1st IUI - BFN

A picture paints a thousand words.

This is the result of my 1st IUI, photo was taken this morning, 15 days after the IUI.

Well,  I sort of knew that the result will be BFN (Big Fat Negative) as I am experiencing a very bad PMS. Not only my stomach is growling, I am also swarmed with fatigue and feeling very bloated. I also have to constantly observe and remind myself to stay positive as negative feelings will just flood in whenever there is a slight grey feeling coming to mind. I guess I have to endure these for a few more days until my period comes. My period would not come until I finish the Duphaston supply, another 3 days to go.

Other than the weigh gain, the ovary pain and the PMS, IUI makes you a stronger person.
Looking forward to the next IUI cycle.

1st IUI - 11th Day Post IUI

Not yet, I have not done any pregnancy test yet. My doctor told me to perform the home pregnancy test next Monday, so I decided to be an obedient patient. Indeed, I guess it is my subconcious mind that want  me to be patient. At least I still have a few more days to remain hopeful if the end result is not desirable.

The pain, mainly on my right ovary that started 3 days after the IUI and reaches its peak 6 days after the pain started, finally subsided yesterday (10 days post IUI). Technically, I cannot categorize it as 'pain'. The feeling is more like a sense of constant tension and tightness, that causes discomfort when you move your body. It is very different from the pain that caused by PMS (Prementrual Syndrome).

Although the findings from the Internet shows that it is not unusual for women to experience ovary pain after IUI,  I still called up the clinic to check if this is really normal and most importantly how long will it take to subside. The nurse replied that it is normal to feel some pain due to the enlarged ovaries and the pain usually subsides after 2 days since the pain begins. So, I suspected my ovaries were really very swollen since the pain took more than 2 days to subside. Due to the discomfort, I have since stopped my regular exercise routine. I also noticed that I have gained quite a bit around the waisteline. Trousers that used to be loose can now be nicely fitted. This is definitely not a good news if I am not pregnant.

Well, after the ovary pain subsided, I started to have the familiar PMS feeling. On and off, there will be some abdominal cramp. My left calf also have the 'wanting to cramp' feeling, just I do not know when it will cramp for real. Of course, if you ask me, I definitely do not want to take these as the indications of the period is coming. But this is really something that beyond my control.

Maybe I should be more relax and not to be so neurotic in observing every changes in my body.

Well, if the period comes, welcome it!
If I hit the jackpot next Monday, celebrate it!
Either way, life goes on!

1st IUI - 6th Day Post IUI

2011.06.18 (Saturday)

Today is the 6th day after the IUI (procedure was done on Monday 13 June). I have been feeling some pain on my right ovary since Wednesday (2 days after my IUI). It started as a mild pinch that occur occasionally.  I didn't bother about it as I have been busy at work.

The doctor said there is no 'pantang' after IUI. I can eat, exercise and work as usual. The only thing that I have to avoid is caffeine. I am fine with this as I don't drink coffee due to pulpilation after drinking it. Well, I did take a short distance flight to Alor Star for a job assignment on Wednesday. I have also conducted an interview that took place in the forest of FRIM (Forest Reserve Institute of Malaysia) where the shooting team have to do a bit of hiking to reach the shooting point. Since I exercise quite regularly, I don't think that the discomfort was caused by the hike. However, the painful twinges has become more and more obvious since this morning. I felt it more whenever I laugh. I even began to suspect if it was a sign of ectopic pregnancy. But this is far too early to happen! Touch wood!

Having done some survey on the Internet, I felt more relieved because I am not the only one who experience ovary pain after the procedure of IUI. Some even experienced more severe symptoms like sore and sensitive breasts.  Phew! What I have been experiencing was considered mild.

So what is the cause of the pain I am feeling? It is the side effect of overstimulating your ovaries to produce eggs. The pain happens mostly after the ovulation.  If the ovulation is triggered by HCG injection, the pain might be more serious.

Well, how can I treat it like nothing happen after taking medication and injection to stimulate my ovaries? There is a lot of activities happening inside there. So, ovaries have the right to show their trantrum too!

Ist IUI - The Procedure

My husband and I reached the clinic at 8:30 am, after driving for an hour. The traffic was heavy as today is the day the school starts after the 3 week break. Heavy traffic was the main reason my husband chose to produce the semen in the clinic rather than at home. He wanted to make sure his 'supply' contributed for the IUI was as fresh as possible.

Semen produced will go through a 'washing' process. Sperm washing allows sperm a higher chance of survival and hence, a higher rate for fertilization. The washing separates sperm cells from semen, which helps to get rid of dead or slow-moving sperm and chemicals that may impair the fertilization.

Since the process of sperm washing will take about 2 hours, we decided to pass our time at the Starbuck in a nearby shopping mall. I was told to keep a full bladder for the procedure, so I did not visit the ladies since 10 am.

By 11:30, we were back at the clinic. My bladder was very full but the nurse said that the semen washing process was yet to be completed. I was given the 'permission' to release half of my bladder. My husband was skeptical that I could release just half. This was actually my 1st time to do so. Yes, we can control how much volume we want to release.

At 12pm, finally we were called into the procedure room for IUI. The nurse showed us a semen container labelled with my name,  to confirm that the sperm belong to my husband. After that we were left in the room to wait for the doctor. The room was very quiet. I could hear my empty stomach growling. I kept looking at my watch. The time seemed to crawl.  I did not know what to expect from the procedure. I read that it was an almost painless procedure; but there were also quite a number of people who complained about muscle cramping and severe discomfort. Besides, I was also worried that I could not make it to a meeting that had been scheduled at 2pm. In fact, I knew that my husband who showed his support by accompanying me today also had an important presentation at 2:30pm. I felt more and more anxious. Suddenly, my husband miraculously received a call from his colleague, who informed him that the presentation was postponed to a later date. I could tell that the phone call had lifted a tremendous amount of stress off his shoulder.

I am ready for the procedure!

At 12:15, Dr. Prashant confidently walked into the room. Holding the result of the semen analysis, he told us my husband had produce some good sperm, 50 million sperms with the motility of 3 (1 being the poorest and 4 being the best). We knew that the success rate of IUI depends on many factors, with some of them unexplained. But, at least this was a good indicator.

After that, Dr. Prashant began the procedure by inserting a speculum into me. I felt very minimal discomfort, but this was considered painless compared to menstrual pain. Next, a very thin and flexible catheter was inserted into the cervix. Washed sperm  is then injected through that catheter.

"Done!" The procedure just took like less than a minute when I heard the doctor said so.

"Really? I hardly felt it." I could not believe that eveything was over.

"Yup, did you think that I was going to put in a knife?" Dr. Prashant replied with a smile.

I told the doctor that I doubt that I was going to ovulate because I did not have a vivid positive result from the ovulation test. He said he was aware about my test results and asked me not to worry as he noticed that I have thick mucus which was normally a sign of ovulation.

I lay for another 10 minutes before we left the room. I made a bee line to the loo to empty the already filled up bladder.

I was given 15 days supply of Duphaston, which I will start taking from Wednesday onwards. The Doctor said I can do a pregnancy test after 2 weeks.

Finger crossed, we hope an angel will be sent to us. But if it is not meant to be, we will try again.

Total Expenses  RM 980

• IUI Procedure
• Duphaston 10 mg x 30 tablets

All in all,  we have spent RM 2320 for this cycle of IUI.

1st IUI - Catching the LH Surge!

The past weekend was somehow very stressful for me. As per instructed, I tested my urine every morning, hoping for a positive result from the ovulation test.

2011.06.11 (Sat)
I did the ovulation test first thing in the morning. As there was no instruction on the packaging ( I was given loose packets without the box), I dip the absorbent sampler into the urine container  for 10 secs, then let it lie on a flat surface. I kept staring at the result window. After about 1 minute, I saw 2 lines appeared, 1 clear and 1 faint.

Hmmm? So how do I interpret it? Positive or negative? Never mind, let's ask Google. The answer I got from the Internet showed that other than 2 clear blue lines, the rest of the variants are considered negative. I also found out that I should dip the absorbent sampler in the urine for 20 secs.

To be honest, I had never used an ovulation test kit before. My previous doctor asked me to monitor my basal body temperature to detect an ovulation, where I was requested to take my temperature every morning, preferably at the same timing before I stepped down from the bed. A sudden drop of the body temperature indicates ovulation. In fact, due to my irregular working hour in TV production line, it was hard for me to measure my temperature at the same hour every morning. Sometimes I woke up as early as 3am for a morning assignment; sometimes I slept as late as 4am after a round-the-clock assignment. But, believe it or not, I still deligently recorded my temperature for one and a half year, not knowing that I was a PCOS patient; and a PCOS patient who does not have regular period is unable to detect her ovulation point because she does not ovulate in most of her cycles! Whenever I recall that period of time where I innocently waited for a sudden drop of temperature on my basal body temperature chart, I have nothing to say except meeting a good doctor is very crucial in the process of treating infertility. Well, sorry for swaying away from the original topic, let's get back on track.

Feeling a bit insecure, I rang the clinic during lunch time to explain my test result to the nurse. The nurse told me the same answer as what I found from the Internet. I was told to continue to do the test tomorrow morning and inform them the result.

2011.06.12 (Sunday)
Excitedly, I did the ovulation test first thing after I woke up. This time the result was clearly negative because I can only see 1 control line. I was confused because at least yesterday there were 2 lines, although 1 was faint. Does that mean things are going backwards?

I texted the nurse to tell her the result of the test and she called me after 10 minutes. I was shocked when she said that she would try to arrange my IUI in the afternoon and asked me to stay at home and wait for her call.

"Why IUI is arranged when I have a negative result?" I eagerly needed an answer. She explained that since the day before there were 1 clear line and 1 faint line, that indicated that the level of LH was picking up. After that, the LH surge might have already happened (as early as12 hours after my previous test) without me knowing. The level of LH will drop after the surge. This explains why I only see 1 contol line (negative) this morning. So, I should be ovulating within the next 36 hours.

Well, now I totally understand the science behind the test, but the point is how do I catch the LH surge if I only do 1 test a day? Well, that is the reason why there are some people who choose to do 2 tests a day (1 in the morning, 1 in the evening) because they just don't want to miss the surge.  But this practice can only be applied to those who have regular period, where they can roughly estimate when their ovulations will take place. They just need to do the test during that few days. For those who have irregular period, it definitely will burn a lot of money just to buy the ovulation test kits.

The nurse then called back to inform me that she was unable to arrange the IUI on that afternoon, so it would be carried out on Monday morning. She reminded us to do our own 'home work' before Monday, just to increase the chance of pregnancy. Well, trust me, making love as per instructed by a third party is indeed very stressful for both the husband and wife!

Ist IUI - Ultrasound #02

2011.06.10 (Fri) - DAY 13
My day seemed to slightly run behind schedule this morning. As I didn't want to be late for my 10:30 am appointment, I drove faster than normal (but still in the safe zone!) and managed to step into the clinic at 10:25 am. I thought I was on time until I found out from the nurse that my appointment was actually at 10:15 am. Anyway, I shall just patiently wait for my turn.

At the waiting area, there were three couples with one couple having their 2 cute little girls with them. Each of the girl were holding an ipad on their palms, quietly soaking themselves into the world of cyber games. Looking at the two beautiful little girls, I could not think of any reason for their parents to visit the infertility clinic. Maybe they wanted more kids or were under pressure to get a boy. Well, I should respect any reason to bring a child to this world, as long as that child will be showered with love and care.

At 11am,  it was finally my turn to see Doctor Prashant. Before performing the ultrasound, he asked if I wanted to empty my bladder before the transvaginal scan. Since my bladder was half full, I proceeded to do so. Well, the result of the ultrasound was encouraging, there were 2 big follicles on my right ovary, the biggest one was 18.4 mm, the other one was smaller at the size of 14.6 mm. On my left side, there was 1 big one (which I forgot to take note of its size).

Dr. Prashant decided to see if I can ovulate naturally in the next 3 days (Sat, Sun and Mon). I will be given 3 Clearblue ovulation test kits, which I am supposed to use to test my first urine every morning, starting from tomorrow.  If by next Monday, the test result is still negative, I am expected to have induced ovulation by taking an HCG jab. Hmmm...I did not expect the arrangement of the natural ovulation to take place. I thought that I would be given the HCG jab today and subsequently followed by the IUI procedure tomorrow (Saturday). However, if things can happen naturally, why use external force? Also, who in their right mind would ask for a jab if it is absolutely not necessary yet? Let's see how it goes. Asking about when would be the estimated date of my IUI as I have an outstation assignment this coming Wednesday, Dr. Prashant said he will arrange the IUI to take place latest by Tuesday. Phew!

Before I left the room, the doctor instructed the nurse to perform an ovulation test on my urine. I was a bit surprised because I just emptied my bladder 5 minutes ago, I truly did not have any more specimen to provide for the test! The nurse smiled and jokingly said she just needed a few drops. I politely apologised and told her that I couldn't even give her a single drop. I asked to be given some time to 'refill' my bladder.

So, I spent the next 15 minutes practically hugging the water dispenser at the waiting area. Forcing myself, I gushed down 5 cups of water.

By then, I caught the attention of 2 little Indian boys who kept looking at me, wondering why this 'aunty' was so thirsty. My constant action of 'demonstrating how to dispense the water' really aroused their curiosity. Before long, the elder one took the gut to come near and tried to dispense some water for himself and his younger brother. They seemed to have a lot of fun trying out this new 'game'. I saw two happy boys giggling and running around with the their paper cups. This infertility clinic somehow looked more like a paediatric clinic today.

Finally, I managed to produce some specimen for the ovulation test. The test result was negative. So, I shall continue to do my own test at home and text one of the nurses (yup, I was given her handphone number) if there is a positive result within the next few days. An IUI will be arranged 24 hours after the ovulation. The Doctor jokingly said neither himself nor his nurses liked to work on Sunday, but if that was meant to be, they will still perform their duty base on the needs of their patients.



I was provided with 3 ovulation kits and 2 containers, one for the urine test and one to store hubby's sperm if he prefers to produce it at home or cannot make it to the clinic on the day of IUI.



So, the only thing that I shall do is to relax and patiently wait for 2 clear blue lines to appear on the ovulation test kits.

Total Expenses  RM 240

• Consultation               RM 80
• Ultrasound                 RM 80
• Ovulation Test Kit     RM 80

1st IUI - Ultrasound #01

Below is the little recap of what I have gone through prior to today's ultrasound (Day 9)

Day 3 - Day 7   Letrozole 2.5mg (twice a day, 2 tablets each time)

Day 6               Injection Folliova 150 iu

My appointment was set at 2pm and I arrived 10 minutes earlier.

The clinic was crowded, but quiet, as usual. There were 4 couples at the waiting area, 1 lady in working suites and an Indian young man, falling asleep on the couch.

I grabbed the latest issue of 'Nu You' Chinese magazine and started to dwell into the world of fashionista, thinking that it would take some time before my name was called.

Before long, my name was called. It was 2pm sharp.

Dr. Prashant was in his OT robe, maybe he just finished performing some procedures.  Smiling, the doctor asked how did I feel. I told him that overall, I am emotionally ok, but physically not that optimum.I felt that I have lost my appetite lately and I felt really bloated and nausea if I eat the normal portion of food that I used to. My tummy has bulged and I have put on 1 kg.  He was surprised that I was already experiencing all these symptoms at such an early stage of the treatment. He said maybe I have developed many eggs. Anyway, the ultrasound will tell the truth.

The result of the transviginal ultrasound showed that there were 1 big and 1 above medium size follicles on my left ovary, while on my righ ovary, there were 2 big follicles.

Dr. Prashant said that my condition is classified as 'reasonably fast'. I think that means my body responded to the medicine faster than normal, but overall it is still considered as acceptable aka. NORMAL. However, he told me he normally does not want too many eggs for IUI and I was told that the big follicles most likely will shrink by themselves after a few days. So, he will give me another shot of folliova (at a lower dosage this time) to 'maintain' the growth of some of the 'meant to be' follicle(s).

I understand that I should not be thrilled to have almost 4 big follicles because they might shrink and disappear (back to nothing?!) OR contrary, they might all grow and if I conceived, I am exposed to multiple pregnancies, which always carry higher risk than normal pregnancy, especially for woman at my age ( I was born in 1977 :p, you do the math).

The nurse then proceeded to 'jab' a shot of Folliova 75 iu to the left of my belly button area.

I am expected to come back for my 2nd ultrasound on Day 13 (10 June, Friday) and most likely the IUI procedure will be performed on 11 June (Saturday).

After payment, I left the clinic at 2:30pm.

One thing I like about Dr. Prashant is he is a friendly no-nonsense guy. If you throw him questions, he will answer you patiently. If you do not have any question, he will give you clear and precise instruction for your next step. My session with him is always short (not longer than 7 minutes for consultation plus ultrasound), but you will not feel neglected or 'rushed' through. There is always eye contact and 'just enough' information for you to carry on with your treatment. 

Total Expenses  RM 260

• Consultation   RM   80
• Ultrasound     RM   80
• Folliova 75iu   RM 100

Ist IUI - Folliova Jab

Today is Day 6 of my cycle. I went to the clinic to have my 1st jab of Folliova (which is actually FSH to stimulate the maturity of eggs).

I arrived at 10:15 am. The nurse who was at the reception counter mentioned my name aloud " XXX is here for her jab!" to another nurse in another room upon seeing me entering the clinic. The atmostphere of the clinic looked more relax than usual. To my surprise, the clinic was not crowded at all, and the lights of the other corner of the waiting area were turned off. There were only 2 nurses (normally there were more) and 2 patients, who seemed to come for jab or some other small procedure. It looked like Dr. Prashant was not in. Anyway, my jab was meant to be done by a nurse.

After 2 minutes, I was in the 'jab' room. The nurse asked me to lift up my shirt, revealing my belly button. She asked me which area that I wanted her to poke the jab. Haha....I asked her which area will be less painful? She shrugged and smiled. Immediately, I knew that wherever I pick, I will still fell the pain. Good thing, able to feel the pain means that I am still alive. She finally picked a 'site', which was about an inch away to the right of my belly button.

If I said it was not painful at all, then I am lying. But, it was really something bearable for a mature adult. This little pain was not a big deal at all.  When I asked is there any side effect should I expect? The nurse told me it would be lethargic. Well, since I have 'survived' from fatigue with Duphaston, bloated and nausea with Letrozole; I don't think I cannot survive from lethargy with Falliova. Just that I need to constantly remind myself to be mindful while I am driving and doing my work.

After setting my next appointment, I left the clinic.

My next appointment with Dr. Prashant is on 6 June (Monday). Looking forward to see the progress of my eggs. In fact, I don't know what to expect. It has been quite a long time that I do not have regular period naturally ( most of the time, I have induced period by taking hormone pills prescribed by doctors). The nurses said it might takes a few cycles of IUI to see how my body response to the treatment. I agreed with them, I am now on an experimental journey to explore my body. Other than being an obedient experiment subject, there is really nothing more that I can do to 'control' the outcome.

Do my best, accept whatever the outcome is and keep trying (well, I know I can only say this if there is still positive balance in my bank account).