The Stimulation

First step is to take medication to increase the number of eggs which is called ovarian stimulation protocols. 

I had to administer an injection a day for 4 days (D-1 to D-4). The nurse briefed us on how to mix the drug from one vial to another vial and finally, to the syringe. The husband was taking up this job so he listened to the nurse attentively. As for me, I learned on how and where to make the injection. I did the first injection in front of the nurse. She did offer to do it but I insisted to do it on my own as I wanted her to provide me feedback if I had done it in a wrong way. We were going to be on our own at home for the next 3 days so I needed to get it right. The moment I injected the medication, I could taste/smell the medication. 

Initially, I would think this is the most difficult part throughout the treatment and boy, was I wrong. Personally, I think this is the easiest part because wait till I share the later stage.

Before we left the centre, the nurse had to collect blood from us - blood test for both of us and hormone test for me. Hormone test results will decide the medication for my second stage of ovarian stimulation as we were to come back on D-5 of IVF treatment to check if my ovaries are responding well to the medication. 

Fortunately, they are responding well. Hence, for the second stage of ovarian stimulation, I had to administer 2 injections a day for another 4 days (D-5 to D-8). The second syringe's needle is longer so it was really painful when I first injected it. It bled a bit when I took out the needle. Dr. Eeson also informed us that we could do egg collection on D-11 but he will share the details with us again when we went back to the centre again on D-9.

What I really like about Dr. Eeson is he will not give you too much information on future process as he wanted you to focus on the current process since it was stressful enough. To me, it felt like 'go with the flow' kind of thing and I am never worried on what's coming next. Maybe, it's just me.

Oh, did I mention that I was craving for char koay teow a lot during these 8 days? I had CKT for at least 2 days in a row!

So, what happened on D-9 when we were back in the centre again? We were being prepped for egg collection which I will share in my upcoming post.

PS: I received questions on where did I inject and the answer is my tummy (the picture above is not my tummy). To be specific, it is the same row as your belly button but 2 fingers away from it - either on the left or right and you can go all the way down. I considered myself lucky as I had one injection a day for the first 4 days whereby I could inject on a different side each day. My trick was I would put the ice pack on my tummy until it felt numb and really red, wiped with an alcohol swab, squeeze the targeted area hard and cucuk. For the second type of medication, as the needle is longer, I put the ice pack longer.

The Decision

In my previous post, I shared about the journey that led us to learn that we are experiencing infertility. No worries, I had already gotten the consent from the husband to share this with everyone. Personally, I wanted to share our journey because I want to create more awareness to everyone that infertility is common in this age and it is not anyone's fault. 

The next popular question most people would ask - Who and why? Hence, I am using the term 'we' because it's us and we are going through this together.

Before we came into our decision, we did some research online if In Vitro Fertilisation (IVF) is the only option for us. In this research, I learned that there are two ways that an egg can be fertilised - traditional and Intra Cytoplasmic Sperm Injection (ICSI). Traditional is understandable whereby a large number of swimming sperm will be placed next to an egg in a laboratory dish. They have to race to fertilise the egg. ICSI, on the other hand, injects a single sperm directly into the egg. Some centres offer different pricing package for traditional and ICSI. I also came to learn about Intrauterine Insemination (IUI) and the cost is much cheaper simply because the procedure is much simpler - a large group of swimming sperm will be placed directly into the uterus and they have to swim their way to the fallopian tube to fertilise the egg.

A disclaimer here, I am no expert in this. I am just sharing my personal experience and the journey that I had been through with my husband.

While we were scouting and deciding which centre to go to, this particular centre's name came to me twice. There is no price difference between traditional and ICSI. Not only that, they have a team that will assist their patients to compile all the checklist, forms, medical reports and invoices needed for EPF withdrawal application. The best part is they offer cashless facility should the patients opt to use their EPF funds in Account 2 for IVF treatment. Hence, we finally made our move and made the first appointment at Sunfert@Bangsar South. I chose Dr. Eeson as our go-to doctor because I thought he would get along well with the husband. 

Making an appointment was really easy - all I had to do was to download the app and select the doctor's available time slot of our chosen date. We had to be there 2 hours before our scheduled time as the husband had to do semen analysis. This is compulsory for all first consultation. Why 2 hours before the scheduled time? The report will be ready by then when it's our consultation with the doctor. Awesome, right? No time wasting here.

We made our decision on the spot after our first consultation with Dr. Eeson. He is very kind with his words and his words are very reassuring. We do not feel uncomfortable like what we had felt with some other doctors whom we had approached before Dr. Eeson. To be honest, the only regret that I personally had - we wasted too much time and money. We should have seek help at Sunfert in the first place. 

Dr. Eeson informed us that we could start the IVF treatment on the second day of my menstrual cycle which was a week away. He shared with us what we would be going through - from ovarian stimulation to egg collection and finally, embryo transfer. Before we left the centre, we reached out to their EPF Support Team to assist us on EPF funding application and also to apply for cashless facility with Sunfert on our IVF treatment. Other than that, there's nothing much we could do while waiting for my next menstrual cycle. 

In short, numerous of waiting game will be going on throughout this journey which I will share more in my next post.

The Journey

It was not easy.

Well, I did think it is going to be easy but in reality, it was not and it came with countless of tears and heartbreaks from disappointment. This post will be full of information on our infertility journey.

I was diagnosed with Endometriosis in the middle of February 2020 when I went for a full body check-up. The last time I checked was back in 2017 and it was all good. When the gynae told me that the cyst was quite big - 4.5cm, I was really worried. 

He said it will definitely affect my pregnancy chances as the cyst was blocking the pathway to my fallopian tube on the left. Plus, we will not know which side of my ovary will ovulate during the month. On top of this, we were waiting for my blood test report on cancer marker as he also found a few fibroids in my uterus. The wait was nerve breaking but, thank goodness, my report is clean. Hence, all I needed to focus was Endometriosis.

As I did not want to opt for a surgery straight, I decided to take medication and with more workouts at home - which slowly paid off overtime. It was 2.9cm in March and less than 1cm in May. However, the gynae still wanted me to undergo Laparoscopy Cystectomy and Hysterocopy. He mentioned there were polyps that needed to be removed as well.

As it would be my second abdominal operation, I was not keen on doing it. Hence, I went to seek for a second opinion in a bigger hospital. That gynae told me that he did not see the need to do any operation as my uterus looks clear. When I told my gynae that I did not want to proceed with the surgery, he called me the morning I was supposed to admit for the procedure. He tried to convince me with the reason that MiCare had approved the Letter of Guarantee for my admission which was not easy. He said he had a patient whose Letter of Guarantee was rejected even though he had made 4 appeals. Of course, I did not listen to him and stood firm on my decision.

Later, I went to see another gynae which was recommended by a friend. As I wanted him to do his own assessment, I did not share with him on my previous consultations with my first gynae. Eventually, I did share with him but that was after he had shared his assessment with me. He, too, mentioned that my uterus is clear but suspected that I might have P.C.O.S.. He did not assess further to confirm this. I stopped getting my consultation from this gynae after my second visit and focused on the treatments since we found out another root cause to our infertility. 

It was until February 2021 when I went to get consultation from another gynae in the same hospital of my very first gynae. He is actually my sister-in-law's gynae. Man, I had seen 5 different gynae in less than 2 years.

But what triggered it?

Well, we were trying to conceive naturally so, for a few months I had been doing a lot of peeing and tested with ovulation test kits to see if I was ovulating. It was not fun when your sex life is determined by the result.

However, that month was different. I found that my LH had been on the high side with Clearblue smiling at me for close to 5 days. It was definitely not normal. The gynae told me to return on the 21st day of my menstrual cycle to conduct hormone test. Besides that, we had a long chat and I was glad that he was my go-to gynae moving forward. 

When the report was finally out, it was confirmed that I have P.C.O.S. - my LH was on the high side whereas my progesterone was really low. Hence, this was affecting my ovulation but it was not hopeless. Fortunately, there are some medications to counter this condition - Metformin to be the top on the list followed by Clomiphene (Clomid).

I started with Metformin which is commonly used by patients with Type 2 Diabetes as well as for weight loss. Weight loss? Yeah, I was not sure about this until the second day I took the medication. I was feeling alright on the first day but, things did not look good the next day onwards - headache, body sore, diarrhea and abdominal pain. I stopped fasting during this period too. Thinking that my body would need some time to accept the drug, I continued taking it. However, as these side effects had been going on for a week, I informed my gynae and he told me to stop the medication as my body was not accepting the drug. 

Thus, the next medication for me would be Clomid but this could only be taken on the first or second day onwards of my menstrual cycle and before that, both my uterus and ovaries need to be clear as well. If I ever took Clomid without proper checking and should there be any swelling or cysts in my uterus or ovaries, Clomid will worsen the situation. The only side effect I had from taking Clomid was I had a high fever during my ovulation period. As we were not sure if it was really due to Clomid or I could have been contracted with Covid-19, I went to take a swab test and fortunately, the report came out negative. Hence, we confirmed that my high fever was due to Clomid. This only happened during the first month I took the medication. It did not happen again for the next few months.

We continued to try along with me consulting my gynae and took Clomid every month. Sooner or later, I was able to take on the pressure and disappointment - I cried less. I also started going for Traditional Chinese Medication and its acupuncture. Spent a lot of money there, of course. Making baby was not sexy to us anymore. And I believed I did not mention that we found the root cause of our infertility after such a long time. Hence, coupled with that, it was more difficult.

After 6 more months of trying, we decided to take another step further - In Vitro Fertilisation - which I shall share more in another post.