It’s all about: second round of ovulation pill and first IUI, our infertility journey#10

Our infertility journey #10

After first attempt of IUI was not done as per plan due to the actual ovulation day fell on public holiday, we tried agian for another round of Clomiphene Citrate 50 mg. My appointment for TOO was on day 13 of my cycle this time because day 12 was on Sunday and the clinic was closed.

I reached the clinic for my appointment at 8.55 am. Prof PC Wong was already back from leave. My really first IUI cycle started:

  • 9 Jun 16 (day 2): took Clomiphene Citrate first day
  • 20 Jun 16 (day 13): TOO follicle 19 mm right and 18 mm left, endometrium 8 mm

The doctor said both follicle and endometrium were at ok size so IUI procedure to be arranged on 22 Jun (day 15). I needed injection of Ovidrel 250 mcg to induce ovulation only at 5-6 pm which will take around 36 hours to ovulate. I was given choices; to have injection at the clinic or to do it myself at home. Thinking about poking the needle onto myself, I already felt fainted. So I chose to come back to the clinic in the evening for the injection. I had 7 hours to kill from 10 am to 5 pm so I went home to take a rest first.

The injection was at the tummy area. The nurse pinched the flesh of my tummy and inject the medicine. It was the same pain when you have vaccination but it was more scary because I looked down and saw the needle going in my tummy. Anyway when I reached home at night, there were small bruises around the needle area which supposed to be normal.


I read that the trigger shot will lead to positive ovulation on the LH test strip. So I tested and all came out positive. It was my first time ever that both lines were the same darkness.

22 Jun 16 (day 15): IUI

We woke up early in the morning and called cab down to the hospital. Reached NUH around 7.30 am and it was still early so we went for breakfast at Burger King. We ordered 2 breakfast sets; Turkey Sausage with egg and Turkey Bacon with egg croissant. It was the first time I tried Burger King breakfast and I loved the crispy bacon and hash browns the most.

Then around 8 am my husband prepared for his semen and brought to the lab. We waited at the clinic for appointment at 10 am. I had small tummy cramp and lower back pain since morning.

We were called in around 10.30. The nurse went out to get semen from the lab then she explained to us about the procedure since it was our first time IUI. The washed sperm will be injected directly into uterus by small long tube so there is no need to ly down after the procedure. She told us that a lot of patients read too much on the Internet and thought that after IUI must ly down to prevent the sperm to flow out. In fact there is a closure at the end of uterus so there will not be any leakage.

When the doctor came in, he checked the washed sperm count which is good at 86 millions. Then he did vaginal ultrasound, it was painful as I felt so sensitive since my tummy cramp due to ovulation. Both of follicles already ovulated so he injected washed sperm. The procedure was quick and only took around 5 minutes.

2 weeks of waiting started.

Total bill: S$835.04

  1. Clomiphene Citrate 50mg 5 tablets: S$1.34
  2. TOO day 13: S$90.50
  3. Ovidrel 250mcg injection: S$90.50
  4. Injection service: S$10.70
  5. IUI: S$642

Yo-liciously yours,

It’s all about: full preparation for first time IUI but never proceed, our infertility journey#9

Our infertility journey #9

We planned for IUI around April but because of my husband business trip oversea we needed to postponed. I was prescribed Clomiphene Citrate 50 mg to be taken daily starting from day 2 till day 6 of menstrual cycle. When my period started, I called in for TOO Time Of Ovulation on day 12 of the cycle to check the size of my follicle.


However prof PC Wong was on leave the week of my TOO and possible ovulation date. So I saw another doctor instead. My first IUI cycle started:

  • 6 May 16 (day 2): took Clomiphene Citrate first day
  • 16 May 16 (day 12): TOO follicle 12.5 mm each side, endometrium 9 mm
  • 19 May 16 (day 15): follicle 16.5 mm right and 18.5 mm left, endometrium 12 mm

You will need to have one dominant egg with the size of 18 mm or more and endometrium of at least 8 mm for the possible fertilization.

The doctor told me that the best date for IUI will be on Saturday (day 17) but unfortunately the clinic is closed due to public holiday. Therefore we needed to forego this round of IUI and try naturally without any ovulation trigger shot.

There are 2 documents needed for IUI; signed consent paper and marry certification.


I did home LH ovulation test which I was not sure again if I was able to ovulate on my own. The test line was not equal or darker than control line for all 3 tests. Anyway we still tried on our own with high hope since I had a dominant egg and my endometrium was good. However at the end of the day, my period started ON TIME!

Total bill: S$182.34

  1. Clomiphene Citrate 50mg 5 tablets: S$1.34
  2. TOO day 12: S$90.50
  3. TOO day 15: S$90.50

Yo-liciously yours,

It’s all about: TCM Chinese medicine, our infertility journey#8

Our infertility journey #8

On 16 January 2016, we went to Thong Chai Medical Institution for TCM Chinese medicine near China town. The treatment here is free of charge with donation from individuals, public and private sectors in Singapore. After registration, we requested for doctor who can speak English. The first visit was on Saturday but subsequently needed to be on weekday.


The doctor wanted me to check temperature every morning. Yes, back to the old way. She gave me paper with tables to plot the graph for daily temperature. I needed to do this for one cycle and came back after my next period started.

After one month plus, my period came so I went back to see her on Monday after lunch. She prescribed me some Chinese medicines to take for the week. There were like 15 things in the package.

Instruction given:

  • Boil 3 bowls of water with one package of medicine about 45 minutes to an hour until medicine reduces to 1 bowl (first boil)
  • Pour out the medicine and boil again with 2.5 bowls of water until reduce to 1 bowl (second boil)
  • Combine first and second boil (2 bowls) and take only half of the medicine. The rest of a bowl keep in refrigerator for the following day

So I am scheduled to see the doctor once a week. Each time I will be given 2 packages of medicine for 4 days. The doctor adjusted the medicine to suit my body each time I saw her. If my period starts, I need to skip the medicine. Chinese believes that the medicine helps stimulate blood flow so period will take away the goodness from the medicine.

Yo-liciously yours,

It’s all about: HSG Hysterosalpingogram, our infertility journey#7

Our infertility journey #7

I had an appointment for HSG Hysterosalpingogram (fancy word which I cannot even pronounce) or fallopian tube check around day 10 of my cycle. This is to ensure that I was not pregnant and my period finished. The check is to see if there is any blockage in my fallopian tubes.

On 28 December 2015, my appointment was after lunch. We reached the hospital little early. After registered we were asked to wait in the waiting area. There was one couple already there. It was very long waiting which my fear became more and more every single minute. About an hour later, one nurse came to the other couple. The wife went to change and went into the room.

Then the nurse came to me and explained about HSG procedure. What to expect and what to do afterwards. She gave me papers to read and sign before the procedure. Then I went to change to hospital gown. About 20 minutes the previous lady came out from the room. I was then called in. My hands were sweating, I was very scared.

In the room, there were few equipments: big x-ray machine, monitor which show the x-ray result and other machines which I do not know what they are for. As I ly down on very cold metal table, my hands became more sweaty. Then suddenly the doctor shouted from the room next door which was connected to this room asking the nurse to get previous lady to wait. I didn’t know what happen but the doctor went out for a while.

The nurse came to my side and tried to comfort me. The doctor came back and she explained the steps. Then a male nurse came in to operate the x-ray machine while the lady nurse held my hand. The dye was injected in and x-ray immediately show the result on the screen. It was painful especially when the dye went in. It felt like someone is grabbing your womb very tight and at the same time pressing so hard on your lower stomach. X-ray machine took few pictures until the doctor had the clear x-ray pictures. The whole process took around 15 minutes then it was over. I was so relieved.

The nurse gave me one sanitary pad as I can expect some dye which has no color and some bleeding. I came out and changed. No more pain. My husband was waiting for me anxiously outside and when I came out he rushed to me. Apparently the previous lady came out and she couldn’t walk due to the pain. We paid for the bill and rushed back to work. That day I had some bleeding not fresh blood, more like last day of period blood, about size of small lime.

We had our appointment with prof PC Wong to hear the results 2 days later. Good news! My fallopian tubes were fine and no blockage.

Total bill: S$293.68

  1. HSG: S$227.38
  2. Consultation for HSG result: S$66.30

Yo-liciously yours,

It’s all about: giving up, our infertility journey#6

Our infertility journey #6

It was already 2015, and very busy year for both of us. My husband changed job which require more travelling and always busy with his workshop and training. For me I was struggling with work as the company was going through re-organization with frozen headcount and numbers of people left the job. More responsibilities were distributed to the rest who stayed. It was very stressful year.

We were still trying for baby. I took another round of Clomiphene Citrate 50 mg in February 2015. This time was not as lucky as last time. With our busy schedules, we decided to try naturally and not to arrange for doctor appointment.

During this year, lots of our friends and colleagues had great news with their babies along the way. Every time I saw someone posted on Facebook of their baby ultrasound or baby clothes or baby bumps, I cried. I felt happy for them but at the same time it hit me very hard. Why am I not able to conceive? It was very tough on me and also on us especially when people asked ‘when are you going to have a baby?’ or ‘why don’t you have a baby yet?’. At one point, the thought of giving up came across my mind.

One day my husband came home from work. He shared with me about his ex colleague who suddenly contacted him after few years. Out of the blue, she asked him about our baby plan. She also had difficulty to get pregnant and now she has 2 beautiful twin daughters. After hearing our story, we arranged for meet up at her place on one of the weekend. She shared her experience which her one side of fallopian tube was blocked. They were trying for IUI 2 times but not succeed. So she went to see Chinese doctor and ate Chinese medicine for a year. Then her first round of IVF was successful. She introduced us her doctor at private clinic at NUH .

There we made an appointment with prof PC Wong at NUH special clinic. Our first appointment was on 19 December 2015. It was my first day of period so I went for blood test because some of the results I took few years back were not usable. Husband also needed to arrange for semen test. At first I was going to request to go straight for IVF In Vitro Fertilization but prof Wong wanted us to try for IUI Intrauterine insemination which was less invasive first. In order to do IUI, I needed to do a test to make sure my fallopian tubes were not blocked. Since it was my first day of period, I was arranged for the test 2 weeks later.

Four years passed, “Nothing happen, No baby yet”.

Total bill: S$618.40

  1. Wife blood test: S$434.40
  2. Husband blood test: S$119.80
  3. Semen analysis: S$64.20

It’s all about: HSG Hysterosalpingogram, our infertility journey#7

Yo-liciously yours,

It’s all about: finally I am ovulated, our infertility journey#5

Our infertility journey #5

We went back to Bangkok in November 2014. I had an appointment with fertility doctor there. I was given pills Clomiphene Citrate 50 mg (Ovinum) to help me ovulate which needed to be taken on day 3-7 of the cycle, 2 pills a day in the morning and at night. I wrote down some symptoms that I had:

  • 7 Nov 14 (day 3): Took first pill
  • 17 Nov 14 (day 13): LOVE
  • 21 Nov 14 (day 17): Got discharge like egg white LOVE
  • 23 Nov 14 (day 19): Tummy ache and backache
  • 24 Nov 14 (day 20): Sensitive nipples LOVE
  • 25 Nov 14 (day 21): Sensitive nipples and tummy ache
  • 6 Dec 14 (day 32): Tired and very sleepy

When my period was late by a day, I was so frustrated because I did not want my cycle to be prolonged and irregular. On 9 December 2014 (day 35), I felt like period cramp but I had a feeling that I should do the test and so I did. I waited for about 1-2 minutes and as expected one line. I threw it away in my toilet dustbin. My husband had Christmas party with his friends so I bought my own dinner. At night before we go to bed, I was brushing my teeth and then something told me to pick up the test from the dustbin. When I looked at it, it was fainted ‘second’ line there. I rushed out from the toilet and show my husband the test. We both saw 2 lines!

IMG_6825

The next morning I did the test again with my first morning urine. AGHHHH definitely 2 lines there. We were very excited and didn’t expect this at all. I went to office as usual but I had diarrhea together with lower back ache. I couldn’t sleep well at night because my stomach was uncomfortable. The next day I went to see GP after 2 times diarrhea in the morning. The doctor suspected I had stomach flu with slight fever at 37.4 C. I told doctor about my home pregnancy test so he refered me to specialist at NUH.

Waiting at the hospital I was very nervous. When it was my turn, the doctor did ultrasound on my tummy. She said there were few follicles in the ovary but cannot find any baby sack so she did vaginal ultrasound but again saw nothing.  I was arranged for blood test for beta HCG. 2 hours of waiting, the result came out and my HCG was 47 U/L. The doctor told me to relax and maybe it was too early to see anything at that point.

  • 12 Dec 14 (day 38): Diarrhea and tummy ache
  • 13 Dec 14 (day 39): Tummy ache and period-like cramp
  • 15 Dec 14 (day 41): Left side tummy pain every 1-2 hours, lower back pain and needed to ly down on sofa and put hot pack to reduce the pain

It was on 16 December 2014 that I cried like nobody business. I reached office in the morning then I felt something was not right. I went to the toilet and I was spotting. I rushed down to nearest hospital SGH Singapore General Hospital. At A&E, I did urine test and went in the waiting area with husband. Then I saw the doctor on duty. He said the urine test was negative and requested for blood test for me. While waiting, I went to toilet couple of times and there were more and more blood clot coming out. I already knew it was the end. After 2 hours waiting for the result, finally it came. We went back in to see doctor and my beta HCG went down to 8.2 U/L. We were told that this was called something like “early miscarriage” or chemical pregnancy.

My heart sank.

Three years passed, “Nothing happen, No baby yet”.

It’s all about: giving up, our infertility journey#6

Yo-liciously yours,

It’s all about: PCOS, our infertility journey#4

Our infertility journey# 4

I was so scared and very disappointed when the doctor first told us that I have PCOS. Maybe this was all along the reason why we cannot conceive. I was very sad.

When we were referred to specialist at Mouth Elizabeth, the doctor explained to me about PCOS. Normally alternate ovary will produce few eggs each month or each cycle. Only one dominant egg will grow to the size that is ready to be fertilized. The rest of the ungrown eggs will slowly die out and disappear. The dominant egg will then move out from ovary to fallopian tube. For those with PCOS, there will not be dominant egg but all small eggs that are not the right size. No egg will be released or no ovulation in this sense.

Refer to my case of stomach ache due to fluid in my reproductive organ, the small eggs which didn’t grow to the right size changed into water bag. Usually for women with PCOS, the obvious symptoms would include long and irregular cycle due to no ovulation, overweight and diabetes. For myself, it was still considered not so bad since my cycle is regular even though it was longer than usual 28 days and I am not overweight but in face a bit under weight.

I made another appointment with NUH clinic again. This time we saw lady doctor. She read the past record and confirmed that I have PCOS but nothing to worry about because my cycle is regular. Polycyclic Ovary Syndrome is quite common and still can try for baby. I came home and did some research online and many women with PCOS can still have baby even naturally. So my hope was still there. Some articles suggested to eat more duck egg, soy bean milk and dark green vegetables.

It’s all about: finally I am ovulated, our infertility journey#5

Yo-liciously yours,

It’s all about: A&E before sun rise, our infertility journey#3

Our infertility journey #3

It was around 5 am on 2 October 2013 (day 23 of my cycle) I was waken up by stomach ache. I usually have stomach ache and I thought this was just like the other times which will go away after few minutes or up to half an hour for more serious pain. However I was wrong. I couldn’t sleep for an hour and the pain did not go away. It felt like someone was squeezing the juice out of your stomach or intestines or whatever it was. I was sweating in an air-conditioning room but my feet were very cold. About 6 am, I couldn’t take it anymore so we rushed down to the nearest hospital KTPH which we were considered lucky to have one about 10 minutes away from home.

Once we reached A&E, I still needed to do registration and pre check up. I remembered trying to stand up but my tummy didn’t allow me to stand up straight. I was standing like a cook shrimp then the nurse wheeled me a wheelchair. After that I did urine test and wait outside in the waiting area. One nurse came over and asked the level of my pain, I told her it was around 8 out of 10. Then she wheeled me in to the A&E ward and my husband was left outside. After few minutes one doctor came over to examine my stomach. The pain was majority everywhere but more on the right side of the lower stomach. The doctor then explained that stomach ache in men and women were not the same. For women there were many organs and more complicated so he couldn’t rule out whether it was appendix or something else.

Then my husband was called in since the doctor suggested to do CT scan. We discussed and agreed to do the scan. The nurse took my blood to ensure no kidney issue. Then injected me with 5 mg of morphine to reduce the pain. In just about less than a minute, the medicine ran through my body and I couldn’t feel my body, no strength to even sit up. Was it ‘high’ feeling? I requested to ly down but inside A&E there were full of patients. The nurse pushed one extra bed for me and slot me in between 2 beds. I felt very dizzy and my body felt like boiled vegetable, no strength at all.

After waiting for the blood result for the kidney for more than an hour, it was good to go and I changed into hospital gown preparing for CT scan. It was my first time in A&E, foreign country, CT scan, injections, and ALONE. My husband wasn’t allowed to come in so he waited outside for many hours with no news about his wife.

No more pain after the morphine but I still on the bed. The nurse pushed my bed to the room with big silver machine for the scan. I moved from the bed to very cold table-like. My hands were very cold, I was very scared. I was told that the machine will inject medicine through my arm where I had one needle already poked into my skin. But before the procedure started, the nurse injected water into my body and also my bottom! I was not sure why but it was like to test for the fluid flow. Then it stared, the machine told me what to do like take a deep breath and hold. Once the medicine was injected to my body, I felt sudden warmth. It was not painful feeling but more uncomfortable. The machine repeated the same process 3 times then I was done and moved on to the X-Ray.

I was pushed out on my old extra bed to the same slot between beds again. While waiting for result of CT scan, I was given one bag of saline which last about 4 hours. After the result was out, the doctor came back and told me that there was water in my right side of reproductive organ and some water also in the liver. I was then referred to specialist to do further check which the hospital will send letter of appointment to us later. At this time, my husband came in. I cried when I saw him because I was very scared and thinking that this was the reason we cannot conceive. Around noon, I was discharged and went home. I had fever the day after and also sore throat.

I didn’t wait for the hospital to arrange for the specialist. A week after, I went to GP to request for referral letter. I went to one specialist at private clinic in Mouth Elizabeth Hospital. After examination, the doctor concluded to me that I had PCOS – Polycystic Ovary Syndrome. He looked at my previous tests which I brought with me from NUH and it was stated that I had PCOS as well. However it was not conveyed to us from the doctor at NUH.

“Nothing happen, No baby yet”.

It’s all about: PCOS, our infertility journey#4

Yo-liciously yours,

It’s all about: first doctor visit, our infertility journey#2

Our infertility journey #2

In February 2013, we wanted to make sure that both of us did not have any (serious) problems. So we decided to go for fertility check up. There is government subsidy in Singapore for Singaporean/ Permanent Resident couples for fertility treatment. We visited GP in one of the polyclinics nearby our place for the referral letter for fertility clinic at the hospital. When we reached polyclinics, we did not request for any specific doctor as any doctors will do. It was our turn and when we entered the room, ‘surprise’, the doctor was my husband’s school friend.

After we had small talks, the doctor recommended us to NUH National University Hospital for further tests. We made the appointment with Clinic G – Obstetrics & Gynaecology Clinic. Our first visit was around April 2013. Since we were in subsidized program, we were not able to choose the doctor which mean no dedicated doctor for us every time we visit. I had my blood test and PAP smear done and for my husband, he was arranged for the semen collection and I had my second-day period appointment for the ultrasound.

We visited the clinic to hear the result of our tests again about 2 weeks later. It was very long waiting (at least an hour) before our turn to see the doctor even though we were earlier than our appointment time. We saw another doctor and he showed us the results of both our tests. There were few pages for my result and one page for my husband. The doctor told us that both of us were fine and no big issue with fertility. He suggested to still try naturally and come back after few months if still not succeed. We agreed and went home.

I soon discovered a new way of checking ovulation which is called ‘LH test strip’. This strip will test LH or luteinizing hormone where women body will produce to regulate menstrual cycle and ovulation. LH test will indicate ovulation only when the test line is equal or darker than the control line. I bought like 90 strips online and I kept on testing when it was near to my ‘ovulation’ period according to the application on my smart phone (yes, I still used it). So I stopped the daily temperature check. But I had no idea why my test line never become the same or darker color than the control line. Does that mean…I am not ovulating???

“Nothing happen, No baby yet”.

It’s all about: A&E before sun rise, our infertility journey#3

Yo-liciously yours,

It’s all about: temperature check, our infertility journey#1

Our infertility journey #1

There are many applications you can download on your smartphone nowadays where you can note down your cycle and it will calculate your “ovulation” date. To know your cycle, you will need few months to record your first day of period and duration of it. If you already know your cycle, then you can kick off earlier. I started to count my cycle in January 2012, for few months I realized that my cycle is 33-34 days which explained  why I did not have period every month.

Of course I used one application to calculate ovulation date. We tried for few months but still not success. In August 2012, my mother introduced me to old-fashioned method, to check body temperature every morning. This method I must say is very tedious as it will work well if you had enough sleep without getting up to the toilet at night. And also you need to be disciplined and check temperature at the same time everyday including weekend! I had a small notebook and a thermometer on my night stand. So what I did was first thing after alarm clock rings, I will grab my thermometer and put in my mouth. Then I will note down my daily temperature in my notebook or just record in your application.

I read so many articles regarding temperature check and ovulation time. Basically ovulation will occur at around half of your cycle (this is the logic that applications use). Normal woman with 28 days cycle, ovulation will fall on day 14 counting from first day of period. So in my case of 33-34 days per cycle, my estimate ovulation should be around day 16-17. This can be detected by a drop of body temperature.

Cycle

When complete one cycle, the application usually has one function to generate graph from your daily temperature. It will give you more of big picture when you look at the graph instead of bunches of numbers. The temperature will be different in term of decimal points so I suggest to get digital thermometer with at least one decimal point (trust me it is way easier to read and more accurate).

There are 2 stages of body temperature:

  • The low zone: ‘low body temperature’ starting from period day 1 until the day of ovulation where temperature is sharply dipped
  • The high zone: ‘high body temperature’ starting from a day after ovulation until a day before your next cycle starts.

If you are pregnant, temperature will continue to be in the ‘high’ zone. Otherwise when temperature starts to drop then your next cycle is coming.

One year passed, “Nothing happen, No baby yet”.

It’s all about: first doctor visit, our infertility journey#2

Yo-liciously yours,