37 Weeks Pregnant With Twins - I'm going to be a Mother!

I will be 37 weeks tomorrow and I am truely glad I have made it this far. I'm not sure if talking to my babies does the trick of holding them inside me until now. Probably it does! ;)

Anyway, Dr Tan kept monitoring my blood pressure and my urine tests since 9/10/2014. On 16/10/2014, we had an early morning call from Dr Tan's clinic informing us that Dr Tan had to attend to two births that day at the Pantai Cheras Hospital. So, we agreed to meet Dr Tan at the hospital itself. Upon arrival, I got myself registered and we waited for our turn to see Dr Tan.

My blood pressure was 130/70 and my urine test showed a rather high protein content. However, Dr Tan informed us that my vaginal swab test the previous week (9/10/2014) confirmed that the traces of protein found in my urine sample was due to a bacteria called "Candida" i.e. I had a yeast infection and not pre-eclampsia so to speak. Thus, Dr Tan did a clean urine test this time just to ensure that the protein content found in my urine sample that day was again due to the same infection. My clean urine was collected using a catheter inserted directly into my uretra. Indeed, there was no protein found in my clean urine sample! Phew! So, Dr Tan had decided to see me again in a week's time.

Both our babies were still head down and their heartbeats were normal (Dr Tan did not measure). Baby A was 2.3kg and Baby B was 2.6kg. Dr Tan said my rapid weight gain was due to the water retention. My legs were really very badly swollen and I'd put on 22.5kg.

On 23/10/2014, we saw Dr Tan again at her clinic at Seri Kembangan. My blood pressure was 138/76 and my normal urine sample again contained a high protein content. However, this time, Dr Tan was very confident that the protein could still be due to the infection and she actually fixed a date for me to have the cesarean surgery on my 38th week. But she insisted that I'll still be required to run the clean urine test again that day just to be sure. So, a nurse collected my clean urine but unfortunately, there was high protein content in that clean sample. :(

Immediately, we were called in to Dr Tan's clinic again and she was shaking her head as me and hubby walked in. Well, it's pre-eclampsia and however mild it may be then, Dr Tan did not want to risk waiting for my condition to worsen before I decide to deliver our babies.

Without much options left, Dr Tan said it is in the best interest of both babies and myself to have them delivered as soon as possible, adding that I am already considered full term now.

Both babies were still head down then and their heartbeats were also normal (again Dr Tan did not measure). However, Baby A's amniotic fluid seemed to be on the low side and weighed only 2kg?! Dr Tan said that the reduction in Baby A's weight could be due to pre-eclampsia. Baby B however was still weighing at 2.6kg. I tried not to be too worried. I myself had put on 23.5kg thus far. Gosh!

There was another 'new' discovery. Dr Tan also told us that Baby A's head was pushed down and slightly further away from my cervix by Baby B. Thus, Baby B could now be the elder sibling! Baby B seemed to be fighting his way out to be number one! Hehe!

In preparation of my cesarean surgery, Dr Tan prescribed two more doses of Dexamethasone injections to further mature the babies' lungs. One dose was administered at the clinic itself at about 1.30pm while the other dose I had it administered at the hospital near our house at 11.30pm. Dr Tan informed us that slightly less than 12 hours for the second dose was acceptable.

Hmm...we will be welcoming our little guys on 27/10/2014! Yaay! I am all excited and I can't wait to be finally holding our bundle of joys in less than 24 hours now! ;D

Babies have been kicking away non-stop. They must be very excited too! Haha!

I am feeling good and I hope I will have a smooth delivery...all fingers and toes crossed! :)

35 Weeks Pregnant With Twins - Birth Plan, Pre-eclampsia

I'm getting quite nervous! ;)  I'm 35 weeks 1 day today and I have mixed feelings! I just can't wait to see my little babies but on the other hand, I need to try to hold them for as long as I could to ensure that they are able to birth at full term with no or little complications.

Well, I have changed my gynae. I find that I am not too comfortable with Dr Jason Lim who is not agreeable with my birth plan or rather any birth plan for that matter. It was rather depressing as I had always highly respected Dr Jason. Maybe we just don't click in this doctor-patient relationship after all.

Anyway, our first appointment with Dr Tan Ee Ping of CT Woman & Child Specialist Clinic at Seri Kembangan was on 11/9/2014. I was 30 weeks 3 days then. It was a pleasant first meeting with Dr Tan. She is a certified hypnobirthing practitioner and I know she definitely supports natural vaginal births.

However, the moment she saw my history of all my previous pregnancies, she frowned. "These babies are very precious to you, aren't they?" she said, looking straight into my eyes. I was suddenly being painfully reminded that this is indeed my fifth pregnancy. I sighed and nodded while stealing a look at hubby. With that in mind and despite all the benefits of having a vaginal birth, Dr Tan somehow indirectly suggested that we have a cesarean birth instead of a vaginal birth so as to 'transfer' the birth risks, if any, to me and not the babies. The reason being there is always a calculated risk for vaginal birth on baby B and this risk will be eliminated if I were to go for a cesarean birth. Well, we have soon decided that we shall proceed with cesarean birth after all.

The scan showed that both babies were finally head-down, side by side. However, both babies were still slightly behind their gestational age with Baby A weighing 1.3kg (2 weeks behind time) and Baby B weighing 1.9kg (1 week behind time). Surprisingly, Dr Tan commented that they were actually of a good size for twin babies. Both babies' heartbeats were in the region of 150s.

Dr Tan also managed to run through our draft birth plan with us and we are happy that she is agreeable to accommodate to almost all of our requests. Well, as we have already anticipated a cesarean birth from the beginning, our birth plan is just a very basic and simple one (I think! Haha!). My main concern is to have a gentle cesarean birth which allows me to have skin to skin contact and bonding time (however brief that may be!) with my babies in the operating theatre itself. The other request which I truely appreciate is for our babies to room-in with me during my stay at the hospital to enable me to fully breastfeed them on demand. I was so happy that Dr Tan is agreeable to these two main requests. :)

Our second appointment with Dr Tan was on 25/9/2014. My blood pressure was 128/70. A bit high according to the nurse. The scan still showed that both babies were smaller than their gestational age although they remained head-down (Baby A was on my right while Baby B was slightly higher on my left). Dr Tan laughed saying that maybe they both wanted me to deliver them naturally through vaginal birth. Baby A weighed 1.55kg (2 weeks behind time) with heartbeats at 140 while Baby B weighed 2kg (1 week behind time) with heartbeats at 144. Everything seemed good so far except that both my feet were swollen. Dr Tan assured me that the swelling is fine so long that it doesn't hurt. In fact, they may continue to swell even more!

I was advised to go on a low sugar diet because I'd gained weight too rapidly. I'd put on 3kg in 2 weeks! Oh my! So, I'm supposed to limit or avoid foods such as rice, noodles, breads, cakes, biscuits, fruits (yes, fruits!), Milo and soy drinks! I must try to eat more vegetables and meat. How could I possibly survive with this diet?!

The birth plan was amended as agreed by Dr Tan. Dr Tan affirmed all our requests and signed our birth plan. Yaaay! She also gave us the emergency hospital admittance form...just in case. However, she added, in the event of emergency and if I have dilated say maybe to a 7cm, then I may as well go for a vaginal birth! How nice! Dr Tan further commented that my cesarean wound may not heal as nicely as some ladies because there are already stretch marks all over my tummy. This is sad...hmm...

Meanwhile, as we have no intention to choose any auspicious date for the births of our little ones, Dr Tan chose two dates for us; one on my 38th week if I could hold that long and the other on my 37th week. :D

Last Thursday (9/10/2014) was my 34th week 3 days. Babies were good and still in head-down positions. Baby A weighed 2kg (about 2 weeks behind time still) with heartbeats at 144 whereas Baby B weighed 2.4kg (on track!) with heartbeats at 141. I was very happy with their progress as they were then at least 2kg each!

However, I was suspected of mild pre-eclampsia. I couldn't believe my ears! My blood pressure was 132/78 and traces of protein (very low content) were found in my urine. There was nothing much I could do except to continue with the low-sugar diet and to see Dr Tan again in a week's time to repeat the urine test and to check on my blood pressure. A 'vaginal swab' sample was also taken to be tested and I can expect the results in a week.

Pre-eclampsia is a serious condition and in severe cases, it could even cause life-threatening problems to both myself and our babies. In a recent development, pre-eclampsia is believed to be caused specifically by a problem with the placenta. The mother's body then responds by trying to deliver more oxygen to her baby by increasing her blood flow to her baby at the expense of her own health, thus resulting in the mother having high blood pressure (blood vessels constrict) which then affects her organs such as liver, kidneys and brain.

Should I be diagnosed with pre-eclampsia, Dr Tan insists that I have to arrange for delivery as soon as possible and not to wait until the condition worsens, but after getting another two doses of Dexamethasone to help mature the babies' lungs. I don't know what to say.

That was really too much for me to digest in a day! Pre-eclampsia?! Gosh!

Now I really have to pack my hospital bag...

30 Weeks Pregnant with Twins - Glucose Tolerance Test, Tetanus Vaccine & Dexamethasone Injections

I just love this! I'm 30 weeks 2 days today! ;D

This is such a big milestone for me. I woke up this morning with a big smile on my face! Couldn't help it! Hehe! I know I still have at least another 7 weeks to go...but I am only thinking about positive thoughts right now.

With each and every kicks/nudges I felt, I know my babies are doing just fine. Many times I could see continuous shifting movements (like a snake sliding underneath?!) from the outside of my tummy! It's like my little bubs are doing some kind of stretching or changing of positions in what little space they have left inside. They must be all squished-up by now! Haha! My tummy feels sore and tight most of the time and getting a comfortable position to sleep on is almost impossible. I didn't use any maternity pillows by the way. Just the normal pillow and bolster that I've been using since pre-pregnancy. My bump is getting heavier too...to the point that I have to sometimes support it with my hands when I am walking. My waistline measurement has gone up to 42+ inches now! Everyone I meet nowadays thought that I would be giving birth anytime now. I must have looked more like 9 months now instead of just 7.5 months. ;)

I have put on about 15.5kg thus far. My friends say that only my tummy looks huge but my arms and legs are not that swollen. My bra cup size remains the same but it's so much fuller. I hope I will have enough milk to breastfeed both my little darlings soon. ;)

The stretch marks on my tummy are very visible now. My belly button will 'pop out' when I am in standing or sitting positions, showing off all my scars from my three previous laparoscopic surgeries. However, it will 'tuck in' when I am lying on my back. To make things worse, there are also a lot of green-coloured veins all over my tummy, neck and chest areas. I also see dark pigmentation on the folds of my neck and armpits! Yikes! My face is getting round too and I have a double chin! I really hope all these will disappear once babies are here.

I'm also exhausted all the time! I couldn't walk for even 5 minutes without looking for a place to sit! I salute all those ladies carrying twins who still work until they deliver. I just feel very blessed to have the luxury to rest at home all these while. I have my hubby to thank for all the love and comfort he has showered me...without him, my pregnancy journey will not be as blissful.

As for food cravings, it has to be curry noodles, curry chicken, roti canai with curry, durians and many more! Basically, I want everything hot & spicy. Haha! So far, I've only ate durians once. I find that it's very heaty. So I'd better eat more fruits instead.

Oh, I've started to drink protein drinks again. Our babies' weights/sizes were not on target again during the last scan on 2/9/2014. Baby A was 2 weeks and Baby B was 1 week smaller than their gestational age. Dr Jason was probably a little concern that Baby A is not growing at the rate he should be and he did a doppler scan on Baby A to measure the blood flow in Baby A's body such as the umbilical cord, brain, kidneys and heart. I was so relieved when Dr Jason confirmed that Baby A's doppler scan analysis was normal. A doppler scan was not performed on Baby B because Dr Jason said Baby B's weight and size is just fine for a twin baby. So, I hope the protein drinks will help to add on our babies' weights.


Glucose Tolerance Test

This test is recommended by doctors between 24 and 28 weeks of pregnancy to check for gestational diabetes. I did the glucose tolerance test when I was 25 weeks pregnant on 4/8/2014.

On the night before the test, I started fasting (no food except plain water) before midnight to ensure that I had fasted for at least 8 hours before the first blood test on 4/8/2014 morning. We arrived early at Sunway Medical Centre and had my blood drawn at about 8.30am. This first blood sample is taken to measure my fasting blood glucose level.

I was then given a very concentrated glucose solution which was very sweet indeed. It tasted like sugar (lots of it!) diluted in a cup of warm water and I was instructed to finish the drink within 10 minutes. Somehow I managed to swallowed everything in just 3 minutes!

Thereafter, I was told to continue fasting (plain water allowed) and return to the laboratory for a second blood draw in two hours' time. I was starving by the time the second blood sample was taken.

However, it's all worth it as my glucose tolerance test results came back normal. :)


Tetanus Vaccine

Dr Jason had also recommended that I be given two doses of the tetanus vaccine. So I had the first tetanus injection on 4/8/2014 and the second on 2/9/2014. It was administered on my shoulder both times and it had that stinging effect that lasted for quite a few minutes. But well, I feel like I am so used to injections already that whatever pain which comes with any injections seem to be bearable. Hmm...IVF is all about needles! Don't you agree?


Dexamethasone Injections

Now, more injections for me. During my last appointment with Dr Jason on 2/9/2014, I was also told to get the dexamethasone injections (a type of antenatal steroid). This prescription was made as twins pregnancy puts me at a higher risk of preterm labour. This steroid injections were meant to speed up the development of the babies' lungs to make them more likely to be able to breathe on their own after birth. Premature babies are at risk of breathing problems if their lungs are not matured.

In view that the dexamethasone injections will be administered in two doses twelve hours apart, I've decided to get it done at the hospital near my house. I had the first dose at 9.30am on 3/9/2014 [3 vials/ampoules of 4mg/1ml each mixed in 1 dose] and the second dose at 9.40pm the same day [also 3 vials/ampoules of 4mg/1ml each mixed in 1 dose].

Again, these are quite painful injections but somehow, I just got 'too used' with the numbness of the injection area (my butt!)...like always. I will do anything so long as our babies are safe and healthy.


I will update more soon. ;)

"The secret of endurance is to remember that your pain is Temporary but your reward will be Eternal."

First Trimester Screening & Fetal Anomaly Scan

Time is flying past...very fast! I can't believe I'm into my 28th week now.

Things are just starting to get REAL for me. I can feel my babies moving a lot...everyday! It's awesome! :)

I've had quite a lot of scans done till todate. It could be due to the fact that we did IVF (with ICSI) and thus, a lot of scans were scheduled during my early pregnancy. I must admit that I do look forward to every single appointment as I know we will be seeing our little ones every time.

These were all my abdomen scan dates ever since the embryo transfer:-

11/3/2014 - beta hCG blood test, no blood detected in the womb (extremely glad!).

24/3/2014 - at 6w0d, saw 2 sacs, our twins' heartbeats detected: 113 & 124.

7/4/2014 - at 8w0d, our twins measured at 8w0d & 8w2d with heartbeats of 180 & 171.

21/4/2014 - at 10w0d, our twins measured at 10w4d & 10w3d with heartbeats of 183 & 171. [We can actually see the babies' hands and feet moving about! It's amazing! The sonographer can also see the babies' nasal bones too! There's no blood in the uterus. I had the last dose of Proluton Depot 250mg at the clinic.]

14/5/2014 - at 13w2d, we had the First Trimester Screening ["FTS"].

9/6/2014 - at 17w0d, our twins measured at 17w1d & 17w6d, weighed at 173g & 203g with heartbeats of 148 & 146.
[Genders confirmed. This was our last visit at Dr Wong Pak Seng's fertility clinic.]

7/7/2014 - at 21w0d, we had the Fetal Anomaly Scan [or simply the "detailed scan"].

4/8/2014 - at 25w0d, our twins are about 7 days and 3 days respectively behind their optimum size. Both their heartbeats were in the region of 150s.

First Trimester Screening ["FTS"]

Well, the FTS was the only test advised to us by Dr Wong. Some patients of Dr Wong are advised to either do an FTS or a Non-Invasive Chromosomes Check ["NICC"]. Both tests are non-invasive. However, FTS is very much cheaper than NICC. With NICC which is performed any time after 12 weeks of pregnancy, the accuracy of detecting Down syndrome is up to 99% compared to FTS' detection rate of 95%.

As we are only advised to run the FTS, we did just that.

FTS is performed between 11 weeks and 13 weeks 6 days of pregnancy. This screening involves a nuchal scan and a blood test. A nuchal scan is done by measuring the nuchal translucency (the fluid-filled space beneath the skin behind the baby's neck) ["NT"] and detecting the presence of the baby's nasal bone ["NB"]. Meanwhile, the blood test is to determine the levels of 2 hormones i.e. the Pregnancy Associated Plasma Protein-A ["PAPP-A"] & the free beta hCG.

I was very anxious while lying down to be scanned by the sonographer. Baby A [the baby nearest to my cervix who will be the elder of the 2 babies] is very co-operative and we got his NT measured at 1.33mm very quickly. However, Baby B [the baby furthest from my cervix who will be the younger of the 2 babies] was happily moving, flipping and dancing about, which gave the sonographer a really hard time! Haha! Finally, after much effort at every possible angle, the sonographer managed to measure Baby B's NT of 1.08mm. Nasal bones can be seen on both babies too. Subsequently, my blood was drawn.

The FTS results will be ready within 5 days (we were told that my blood sample will be sent to Taiwan for testing). So, the method of screening for FTS is by taking into account of my age, NT, NB, PAPP-A & free beta hCG. An NT measurement of less than 3mm is considered normal. The absence of NB may indicate a higher risk of baby having Down syndrome as recent studies shown that 3 out of 4 babies without their nasal bones had Down syndrome. The level of PAPP-A is relatively low and the level of free beta hCG is relatively high in cases of Down syndrome.

We were so relieved that my FTS results came back with a low risk of our babies having Down, Edward or Patau syndromes. I just couldn't bring myself to run the invasive tests such as the amniocentesis or the Chorionic Villus Sampling ["CVS"] if my FTS results came back with high risks. I don't even know what I'll want to do then...

In addition to just the NT scan and NB check, the sonographer also managed to see the gender of our babies despite all the acrobats performed by our little bubs! We were told that our babies will most likely be BOYS. We were thrilled and excited! This was later confirmed at our 17th week scan. Yaaay!


Fetal Anomaly Scan ["detailed scan"]

A detailed scan is to be performed between 18 weeks and 22 weeks of pregnancy. The purpose of this scan is to take a closer look at the development of the babies in mid pregnancy by examining the babies' organs and taking their measurements to allow early detection of any abnormalities (if any) which may or may not be treatable.

As Dr Wong no longer sees me after my first trimester, we have decided that we should be in the good hands of Dr Jason Lim Meng Hock for subsequent antenatal check-ups until delivery of our babies.

Dr Jason Lim performed the detailed scan on me at 21 weeks. He is definitely still a very professional doctor that I've met a couple of years back. He is serious-looking, firm, no-nonsence, well-mannered and definitely knows what he is doing all the time. Sounds scary? Haha!

Anyway, he was surprised when he saw two babies (well, Sunway Medical Centre couldn't locate my file; so Dr Jason Lim had merely took down notes of our history and we had 'forgotten' to inform him that we are having twins!). He said that he will then had to do two detailed scans. He started of with the babies' heads (shapes & structures to see if there are any visible brain problems), facial features i.e. the eyes, nose, mouth (no cleft lips), the spine (alignment of bones etc), hands & feet (with fingers & toes), the heart (the four chambers should be equal in size with the inflow & outflow of blood through the blood vessels), stomach and kidneys. Dr Jason Lim also did a quick check on the placentas and confirmed that Baby A's placenta was not low-lying in my uterus. What a relief!

I'd actually had a hard time lying motionless for a long period of time. Maybe I should not empty my bladder completely for future scans. Baby B, like always, was very active compared to Baby A. Baby A was in a head-down position with his legs up on my right ribs and facing my front while Baby B was breech with his head on my left ribs, facing my back. Thus, Dr Jason Lim had a hard time trying to have a good look at Baby B's heart and while he was at it, pressing his magic wand over and over on my tummy at every angle he could find (he never gave up trying!), I'd suddenly felt dizzy and started to have cold sweats! I'd quickly exclaimed that I was about to faint! However, Dr Jason Lim just calmly asked me to turn slightly to my left and he'd simply continued the scan as though that was a very common scenario. Haha! Hubby got very concerned though but I was fine after a while and the scan was continued.

In conclusion, Dr Jason Lim said that he couldn't find any visible abnormalities in both babies and that we should treat it as good evidence that the pregnancy is normal. We couldn't have been happier! :)


I couldn't wait to see Dr Jason Lim again in our next visit on 2/9/2014. Twelve more days to go!

Confinement Lady or Confinement Centre?

Seriously, do we really need a confinement lady?

I always wonder...why do Malaysian Chinese especially like to hire confinement ladies? The western countries, for example, never had them...and they survived. Who are these ladies? To put it simply, they are women (usually quite elderly) known to be experienced with taking special care of newborn babies and their mothers immediately after births. Some may call them confinement nannies or "pui yuet" in Cantonese which means "companion for the month". They will normally adhere to the Chinese traditional confinement practices which some may find rather 'ridiculous' or 'unbearable'.

Anyway, it never really occurred to me that I should get help during my confinement days as I've thought my mom will be there for me. However, when a friend casually asked if I'd secured a confinement lady, I was dumbfounded. I was 18 weeks then and was advised that since I'm a first-time mom and the fact that I'm having twins, the more I should consider hiring a confinement lady. I did panic for a while though...

I later discussed with my mom and she said it may be a good idea after all as she has no experience taking care of two newborn babies at one time.

So without any further delay, I started calling a few contact numbers given by friends, colleagues and a few recommended by the forums/bloggers. To my dismay, all of them are already booked during my birthing date. A few of them offered to attend to me for 2 weeks or so (they are trying to squeeze me in to fit their tight schedules) but after much thought, I'm not too keen. A few ladies simply told me that they do not even attend to twin babies. What surprised me most is the 'market price' for confinement ladies for attending to twins. It's between RM6500 and RM8000 for 28 days! That excludes the additional compulsory 'angpow' of between RM300 and RM500! My goodness! I'll be spending a fortune here...

While I'm in the middle of this craze, one of my sisters-in-law (she's pregnant too and she's just 2 weeks behind me on the due dates) suggested that we pay a visit to Gina's Place. It's a newly set-up confinement centre in Taman Yarl, OUG, since April 2014. My first response was negative! A cousin sister of mine has stayed at a confinement centre about 2 years ago with her baby girl and her experience was really bad with utter dissatisfaction. So needless to say, I have a pretty bad impression with confinement centres.

Although extremely skeptical, we went to Gina's Place to check out the centre. I went solely with the thought of accompanying my sister-in-law. Little did I know that I'll fall in love with the place! Haha!

Gina's Place has a quiet and serene setting that I believe I would enjoy during my confinement period. They are operating at a bungalow with 8 rooms to accommodate a maximum of 8 mommies at one particular time. Of course they also have a room or two for the nurses and maids on duty during the night shifts. The nurses are registered nurses and they work on 8-hourly shifts throughout the days. What I love most is the fact that they are 100% breast-feeding friendly. Gina is a lactation consultant herself and the nurses are trained to only assist the mommies in breast-feeding or feeding babies with expressed breast milk using not bottles, but syringes and spoons. The centre looks very clean indeed and they allow the husbands (only husbands!) to stay with the mommies throughout the 28 confinement days.

Now, to be looked after during confinement at a specialised confinement centre doesn't come cheap. I've discussed with hubby, taking into consideration of all aspects we could think of, and I'm surprised that hubby actually encouraged me to stay at Gina's Place. Hubby is quite concerned that I don't get stressed up after the births of our little babies as we would foresee some 'discomfort' or 'unwanted scenes' with having the confinement lady, my mom and his mom (together!) at our house during my most vulnerable days.

So, we have finally decided that I shall spend my confinement days at Gina's Place. My mom wouldn't have to worry whether she could cope with taking care of our two little babies after all...at least not for the first one month after their births.  I hope we've made the right decision and that I'll be able to share my beautiful experiences at the centre very soon.

19 Weeks Pregnant with Twins!

It's been a long long time since I have last posted any updates. I just feel like, well, maybe I should wait a little longer to ensure that our babies are more stable. To be honest, most of the time I still feel like I'm dreaming! Haha! And yes, we are having twins! :)

I am into my 20 weeks of pregnancy and things have been really slow at the moment. Maybe I should start from where I stopped.

Well, I spotted/bled from 20/3/2014 to 9/4/2014 (21 days) and thereafter, I had another scare on 18/5/2014 (Sunday) at 13w6d! I'd just started bleeding red suddenly like a light menstrual flow at about 11pm at night and I'd imagined the worst! I wore a pad as I didn't know if the bleed will get heavier through the night. Sleep was almost impossible and I kept my fingers crossed for a miracle until the next morning. I called Sunfert early Monday morning and was asked to go to the clinic that day itself for a scan. It was such a relief to see both my babies still 'dancing' in my womb. Phew! Dr Wong said that it is very likely that the blood is due to the low-lying placenta of baby A [the baby that lies nearest to the cervix/exit] and unfortunately, bleeding and spotting is very common in multiple pregnancies. So, I have to be prepared for situations like this and to stay calm always. However, I have to notify Sunfert whenever I experience bleeding or spotting of any sort. This second bleeding episode quickly tapered to spotting which lasted until 30/5/2014 (13 days). In fact, I'd only used panty liners from 19/5/2014 onwards. So much on bleeding/spotting but thank goodness ('touch wood'!) I have not had any since then. I have no cervical mucus either.

I have gained about 8kg thus far even though I don't really eat that much. I just don't have the appetite to eat and I don't look forward to eating at all. I still feel queasy after meals, especially after dinner. It might sound silly, but standing under the running warm shower, blow-drying my hair and brushing my teeth also make me feel sick. However, I am feeling so much better these days. I have never vomited although there were those awful days when I had to fight the urge to throw up, standing helplessly with teary eyes next to the toilet bowl and swallowing hard to calm my stomach. I'm glad I'd managed to keep everything down.

I drink about 3 litres (or more) of plain water every day so that probably helps to avoid constipation too. One thing I noticed, I don't have to urinate as often as I'd used to once I'm sleeping. Sometimes I could even sleep through the whole night without going to the toilet. How nice!

My tummy area started to itch at about 17 weeks and I know the stretch marks are coming! I have to confess that I am not disciplined enough to apply lotion/oil everyday. Sometimes I will apply twice a day and sometimes I could skip a day! Haha! I'm just using Bio Oil and the normal moisturising lotion. I try to cover as much area as possible including my breasts, my butt and my upper thighs. Hopefully those marks won't be too visible.

I also find that I couldn't hold my bladder when I cough and sneeze! How embarrassing! Maybe I should really try the kegel exercises to strengthen my pelvic muscles and bladder? :)

And oh, the vertical line, which they call the linea nigra, has also appeared between my navel and pubic area. I find it quite cool actually. Hehe! At first, I'd thought those were marks left by my maternity pants. So I'd kept adjusting my pants to make it looser until it's too loose that it kept falling down! Silly me! It is very light brown in colour and the area along the line seems a bit hairy. Weird, huh? My belly button is starting to protrude too and I just love it! I find all of these changes very amazing indeed.

I'm always out of breath by the time I reached the top of that flight of stairs in my house. I couldn't even go grocery shopping without panting for air so very often. Bear in mind too that I don't even carry anything! Stamina seemed to have escaped me totally. Sigh... I've tried a couple of times asking for Dr Wong's advice to have some exercise during my second trimester. To my dismay, Dr Wong is against any form of exercise (pre-natal yoga and swimming included!) in any multiple pregnancies. Again, his advice is to rest, rest and REST. Hmm...

Every night, I'll be having weird dreams. I've dreamt of my family, my relatives, my primary/secondary school/collage/university mates, my colleagues, my friends whom I haven't met in ages, my hubby and even superstars! All in the weirdest scenarios. I haven't dreamt of any babies yet though.

One thing I've dreaded to feel so much...movements. I couldn't make it up whether it is just wind or gas or could it really be movements of my little pumpkins! Oh well, I will wait for it. ;)

My next appointment (in 2 weeks time!) will be with Dr Jason Lim of Sunway Medical Centre too. The reason for the change being that Dr Wong no longer attends to delivery of babies since mid of year 2013. So I had my last appointment with Dr Wong at 17 weeks and thereafter, Dr Jason Lim will take over my matter. Hubby and I have decided to see Dr Jason as we think he has done a great job with my 2 laparoscopic surgeries earlier in year 2008 and 2011 for termination of my ectopic pregnancies. We'll see...

I love my growing tummy and I've been talking and singing songs to my little darlings like a crazy woman! Haha!

I will update more very soon...till then, I wish that all those who are trying to conceive to have faith and not give up hope yet and for those who are expecting, to stay happy and healthy throughout the pregnancy.

Pregnancy Symptoms

It is always great to have at least some of the pregnancy symptoms as I'm sure it gives such good assurance to every pregnant lady that their little ones are doing fine. The same goes to me.

When achieving a pregnancy alone is so very difficult, it leaves me with not much room to complain about any pregnancy symptoms that I have. I almost feel guilty to even mention it! Ha!

Well, the first thing I'd experienced is the lower backache. I had it even before I did my beta test! I didn't give much thought about it until I'm tested positive. I still have it now. My lower back aches when I brush my teeth, when I sit/stand for too long, when I change from sitting to standing position or vice versa, when I bend myself to pick up the lightest thing, or when I am simply walking. So, I know I have to be very careful not to stress my lower back. No heavy laundry baskets or groceries etc...probably nothing heavier than 5kg?

Then I have morning sickness which kicks in at just shy of 6 weeks. I feel constantly queasy and nauseous the whole day, everyday. From the moment I woke up, it lingers on until I finally go to bed. Sometimes I feel it even when I wake up in the middle of the night to use the toilet and it makes it so much harder to get back to sleep after that. I have not vomited though. I lose my appetite and I couldn't stomach most of my favourite foods anymore.  I could only eat some very selected foods which includes soup noodles, dry noodles, porridge, chicken and fruits (luckily!). Ginger doesn't look (and taste!) appealing anymore. Fish and brocollis (and now garlic!) taste so weird and almost...yucky! Lately, I find that the queasiness fades a little in the mornings. I simply try to eat and drink all that I could stomach in the mornings then. Anyway, however bad I am feeling, I must admit that I am happy that I still feel sick (I must be crazy!) and I know I'll go paranoid once all these queasiness disappear! Haha! I can handle this sickness...yes, I surely can! :)

There is this bloating too. My stomach looks fine in the mornings as I can only see my own tummy fats! Hehe! But towards the afternoons, it gets bloated so much that it really looks like a bump. Of course, I know it's only fluids and wind.

Constipation! It's not that bad actually. I'll get constipated maybe about once in a week? So, I'm good! ;)

My breasts do feel a bit tender to the touch and maybe a little sore/swollen at times but nothing unbearable.

I feel tired and exhausted all the time...but well, maybe not exactly tired. It's more like feeling bored and lazy because I'm at home most of the time! I couldn't imagine how 'strict bedrest' would make a person! I'll definitely go crazy!

Frequent urination is also one of the pregnancy symptoms. But I would think it's also due to the amount of water that I consume everyday. I will have to make one or two trips to the toilet every night. I wouldn't mind at all as long as I could get back to sleep...but sometimes the queasiness really got the better of me.

I also have this increased sense of smell. One of the few that I hate most is the smell of cigarettes! I will turn away every time I smell it from hubby's breath! Yikes! Then, I'd almost choked myself every time while cutting raw meat/chicken. Haha!

I wouldn't say I enjoy all these symptoms...but I want them to stay, at least until the end of the first trimester, so I could have peace of mind. These symptoms somehow give me great confidence that this pregnancy will be just fine.

Oh well, the joys of being pregnant! ;)


"You never understand life...until it grows inside you..."

Spotting/Bleeding

The sky looks quite moody right now. Me too...

I do not know how to describe my feelings at the moment. I want to get all excited and happy...but the fact is, I am so worried every day. Can I blame it on the hormones?

I started to have some spotting on and off since 20/3/2014. It could be a very very light tint of pink/brown or brown or red! Then I had a real scare on 27/3/2014 after work. I felt myself gushing blood and within just 4 hours, I had soaked the whole pantiliner with bright red blood! I got paranoid!

The next morning, I called Sunfert while on my way to work. By the time I got through, I was already at my office. The nurse who answered my call asked me to lie down and rest. I kept asking if I should see Dr Wong but she said I should rest at home and not work that day. She also reminded me to get the Proluton Depot shots on the specified days as instructed. I knew there's nothing much they could do but I just got so scared. Luckily the bleed had tapered to red spotting then.

Until today, I am still spotting on and off. On a good day, there will probably be just one drop of blood the whole day. Otherwise, I'll have a bit of a mess on my liners. However minimal the bleed is, my mind just couldn't settle itself.

The scans showed some blood in the uterus but Dr Wong said that I should be fine as there is very little blood and it will resolve.

I remember so clearly how I have bled for 4 weeks prior to my miscarriage last October. The fear of losing this pregnancy is just so strong. Even hubby refused to talk about this pregnancy if the discussion could be avoided. Superstitious you may say, but after all that we've been through, I'm not so sure myself. Am I forbidden to write anything now? Is it too early to talk?

Well, suffice to say now that everything is good so far, except for the spotting/bleeding, and our scans at 6 weeks and 8 weeks detected strong heartbeats. Measurements have been on track thus far.

Will I get to buy myself some maternity clothes this time? I hope all is well. Everything crossed for an uneventful pregnancy!

I'm not a religious person...but please say a little prayer for me...

Pregnancy Tests

I survived the two week wait!

I have been contemplating whether to use the home pregnancy kit since the night before yesterday. This is so not me as I have only bought 3 such kits in my whole life. Since this last kit is going to expire on 9/5/2014, I thought I might as well use it. It's one of the Watsons' home brand, a cheap one. Haha!

So, as early as 5.30am yesterday, I jumped out of bed feeling super anxious. I re-read the instructions again while holding my bladder! It reminds me of the day of embryo transfer. Hehe!

I did the test at 5.45am (I couldn't hold any longer!) and to my surprise, I saw 2 lines appeared almost immediately! My hands were a bit shaky and I held my breath. I read the instructions again (I know, I sounded dumb!) to ensure that I did the test correctly. Well, the test line was dark, almost as dark as the control line. I've only seen a faint line once before in my first pregnancy (which ended up as my 1st ectopic pregnancy) so this is quite unbelievable. I was excited!

Shortly after, I told hubby (who still looked like a zombie!) in my calmest tone possible and proudly showed him the test kit. He pretended that it's no big deal but I could see his eyes looking at the 2 lines. He said "Don't think too much, just let things be". I know he doesn't want me set my hopes high. He wouldn't know how to console me if it was a false positive.

I took deep breaths while hubby showered and tried to remain calm. Maybe the kit was faulty because it is nearing its expiry date? Maybe it's indeed a false positive? Or something is just wrong somewhere?

At Sunfert, we got registered at 7.45am and I'd quickly went to the laboratory to get my blood test done. The results will be ready within 2 hours or later. Since our appointment was at 11.30am, we decided to return home. I know hubby has an appointment at 2pm and he suggested if it's ok for me to see Dr Wong alone later. I agreed.

I returned to Sunfert by 11am. My tummy felt bloated and there's some tightness around my lower abdomen. I also felt butterflies in my stomach!

While I waited and waited, one of the nurses recognised me and greeted me with a smile. She asked me how I'd feel but I think I'd just got too emotional with such a simple question that I had tears pooled up in my eyes! Silly me! Part of me was so scared and shaky. The other part was probably just numbness. I don't know...

My name was called. I took another deep breath and walked in to greet Dr Wong. He looked happy, I think, and asked me to sit down. He then congratulated me with a big smile on his face! I must have stared at him...all blank! He gave me the blood test results sheet.

It said 1,071 mIU/ml!! I was totally speechless.

We have hoped and hoped for this for so long and before I'd realised it, I found myself asking Dr Wong if I could cry?! What a silly question?! Dr Wong gave me a hug instead. I cried.

Dr Wong said my hCG level is high so I may have more than one embryo implanted! But I told him that I don't have any symptoms other than the on and off spotting from 6/3/2014 to 9/3/2014. He smiled and said "No symptoms are normal". Dr Wong also said the spotting should be implantation bleeding. He did a tummy scan and concluded that there was no bleeding in my uterus. What a relief!

Dr Wong also said he could only tell whether it's a singleton or a multiple when he does another scan next Friday, 21/3/2014. No heartbeats yet by then, he warned...maybe by the end of March 2014?

I am to continue all my existing medications and pessaries and the IM Proluton Depot 250mg injections (every 3 days) for the next 2 weeks.

Can't wait to see Dr Wong again on 21/3/2014! Wish me luck! ;)

Spotting

To be honest, I am not in the best of moods now. :(

I am still spotting on and off since 6/3/2014 and I couldn't be sure if this is implantation bleeding. If I lie down, there is hardly anything. But when I walk about and being a little active, there'll be enough blood to stain on my liners, albeit very very little. I think it's more like pinkish brown. Please, please...let it be gone by tomorrow...

Other than the spotting, there is no pain or any cramps whatsoever. I feel bloated though. Maybe I drink too much water? Couldn't be, huh? Haha!

I try to stay positive. As long as my menses does not show up by 11/3/2014, I could still test positive!

Two more days and counting!

Hoping for a miracle...

Implantation Bleeding?!

Ok, so I freaked out this morning when I saw blood stains on my liners. Probably it's just a few drops max? But it was definitely there when I wiped.

The thing is, I couldn't really tell if it's pink or brown or red (ok, I'm partially colour-blind!). My best guess is that it's brown.

I do not know what to think. My previous experience with spotting/bleeding was never a good one and I believed it led to my miscarriage. So, for a moment this morning, I'd thought it was all over!

However, that was 8am. I don't see anymore blood stains now...well, maybe still a little on used toilet paper. I am hopeful now that the spotting could actually be implantation bleeding as it hasn't got any heavier. In fact, it tapered off fairly quickly.

Implantation bleeding happens when the embryo attaches itself into the uterine wall. Some of the tissues may be shed which leads to the bleeding. It is normally not as heavy as period and may be accompanied by light cramping. Some reports say that it could last between a few hours to a few days or even a month.

Well, I do have lower backaches and mild night sweats (in air-conditioned room!) occasionally but nothing alarming. However, I do not feel much cramps if I may recall and I certainly hope this is not the beginning of my menses!

My beta testing is not until 11/3/2014. Five more days to go!

Everything will be better tomorrow...fingers crossed!

Surviving the Two Week Wait

TWO WEEK WAIT...I have gone through these moments too many times. Sigh...but this is the first time I have decided to take a full 2 weeks medical leave from work.

I've never intended to have strict bed rest but maybe just this once, I'll try not to move about too much. There will still be exercises for me...well, going up and down the stairs! Haha! But that's about it.

I drink loads and loads of water every day (3 to 4 litres) and took my vitamins and medications timeously. Since I'm on leave, I do the pessaries insert vaginally and rest even more each time. I still have 2 vials of Proluton Depot 250mg left, one to be injected tomorrow (6/3/2014) and one on 9/3/2014. Never to forget those.

Water rationing has started and my house area is affected. Earlier, from 10/2/2014 to 27/2/2014, we didn't have water supply due to the ammonia pollution in Sungai Langat which resulted in the closure of two water treatment plants in Cheras Batu 11 and Bukit Tampoi. Our residence at Sungai Long survived only with water distributed by the Syabas water trucks every day (or every other day), although they were never on time.

Now, with this water rationing...we will enjoy water for 2 days and go without water for the next 2 days. This will continue until end of March should Mr Rain decides not to show up still. :(

I feel really bad for not being able to help to collect water. Those pails are just too heavy for me! I just do not want to risk anything. There was a time when my neighbours came to help my mother-in-law with the water while I hid inside the house! I felt totally ashamed of myself but I just couldn't tell my neighbours why I couldn't help. Sigh...

I was constipated for the first 2 days after the embryo transfer. It was so uncomfortable but I didn't push it. I took dried prunes (about 5 to 6 daily) thereafter and it does the trick!

The craze for ginger egg soup was so great that I had them 2 days in a row immediately after the transfer. However, I'd freaked out after that as I've then read that ginger could actually caused uterine contraction?! Hopefully no damage was done. I just love ginger!

I also eat at least 4 egg whites (100% cooked) every day for the protein intake. As for the rest of my meals, I try to eat in moderation of most things. My mom is so sweet, she will bring me dinner everyday so I could have at least one home-cooked meal a day. Sometimes I'll make myself simple scallop porridge for lunch. I try to stuff myself with avocados too but it's just so difficult to wait for them to ripen.

I still eat take-away hawker food in the mornings and sometimes lunch but I am avoiding oily and fried food as much as possible. Mostly soup noodles and nothing raw, no raw eggs especially.

I wear socks and use the heat pack on my feet every night. No warmer of any sort on my tummy though.

I do silly things like calculating my due date and talking to my little bubs inside me. Haha! But thoughts that I am actually pregnant (until proven otherwise!) makes me very happy. It creates positive energy, so why not? :D

No symptoms of any sort right now. I'm trying very hard not to over-analysis every minute feeling I'm experiencing. It'll drive me crazy. For all I know, it could just be all the pumped hormones that's still left inside my system.

Now, what else is there to do before I go insane?

Embryo Transfer

Well...I am officially in my two week wait now. So much to digest in so little time. I must admit, I am just too lazy and not in the mood to write earlier. I guess I'll backtrack to where I stopped. Ha!

24/2/2014: So we were happy with the 13 eggs collected and boy, excited I was! I was given another instructions sheet on Embryo Transfer which was scheduled on 27/2/2014 at 12noon. There were more prescriptions too:-

(i) Cardiprin 100 (contains Aspirin 100mg & Glycin 45mg) half tablet a day for 8 weeks! Yes, 8 weeks.

(ii) Cyclogest 400mg twice a day, one pessary at 11am & one at 11pm starting on 25/2/2014.

(iii) 2 vials of IM Proluton Depot 250mg, one vial to be injected on 25/2/2014 & one on 28/2/2014.

My tummy felt sore and bloated immediately after OPU and I remembered feeling the pain as I walked. This bloatness and tightness in my lower abdomen was really uncomfortable but thankfully it finally resolved the following night.

So on 25/2/2014, I took the first intramuscular (IM) injection of Proluton Depot 250mg at the hospital near my house at 7.40am before I left for work. There's really no particular timing for the shot but I'd prefer to do it in the morning...just in case.

Then, I started with the Cyclogest pessary at 11am in the office toilet...rectally, of course. A vaginal insert would require at least an hour of lying down after the insert so as to prevent it from dropping back out. I did the vaginal inserts at night instead. It wasn't that difficult for me because I've done this too many times before. To be frank, those pessaries are really gross and it's such a mess down there! Eeew...

I took half day leave to have a session of the mind body fertility theraphy with Mr Ong. Yeah, I've never mentioned about this earlier too. His centre is in Petaling Jaya. I had totally forgotten about the four sessions which come free with the Sunfert IVF package. I was so grateful that Mr Ong was able to allocate time for me at the very last minute.

The intended 2 hour session was extended to 4 hours! I was skeptical at first but I had a wonderful experience with the hypnotherapy session. It taught me how powerful a human's mind could be...and how to trust that my body is healthy to carry a baby to term.

That night, I listened to a few tracks given by Mr Ong and it were so soothing and relaxing I couldn't remember when I'd actually fell asleep! I tried the instructions for self-hypnosis too but don't think I'd managed because I was so very sleepy! Haha!

Anyway, I had another 4 hour long session the following morning (26/2/2014). It is very important to be stress-free especially during and after the embryo transfer. Mr Ong asked me to request for the mp3 that he has prepared for the use of patients during the embryo transfer from the Sunfert nurses before my transfer. It'll help me to relax. I'd certainly hope so.

The day finally came. It was 27/2/2014, the day for my embryo transfer! Yay!

I'd showered with water only (no perfumes, no cosmetics) in the morning and was ready to go.

Hubby was outstation. So my mom accompanied me to Sunfert. We reached at 10.15am and since we were early, we both had breakfast together. I emptied my bladder at 11am and started drinking the 250ml water as instructed. I'd also inserted the Cyclogest pessary at 11am, rectally again and tried not be anxious but it's really tough.

At 11.20am, I was called into the consultation room. I felt like a young student, eager to get my examination results! Haha! The nurse calmly informed that 13 eggs were earlier retrieved but only 12 were matured. ISCI performed on those 12 eggs but only 6 fertilised. I was hopeful...

She continued, however, although the fertilisation rate was not fantastic, 4 out of the 6 embryos were of good grade while 2 others were of average quality with 5% and 10% fragmentations respectively. My heart was racing with joy as we have never had any good grade embryos in all our previous IVF attempts.

The plan was to transfer 3 good embryos and freeze the rest. Sounded good to me. Fingers crossed!

I was in the theatre again by 12.15pm. I saw a monitor screen on the wall which showed 3 handsome-looking embryos and the nurse told me they were mine. It's so amazingly beautiful. I've never seen any of my previous embryos before. They were all between 9 to 10 cells embryos. And I found myself smiled and smiled...and smiled! ;)

There were 8 scheduled procedures by Dr Wong that day so they couldn't afford much delay. The nurses were busy scanning my tummy and gosh, it was so uncomfortable I felt I could burst anytime! The pressure on my semi-full bladder continued and I heard someone mentioned that this was going to be a little difficult. Well, I have a retroverted uterus.

I tried my best to stay calm and asked for Mr Ong's mp3 again. The nurses told me that they're getting it ready for me. But Dr Wong was already in the theatre then. He told me that he will transfer 3 day-3 embryos. He said he had decided that maybe day-3 embryos would be better of than blastocysts after all and again, asked me not to be worried.

A nurse then whispered into my ears informing that they couldn't get the batteries for the mp3. I was rather disappointed but politely asked if I could actually use my mobile phone instead? The nurse quickly got me my mobile and I'd immediately played one of the music tracks shared by Mr Ong earlier in his sessions.

I'd just closed my eyes and let my mind wandered with the music, not forgetting to breathe slowly. I'd visualised how comfortable the embryos were when they were inside my womb and before I knew it, the procedure was over! I think I did great! For the first time ever, I felt my lower abdomen was totally relaxed during the whole procedure. I was pushed out of the theatre at 12.40pm on a slightly slanted (30 degrees maybe) bed to the recovery bay where I was required to rest in that position for 1 hour. So I continued listening to the music with my legs slightly raised.

More than an hour later, I got dressed up in my own clothes and made a bee line to the toilet. Luckily it was only 250ml of water! Otherwise, I couldn't imagine how I could handle more than 1 hour without bursting! Haha!

I was given yet another instructions sheet titled "Pregnancy Test". There was a part that states the following:-

(i) refrain from strenuous activities such as exercise, intercourse or other physical activities that may cause undue strain to the abdomen.

(ii) take a healthy and balanced diet with lots of fruits, vegetables and fluids. Avoid traditional herbs, alcohol and smoking.

(iii) try to have adequate rest and sleep over the next two weeks though there is no need for complete bed rest. You may wish to resume work after one week unless your work is extremely stressful or involves traveling.

The nurse also told me not to take bananas, papayas, watermelon and pineapple as these fruits may encourage uterine contractions which may affect implantation.

Again, more prescriptions:-

(a) Duphaston 10mg, one tablet twice a day until beta testing.

(b) Dexamethasone 0.5mg, dosage to be increased to one tablet twice a day until beta testing.

(c) Cyclogest 400mg, to be continued twice a day until beta testing.

(d) 3 vials of IM Proluton Depot 250mg, one each to be injected on 3/3/2014, 6/3/2014 and 9/3/2014 at any time of that scheduled day.

My mom and I went for late lunch near my house while on our way back home. I couldn't be bothered much as we were both very hungry. We had economy rice. I took only the green vegetables and tofu. It's a satisfying meal! :)

I lied down once we got home. I'd only showered later that night. I felt some cramps too that late evening and at night on my lower abdomen, somewhere near my ovaries I would say. But it's bearable.

So, here comes the dreaded two week wait...

Days Leading to Egg Retrieval or Oocyte Pick Up ["OPU"]

So much has happened in the past few days.

I had the following injections since 14/2/2014:

14/2/2014 to 22/2/2014: Menopur 150iu & Bravelle 150iu mixture in 1.5ml of sterile water for 9 days.

18/2/2014 to 22/2/2014: Cetrotide 0.25mg with 1ml of pre-filled sterile water for 5 days.

22/2/2014: Pregnyl 10,000iu which is the hCG trigger shot.

The morning injections of Menopur, Bravelle and Cetrotide were uneventful. I was rather relaxed and for the first time compared to my previous IVF attempts, I've not experienced any bruises! There were times when I may hit a capillary or two but they were just fine thereafter.

Our second appointment with Dr Wong was on 18/2/2014 at 11am. We reached Sunfert at 10.20am, got registered and went to the laboratory to get hubby's blood drawn for the required tests: blood group, Hepatitis B, HIV-1 & HIV-2 and VDRL. It was a long queue at the laboratory and hubby got really anxious. As his turn approached, he became so uneasy that I couldn't help but laughed away! Well, he had this little fear with needles. Haha! So a quick prick was all it needed and it was over before he'd even realised it! :D

I had lunch at one of the cafes in Sunway Medical Centre as hubby again had a lunch appointment. Hubby left after I'd finished lunch. I had my scan at 1pm. We saw 4 follicles on my right ovary with the biggest being 10mm while my left ovary saw 5 follicles with the biggest being 13mm. Dr Wong seemed pleased though and he prescribed an additional drug starting on 18/2/2014 i.e. Cetrotide 0.25mg.

After getting the fresh 5 days' supply of Menopur & Bravelle and the new Cetrotide, I made a beeline back to my office for work.

My next appointment was on 22/2/2014 at 1pm. It was a Saturday and Sunfert opens half day on Saturdays. So I must be one of the last patients of the day. Hubby was not able to accompany me that day. I took my time and reached Sunfert at 12.50pm! There were still many couples waiting for their turns so I went for lunch alone at the cafeteria.

Very soon, most of Dr Wong's patients left and it was already 3.40pm when I finally had my scan. So, 5 follicles with the biggest being 20.5mm on my right ovary while the left ovary had 6 follicles with the biggest being 20mm. Dr Wong was happy with what he saw and I'd texted hubby straight away!

I was then briefed by one of the nurses as to what to do next. The following were the extracts of the contents of a chart given to me with specific instructions prior to egg retrieval or oocyte pick up ["OPU"]:-

1) 22/2/2014

- to administer subcutaneous Pregnyl 10,000iu at 7.30pm sharp.

2) 23/2/2014

- to take Curam 625mg (antibiotics tablet) one tablet twice daily (after meals) for 2 days i.e. 23/2/2014 & 24/2/2014.

- to take 2 tablets of Dulcolax (laxatives) at 11pm.

- no food or drinks after midnight (not even plain water!).

3) 24/2/2014

- OPU at 8am.

- to shower with only water in the morning without the use of soap, perfume or make-up.

- to arrive at Sunfert at 7.30am.

- husband will be required to provide semen sample at the same time unless otherwise instructed.

- OPU will be done under sedation and it will only take about 15 - 20 minutes.

- after OPU, I should be able to leave Sunfert after 2 hours and I will need to have an escort to accompany me home.

- to complete the antibiotics.

In addition to the above, I was further prescribed with Dexamethasone 0.5mg tablets, one tablet daily for 3 weeks from 22/2/2014. I was told to take Dexamethasone to prevent miscarriage as I had a history of previous miscarriage.

So off I went to the pharmacy for the supply of Dexamethasone and left Sunfert at 5.10pm. I was totally exhausted! My tummy felt heavy and uncomfortable.

Once I got home, I had my dinner and got busied collecting water. My house was without water supply since 10/2/2014! We are surviving from whatever that was left in the water tanks and the supply from the Syabas water trucks. While I was at that, it suddenly struck me...the hCG trigger shot!

I looked at the clock and I couldn't believe myself! It was 9.25pm! I ran to get ready the mixture of 2 vials of Pregnyl 5000iu with one vial of sterile water. My hands were shaking and I just couldn't think properly. I managed to inject myself with Pregnyl 10,000iu at 9.30pm sharp. That was exactly 2 hours late! Gosh! How could I have missed it?! I must have messed things up terribly at the very last minute...I knew I had!

I frantically called the nurse careline but it all went to voice mail so I left a message for them to return my calls. I called hubby and he tried to calm me down. I felt ridiculously stupid... and as I'd expected, I couldn't really sleep.

As early as 9.40am yesterday, 23/2/2014 (a Sunday!), I'd called the nurse careline again and thankfully a nurse answered at my second attempt. She said she will call me back as soon as possible and said not to worry. I kept checking my mobile and the nurse finally called me at 12.30pm. She assured me that Dr Wong said I shall continue with the rest of the instructions with OPU on 24/2/2014 at 8am as planned. What a relief! Phew!

I woke up this morning (24/2/2014) at 5am. I had stomach discomfort since last night after taking the laxatives (Dulcolax) at 11pm but I just couldn't empty my bowel. I showered as instructed and we both reached Sunfert at 6.50am. The clinic was still closed so we waited at the hospital lobby. I was hungry and thirsty as I'd fasted since 11pm last night but that was no big deal. To my surprise, I had a sharp stomach pain at 7.15am and I was so glad that I'd managed to clear my bowel before the OPU. Hahaha!

Dr Wong arrived at 7.45am and saw us waiting at the clinic. He asked me again if I had administered the hCG trigger shot at 9.30pm on 22/2/2014 and I'd affirmed that. He went on to explain that OPU at 35 hours after the hCG trigger shot is acceptable and in fact, practiced by many IVF clinics. His words made me calm as I'd read that OPU should be performed between 34 to 37 hours after the hCG trigger shot.

Within minutes, hubby was asked to complete a consent form and I was asked to empty my bladder. Hubby then went away with a mischievous look to get his semen sample done while I waited. Before I could see hubby again, I was asked to change into a fetching hospital gown and waited at the recovery bay for OPU.

A clock on the wall ticked 8.20am and I was excited. By 8.40am, I was lying on the operating table in the theatre with the intravenous device duly attached on my left hand which I knew will be used to administer anesthesia and I had an oxygen mask on my face. There were 2 nurses in the theatre with me.

Dr Wong came and gave me a pat on my shoulder to inform that he will start the OPU procedure and assured me not to be worried. I managed to peek at the wall clock again...it was 8.50am. The next thing I remembered was I saw the nurse injecting anesthesia drug into the intravenous device and she asked me if it hurts. I said no and immediately felt dizzy. I felt that the operating table was lifted so my head was lowered and my legs were slightly raised. There goes my dignity...hahaha! Anyway, the room continued to spin and when I opened my eyes again, something told me the procedure was over. Yes, I managed to see Dr Wong leaving the theatre and it was just 9am!

Ironically, I couldn't recall how I got back to the recovery bay which is located just outside the theatre. I woke up at 10am and I still felt a bit dizzy so the nurse asked me to lie down for another 10 minutes. Then I got dressed up and waited outside for further instructions.

Hubby had left once I was in the theatre and he said he will be back shortly. I was given some biscuits and hot Milo drink. Later, at the consultation bay, I was informed that we had 13 eggs! That was an amazing number! I was so pleased. So were hubby. :)

Deep inside, I am hoping for at least 50% fertilisation...

Antagonist Protocol

The day has finally came. I have my menses on 11/2/2014 late at night and Dr Wong took my day 1 to be on 12/2/2014.

We reached Sunfert at 8.20am on 14/2/2014 and got a queue no. 17. Did a vaginal scan at 10.20am. Dr Wong saw an image that looked like a corpus luteum or a corpus luteal cyst. My heart sank while waiting for Dr Wong to decide whether to start the injections that day which was my day 3 of menses. "Let's do a blood test," Dr Wong scratched his head.

So off I went to the laboratory to have my Progesterone levels checked. It has to be really low. As the results could take about 2 hours to complete, I had to wait for the blood test results alone as hubby had to leave for a work appointment. The waiting time was really bad as we were subsequently told that Dr Wong had to perform an emergency caesarean delivery! Then there was another procedure to be attended to thereafter. Finally I get to speak to Dr Wong again at 2pm.

The test results were very good indeed. My Progesterone level was less than 0.2 ng/mL and I was given the green light to proceed with the antagonist protocol or a short protocol. The corpus luteum was expected to resolve on its own and I hope there will be no further complications.

I then waited again for consultation on how to administer the injections.

The prescription: 150iu Menopur & 150iu Bravelle for 5 days (commencing on 14/2/2014).

Menopur contains two naturally-occurring female hormones, follicle stimulating hormone (FSH) and luteinising hormone (LH), extracted and purified from the urine of post-menopausal women whereas Bravelle contains FSH.

After a demonstration by a nurse, I was asked to repeat her steps using the 'demo kit'. Immediately thereafter, I had to repeat a second time using the actual drugs and administer the first injection on myself under the nurse's supervision. I did it with some struggles though. Haha! These drugs are new to me as I was previously given Gonal F straight from pens which do not require the mixing of powders.

We are scheduled for oocyte retrieval or egg collection on 25/2/2014. It could be one day earlier or one day later i.e. on 24/2/2014 or 26/2/2014. In between, we have to go to Sunfert again on 18/2/2014 and 22/2/2014 for further scans on egg follicles and uterine lining. Embryo transfer date will depend on the development of the embryos after egg collection. It will either be a day 3 or day 5 transfer. However, I have informed Dr Wong that based on my previous experiences with long protocols, all my previous three fresh IVF transfers were day 2 embryos. Dr Wong has his reservations and would like to wait and see.

I was also informed by the nurse that the clinic's usual practice is ICSI and not just IVF alone. That sounds good to me.

As I was getting ready to make payment (the first instalment of the IVF/ICSI package of RM15,500-00), I was told that I have to do yet another blood tests! It was already 4.30pm and I was starving! Sigh...

There are four other tests that both myself and hubby needs to take before oocyte retrieval. We both need to test on our individual blood group and get clearance on Hepatitis B, HIV-1 & HIV-2 and VDRL. The venereal disease research laboratory (VDRL) test will determine whether or not one has syphilis, a sexually transmitted infection.

To the laboratory again I went. The nurses there recognised me immediately but unfortunately, they had to draw my bloods again as the earlier collection was insufficient. I managed to finally leave the hospital by 5pm. What a way to spend Valentine's Day...

Yesterday (15/2/2014), I'd panicked as I'd almost forgotten all about the injection! Nearly missed the morning jab! Haha! Managed to inject the mixture of Menopur and Bravelle at 8.15am. Phew!

Today, my third injection was done at 8am. Each time, I will experience a slight pain/cramp around the injection site immediately after the jab but it subsides after a while and nothing unbearable.

Fingers crossed for at least 5 good quality eggs...am I being too greedy?! ;)

Endometrial Scratching

The term alone actually scares me tremendously! I have never heard of this term until I met Dr Wong for the first consultation on 10/1/2014.

Endometrial scratching is exactly what it sounds like. It is a procedure where the doctor intentionally injures the inner lining of the uterus by taking a small sample from the lining. Yeah, just like having a pap smear. "It has to bleed a little though", Dr Wong explains. This procedure is to be carried out after ovulation but before the planned IVF program. It is reported that the damage caused by the scratch gets the uterus to regenerate and repair itself which increases the implantation rates by as much as 20%, thus raising the odds of pregnancy and life births.

However, it is advisable not to have unprotected intercourse in the four weeks before the planned endometrial scratch procedure, to avoid the risk of a possible pregnancy as the physical procedure is detrimental to any early pregnancy.

Today is day 14 of my menses. My appointment with Dr Wong is at 8am. We reached Sunfert at 7.45am and our queue number is already a 6! By the time I was on the surgical table, it was 10.10am. I told Dr Wong that I believed I'd ovulated on 27/1/2014 and from the vaginal scan, he agreed. By 10.20am, the endometrial scratch was performed! I felt a sudden cramp and an almost immediate tummy discomfort similar to period cramps but the pain is bearable. Hopefully, it is also worth it.

Dr Wong also informed that my AMH ("antimullerian hormone") testing (or simply the ovarian reserve testing) results is slightly below the normal range with a reading of 9.6 pmol/l. The normal range as per the report dated 11/1/2014 is between 14.3 - 48.6 pmol/l. However, Dr Wong explained that such results is expected for ladies of my age. If it is below 6 pmol/l, then I may require further medications. For that alone, I am happy.

When I reached home, there were blood stains on my liners but it was minimal. I rested in bed the whole afternoon and the pain was gone before I'd realised it!

My next appointment will be on day 2 or day 3 of my next menses which is likely during the second week of February 2014. I am anxious to start...fingers crossed.