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...