Hello all! I'm new to this thread and not sure if I should be posting here.
Warning: Long entry below with lots of information.
I'm seeing Dr Tan Heng Hao at KKH too. But after my 1st consultation (where he placed me on the IVF route) in Feb 2014, I've not been required to see him. I've read on some of the forums that I might see him again during the oocyte pick-up procedure (if I ever get there). Just to share what my journey in KKH has been so far, for those who are also interested in the IVF process. Do note that the procedure/process/protocol will vary from patient to patient based on our medical conditions.
Background (Medical history)
I'm 30 this year (born in 1984) and have been diagnosed with PolyCystic Ovary Syndrome (PCOS). This means that my period is irregular and I have many small follicles in my ovaries which are unable to mature into proper ovums (thus never ovulating naturally on my own). My hormone levels are all over the place too. Since I got married in 2007, my hubby and I have been trying to conceive. We saw Dr SF Loh (when he was still in KK Hospital) and he prescribed Clomid for me. 6 cycles of Clomid did nothing for me, and I did not ovulate even when I was on the highest dosage (150mg daily). I moved on to see Dr Johti Kumar at Gleneagles and I did ovarian drilling in Dec 2012. He started me on Puregon (dosage between 50 - 150 iu) immediately after the surgery and unfortunately, I did not respond well to the jabs. In March 2013, he noticed a 2cm cyst in my ovary and advised that we stop all fertility treatments until the cyst went off on its own. If the cyst did not go off, I was to undergo another operation to remove it. In early May 2013, the hubby and I were pleasantly surprised to find out that I was pregnant. Unfortunately, it was a chemical pregnancy that ended in middle of June 2013 where I had a D&C (abortion) done. Since then, my period has been more or less regular, but despite our valiant attempts, I have not gotten pregnant.
Tired of waiting, my hubby and I decided to see Dr Tan Heng Hao at KK Hospital to consider IVF. Dr Tan was very understanding and while we had gotten pregant on our own previously, he knew my anxiety over wanting another child (especially after my miscarriage). He placed me on the IVF route and we got started in April 2014!
Sequence of Events
Feb 2014 - 1st consultation with Dr Tan. I had my blood tests done and the total bill (including the consultation fee) was about $508.
Mar 2014 - Briefing at KKH was another $600, cos they also had to run blood tests for the hubby.
19 Apr 2014 (Cycle Day 3, Stims Day 0) - My period came on 17 Apr 2014 and I was rescheduled for the 1st ultrasound scan on the 4th day of my period (cos it coincided with a public holiday) and this is also known as the baseline scan. Signed the medisave form (so that payment could be made directly through my medisave account without having to fork out cash. Do note that your hubby has to be there if it is a joint withdrawal from both your accounts) on this day too. Was given instructions on how to administer daily injections of Menopur (150iu) and asked to return for the 2nd scan after 4 days of stimulation jabs. (
Warning: For those new to Menopur, you will feel very lethargic and at times, slightly depressed. At least, that's how I felt!)
24 Apr 2014 (Cycle Day 8, Stims Day 5) - The nurses would do a scan to check on the progress of your follicles. Unfortunately for me, my follicles did not grow very much (5 follicles ranging between 5 to 6mm). I was required to continue with the same dosage and to return for the 3rd scan 2 days after. I also saw my TCM doctor at Thomson Chinese Medicine and she did acupuncture for me.
26 Apr 2014 (Cycle Day 10, Stims Day 7) - At this scan, I saw 11 follicles of sizes 6-9mm. I was given an additional jab of Orgalutran, which is an anti-ovulation drug (to prevent auto-ovulation) to be administered day. That's 2 jabs a day! They also gave instructions to continue with the same daily dosage of Menopur and to return next Tuesday. (
Warning: This Orgalutran caused me to have night sweats and hot flushes.)
29 Apr 2014 (Cycle Day 13, Stims Day 10) - The scan showed that there was only 1 dominant follicle of size 14.5mm and another of 10mm. The rest of the follicles were still at 5-6mm. These results are considered very dismal as ideally, the follicles should have already grown till 16-20mm in order to be considered mature. I saw from the charts at KKIVF Centre that the average number of days of stimulation should be about 10.5 for my age group. The medical officer (MO) on duty introduced an additional dosage of Puregon (50 iu) to my mix of injections, bringing my total daily injections to a grand total of 3 jabs a day! I was tasked to return the next day to monitor the progress. I also went for my TCM appointment and did acupuncture.
30 Apr 2014 (Cycle Day 14, Stims Day 11) - Unfortunately, the scan showed that the dominant follicle had experienced speedy growth from 14.5mm to 18mm (3.5mm within a day!) and the 10mm follicle also grew to 12.5mm whereas the small follicles only grew by a measly 1mm. Sigh. The MO instructed that my dosage of Puregon be upped to 150 iu. I also asked for clarification as this may mean that my dominant 18mm follicle would be "over-cooked". She explained that there are too few follicles and hence not possible to have an effective IVF procedure. She chose this protocol to try if the other follicles would grow bigger to make this cycle a viable one, but this would be "sacrificing" the dominant (possible good??) follicle. But there are no guarantees, and if the other follicles still do not grow, I would need to abandon this cycle. All my pain for... nothing? My TCM doctor prefers that I try IUI this cycle with that 1 dominant follicle rather than to waste this cycle, but I couldn't get Dr Tan (he was away in the morning) to ask him and when I tried calling KKH Clinic D to talk to him, their lines were busy. Just sharing so that you ladies can be better prepared next time. My next scan will be on Saturday (2 May 2014), hoping that the other follicles will "wake up" and start accelerating on their growth!
Money Matters
After the initial consultation, blood tests and briefing sessions, everything else is paid through my Medisave Account.
If there is anything that you all want to find out, let me know and I can try to see if I can share (or ask KKIVF when I'm there the next time)! In the meantime, good luck everyone (including me, 'cos I really need it now)!