IVF at NUH--feedback pls

Hi Emily, yr D2 BT might be testing for hormones, kind of let them decide what exactly is yr problem.
As for the appt, prof would scan & see what is the problem & maybe inform U what is the options like, since this just the 2nd appt with Dr.
3rd appt they would have the results by then, so they will inform U by then is short or long protocol if starting IVF.
Becos for long protocol, the jab is to start on 21 day of the cycle.
 


Hi Mel,

Thanks for your reply thru email & thanks for your sharing.I just called NUH and the earlier appointment i can see Prof Wong is 2nd June!!! Long time waiting as the nurse told me he got leave in between Apr & May.

What do you do plan to do now? Consider another try for IVF? Do u consume any supplement to improve body condition?
 
Hi emily: Bluenosebear is right that Prof will advise you which protocol is suitable for u. I registered for March ivf cycle, and was advised of the protocol in earlier review sessions with prof in Feb. So when my mense started in Mar, i called chr on menses D1, and then D2 BT & scan actually triggers the start of the ivf cycle cos i started injection on D2. As for the protocol, it depends on ur age, fertility prob, any past med history etc... so prof will give u professional advices.

Hi Lavender: oh ya prof got a busy schedule for Apr n May, many conference leaves. but if you already made up your mind for ivf, u may register your interest with CHR 1st to chomp a slot. last time I wanted to book Apr or May cycle, but all fully booked. So I took Mar which still was available.

I do plan to try again, but not sure how long I need to rest before the next cycle. found from internet at least need to rest for 3 menses cycles. will consult prof during my review on 02 May.
after the failed ivf, i stopped TCM, and currently only taking royal jelly. heard royal jelly helps to balance hormones (this is impt after ivf cos there is too much hormone introduced to our body). royal jelly also helps to improve fertility for both man n women. So i just give it a try.
 
Bluenosebear: my 1st ivf was 3 yrs ago, and I didn't respond well to the initial dosage on Gonal-F injection (125ml). so after every BT, my dosage was increased. eventually i got 8 eggs retrieved.
For 2nd ivf, prof changed me to short protocol to skip the 2 weeks suppression, and my Gonal-F dosage started from 300ml and maintained throughout. 2nd ivf i got 9 eggs retrieved.

Now i think back, he din really specify the reason of changing me to short protocol. He said since u haave tried long protocol, this time will do short. may cos im getting older, lol... long protocol has the suppression period before stim to regular the hormone in our body, so reduce the risk of over stimulaiton. usually for patients with younger age, it usually start w long protocol.

u on long or short one?
 
Hi Mel,do u mean i can chomp IVF treatment slot at the same time while waiting my appt to see Prof Wong on 2nd June? If yes then i better chomp July hor? I think by the time July should have enough rest,right? I also wonder how should i 'tiao' my body,maybe i should see TMC for advise?
 
lavender: u wanna try call chr see if can register 1st? or else i go find out n update u after my 02 May review.

did u see TCM before? if not should try it to balance ur body and make it a better environment for fertility n implantation. esp most of gals tend to have 寒气, which is no good for pregnancy, difficult for embryo to implant also. After my 1st failed ivf, i started to see tcm and started to be careful n take better care of my body, eg. wear home slippers, long pj pants, minimise ice cold drinks etc. and it did help. I used to feel cold feet most of the time, but now my feet is warm throughout the night even without blaknet. Even not for ivf, it would be beneficial for your body. Hope TCM could help u in ivf~~
 
Thanks blue and mel for the advice.

my doctor is not prof wong, but clara ong.
If can really choop ivf date, i think i will job Jul too. Not sure if available.


Besides, royal jelly is not suitable for pcos patient.
 
ya i also found some info saying royal jelly is not good for ppl with cyst. However, there's also contradictory info saying that royal jelly help to balance the hormone and elevates cyst condition. so i will consult prof also.
 
Mel- my 1st & 2nd ivf is long protocol.
I suppose to see Prof on 2/5, but I have meeting, so I change appt to 8/5.
Likely to do 3rd fresh but I might do in sept or oct time
 
Mel,

NUH nurse called me that i can have appt tomorrow to see Prof Wong as got people cancelled appt last minute but i cant make it as not mentally prepare and not yet get my medical report from KKH,but i'm able to change the date a bit earlier as end of May.I called CHR to check about the chomp IVF slot but nurse said cant,have to register only after see Prof Wong.

Thank you for your advise.I tried accupucture before but didnt do during IVF treatment.I falled sick (2 days fever,flu and cough for 1 week) during the weeks of my stimulation stage.Not sure whether this is one of the reason that i got few eggs (6 / 7 during scanning and only 5 eggs retrival) and since then i'm get cold easier(normally i can stand the cold compare with most people)!Maybe my body become weaker...
 
Hi lavendar, maybe u shld revisit tcm and tiao ur body 1st to prepare for ivf.

lavendar, blue: maybe we could be ivf buddy in ur next fresh cycle =)
any other sister considering Aug/Sep/Oct period?
 
hi emily thks for the update.
Actually i am not sure why i was given the may appt. prob we still have some reports that she need to c .
 
Hi mitzi, welcome to the forum. Have u registered for sept/oct cycle yet? If not, when is ur appt to see dr for review before the registration?
 
Hi Mel,
I have not registered yet as I am still not 100 per cent sure. I had a failed fresh cycle early this month. It was my 3rd one. I hear that most sisters stop at the 3rd cycle. I am very apprehensive right now. I want to try again, but I am also scared of another failure. Prof said there was nothing more he could do. So that is where I am now....
 
Mitzi: If u do not have any concern financially, and u r willing to try again, don't give up. Keep faith and ur dream will come true. I fully understand the fear of another failure. It's really heartbreaking to know the result of BFN after gong thru all the injections, anxious wait with so much hope. It's difficult to face the disappointed DH, in laws n families. But there r also many encouraging stories of successful ivf after many failed cycles, some even conceived naturally after 6 failed ivf. So miracle happens n ur time will come sooner or later.
 
Mitzi, go for your 3rd attempt. I did mine and succeeded
happy.gif

Don't give up..
 
Thank you very much, Mel and Su yana, for the encouragement. I am trying to pull myself together. Mel, hopefully we will be cycle buddies!

Btw, do any sisters here have experience in dealing with husband's DNA fragmentation? It is my issue.
 
yes mitzi, a few other sisters are considering Aug/Sep/Oct cycles. hope we can be cycle buddies.

im not sure abt DNA fragmentation. what did dr say abt it?
 
Hi Mel,
I haven't seen much discussion about this in Singapore, so I want to say a bit more about this, in case it is of some use to the sisters who face male fertility issues.

Some men have DNA fragmentation in their sperms. It means the sperms' DNA is damaged. If DNA fragmentation is above 30%, the man is practically infertile, even with IVF. The embryos don't tend to survive beyond a certain number of days (5-8), hence no implantation. Or if there is implantation, the embryo is weak so it could end up being an ectopic pregnancy or miscarriage. The DNA fragmentation test is not routinely done as part of the sperm test in most clinics here. NUH does not. We only found out that my husband had this issue when he went to the TCM shinshei Madam Tan in Jurong, who then sent him to see Dr Chen in Gleneagles. As part of the sperm test there, they also did DNA fragmentation. It can be caused by different things, e.g. smoking, exposure to radiation and varicocele (enlargement of veins in the scrotum). If a man has this issue, his sperm test tends to show low in everything (morphology, etc) or it can show normal.

We did discuss with Prof and he recommended husband taking high dosage of Vitamins C and E, which is consistent with what we've read on the internet. basically these are antioxidants, to reduce the damage to sperm DNA. it's the least invasive method. It seems to be universally recommended. We did that. In my 2nd cycle, I was pregnant but it was ectopic. So we did feel that it helped. Maybe just not enough. Surgery (to correct varicocele, which my husband has) is another possibility, but its success rate is not that high (i can't remember exactly but it is more than 50% but below 80%). That is the reason why we didn't go for surgery yet and wanted to try some cycles first.

Prof didn't seem very concerned about this DNA fragmentation thing when we discussed it with him in 2010. Also, at that time I didn't find a lot of women talking about it in all the US IVF forums yet. But when I look at it now, I see there's been a bit of progress in the last 2 years; a lot more clinics do that test now and more husbands have gone for surgery etc. In cases where DNA fragmentation decreases after surgery to a more acceptable level, some people get pregnant naturally and some people have success with IVF after that.

Since I am willing to go through another cycle (and with no subsidies or CPF this time), i feel that I should deal with this DNA fragmentation issue more aggressively. We didn't discuss it with Prof in our review so I intend to go back to talk to him about it.
 
Mitzi: this is a very good piece of info! the symptoms seems familiar, and for my last 2 cycles, my excess fertilized embryos didn't further develop after ET, so end up no frozen embbies. my dh sperm quality is low in morphology, but he doesn't smoke at all. think we will need to arrange for a test on this DNA frag soon. thanks so much for sharing!
 
Mel & Mitzi, my hubby also have sperm quality & quatity issue.My hubby consume tribestan and multivitamin consist zink & various vitamin not sure whether sufficient to improve his sperm situation.What your hubby consume besides vitamin C & E? My 3 eggs mature but only got 1 fertilized after injected sperm to my eggs in my previous ICSI cycle, not sure whether it's sperm issue coz only 1 egg fertlized? and of coz this embroy didnt implanted and most probably i will try 1 more ICSI.Hopefully can improve our body condition before next try.Any advise?
 
Lavendar: my dh have tried zinc, selenium, multivit, TCM, but not much improvement. my last cycle in Mar, prof asked him to take Vit C&E. just recently, he started taking royal jelly together w me, and he also trying Blackmore Men's Performance Multi. dunno if this is gonna help, but we just try everything.

After reading Mitzi's info, now we may consider for a sperm test to check the DNA fragmentation, since we didn't know abt it before.
 
Hi Mel,mind i ask what make u to do ICSI?Is it mainly of hubby sperm issue only?For my case,that is the reason...as we ttc about 5 years and now i think my age also an issue as seems not many eggs even with high dosage for puregon.I start eating Q10,hopefully can improve my eggs condition.
 
Hi Lavendar: we embark icsi due to both of us not in optimal condition. my dh got speerm issue, and I had 2 op for ovarian cyst removal. 1st time was before our ivf journey, which we tried natural but couldn't conceive after 1 yr. so end up we went for consultation, and gynae found ovarian cyst on both sides. after 1st op, we tried natural again for half a yr, but not successful, so we tried 1st ivf but BFN. 1.5 yr after my 1st failed ivf, i was found to have cyst again via PAP SMEAR check up(but it's a diff type of cyst). so i had op again to remove it as the size is growing bigger. then gynae recommend me to try ivf again to try to conceive asap to prevent cyst from recurring.

since u do not have much prob, have u considered trying royal jelly. it's good for both man & woman to improve fertility.
 
Hi Mel and Lavender,
The vitamins your DHs are taking are the ones I've seen being recommended from internet sources. So you are already on the right track. For my husband, he's only taken Vit C and E and GNC multivitamin and Chinese medicine so far. I think I'll add some more for him, from what I hear your husbands are taking :)

A few other things about DNA fragmentation test: it is not cheap and not all medical professionals believe in it. I can't remember the exact price but it's not $100-200 like the usual sperm test. I just remember vaguely the bill from my husband seeing Dr Chen and for the test was closer to $800-1000. That's probably why it's not part of the routine sperm test; because it's expensive and at the end of the day, if they find DNA fragmentation issue, the main recommendation is still to take vitamins anyway. So sisters, take it easy about doing the test, esp since your husbands are already taking vitamins.

In my case, I want to explore the surgery option because my husband has varicocele. Apparently it is quite common, affecting about 15% of men. It doesn't seem to be a big problem on its own. Just that I feel if it causes DNA fragmentation, then i want to deal with it.

Can I ask you where you buy Tribestan, please?
 
Thks Mitzi. When I told my hubby abt this, he was quite concerned n worried need to do op. but then if we dun check it out, there's a possibility the embryo quality will not be gd n even the 3rd cycle may not be successful. It's quite worrying. If we do the test, will it be able to tell if it's caused by varicocele?
 
Hi Mel,

You don't need to do the DNA fragmentation test to diagnose varicocele. The doctor only needs to feel the man - that is all. And do remember it is fairly common, so even if a man has varicocele, it doesn't automatically mean he has DNA fragmentation. And even if a man has it, not everybody chooses to do an operation. The success rate of the operation is a bit of a question mark also. I am looking for a urologist to ask all these questions. So don't scare your husband :)

I agree with you about checking everything out. I feel that even if I eventually don't succeed, having checked out everything makes me feel like we've done our best.
 
Mitzi I bought it KKH pharmacy.

Btw ladies juz to share wif u. B4 me n DH decided to embark on IVF, DH has had his SA late last year He wasnt taking anything supplements et dat point of tyme. His vol is 3 million, morphology 2% and his motility 58%. He was prescribed Vigor Ace to improve his semens. He jus took Tribestan 1 month ago together wif Vigor Ace. I started my Lucrin injections on 16 April tis year. B4 kicking of wif e injections, DH requested for another SA. Thank GOD, surprisingly ther is an improvement even though not dat much. His morphology is 5% motility is 65% n volume is 3.5million now.

So now DH is stil on Vigor Ace, Tribestan for his supplements. Besides dat he ate kiwi, almond n folic acid everyday. I m on D24 of Lucrin.
 
Mitzi: my dh was checked by gynae before and he din mention anything varicocele. not sure if need to check again. prob will ask prof. thanks for the info. so for the meanwhile, we will continue the multivit, hope it could help more or less.
 
Hi Nurul, can i know how much the dosage of tribestan your DH eat?

Hi Mitzi, i bought at JB My pharmacy (http://www.mypharmacy.com.my/about.php) , which is cheaper than to buy in SG.I heard KK pharmacy sell 90+ but My pharmacy S$60+ with member discount after convert to SGD.

Hi Mel, i didnt try royal jelly but i eat bee pollen instead,should be same function as royal jelly too.
 
Hi, im new to this thread.

Mel
Great to see you here ;)

by the way, i had 2failed ivf fresh cycles with kkivf & had decided to get 2nd opinion from NUH. Just called to book an appt with Prof Wong as a pte patient on 02 June (earliest slot). As i am totally new to NUH, can the ladies here advise what is the process & waiting time over at NUH like?

my day2 hormone test & day 21 progestrone test was done in kkh slightly more than a year ago, from your experience, do you think a retest will be ordered? since i will be a new patient there, how long will it takes for me to start the actual cycle? ive check with CHR & it seems that the appt for fresh cycle is already in June 2012. I hope to do mine in Jul/Aug/Sep, not sure will i be in time?
sorry if ive got too many questions...hee...
 
Hi babywishdreamer: nice to see u here too! wave wave~~

I think June is the earliest slot for Prof Wong le. Cos i supposed to meet him for review on 02 May (after my failed ivf), but it was postponed to 01 June due to Prof wong going overseas.

Process should be quite similar to KK, from other sister's feedback. Prof will review 1st, then decide if u will be on long or short protocol. You will need to go CHR to register for next ivf cycle 1st. It depends on their availability, which next available cycle might be a few months later.

since ur last pre-ivf BT was done almost a yr ago, likely u will need to test again. once u got ivf cycle registered, CHR nurse will advise u when to go for the test.

we have a few sisters here (lavendar, bluenosebear, maybe mitzi?) who are looking at Aug/Sep/Oct time. hope we can be cycle buddies soon!
 
Hi Mel! *wave wave*
happy.gif


Thanks for the info. Oh, ive called CHR and they told me can only register/book on Prof's advise after i see him. icic. good to know that its registration first then schedule for the tests. Initially i thought have to do all test first before can book appt which by that time dunno when loh..haha..

Yes yes, hopefully we can all be cycle buddies!
happy.gif
 
Ladies, My FET is due in mid May. I am just waiting for my menses but I called up CHR for some reason and got to no Prof is on leave from 9th May to 24th May. CHR suggested that I can go ahead with Dr. Steven Chew. Any Feedback on him?
 
Hi Siddhi, no worry. He is also good. I think one of my IUI is done by him and he is quite gentle. One of the sisters, andreanie did fresh with him and I think she has delivered already.
 
Hi Mel, Thanks for your quick response....I also made this search...Searched in some other threads though very limited feedback about him but all good

CoolCool *wave wave* How are you? Hope your baby is doing fine? Which week u are in? Thanks for your reply.....
 
Hi babywishdreamer,

I'm also done by 1st failed cycle at KKH last month and made appt to see Prof Wong end of May.Will u take medical report from KKH about your previous IVF treatment to see Prof Wong? I have checked that the medical report cost $80++ and only for 1-2pages.Which dr did IVF treatment for you in KK? Did u go back to see your Dr after failed IVF in both of your cycle? Do u think i should see dr at KK (for review my failed IVF) since i have decided switch to NUH?

Glad to meet you here,we can be cycle buddies and both have same background (failed in KKH).Do u satisfy KKIVF center? What make u plan to switch from KKH to NUH?
 
Hi Lavender, *wave wave*
I'm still considering if i wanted to get the medical reports. I've wrote in to KKH and this was the price list they sent me: a) Investigation results - $5.35, b) Ordinary Medical Report(provides relevant facts about medical condition of patient)- $80.25, c) Specialist Medical Report (provides specific opinion or prognosis from specialist on medical condition of patient). Considering a) &/or b).

Im under Dr Jerry Chan.You? yes i did went back the first time. the second time is just last week so appt is not so early. Im thinking to just go back as well to at least know the whole situation better & see what Dr Chan suggest before i decide. My appt with him is before the appt with Prof.

do u mind sharing your first cycle details & how come you decide to switch? as for me, since ive failed twice in the same place, im hoping a change will bring me better luck & ive read lots of reviews here that Prof Wong is very good & nice.

Yes yes, glad to meet u here too
happy.gif
Hope that we can be cycle buddies together with a few other ladies here (Mel, bluenosebear, mitzi?)!
 
Hi babywishdreamer, *wave wave*
Glad that you reply my message so fast!Actually this morning i just went to KKH for medical report.But at the end i only requsted for my blood test 2012 report(free for charge,blood test 2011 for $5.25 which i already have a copy for my D2 & D21 menses blood test before i start my IVF treatment).For medical report, KKH staff told me need 1 mth plus to ready the report (i was told 21 days which i called in b4) and by the time it is too late to show Prof Wong. I'm thinking whether can i request my Dr (Dr Matthew Lau) to provide some document or write report for me when i see him for review? Your both cycle with same dr?

I done my ICSI and have my blood test bfn mid of this month.Dr Matthew Lau suggested we go thru ICSI as my hubby sperm quality & quantity are poor and i'm mid of 30s now.Dr didnt say i have any problems just said my AMH a bit low 2.3 but this is consistent with my age.During scanning,i have 6-7 eggs but during ER only 5 eggs retrived and 3 eggs injected sperm and only 1 embroy fertilised.1 embroy with grade 3 and 6 cells was transfered and get bfn at the end.I have fever 2 days and 1 week flu & cough during my stimulation stages,not sure whether it effect my eggs quantity & quality or becos of my low AMH reading.

Honestly,i'm not really satisfied and happy with KKH as only get to see Dr during ER & ET and the rest of time all deal with nurses.Nurses are too busy and even provide wrong info for me, and they always very rush seems no time for me to ask more questions.After ET rest 5-10 mins but NUH can rest few hours,right? I want to switch to Prof Wong as i want to have only 1 dr fully focus to my treatment unlike KKH,my ET & ER dr is A,but the dr decided my injection dosage is Dr B then the dr C review my eggs size after scanning and decide to add more dosage for another few days injection.I feel that is really 'messy'(hope u get my point). How about u? Mind to share yours IVF cycle & KKH experience and opinion as well?

How do you prepare yourself before start next cycle? We can always come here to exchange info as we will be cycle buddies very soon
happy.gif
 
Lavender
yah, they told me 21-30days & i was like huh??!! but for my case will still be on time because my appt is only on 02 June. Nope, first cycle was with another Dr who went over to tmc but i have financial constraint thus did not follow suit. No harm checking with him?

oh, your case slightly opposite of mine but your body condition definitely much better than me. there's nothing wrong with my dh's sperm. for me i have a blocked tube, ovulation prob & low AMH-1.1 which is too low for my age as im in my early 30s.
my 2nd fresh was worst than my first. first cycle i had 2 grade3 embryos but BFN.the recent one, i did not even make it to ET - scan shows 6, retrieved 4. only 2 with eggs & out of which only 1 fertilised but eventually did not divide so ET cancelled. Nightmare!

my tcm told me to be very careful not to fall sick, have flu or sore throat etc when starting the cycle. Maybe the next round, you go build up your body? Did you do anything for your first try? i.e. tcm, supplements, accupuncture etc?

i understand what you mean. i was taken aback during my first try as well as i thought im going to see my dr during e scans & review as i have alot of qns to ask. but i think i get used to it eventually...haha...yes, i also wanted to have 1 Dr to fully focus on my treatment, maybe it will not help much in the outcome technically but i think it does help psychologically.

I am still thinking. Hesitant as to whether i should go back to tcm as i did nothing at all during my first cycle but result was better than my second cycle where ive done much more. *pondering* tentatively i think im going to load up on supplements - currently taking blackmore conceive well gold & ensure milk. thinking of getting evening primrose oil & flaxseed too. Heard that maca is good too but seems like cant find in SG? will cont to look for it. what about you?
 


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