Dragon Baby?

After few years trying for a baby and few consultations from the doctor, we decided to opt. for an IVF. And as we are no longer in the range of "still young" age, we thought that maybe IVF would be a better option for us. This treatment is our first experience and hopefully, it will go smoothly. And now we are in the process of "doing" it. All these treatments is being done in Mulhouse, France.

The procedures:

First, we have to make an appointment with our personal doctor, telling them that we desired to conceive and bla bla bla. They will write a referral letter and advise us which gynae to go and who to contact. Only with this letter, we can make an appointment with the gynae.

When attending an IVF clinic for the first time, the doctor will conduct a consultation. He or she will review in depth the past medical history, conduct physical and internal examination The doctor may order some investigations (semen analysis (fr your partner) and blood test for woman) before proceeding with treatment. For our case, the doctor proposed to us to start with IVF as she knew we have been trying for 2 years. And I guess it also depends on age or infertility problems. Before we starts IVF treatment, we were issued with consent forms and information sheets about our treatment.

The treatments (Superovulation):

 

After the 25th day of my menses (17th Jan 2012), I was advised to take the hormone pills "Oromone 2" until my menses come and to continue taking them until my menses is clear. When I had my menses on the 1st day, I called the hospital to inform them that I have my menses (they will advise you to call them). Once the period is cleared, I was asked to take blood test to check my progesterone level. My period came 4 days after taking the hormone pills and was advised to continue the hormone pills until my period is clear. I stopped taking the "Oromone 2" hormone pill the day before my blood test (only take 1 in the morning).



Oromone 2

The next day (26th Jan) , I took my blood test in the morning and the result came out to be ok (which means it was < 1). So, I need to continue with the hormone injections (Menopur=4amp=300UI) for 5 days. We called the nurse near our area and she came to our apartment to give me the injection. In fact, these injections can be done by ourselves but since my husband and I are really not "uncomfortable" with the needle and injections thingy, we decided to let the professional to do it. Usually, these injections are to be done between 6pm - 8pm for 5 days. To be honest, it really hurts.

Menopur

On the 6th day (31st Jan), I took blood test and did ultrasound scan (ecography)  to check my progesterone level, LH and the size of my ovaries. On the same day, the nurse from the IVF centre called us to give us the result and advised us what was the next steps. This time, I need to increase my hormone injections. Menopur (4 ampules) + Orgalutran (1 ampule).  In the evening (same timing), the nurse came to my apartment and gave me those injections. She injected me twice (1 injection for Menopur + 1 injection for Orgalutran). It really hurts (for me of course! ). I had swollen on my belly the 2nd day of the injection (Orgalutran) and it really hurts. The next day I still had pain and it was blue. Well, maybe for others, these injections are not so painful. I'm really scared of needles...that's why!

Swollen after Orgalutran injection

Note:

The number of follicles is counted and the diameters of the growing follicles are measured. The ultrasound is also used to measure the thickness of the endometrium and assess its quality for implantation of the embryo. Serial blood samples may also be taken to measure the levels of estrogen and sometimes LH and progesterone. Estrogen production increases as the follicles develop.

2 days later (2 Feb), I took blood test and ecography again. This round of ultra-sound check, the doctor found out that I have a polyps. But she said that it's ok and I can still continue with the procedures. And if I'm not pregnant this cycle, I will need to remove the polyps. It was really an unpleasant news for me and I was really upset as I found out later (on internet) that polyps might cause miscarriage and chances of implantation is very low.

As usual, the nurse from the IVF Centre called us and informed us to reduced the dose. This time, it's on 3 ampules of Menopur + 1 ampule of Orgalutran.



Orgalutran

2 days later (4 Feb), I took blood test and ecography again. When the doctor did the vagina scanning, she told us that probably the punction will be on Monday. (When the ultrasound scan indicates a reasonable size and number of follicles and the diameter of the leading follicles is greater than 18 mm. In addition,  the lining of the womb is of good thickness and quality. The estrogen levels correspond to the number of growing follicle).  I was asked to stop both the Menopur and Orgalutran injections and a different type of injection called human chorionic gonadotropin (Ovitrelle) is given in a dose of 5000-10000 iu. (The injection is essential because it simulates the woman’s natural LH surge. This surge also initiates the final growth spurt of the eggs. hCG injection is carefully timed and is usually given at night to allow egg collection to be performed at a convenient time, about 36 hours later). At 10.40pm, I took the Ovitrelle injection before going to bed.

Ovitrelle

6th Feb., we went to the hospital (IVF Centre) at 7am. First, we have to registered at the counter to be admitted. (as I opted for general anesthetic). Once all the registration is done, I checked in the room (No. 104) while my husband went to other area to do sperm collections. Well, after waited about 3 1/2 hours, I was pushed to the operation theatre. I was so nervous and afraid but the operation teams were very friendly and kind. They were gentle and they explained every details of what they were doing.

1 hour later, a doctor came to me and wake me up before pushing me back to my room. It's so incredible, the last thing I remembered was, the doctor told me that I will feel a bit drowsy. And when I got up, everything is done and I was at another room. (The whole procedure takes about 20-30 minutes).  I had some abdominal pain and they have gave me painkiller. (I was on drip as I said I had pain). After 1 1/2 hours out of the surgery, they brought in some lunch. (To let us gain back some energy before discharging).

Just before discharged from the hospital, Dr. Ewig came to our room and told us that they have managed to extract 10 good eggs and the fertilization will take place the next day. While waiting for the embryo(s) transfer on Thursday (2 days later), I need to take some medication for preparation of the embryo transfer and painkiller after the surgery.

Treatments after IVF procedures:

You may experience some mild discomfort following the procedure, but this will be relieved with painkillers. Antibiotic is usually given to prevent infection.

Estima & Spasfon

 

**To continued taking the medications until the day of embryo(s) transfer.

 1. Estima (Progestrone) - to be inserted in your vaginal.

2. Spasfon - Oral intake

 



Day 3 (8th Feb), a doctor from the IVF centre called me and informed me that the embryos transfer will take place on Thursday at 9.30am. He told me that they managed to get 3 healthy and matured embryos for the transfer. Apparently, 10 eggs were retrieved but 6 eggs were fertilized and only 3 embryos were in good qualities (2 embryos of grade 1 and the other one was grade 2).

Before the transfer, I need to do the following:-

Morning before the embryos transfer :-

1. Insert the Estima Progestrone capsule into the vaginal when I get up in the morning.

2. 1 hour before the transfer (8.30am), I need to drink 1 litre of water together with Spasfon.

 

Day 4 (9th Feb) - Got up in the morning and first thing I did was to insert the vaginal capsule (Estima) into my vagina, had my breakfast and then drank 1 litre of water.

Reached IVF Centre at 9.25am and waited till 10.30am before they transferred the embryos. It was unfortunate that only 2 embryos were in good qualities. The 3rd embryo was not in good quality so the doctor said that it's no use to freeze it. Therefore, we transferred 2 embryos.

Went back home and rested the whole day. Now we need to wait for 2 weeks for the result (23rd Feb) - blood test. Keeping my fingers crossed !!

Note: continuing taking Spasfon for the next 5 days and continue the Estima until 23 Feb (the day of blood test).

 

23rd Feb 2012 - after 2 weeks of waiting, the day has arrived!!! Went to the hospital for blood test in the morning (7.30am) for pregnancy check. Went back home after the blood test and waited till noon before we called the lab to find out the result. Hmmm.....unfortunately, sadly, the result was negative :( I was so upset and very disappointed. Somehow, I knew that this cycle will be not be successful and implantation failed due to:-

• polyps
• after the transferred, I had cramps for few days (maybe due to poor technique during transferring the embryos). 
• arrest of the embryos (meaning the embryos stop developing)
• I was very sick before, during and after the embryos transferred and therefore, resulted in poor diets!

On the same day of blood test, my menses came. First day of menses, was just a bit of very low flow but the 2nd till 4th day, I had very heavy flow. Bad backaches on the 2nd day and terrible cramps on the 3rd & 4th day of my menses.

The next steps, is to reschedule an appointment with my gynae for my removal of my polyps before trying again IVF for the 2nd time. As we are in France, the appointment might take months.

2nd March 2012 - Appointment with Mdm La Marca

One week after the result, I went to see Dr. La Marca again to do an "hyteroscopy" as there was a polyps in my uterus when she did the embryos transferred. This procedure is to double confirm and to remove the polyps if they exist.

Note: A hysteroscopy is a way for your doctor to look at the lining of your uterus. A thin viewing tool called a hysteroscope. The tip of the hysteroscope is put into your vagina and gently moved through the cervix into the uterus. The hysteroscope has a light and camera hooked to it so your doctor can see the lining (endometrium) on a video screen.

During the hysteroscopy procedure, doctor could see a cell tissue but was not able to locate any polyps in my uterus. Therefore, as a result, there were no polyps and she said that I can start my next IVF procedure in the month of May (after 3 months rest).

2nd. IVF attempt

As all of you are aware, this will be my 2nd attempt to have a baby thru IVF. The first cycle ended in early Feb 2012. This time, Dr. La Marce switched us to a different protocols (long protocols). Hopefully, this we can more eggs retrieval and better embryos qualities.

18 May 2012 - Started with Superfact 0.3ml injection (between 6pm-8pm) on the belly. As usual, it was done by the nurse at our apartment. The injection was not as painful as earlier but it still stings :)

Needles

Superfact 1mg

 

Nevertheless, this injections have some side effects. I have headaches and experienced giddiness. I had very low blood pressure  which make me almost fainted. I felt tired easily and was not really active.

31 may 2012 - after 2 weeks of Superfact injections, an ultrasound examination and blood test is required to check the progress of the procedure. When asked, I told her (Dr. La Marca) that I did not have my menses. She was a bit surprised. Finally, during the ultrasound, she found out  that there were few functional cyst in my ovaries. After the blood test result arrived (ard. noon), she decided that I should stopped totally the IVF process.

Hhmm....another big disappointment! I was prepared for the 2nd attempt. I told myself to be strong this time and have the courage to go thru all the injections (which was really a stress for me). But after going thru 2 weeks of injections and pain, it FAILED again. And the worst thing is that I'm having few functional cyst in my right ovary. So, the doctor told me to stopped the injections and see if the cyst will go away by themselves (usually they do but it probably takes 2-3 months). So, now I have to concentrate of getting off the cysts.

Functional ovarian cyst follow-up

One and the half month later (17 Jully 2012) , I went to see La Marca again to check if the cysts are still there. Unfortunately, there are. Therefore, she prescribed Minidril (contraceptive pills) to be taken for 21 days and stop for 7 days (menses will come after 3/4 days after stop minidril). So, I started Minidril on 23 July 2012 and stopped on 12 August 2012. My menses came 3 days later (16 Aug. 2012)

Minidril

21st. Aug. 2012 - Went to see La Marca again to do ultrasound check. This time, I was happy when she told me that there are no more cysts. And I should continue the Minidril for another cycle before starting my treatments for the next IVF. So, I started to take Minidril today.

 

 

3rd September 2012 - After one week holidays in Locarno, Swiss & Cattolica, Italy, we went for blood test before the proceeding with the IVF procedure. (as it was almost one year ago we did the blood test, so now we have to do it again).

 

3rd IVF attempt

7th Sept. 2012 - Decapeptyl 0.1mg (1 ampule) injection starts.  As usual, it has to been done between 6pm to 8pm on the belly. And at the same time, I continued taking Minidril.

Decapeptyl 0,1mg

10th Sept. 2012 - Today, will be the last day of taking Minidril but still continue the Decapeptyl injections till further instructions.

 

My side effects of Decapeptyl are:-

• problems sleeping at night (insomnia)
• mood changes
• eyes sore (one of my eyes were  red)

** I do not know why I can't sleep at night! I had backache and gets up often in the middle of night. I'm not sure if it's the medication I took....????**

14th Sept. 2012 - Got up early in the morning (can't sleep again last night!) and got myself prepared for Colmar (appointment with Mdm. Gass, CCI) at 10am.
Arrived at Colmar train station and 10min passed 9am but I finally arrived at CCI at 10min to 10am. I got lost and walked for more than 30min!
The worst thing is that my menses came while I was searching for my way!! What a day!

After a long day yesterday, finally I could sleep well last night! Looks like if I'm not on my pc the whole day, I am able to fall asleep easily.

17th Sept. 2012 - This morning hubby went to Diaconat to do his sperm analysis.

18th Sept 2012 - Blood test and ultrasound in the morning. As usual, the nurse from Diaconat called me and advised me the next steps. So, I will still continue Decapeptyl till Friday (21.9.12). On Friday, I will have to add Menopur to my treatment. Therefore, I will have 2 injections :-
Decapeptyl   (1 ampoule) +   Menopur (4 ampoules = 300UI)

And followed by blood test and ultrasound on 25 Sept. 2012 (Tues)

21st. Sept. 2012 - I start my Menopur (4amp.) injection today. So, there are 2 injections this evening. Decapeptyl (1amp.) + Menopur (4amp.)
The Menopur injection was so painful. When the medicine went inside, I can feel like it's burning inside. Well, for baby sake, I will endure it.

22nd Sept. 2012 - This morning when I got up, I had swollen on my belly where the Menopur injection was done. I can even feel the pain when I run. Hopefully, it will go off before this evening. Unfortunately, it's still swollen and I had to ask the nurse to be careful when doing the injections.
And at the same morning, when I went to toilet, I noticed that I had light spotting (brownish). Each time when I wipe with tissue, there's some brown stain. I hope it's nothing to do when my treatment. (coz the last time when I experienced some symptoms, there were some cysts). Hopefully, it's from the remaining menses (which I had 10 days ago). It makes me worried.

23rd. Sept 2012 - Still have some brownish stain and swollen on the belly (where the Menopur injection was done).

24th Sept. 2012 - Still experienced the pain and light spotting. Called La Marca office this morning but her secretary said that she is on leave this week. Well, I'll have to wait till tomorrow when I do my blood test and ultrasound.
Don't have good feelings about this and it makes me worried :(
Just keep my fingers crossed.

25th Sept. 2012 - Went to Diaconat at 7.10am and took blood test. Continued with ultrasound at Diaconat. The gynae said that my ovaries are still very small and probably they will increase the dosage of the treatment. That means they will increase the dosage of Menopur......ppffff....more pain coz more dosage! And looks like the punction will only happen mid of next week. Anyway, I'm glad that there were no cysts and the vaginal bleeding was due to the Menopur treatment. The doctor said that the bleeding was due to beginning of Menopur treatment. I was relieved! :) Let's wait for the nurse to call this afternoon to tell me the amount of dosage to take next.

The nurse from Diaconat called at 12.15pm. So, starting from this evening, I will continue with 1/2 ampoule of Decapeptyl + 5 ampoules of Menopur. (For Decapeptyl, I will need to mix the solution and the powder together and then use only half of the dosage. Whereas for Menopur, 5 powder mix with 3 solutions).

p/s: Vaginal stops.

29th Sept. 2012 - Blood test and ultrasound this morning with my hubby. There were so many patients. Surprisingly, there were many people doing IVF here. Well, as it's paid by the French government (Securite Sociale), everybody takes the opportunity to do IVF. We are entitle to have 4 IVF (transfers) in France.

During the ultrasound, the gynae told me that my follicles are still small and there were only 2 follicles that were big enough but in order to do the "ponction" (eggs retrieval), I should have at least 4 good size of follicles. Hhmmm...looks like my body does not really respond to the medications (drugs) this time :(
So, starting from this evening, I will have to increase my dosage of Menopur. Therefore :-  6 ampoules = 450UI (Menopur) + 1/2 amp. (Decapeptyl).

My next ultrasound and blood test is on Monday.

1st. October 2012 - Reached Diaconat at 7.40am (quite heavy traffic today). took blood test and went up for ultrasound. When I reached at the Secretary counter, she told me that Dr. La Marca was waiting for me at 7.30am for ultrasound. Well, I didn't know that! When I received the call from the Secretary last Sat. afternoon, she told me  the dosage to take, when and what time to go for blood test and ultrasound. She didn't said that Dr. La Marca wants to do the ultrasound at 7.30am. She only said that I should be there at 7.30am for blood test and ultrasound. So, Dr. La Marca has left and another gynae did the ultrasound for me.
Well, as anticipated, my follicles are still small (not big enough for the ponction). Only 2 follicles were big enough. I have around 8 follicles (left and right ovaries). HHHmmm....now, I'm really worried and am not sure if I will be able to continue till the ponction (egg retrieval). This time, it doesn't work as the 1st. IVF treatment. I wonder why?! Maybe I'm worried too much during the treatment? Stress? Well, can't blame myself as I had cysts before and each time I think about it. Wonder if it will work, if I have cysts, if my follicles produce good quality eggs, etc etc......:((
It's already 12.40pm and the secretary from Diaconat has not call me to give me the instructions for next steps(usually she will call me before 12pm). Again, I'm worried.

It's 2.30pm and Centre FIV Diaconat has not called me yet. So, I decided to call them instead. Spoke to the secretary. She took out my report and said "Mdm. Felden, I have bad news for you. You have to stop the treatment coz the follicles did not responded to the drugs given. Pls call Dr. La Marc for further details. I'm sorry". When I heard this, I was shocked and silence for a second! I asked her if she was sure it was me. And she said "I'm sorry, Mdm Felden." So, I called Dr. La Marca and asked her in details. She explained to me that the drugs she prescribed to me did not have good respond to my ovaries. Apparently, the follicles stopped to grow. Only 2 were big enough which were 18mm and 17mm. With only 2 follicles, she said there will be no chance of pregnancy. So, she decided that I should stop and change to different protocol for the next IVF attempt. Change to the 1st. protocol as in Jan. 2012 (which is the same treatment for my 1st. IVF).
Only God knows how sad was I. I cried so much and was so disappointed and angry!
Now, what should I do?

2nd. October 2012 - My nipples are so sensitive. Even when my shirt or bra touches them, it hurts!

6th October 2012 - My nipples and breasts are still sensitive. Since, my 3rd attempt of IVF didn't work out, I started to find more information on Internet on how to improve my eggs quality and how to make my next IVF successful. Well, I read about the dos and don'ts and tips on how to improve my eggs quality. One of them, was to take supplements. Maca and Royal Jelly were one of them. On Friday (5th. Oct.), I went to the nearest pharmacy and bought a bottle of Royal jelly and Maca. http://www.healthguidance.org/entry/3439/1/The-Magical-Benefits-of-Peruvian-Maca.html

This morning, I decided to let my hubby take Maca (as it helps to improve sperm quality). And I also took one during lunch time. (as it also helps women in infertility). HHmm.....well, I'm not sure if it was Maca or Royal Jelly or both that makes having such a terrible headache. I had this painful and terrible headache throughout the whole night which make me didn't sleep well.

7th October 2012 - Since last night, I had such a bad headache, I decided to take a rest on all the supplements today. This morning, I had a very light pinkish spotting when I wiped after urination.
p/s: my nipples are still painful/sensitive.

9th October 2012 - This morning when I got up, I noticed that my breast and nipples are not painful and sensitive anymore. Went to toilet and noticed that I have very light pinkish spotting when I wipe. Hopefully, my period will come soon.

p/s: I started Maca again since Monday morning (8th.Oct.).


12th October 2012 - Today, my menses came and I fixed an appointment with Dr. La Marca for an ultrasound on Monday (15.10.12) at 7.30am to check if I have any cyst (due to the hormone treatment I had earlier for IVF).

15th October 2012 - Ultrasound this morning with Dr. La Marca at 7.30am. As predicted, I  had functional cysts and polyp again. Therefore, she advised me to make an appointment with her secretary to do a hysterscopy to confirm the polyp. And as for the cysts, I will need to take Minidril for 2 months. In December, will have another appointment with her for the next IVF (if there no polyps or cysts).

16th October 2012 - Started Minidril this morning.

24th October 2012 - Was at Dr. La Marca clinic this afternoon. Did hysterscopy and it's confirmed that I have polyps. 2 polyps in my uterus lining. Therefore, she advised me to see Dr. Blum to do the operation (removal of polyps).

Managed to get an appointment with Dr. Blum on 14/11/2012 at 11.45am to schedule for an operation.

I also did papsmear today. Result will be in few days. Hopefully, no more bad news.
 

6th November 2012 - Till today, I still have not received my papsmear report. Just don't understand how these people in France work!! And why am I not surprised when at 3.20pm, the secretary from La Marce office called me and told me that my appointment with Dr. Blum (whom I'm going to meet to fix my operations date) was postponed to 17 December 2012 at 14h30!!!! When asked, she told me that the reason was because all the doctors will be on strike next week!!! Doctors strike!!! Can't believed it! And because of these, I need to wait for another 6 weeks. Unbelievable!

- Minidrill stopped today.

p/s: After 2 weeks of Minidrill, I experienced bad stomach pain for almost 1 week. It gets better just 3 days before I stopped.


Finally I received my papsmear report after 3 weeks of waiting. Thank God the result is ok.

4th December 2012 - I stopped Minidril. This round of Minidril, I didn't have any bad symptons.

2nd December 2012 - I experienced very terrible pain in my stomach in the middle of the night. I couldn't sleep well.  When urine, I can felt the burning pain especially when I'm about to finish to urine. It felt like something couldn't come out from my private part (urination part). It was so uncomfortable. The next morning when I got up, I felt slightly better and I thought probably I ate something bad last night. So, I ignored it. Well, I still have this uncomfortable feeling during urination. I drank alot of water because a friend told me that probably it's due to a small infection which was caused when we have intercourse with your partner. The pain was not so severe anymore. But during the night I had pain again. But this time, it was near my waist.
Next morning, when I got up, I didn't have the pain anymore. So, I thought, it was over. So, I went to school in the afternoon and I walk alot. In the evening, when I reached home, suddenly I had this severe pain on my left waist. It was so painful that I could almost fall down on the ground. I cried out but there were nobody at home. I was alone. I still didn't take any painkiller or paracetamol. Bared with the pain and went to bed. I still can remember how painful it was that night. Didn't sleep well. Finally, managed to sleep for 3 hours. Got up the next morning and I felt  better. Decided to proceed my plan to visit a friend in Strasbourg (5th Dec). Had lunch at her place and went out for shopping later. We had a good day. Went back home and when I reached home at about 7pm, I had this terrible pain again. This time, it was on my right waist. And I knew it was just a normal back pain. I knew that it could be my kidney. I was afraid that probably the infection went to my kidneys. Took painkiller this time and went to bed.

6th December 2012 - Got up in the morning and I felt that pain is still there. Decided to go to see a general doctor for a consultation. After explaining to the doctor about my problems, he advised me to go to the lab to do a urine test immediately and mamography (for the kidneys) as he's afraid that I might have infection in my bladder and probably it could go up to my kidneys as I have waited too long to consult a doctor. So, I went to do my urine test on the same morning. While waiting for my result tomorrow, I decided to go to school in Colmar eventhough I still have some pain. At the same time, I also did an appointment for my mamography on 7th Dec. at 11.15am
Started the antibiotic tonight.

p/s: my doctor prescribed me an antibiotic for my uring infection ( Oxfloxacine) for 10 days.

Ofloxacine 200mg

7th December 2012 - Went for the mamography test. Took about 15min. After the mamography, the doctor said that he did not see anything abnormal. I was relieved. But somehow, in the evening (especially when I walk alot or stand too long), I'll have the pain again.

12 December 2012 - After few days taking the antibiotic, I felt better. Less back pain. Had headached for the last 2 nights (Monday and Tues).


17th December 2012 - Appointment with Dr. Blum to fix a date for my operation (to remove my polyps). It was set on 17th Jan. 2013. He also advised me to continue my Minidril.

Start Minidril on 17.12.2012


Before my operation, I need to :-

a) fixe an appointment with the anethestic. Luckily, once I had my operation date, I went straight to the hospital to make an appointment with the doctor on 11. 01.2013 at 9.20am.

b) register myself for the admission before the operation. And they will call me a day before my opeation date to inform me the exact time to check-in for admission. Normally, it will be early in the morning.