I’d started balling a bit). He looked at me and said “Oh I’m so sorry to hear” and hugged me. He asked if there was anything he could do like offer me a break or some sort of arrangement. But I can’t predict how long IVF#2 will take and even if I did succeed, the nature of my job is highly deadline driven and the last thing I need is to be highly stressed during pregnancy given it’s been quite turbulent to begin with.

By this time, both he and I were red eyed and teary. Turns out he and his wife had been on this journey themselves so he completely understood. He said “Work you can always find but family always comes first… So you do whatever you need to do, I fully support you.” With such supportive words, I left his office regretting my decision even more! Was I making a huge mistake leaving a good company and job behind?! I felt so so torn.

When I got round to telling my colleagues, I kept the reason vague such as personal reasons. On one occasion, I did share with a female colleague which I wished I hadn’t now because though sympathetic and I know she meant well, she said “You know many people can still go on to have successful pregnancies after a miscarriage?” Almost like hey, it’s not the end of the world honey, you’ll have another one. Well, yes I do know. But what she didn’t know was that it had taken me almost three freaking years to get pregnant in the first place, only for that one chance to end in miscarriage. Who knows how many more years and hundreds of thousands of dollars it would take to get pregnant again? Four? Six? Ten? Or never. So no, I didn’t appreciate that patronising comment even if it was meant well.

Nov 2016 (Ready For IVF#2 – Site Visits To Jetanin and Superior Art, Bangkok)

Two centres were recommended to us by a friend who succeeded at one and also my Chinese doctor. One is called Jetanin, apparently one of Thailand’s largest and most established fertility clinics. The other, newer centre, is Superior Art (SART). In actuality, they’re sister companies (SART used to be the lab for Jetanin and subsequently branched off to provide IVF treatment as well). Following a site visit and meeting with the doctors at both centres, we decided to go with SART as I had a friend who successfully did her IVF + PGD testing there and has now given birth to a beautiful baby boy (amongst other reasons, see below link).

To reduce the time we needed to be in BKK, DH and I opted to split IVF#2 between HK and BKK: (1) stimulation part + trigger shot in HK; and (2) egg extraction + PGD testing + embryo transfer in BKK.

In case anyone is considering doing IVF in BKK, I’ve done a summary of my site visits to both Jetanin and SART (pros vs cons), along with costs which can be viewed here.

Blood Tests

Prior to our site visits, I had emailed both Jetanin and SART to give them the full download on our situation. The centres replied within a day and suggested we do the following blood tests to try to find the cause of infertility and miscarriage (FINALLY!! Doctors who are willing to investigate further before throwing you into expensive treatment straight away!!!) They suggested testing for:

• ANA
• Lupus anticoagulant
• Anticardiolipin
• Anti-TPO
• Thyroglobulin Ab
• Karyotype Blood Chromosome for husband and wife (through consulting with ‘Dr. Google’ and research in baby forums, we realised that it was important to test our own chromosomes before doing PGD to rule our own chromosomes out from being the problem). 

We did the blood tests at Jetanin because they were our first appointment and it was slightly cheaper than at SART (SART confirmed that they would accept the blood results). The blood results (except the Karyotype) came back within the same day (so efficient!) Generally speaking, everything was fine except a question mark on my Thyroglobulin Ab (Anti-TG) levels. My level was positive 351 which is on the high side. Usually people are negative or far lower. Although unconfirmed, having these antibodies in my body could possibly mean that I have an overactive immune which attacks itself (and potentially a fetus, resulting in implantation failure or miscarriage). The doctor said he’d talk to the in-house thyroid doctor to see if I needed to be put on immunosuppressants to calm my immune (steroids).

The other unusually high level was my ANA. It came in at 1:1280 and these levels can be commonly linked to Lupus. However, my Lupus Anticoagulant tested negative which rules it out. So it’s really quite confusing but during a consultation with an endocrinologist in HK, it’s nothing to worry about for now but is probably something to keep tabs on in the future. E.g. risk of developing hyperthyroidism/autoimmune disease. I informed my doctor at SART of this (and passed all blood results as well as our IVF#1 medical history to him) and as a safety precaution, he proposed to prescribe a low dose of Prednisolone (steroids) to calm my immune just in case.

29.12.2016 – 07.01.2017 (Stimulation Stage)

For the stims stage, we went to meet both Dr. Alex Doo and Dr. Phillip Ho in Central. Both spoke good English and Cantonese and explained things clearly. However, I felt that their attitude and tone switched as soon as they found out that we weren’t doing the full shebang with them (it means they earn a lot less from us). They kind of just stopped patiently explaining things and said “Well in that case, I’ll just do the injections part per your Thai doctor’s request and everything else has nothing to do with me.” It felt like they had completely detached and didn’t care as much (even though, technically we are still their patients and paying them a big sum for the injections). Anyway, although we initially decided to go with Dr. Doo, we changed to Dr. Ho at the last minute because he had annual leave lined up during the time we expected to need him. Plus, the waiting time at Dr. Doo’s clinic was horrendous (we waited 2 hours for an appointment once!) and he was pretty rushed every time he saw us. How do working TTC ladies manage this?! You tell your colleagues you’ll only need an hour and you end up being away for 2.5hours (including travel time). It looks unprofessional on our part and means that if we have hard deadlines and in the case of my previous role, an under resourced team, we just end up stressed out and crazily rushing back to catch up on time. My last company ended up deducting the time out from my salary because I had used up all my annual leave! Was. Not. Happy. About. That.

Stimmed for 10 days at 175ml Gonal F. The best part is the almost zero wait time at Dr. Ho’s and after what was a ‘not so great’ start, I found him to be a very pleasant doctor and his nurses, especially Kristy, is fantastic. The worst part is that he’s quite expensive especially if you have to see him on a public holiday (but then again, who in HK isn’t?!)

FYI here’s a quick break down of his 2017 charges:
Consultation: HK$1800
Ultrasound: HK$1100
Blood tests to check hormone levels (E2, FSH): Ranged from HK$1100 – $1700 per test
Public holiday surcharge: HK$3500
Yep, crazy eh?

08.01.2017 (Trigger Shot)

Decaptecel trigger shot x2 at 12.30am. No OHSS!! Yay!! Avoid Ovidrel at all costs if you are at risk of OHSS – it encourages it!

Fly to BKK to have egg extraction the next morning.

09.01.2017 (Egg Extraction – Embryo Culture Day 1)

22 Oocytes extracted.
20 with eggs in them.
16 fertilised eggs on day 1!!

Although we’re not out of the woods yet, this was already a much better result than IVF#1! Fly back to HK on 11/1.

12.01.2017 (Embryo Culture Day 3)

Slight bleeding.

Received lab update via email. We have 19 fertilised eggs at day 3!! Fanbloodytastic!!

11x grade 1
3x grade 2
5x grade 3

Note that at this early stage, the grading is still based on observing the cell division and overall “look” of the embryos (it does not mean that the embryos are chromosomally normal, even if they are grade 1 or 2).

Pray that they all make it to day 5 blastocyst stage.

14.01.2017 (Embryo Culture Day 5)

Received a telephone call and progress report via email from SART. We have two grade 2 hatching blastocysts. The PGD will be done on them today and they will be frozen today.

We will stay in touch with SART tonight and tomorrow morning as to the rest.

15.01.2017 (Embryo Culture Day 6)

Fantastic – we have another seven ready for PGD! So now, we’ll have a total of nine embies!! They’ll do the biopsy today and freeze the remaining seven today. The PGD results will be ready within 10 days. Can’t wait!

2x FHB, Grade 2
3x HB, Grade 2
2x HB, Grade 3
1x EB, fg, Grade 3
3x Compact/fg, Grade 3
2x Cell/fg, Grade 3
Deg, 1

20.01.2017 (PGD Results)

No. of embryos tested:
Nine Grade 2 embryos (two day 5 blastocysts and seven day 6 blastocysts)

Today, we got the much anticipated PGD results for all nine embryos. SART emailed us the detailed report and followed up with a phone call straight away. Initially we were advised that it would take up to 10 days to get the results and today is the sixth day so we’re again, very impressed with SART’s efficiency and level of customer care.

In summary, of the nine tested, only two embryos were considered viable. The rest had either extra chromosomes or missing chromosomes deeming them unsuitable. That means that they would have likely failed to implant/miscarried/be a still birth/live birth with serious defects.  It was a little hard to let go of them (i.e. let them be discarded of), because I thought that maybe, just maybe, they could still turn out ok… I mean, the fact that they had all survived to blastocysts on day 5 and 6 meant that they were all lil fighters already… And maybe there’d be a miracle somewhere in this batch where the chromosomes would correct themselves… I was feeling a little bit sad after the surprising news and couldn’t help but sob a few tears in bed that night.

Don’t get me wrong, two normal embies is still good news and we’re happy and relieved that we have them. However, having had only three embies for transfer in IVF#1 in which all were unsuccessful, we knew all too well that the chances of using up both and being left with nothing was high. If we had 2-3 more “normal” embies, at least if there were any hiccups with the first or second transfer attempts, we’d still have a couple of backups.

In the current case, our two embies basically means that we only have “two shots” at getting pregnant with IVF#2.  Although they tested normal and our chances of having a healthy pregnancy to term is higher, it’s of course, still not guaranteed – it still has to survive the thawing process, successfully implant and then carry to term. We don’t have any backups so we can only be positive and hope for the best that these two, will finally be our rainbow babies.

21.01.2017 (Period Day 1)

I’ve been having brown spotting since 12/1 and I had assumed that it was the residual blood coming out from the egg extraction surgery. However, it got a little more “fresh” looking yesterday and I asked Dr. Pokpong at SART if this could be my period coming. He said to observe it for a few days as it seems a bit early for my period to come (only 1.5 weeks after egg extraction) but then my AF started flowing properly today so that settles it.

I wrote to Dr. Pokpong to notify him and also called Dr. Ho’s clinic to notify them. Dr. Ho will continue to assist by providing overall monitoring and support to ensure that my uterus will be in optimal condition for the transfer. I am hopeful that all will go to plan, my lining will thicken nicely and that there will be no glitches. I was given the option of taking hormone medication to make my E2 and P4 levels more predictable but I decided to do a “natural” cycle and let my own body produce the necessary hormones and also to let it rest. The nurse said that it wouldn’t be an issue and that the only downside was that my ovulation would be less predictable. That’s fine I thought, as we could wait.

Ultrasound with Dr. Ho is booked for 23/1 so I’ll keep you updated.

Wondering whether to go get acupuncture done… It doesn’t seem to have helped much in my previous attempts and is quite costly… I have until 23/1 (Day 3) to decide….

01.02.2017 (Blood Test)

E2 and FSH too low… Wait another 3 days.

04.02.2017 (Ultrasound)

6-7 small follicles in both ovaries. Large one not big enough yet. Wait another 4 days for blood test.

08.02.2017 (Blood Test)

E2 too low…

12.02.2017 (Blood Test)

E2 has risen so we need one more blood test tomorrow to see if it drops. If so, then the LH surge would have been today (the LH surge is the reading before the drop) and I would be ovulating in the next 24-36 hours.

13.02.2017 (Ovulation)

E2 dropped, yay, finally!! I’m ovulating soon so I should be making my way to Bangkok in a few days.

Emailed Dr. Pokpong to advise and find out next steps. He responded that we need to fly out 16th Feb, do a blood test and ultrasound on the morning of the 17th and do the embryo transfer on the morning of 18th Feb.

16.02.2017 (Depart For BKK)

Today we fly out to BKK. We feel a lil excited but from our previous experience and setbacks, we’ve learned to manage our expectations and refrain from becoming overly excited. I think this is the only way we’ve managed to get through these last few years… If we got super excited each time, we’d have had way too many crash landings… Anyway, whatever happens, we’ll remain positive and at least we’ll get to escape the chilly weather in HK for a bit and enjoy the sun and some yummy Thai food!

17.02.2017 (Pre-Embryo Transfer Check-Up)

We had a blood test and ultrasound appointment with Dr. Pokpong at 10.30am. My lining was doing well at about 8.5 and the corpus luteum was present confirming that I had already ovulated. Whilst we waited for the blood test results, we discussed the PGD results of the embryos.

Even Dr. Pokpong was surprised at the results and we asked what could possibly be the reason for 7/9 of our embryos being chromosomally abnormal. Since our Karyotype tests came back normal, it’s neither myself nor DH being the issue. That leaves it with either the egg or sperm being abnormal (or both – there’s no way to tell), or, that both are normal, but as the embryos develop, they become abnormal for one reason or another. There are just too many variables involved to really know.

I used the opportunity to prod Dr. Pokpong as to why one’s egg or sperm might be abnormal and he said that if it’s not genetic (our Karyotype ruled that out), then environmental factors such as exposure to toxic elements – smoking, drinking, high caffeine intake, bad chemicals in food, drink and products all play a significant role. Since neither of us smoke, barely drink, and have a low caffeine diet, it can’t be that. We have however, been exposed to 30+ years of toxic chemicals and endocrine disruptors (think parabens, 1,4 dioxin, BPA, phthalates… the list goes on…). I won’t go into it here but you can read more about endocrine disruptors here. Other external factors include men taking hot showers, baths and saunas (yes, they kill the sperm!) and women with PCOS.

I further prodded to see if this was going to be a permanent issue for us i.e. is it going to be a problem if we want baby no.2? Dr. Pokpong replied that it’s hard to say and that there are too many variables involved. It could also simply be that this just wasn’t a good batch. I try to remain positive and hope that this lil one will flourish and grow into a full term baby because we only have one more in the freezer if we want baby no.2. I really, really do not want to go through IVF#3…

The blood results came back within an hour and judging by Dr. Pokpong’s reaction, we could tell that it wasn’t good news. “Is it too low?” I asked. Still taken aback himself, he hesitantly responded “Yes”. My Estradiol was at a mere 21 and progesterone was a mere 5.49. There’s no way the embryo would implant with these levels. He explained that because I decided to do a natural cycle (i.e. didn’t take hormone meds but rather let my own body produce the necessary hormones), it was harder to predict what “my” normal range was for a natural cycle. Anyhow, these readings were too low. The benchmark for an artificial cycle was a minimum of 200 for E2 and 10 for progesterone.

I was gutted… If only I had opted for an artificial cycle and taken the meds, then we wouldn’t be sitting here discussing this major setback. All my fault! Do we cancel the cycle or do we not? Given we only had two embies left, DH and I were on the same page that we didn’t want to force it. If Dr. Pokpong says the chances will be low, we’d be fine to cancel the cycle and go back next month. There was no way we’d want to waste our chances. Dr. Pokpong suggested that he could try give me a big booster of estradiol and progesterone via oral medication, vaginal inserts, belly cream and injection. He suggested we could try to see how much my levels increase by the next morning (the day of transfer) and if it’s acceptable, we could still give it a go. If not, then we’ll just have to cancel the transfer. We decided to give it one last shot according to his plan and I took a painful shot to my bum (I think the nurse administering it was a newbie) and went away with the meds hoping for the best but prepared for the worst.

18.02.2017 (Scheduled FET Day)

8AM… We arrived back at SART for the blood test. Great, it was the newbie nurse again. I have very thin veins so this time, I gave her my left arm as it seems no longer possible to draw blood from my right arm. It’s been jabbed so many times that I think the veins have just collapsed which explains why the nurses in both HK and BKK have been having difficulty drawing blood from it… Even when they swivel the needle left and right under my skin! Oh the joys of IVF!

When done, we returned to the hotel to rest for a couple hours. It was still breakfast serving time and as we had literally dashed in and out with a croissant before we left, we decided to try our luck to see if they’d let us in again for a “proper” breakfast if we explained that we were in a rush this morning. And that’s the best thing about this hotel… They recognised us and let us in again! Yay, proper breakfast, here we come!

We got a call at around 10am asking us to return to the centre. I asked what my levels were as if they were still overly low, there wouldn’t be a point in going in. After some passing around of the phone, I was informed that my E2 was 134 and P4 was 11.5. What a big difference! Whilst it was much higher, I asked if it was ok as Dr Pokpong had said that in an artificial cycle, the benchmark levels were E2 at 150 minimum (ideally 200). Dr. Pokpong still wanted to see us so we made the journey back.

10.30AM… Dr. Pokpong explained that although the levels didn’t meet the benchmark levels of an artificial cycle, as I was on a natural cycle, it “could” turn out to be ok although there really is no way to know for sure. One thing he did point out was that the uterus lining was good along with everything else and that in fact, not all IVF clinics measure the E2 and P4 levels – they usually put the focus on the lining. If the lining is good, they’re happy with it. Given that Dr. Pokpong will continue me on the hormones medication, we decided to take the chance that my levels will continue to rise throughout the day and following the transfer so will hopefully catch up in time.

We signed the consents to thaw embryo #4 which would take 3 hours and walked over to Central Embassy to get some lunch. We had the most delicious Tom Yum Noodles!!!

1PM… We arrived back at the centre to start prepping for my transfer. We got taken to the surgery section and they swiftly got me changed and waiting in the embryo transfer room. The best thing with SART is that their paperwork is very well organised and efficient – we had done everything at the beginning of the whole process and any other form we needed to sign was quick to do.

The nurse ultrasounded my belly to check my bladder – the bladder must be quite full so that they could see where they needed to shoot the embryo in through the catheter. I was rather full already (with still an hour to go so I was advised to relieve myself and then drink two cups of water to fill up again). As always, the nurses were very polite and helpful.

After some more waiting, Dr. Pokpong arrived and the nurses began prepping me. There was a TV monitor facing the bed which suddenly switched on and there, on a microdish, was our precious little embie #4 just hanging out!! It had fully hatched from the zona (shell) by now, having been frozen at the hatching blastocyst stage so that was a good sign as it meant that it had progressed. It looked like a lil fuzzball, with lots of bubbles stuck together. Although it wasn’t even a baby yet and may not even become one, I felt a wave of maternal instinct sweep over me and I wanted it put inside me straight away so that I could give it all the love and warmth that it needs to thrive. I hope this will finally be our rainbow baby.

The procedure was quick and lasted 20 mins. I was asked to rest for an hour and call if I needed the toilet. I did, after 10 mins and they brought in this steel basin and propped me up onto it. Wasn’t expecting to relieve myself that way but hey, a woman’s gotta do what a woman’s gotta do.

During my rest, the nurse came in to confirm my medication requirements and go over the instructions. She also gave me a photo of my little embie! How very sweet of the clinic to think of that; such a nice touch. Inside my package was also a leaflet telling me the do’s and don’ts as well as a medical letter written by the centre to airport staff requesting that I be allowed to take all my meds and can of Estradol gel into my hand carry with me as well as requesting for wheelchair transportation to the gate to avoid too much walking. After an hour had passed, I was allowed to get changed and leave. The nurse, who remembered me from the egg extraction surgery, waved me off and wished me luck.

Back at the hotel, we ordered room service for the rest of the day and just chilled. So make sure if you decide to do destination IVF, to pick a hotel that has good reviews for food as you’ll be spending a lot of time eating in!

19.02.2017 – 20.02.2017 (Bed Rest)

Feeling fatigued and sleepy. More rest and eating in. We stayed at a wellness themed hotel and the food was really healthy, tasty and affordable.

21.02.2017 (Depart BKK)

Checking out today and flying back to HK! Missing my dog and very much looking forward to a snuggle with him. Dogs are the best way to release those endorphins and de-stress!

26.02.2017 (Cheat HPT)

Yeh I know… the blood test is only one more day away but I couldn’t help but cheat! J Bought the Clearblue HPT and did my deed on it. My heart sank as I saw a dark blue horizontal line within the first few seconds. But upon closer inspection, there appeared to be a very, very, barely visible vertical line. Hmm… Maybe I’m imagining it so I take it to DH and show him. He sees it too but agreed that it was very faint and that we shouldn’t get our hopes up yet.

27.02.2017 (First Beta HCG Test)

We went in the morning and then had lunch whilst we waited for the results. They came back within 2 hours and the result was 100.1 IU/L – POSITIVE!!! Well done my little embie!! I showed DH the Whatsapp message from the nurse and he let out a smile. I was a little worried that the level seemed a bit low for 4 weeks but apparently it’s still early, plus it’s the not first reading that counts, it’s the second one to make sure that it’s doubled. We scheduled a follow-up HCG test in four days’ time and by then, if all goes well, it should have at least tripled.

The clinic also tested my progesterone and thankfully that came back at a good level at 67.29nmol/L.

I share this with Dr. Pokpong and he congratulated us and then instructed me to continue on a reduced dosage of Prednisolone and all the other meds until a fetal heartbeat is shown on the ultrasound.

03.03.2017 (Second Beta HCG Test)

Result was 668 IU/L!! Yay, it has at least tripled!

I make an appointment with Dr. Ho’s clinic for the ultrasound but deliberately delay it to when I would be 7 weeks. Although we should be able to see the heartbeat by 6 weeks, I didn’t want to go in too early (given what happened the previous time around).

12.03.2017 – 17.03.2017

Been feeling mildly nauseous this week (6.5 weeks mark). I’ve been drinking hot ginger water almost every day but it doesn’t seem to help. I read online that to combat nausea, pregnant women should keep snacking throughout the day – don’t let your stomach go empty and it was right! As soon as I ate, I felt much better!

20.03.2017 (First Fetal Heartbeat Ultrasound)

These last two weeks seemed to last forever but finally the day arrived! As usual, we didn’t have to wait at Dr. Ho’s office and we went straight in to see him. I was greeted by “Mr. Wandy” again and there on the monitor was our lil B. Dr. Ho pointed out the sac, the baby (a blob) and it’s size was 0.78mm at 7 weeks. That’s all good but please show me the heartbeat, I thought as I looked on with wide eyes. And then finally, he pointed to the heartbeat and confirmed that all was fine at 160/min. The EDD (estimated due date) was 5 November 2017. I looked up at DH and we both smiled at each other. We felt cautiously relieved.

As Dr. Ho no longer delivered babies, he wrote a referral letter for us to see Dr. Danny Leung at the Sanatorium. When I returned home, I booked a follow up appointment with him for two weeks later.

I contacted Dr. Pokpong at SART to let him know about progress and to thank him and his team for doing such a wonderful job.

03.04.2017 (9 Weeks Scan)

We were back at the Sanatorium and boy do I not miss the waiting time. From the time we registered to the time we left, it had taken two whole hours. Anyway, we met Dr Danny Leung for the first time and he was very pleasant. As he scanned my tummy (yay, good riddance Mr. Wandy!), we saw the baby had increased in size and at one point did a little crunch as if to say hello to us! We were relieved to see a clear heart beat and that the size was growing as expected. Dr Leung briefed us about the Oscar test (HK$4,000) and the Safe 21 test (HK$6,500) and asked which one we’d prefer to do. He mentioned that because we’d already done the PGD, it should have filtered out Down’s Syndrome and other chromosomal issues but for peace of mind, DH and I chose to do the more comprehensive and accurate (but more expensive) Safe 21 blood test. We booked our appointment for our 12 week’s scan and arranged for the test to be done then.

20.04.2017 (12 Weeks Family Announcement)

Finally!! The day has come to tell our family…. Yes, we didn’t breathe a word of the pregnancy until the baby was more stable and yes, it was hard to hold in, especially since my mum had tried to dig for information a few times (even though I specifically told her not to ask!)

Anyway, it was perfect timing because my sister was in town so that made it extra special. We had planned an early mother’s day lunch today so my plan was to reveal the news then. As everyone sat down and finished ordering their meals, I took my phone out and Whatsapped a picture of our baby scan to the family chat with the caption “Meet your grandchild /niece / nephew!!” I then said “I’d like to introduce someone to you. Look at your Whatsapp guys”.

My parents got their phones out and as my sis was an out of towner, I realised she didn’t have internet access. So I showed her my phone instead. There was a kind of confused sort of silence which lasted a whole two minutes! I then prompted them and asked “You guys do know what it is right?!” And they continued to look confused until DH could no longer take it and blurted out “We’re pregnant!!” My dad finally broke his silence and said “Is this an April Fool’s joke?!” whilst my sister, also shocked, asked me if I was serious. When I nodded, she burst into tears and hugged me and it was then that my parents FINALLY realised what had just happened and congratulated us.  “Wow, this came as a complete surprise, it’s absolutely fantastic news!!” exclaimed my dad whilst my mum grinned from ear to ear. Man, finally I thought as I dried my ears. Lol. My poor granny, who has been experiencing a very painful back lately, suddenly lit up upon hearing the news and I was happy to see a spark of motivation in her eyes and give her something to look forward to.

It’s not that my parents didn’t know what a baby scan looked like, it was just that they couldn’t believe it because initially, every time they asked me about it (before 12 weeks), I brushed them off and just said that there was no update so they took it as being unsuccessful. Little did they know that we’d been keeping such a huge secret from them for 3 whole bloody months!!

Anyway, after this first ‘pregnancy reveal fail’, we were due to repeat the process with the in-laws at dinner. I revealed the same way but this time, their reaction was very different! My MIL leapt up straight away and hugged and kissed DH and I with joy and I became teary again. Yay, success!! LOL.

Ahhh it feels good to finally let them in on our lil secret and be able to share the happiness with the family. Everyone is just so happy, as are we 😀

25.04.2017 (12 Weeks Scan)

The scan was fine and so was my urine sample to test for blood sugar. Phew! They drew some blood for the Safe 21 test and advised it’d take a week to get the results. For those wondering, this is a comprehensive blood test that detects a broad range of chromosomal abnormalities e.g. Downs Syndrome etc. We had the option to just do the Oscar test and only test for Downs Syndrome but the Safe 21 is a newer, more comprehensive and significantly more accurate test than the Oscar (with over 98% accuracy) so we thought we may as well do this for peace of mind. It is quite a bit more expensive though.

05.05.2017 (Safe 21 Results)

It felt like ages but finally, the nurse called to give the good news that the results were normal, yay!! I think by this stage, DH and I can finally breathe a sigh of relief and “let go” of most caution. Of course, I want to wait until our 20 week morphology scan to be sure but man, does it feel good…

The other piece of great news is that:

25.05.2017 (16 Weeks Scan)

Aside from catching a cold this week, I’m pleased to report that everything is going so far so good and that the morning sickness has subsided.

22.06.2017 (20.5 Weeks Morphology Scan)

One last major milestone to pass before letting out a big sigh of relief… This ultrasound was the most detailed to date. The doctor went through all of our lil one’s organs, limbs and structure and we’re so pleased that all is in order.

She has grown so much now…. She’s no longer this lil blob but a fully-fledged baby with visible limbs and organs. She even did a 180 turn for us! =D

Unfortunately, we couldn’t see her face properly because her little fists were covering it so I’m hoping she’ll be less mysterious and we’ll see it at next month’s scan!

22.06.2017 – 21.07.2017 (Gas or Dancing?!)

I began feeling flutters and twitches at around week 20. I brushed it off as gas at first but realised after a while that it was in fact our lil one moving around!

Now at 22.5 weeks, our lil one is pretty active. I sometimes feel her during the day but mostly at night before bed time.  She is most active doing her rollie pollies, dancing and kicking around 11pm-1am – such a lil night owl!  And in this past week, we can finally feel her movement from the outside of my belly.  It’s nice that finally, my DH gets to feel her moving too =D  I also tried to get Rexy near my belly but he doesn’t seem to be picking up on her existence yet, dummy!

Other than that, we have started buying all the big things like the pram (we decided on the Yoyo+ in taupe, yay!), the cot, baby carrier etc.  I’m so glad that Target delivers (most items) to HK now so we were able to get quite a few things online that not only work out cheaper but are also prettier than items available in HK.

Being the organised mama-to-be, I have a spread sheet of everything we need to buy and would say that about 95% has been ticked off the list. Of course, I’m pretty sure, this list is ongoing and that I’ll have missed quite a few things off which I’ll soon find out…

Will keep you posted!

July – August 2017 (6-7 Months)

Went in for my Glucose Challenge Test (GCT) first thing in the morning. I was asked not to eat or drink anything from 10pm the night before until after the test. My blood was taken before I was given a liquid sugar concoction to drink. It was HORRIBLE. I was told that if I threw it up, I’d have to do it all over again so I took my time and sipped it. YUCK. Went back for a blood sample after 1 hour and returned again at the 2 hour mark. Finally, I was able to leave and eat my first meal of the day.

Got my results a couple of days later. My 2 hour fasting glucose was 9.6mmol/L and the acceptable limit is 8.5mmol/L… Oops… Failed! Was a bit surprised given that I’m a skinny girl but apparently, being slim does not mean you’re safe from diabetes. It’s a combination of hormones, age, weight and the fact that I had PCOS, also increases the chance of developing Gestational Diabetes. I was asked to go in to meet with the Dietitian (Flavia) and Diabetes nurse (Jade) to go over my food intake and options.

Met with both the Flavia and Jade and they explained to me what it meant to have Gestational Diabetes (GD). Once you have it, there’s a 90% chance of getting it in subsequent pregnancies and a 60% chance of developing type 2 diabetes in 5-10 year’s time. The first course of action is to understand my diet and give me a target meal plan of carbs, protein, fruit and veg. I was given fact sheets calculating how many carbs each food type had so that it helped me to calculate my carb intake. I was then shown how to prick my finger 4x a day to record my 2 hour post meal blood sugar. My target was <6.7mmol/L although they’d accept 7. Urgh… I took the fact sheets home and recorded my food diary and blood sugar results daily. The first 2 days were so difficult as I wasn’t quite sure what to eat so by 4pm, I was super hungry! Before being diagnosed with GD, I would just eat biscuits, crisps, cake, croissants etc…. All totally bad foods that would spike my blood sugar by the way. However, over the course of the week, I began to figure out which foods were ok and which were not. I settled on having cheese on wholewheat toast and a little bit of fruit for my afternoon tea and that held me over until dinner time. I would also eat 2-3 wholewheat crackers and cheese with milk before bed time. In total, my target was 4-5 meals per day. White carbs and fried foods were a no no although I was allowed a once a week treat.

At the end of the week, I sent the results back to Flavia and Jade for their review. As I was able to control my blood sugar by managing my diet and doing exercise (swimming 2 times a week, 30 mins brisk walking 3-4 times a week and the odd prenatal yoga session), I didn’t need to go in to see them again and didn’t require insulin shots.

After another 2 weeks of monitoring, I was allowed to decrease the finger pricking to 2-3 times a week. However, there was a week or two where i completely slacked and ate out a bit more resulting in my blood sugar exceeding 7 and 8 within one week. Both Flavia and Jade called me up to see what was going on and I explained that I’d been naughty and eating out a lot. They asked me to prick my finger more often again to show them that I’m still able to control my blood sugar by diet. Luckily, my readings have gone back to normal again now….

September 2017

Developed a super itchy rash at night that wouldn’t go away! I tried Calamine lotion and Calendula cream but those only relieved the itch for a short while and the rash just got worse and spread. I started losing sleep over it and decided to call my Obstetrician who referred me to a dermatologist. It turned out that I had a mild form of PUPPS rash and because I’d been scratching, I developed a mild bacterial infection as some of the rash had pus in them. PUPPS is a common pregnancy rash and is caused by the ever changing pregnancy hormones. Whilst it can be relieved with medicated cream, it won’t really go away until after giving birth…. What?!? That’s like 7 weeks away!!! Sigh…! The doctor prescribed some baby safe steroid creams and boy, whilst I was at first reluctant to use the creams, they quickly helped to relieve the itching and even helped to get rid of most of the rash. Nowadays, I just get the odd small flare up here and there but it’s nothing the cream can’t fix. Ahh… Back to sleeping well again….

October 2017 (The Final Countdown…)

October turned out to be an eventful month (aside from the birth of course!)  It began with lower than usual amniotic fluid readings and I was to see Dr. Leung every 3 days to monitor the levels.  The reason for the close monitoring is because if there isn’t sufficient amniotic fluid in the uterus, it could be an indication that the baby is in distress i.e.  the umbilical cord is restricting oxygen to the baby (if looped around baby’s neck), or that the placenta is deteriorating.  Whilst it is perfectly normal for the amniotic fluid level to drop nearer to the birth, it should generally stay within the range of 10 or above. My level was around 7, hence the close monitoring.  If it ever reached 5 or below, then a C-section would have to be done straight away so as to prevent/reduce any distress to baby.  However, as Dr. Leung was happy with baby’s heartbeat and baby was still moving, he was ok to let her stay in a bit longer (or as long as we could safely stretch it) to give her little lungs a bit more time to develop.  It was quite an anxious time for us as given the lack of space and fluid for baby to move around, her movements were not very obvious at all so sometimes I missed them and would get worried.  As we made it to mid October, it became clear that we wouldn’t make it to our scheduled C-section date of 23 October.  My levels although stabilised and even increased a little at one point, dropped again to near the 5 mark so for the sake of peace of mind and given that baby was 37 weeks already, he was happy to bring her into the world in a few day’s time.

With a bit of reshuffling, on 19 October 2017, our beautiful daughter Amelie was born weighing 5.7lbs with a healthy pair of lungs.  The moment I heard her cry is a moment I’ll never forget.  I breathed a sigh of relief that she was ok and then the tears started rolling down my cheeks.  The doctor placed her with me and DH and I took photos with her before she was whisked off for the usual checks and clean up.  I was feeling pretty nauseous after my epidural and needed an anti-nausea vaccination to prevent me from vomiting.  I was feeling so woozy that I declined to breastfeed the first time – a big time mistake because as a first time mum, I did not realise that my boobs were engorged at the time and by the next morning, I had a slight temperature (mild mastitis) and the most painful boobs EVER!!  Even when I breastfed and pumped the next 2-3 days, it did not relieve the pain because the milk ducts were so clogged.  Why did nobody warn me about this I kept wondering?!!  This pain was more painful than child birth!!  Fortunately for me, the day before checking out, a wonderful nurse took pity on me and went out of her way during her night shift to massage me and help me pump for 3 hours straight (from 2am-5am!!)  It was the most awfully painful massage I’ve ever endured yet I am most grateful for having it because as the nurse said herself, if I had gone home without it, I would’ve been in big, big trouble.  It’s no wonder the nurses at The Sanatorium are trained and paid so well.  They totally deserve it!!  The next day, she checked in on me again, helped massage me a bit more and gave me more advice for which I am forever grateful for.  All in all, my stay at The Sanatorium was very good and I would highly recommend it to anyone considering it.

And now… To end this first chapter of our journey, we’re thrilled to share a couple of piccies of our little sweet heart Amelie…

To follow the second (and last) leg of our journey which I’ve just posted, please read here.

Thank you for following our journey.  I sincerely wish you the best of luck in your own journeys. Sending buckets of baby dust to you all!

Lots of love,

Roz

xoxo

Disclaimer:
* The contents of this blog are based on my own personal opinions and experiences and in no way represents professional medical advice. Please exercise judgement and seek professional advice when making decisions.

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