Third IVF

I thought I'd make a record for our 3rd IVF/ICSI before I forget about it. These days my memory is just really terrible.

This is our 3rd IVF, 2nd in KL Fertility with Dr. Helena. 

I had thought that third time would be the charm, but sad to say, that was not the case. Our second IVF did not yield very good results, with 9 eggs collected and only 1 made it to an 8-cell day 3 embryo. So Dr. Helena advised us to go for dual stimulation before the FET. It was quite painful on our pocket, because by the time we did this 3rd cycle, we were still paying for the installments from the 2nd cycle. Infertility is not only a tough and life-changing journey, it's an expensive... "disability" as well.

Prior to doing this 3rd cycle, Mr. S and I spent almost 4 months eating healthy and changing our lifestyles. Like... I exercised more. We installed a water filter to avoid drinking bottled water. We ate mostly home cooked food (except for Mr. S's lunch at work) and I brought my office lunch from home. We ate all the Chinese and Western fertility foods, cut out all soy products (except for soy sauce) at Dr. Helena's advice, almost totally avoided carbs (me), lost a bit of weight (about 3kg), and avoided refined sugars.

I had thought that doing all these might help my egg quality or his sperm quality, but I'm not sure it really helped a lot, maybe just a little.

This time we spent 2 weeks in KL. The 2nd cycle was so tiring for me because I took day trips for every appointment every other day, not to mention expensive and sometimes the flights were fully booked. I've paid RM1k for a one-way domestic flight and that month, literally my whole salary was spent on buying flight tickets. Ouch! So this time we decided to stay in KL for 2 weeks and although we didn't spend less, I felt that it was a more laidback cycle. After all, if I'm going to spend my whole salary on flight tickets, I might as well take time off work. It makes no difference.

I took unpaid leave and told a lot of lies about why I was going to KL (instead of overseas) for 2 long weeks! I didnt't want to, but it was not an issue to be broadcasted. My husband had a negotiation with his boss to work from a remote location. I am very grateful to both our bosses, who were understanding enough and allowed us the flexibility to take long unpaid leave (me) and to work from home (Mr. S). I made sure and kept reminding my husband that we should not take this for granted and give back more. 

22 August 2017

It was my Cycle Day 2. I went first because Mr. S had an important meeting he couldnt get out of. I had to get an expensive last minute flight to KL to get my day 2 bloody scan. 

Scan results:

Right - 8 follicles

Left - 5 follicles

I was also sent for a blood test to test on my estrogen and progesterone levels. This will determine whether we could  start the IVF cycle. I was so worried it would get cancelled because we have already invested in 2 weeks' worth of accommodation, which at that point was already almost non-refundable.

While waiting, I went next door to Xi Fertility at the advice of Dr. Helena, hoping to do also use TCM to help improve my egg quality. I had acupuncture done, and the TCM doctor gave me powdered medicine which I had to take twice daily, 1 hours before or after Western medication. It was really horrible, and made me dizzy sometimes and nauseous throughout the whole cycle, which was probably what made me lost a bit of weight :) 

The blood test came back fine and so we started the IVF cycle with 100mg Clomid & 300iu Menopur.

26th August 2017

I went back for a scan to see how my follicles were responding to the medications. Only 9 follicles seemed to respond, and they all came from the Right ovary. :( Dr. Helena said it was probably due to my endometriosis (on my Left ovary). god I hate this stupid cyst. I've had it removed via laparoscopy back in 2015, but it was back within a year. T_T

Continued with 100mg Clomid and 300iu Menopur

Added on Ponstan 3 times a day to block ovulation

Once again, went to Xi Fertility for acupuncture and more medication.

28th August 2017

Another appointment to look at my follicle growth:

There were 7 follicles between 10-14 mm and 5 less than 10mm.

Dr. Helena commented that once again, like last time, my follicle sizes are all over the place. They were growing at uneven rates. She said it could be bad blood circulation, but I've done acupuncture and walked so much, so can my blood circulation still be that bad? 

Anyway, we continued with the same dosage of Clomid, Menopur and Ponstan, and I went back for more acupuncture where the doctor used more and longer needles on my abdomen and TCM medication, which she also increased the dosage from 50g to 60g.

30th August 2017

Scan results showed that I had 10 follicles between 10-16 mm (6 of which were between 12-16 mm) and 1 of them came from the Left ovary!

It was decided that the egg retrieval would be done at 9:00 am on 2nd September 2017, so there were still time for my follicles to grow. 

I continued Clomid for 1 more day, Ponstan till 1st September, and started Augmentin (antibiotics) from 1st September onwards.

I was given a double trigger (Hucog & Ovidrel) at 9:00 pm on 31st August 2017. Dr. Helena said she hoped that the double trigger would help my egg quality. 

31st August 2017

Triggered 5 minutes late because we took too long mixing the powder and the liquid. Ovidrel is the best because it had been pre-filled. Gave me a mini heart attack because the nurse stressed that we must be on time! Manically googled and calmed down a bit after reading that some people were later by much more and they turned out fine. I texted my nurse after the trigger, and she replied later that a few minutes later is actually fine. Phew.

I felt a bit bloated and nauseous (most probably from TCM meds) and I had ovarian pain for 1 day but it was nothing like our 1st IVF with a different clinic - I was so bloated and I could feel my enlarged ovaries with every step taken. It wasn't comfortable but at least I felt that they were working. It was a long protocol so maybe that was why I had more follicles.

I also had to fast from midnight onwards.

2nd September 2017

We were asked to check in to the clinic by 8:00am. As usual, no makeup, skin care, chemical etc.

They collected 11 eggs this time. And for the first time, I had nausea from GA when I drank (after the procedure) the Milo given to me after I woke up. Maybe I drank it too fast. But it made me dizzy and nauseous I had to ask for a bag. But luckily it was just terrible nausea and I felt better when I closed my eyes and slept a bit more. 

The pain was bearable, again unlike my first IVF where I couldn't even walk straight for 2 days, maybe because there were less follicles. This time (like the 2nd time), I was able to go shopping from the 2nd day onwards. However, even after 1 week, I was still having cramps on and off. 

We were not going to do a fresh transfer because my lining was thin from Clomid. So Dr. Helena said the earliest we could do an FET was in October. However, for now, I am worried about the outcome. I pushed it out of my mind, telling myself that I've done all I could. Surely there should be some improvements? I was really scared to think about the results.

8 September 2017

Today was the day I would know our results. I couldn't wait for the clinic to call me. So I called them first.

From the 11 eggs collected, we had 6 mature eggs, 5 immature eggs. All 6 mature eggs fertilized through ICSI. They froze 2 of the best looking ones with 7 cells on day 3. The remaining 4 were slower and arrested on day 4 although they tried to culture it to day 6. Sad news for us.

Summary of our embryos: 

2 7-cell day 3 embryos - Grade 2 (This cycle)

1 8-cell day 3 embryo - Grade 2 (Last cycle)

Is there any improvement? Maybe a little, but not much. The last time we collected 9 eggs which resulted in 1 day 3 embryo.. so there is a slight increase in percentage.

Is this all worth it? 

I was not very convinced that we would succeed from day 3 embryos. But in our 1st cycle, our good looking blastocyst also turned out to be a blighted ovum. So we shall just go ahead with this and hope for the best. Don't think! But I really hope we get a healthy baby out of this. I dread having to go through all these again. Physically, emotionally and financially. And our age is also catching up. 

I feel very bitter seeing friends and people I know who only have to go through this process ONCE to have a healthy baby and still have many leftover to freeze. :(