IVF/ICSI Support Group

[ron8129]

Thanks bbpooh81. If allowed ..think I will go for ivf if doctor gives the go ahead after assessing my risk of ohss. Dont want to waste a cycle.my follies inceased by 2 more largest being 15.5 on left and 16.5 on right ..im so bloated now

H0peful,

Sorry you had been rushed into the ivf world. But welcome (eventhough we dont like to see more members )

I am sure u know no decent doctor in SG will proceed w IUI with that many follicles. The good news from an ivf perspective is you have a good (abt 10-12) number of good and even-sizwd follicles with v low stimulation. and that you were doing IUI means hubby's sperm shls be quite good.

Looking at your follicle size its v even growth and u look set to hv many usable follicles upon retrieval. If you decide to proceed with IVF, these are all good sign. You can transfer one or 2 embryos this round and keep the rest for siblings and no need to do more injections in the future. Youe lining looks good too.

Is IVF a sure success? No. But many do succeed on their 1st try, or 2nd.

Is it really scary? The worst part is actually the 2ww. But that is the same for the IUI.

Trigger - you will trigger just like IUI but maybe w a different med. 36hr later instead of IUI process, you will go back for retrieval to "catch" the matured eggs.

How painful is the eR? most of the time you wont feel a thing during the retrieval process. Go there in morning hungry after fasting, v nervous, open your legs, given an plug to drip in the sedation drugs and u konk out.

Post eR? There is a risk of OHSS but for you even if you proceed w IUI or at current stage you r still high risk. Try to drink lots and lots of water to help flush out the meds. If you can do it, 2L water a day. After ER, the first 2 days you may feel some cramps and pain as the body recovers. But if you are retrieving around 10-12 it's not so bad. Only risk is monitor OHSS.

Next step - egg fertilisation. Natural IVF or ICSI? They may offer you natural IVF if your hubby's sperm looms strong. Or a 50:50 mix, or a 100% icsi. Most of the time the embryologist will decide but please ask them if you can what they plan for you. I believe ypu can InSIst if you u want a certain method.

Waiting to hear how many eggs r fertilised and how many good ones available for transfer or freezing is scary. but then again after IUI you hv no idea if the egg actually fertilised or not.

2 or 3 days after ER (or d5 if you hv good blastocyst, ie d5 embryos), you go back and proceed with embryo transfer. Process similar as IUI. Open legs, full bladder, and instead of injecting the washed sperms you will be transferred w the selected embryos.

Then 2ww. Ans hopefully good news during beta.

Good luck. Can't he easy hvg to make this decision so suddenly. But it's not that bad really. It's the damn beta bfn that cuts like a knife

 

[ron8129]

H0peful, sorry just re-read your original post that your hubby has male factor. Surprised they recommended IUI for you?

 

[mqiu]

Thanks bbpooh81. If allowed ..think I will go for ivf if doctor gives the go ahead after assessing my risk of ohss. Dont want to waste a cycle.my follies inceased by 2 more largest being 15.5 on left and 16.5 on right ..im so bloated now

Er really not that bad. I had 40 or so follicles growing so my poor ovaries were poked many times and yet I cant rem any pain. I was more scared of the daily needles and blood tests my doc had me take cos I was high risk for ohss (testing for estrogen level).

 

[h0peful]

H0peful, sorry just re-read your original post that your hubby has male factor. Surprised they recommended IUI for you?

Doc says im young so suggest iui cos hb sperms can be washed. I have risk of 4 fertilized eggs for iui cos 4 of my follicles are of the right size for ovulation already. Dey gav me option to try naturally and cancel this iui or proceed with iui with risk of quardplets or convert to ivf but told me usually people of my age r not keen on ivf yet. We decided to go with iui after discussing ... im not sure if is a wise choice cos there are risks of killing the embbies if tested to be bad and risk of miscarriage ... im really at a lost now

 

[bbpony]

Can share how many egg whites to eat during stimulation and how to prepare the egg white?

 

[mqiu]

Can share how many egg whites to eat during stimulation and how to prepare the egg white?

Hard boiled! My doc limit to 2 per day.

 

[ron8129]

Doc says im young so suggest iui cos hb sperms can be washed. I have risk of 4 fertilized eggs for iui cos 4 of my follicles are of the right size for ovulation already. Dey gav me option to try naturally and cancel this iui or proceed with iui with risk of quardplets or convert to ivf but told me usually people of my age r not keen on ivf yet. We decided to go with iui after discussing ... im not sure if is a wise choice cos there are risks of killing the embbies if tested to be bad and risk of miscarriage ... im really at a lost now

This is my personal judgement and totally not medical trained.

But 4 (or looking at the sizes maybe up to 6) lead follicles looks v scary to me unless you are ready for multiples (both the high risk pregnancy and post-delivery caring for quads), or if not, to be prepared to selective mid-term termination at a later stage if you are not ready or for medical reasons (body cannot cope, a baby not growing as well).

Did they discuss with you the implications & possible risks (from a medical pregnancy & delivery point of view) of carrying multiples, esp triplets or quads? I am still v surprised the doctor offered to proceed w IUI. .wow..

If you are, go for it. There are a few successful quads in SG and I think the oldest are already in college level. And who knows, maybe only one lucky fella will stick and it will be a smooth uneventful pregnancy.

30 is young. but not too young is this your 1st IUI?

 

[ron8129]

I am not trying to scare you but i am hoping you get both POV rather than the doc just leaving you to decide and say "up to you lah".

In the end, we all need to follow our heart but dont push for it to proceed simply because you hv gone all the way with the injections this month.

There is always another opportunity for another round at lower dosage of stimulation drugs if you decide to abort this cycle & get a more controlled result. That is another option too.

 

[hopeful13]

Hopeful13,

Wa... that colleague of urs who knew u r gg through ivf and still commented u r lucky dun have children, that is really insensitive of her to say that.
Aft I failed my 2 rounds of iui, there is this auntie in office said "wa... you really want to have kids very much hor, watch this kind of video!" I was watching a funny baby video in yahoo news. Then I very impulsively said "我每一次做一些东西你就要讲这種东西."then aft that time she never say anything about baby to me.

Yah from then on, I sort of distance myself from that colleague. Good on you! Sometimes just need to be rude to such people before they shut up.

 

[old aunty]

I'm 37, started Ivf age of 32, married at 23.
Care to share your Ivf journey in a nutshell?[/QUOTE
Sure. I'm 42 this year , married late ,failed my first fresh at SGH even though everything looked fine with 27 follicles ,10 fertilized eggs and eventually 4 blastocyst s with minimum stimulation .guess it was due to age and chromosomal abnormality . now doing FET with my two remaining precious blastocyst embryos

 

[h0peful]

1st iui hence in delimma. Hb said so long Im comfy about it. Didnt really get a good advice from doc cos it just asking me to mke my oen decisions. Dey spoke about the possibility of mc and having to terminate in the midst etc but told me is still go choice if I think I cam handle multiples and the up and downs should I mc or have to terminate any in the process.

 

[bbpony]

Anyone taken growth jabs during ivf at kkh? Can advise the name of jab? Did doc share why it is necessary to take such jab?

 

[old aunty]

Thanks Ashley,
I worry if I tell him some procedure to do my boss might keep asking what thing.

No matter what I will go ahead with this IVF
Coz I had 3 miscarriage and ectopic pregnancy
Had been trying for four yrs normal which fail.
Hope this my first IVF which will success.

Jiayou Nagano!

 

[old aunty]

Nakano, Wishing u all the best for your coming ivf

 

[ashley11]

Base on my last checked with Dr loh, thailand no longer allowed donor plan....

I've just emailed the centre two days ago and they recommended an independent agent who can provide donors!! Some of the donor photos look familiar as they are the same batch whom I screened in 2013, anyway there is still donor availability, the fertility centers just worked around it.

 

[ashley11]

Woah, I've never imagined any woman over 30 producing blastocysts! Mine barely made it to day 3. U have one good chance!! Jia you!! @old aunty

 

[ashley11]

Thanks Ashley11. Yup, i'm referring to dr loh sf. Deep down, I feel it would be my egg issue more than the lab as I have seen many of the ivfers in sgh conceive successfully.. or maybe he felt the protocol dr yu gave me is not suitable..Dr yu is my dr in sgh..

I've seen dr Yu too, she's a very experienced Ivf specialist. If I were u, I will switch centre and dr to eliminate or alleviate doubt that sthg could be wrong with the lab, ur luck with this dr etc. the other way is to visit a dr that you potentially want to do the next cycle with, hear his point of view and then decide to continue with dr Yu or new dr.

Btw, did your eggs fertilize? U did go to et stage right?

Side track, why did u choose dr sf loh as your advisor? I was under him 3 tries in KKH and his attitude sucks!! Arrogant, uncaring and don't have time for patients. and I feel that leopard will not change his spots, I think he is more like a dr, or more compassionate in TMC as he is representing a Pte hospital where patients pay much more. My sister had a very bad experience with him too. When she confided that she is feeling unwell after getting pregnant from his Ivf, he said to her "you asked for it, right?" I was like.......wth.....

 

[ttc77]

Hey everyone, need someone help
I'm highly confused

Today is day 3 of my menses. Just went to see Dr Loh for medicated fet as I suspect I'm not ovulating since failed ivf

I was told for medicated fet, it doesn't matter if I have ovulation
N the medicine that was given was not to induce ovulation like what I previously thought, but to build up the lining

N Dr Loh told me I only need to go scan one time, on day 12 of my menses.Then subsequently I can choose myself to transfer anytime between day 15 to day 19 of my menses.
I asked him if my lining is not thick enough on day 12 ,Then what will happen?

He says increase medicine dosage. But no need scan anymore.

The info is so different from what I imagined previously

Is this what the sistas here Who have done fet also experience? How come if lining not thick enough no need scan anymore?

Also, today is day 3 n He never scan me too. He says no need check for lining now

 

[littlejo]

Thanks bbpooh81. If allowed ..think I will go for ivf if doctor gives the go ahead after assessing my risk of ohss. Dont want to waste a cycle.my follies inceased by 2 more largest being 15.5 on left and 16.5 on right ..im so bloated now

Personally I think u seem to be pretty fertile. I know ivf protocol is more invasive compare with iui but ivf has higher chance of conceiving with iui. Ur ultimate aim is to conceive so I think why dun u have a really good talk with an ivf doc about the success chances of iui and ivf and what are the side effects then make a decision. If doc said ur case high chance, think going the pain may worth taking. Last time I dragged the thoughts of gg ivf cos of all the medicine and side effects but my fresh cycle failed. Now thinking back these pains are nothing much if we could only succeed in having a healthy bb.

 

[babyloveyou]

TWW begins today! Any sisters also in their TWW?

 

[littlejo]

TWW begins today! Any sisters also in their TWW?

Jmec, u did ur ET already? How many embryos transfered?

 

[littlejo]

Hey everyone, need someone help
I'm highly confused

Today is day 3 of my menses. Just went to see Dr Loh for medicated fet as I suspect I'm not ovulating since failed ivf

I was told for medicated fet, it doesn't matter if I have ovulation
N the medicine that was given was not to induce ovulation like what I previously thought, but to build up the lining

N Dr Loh told me I only need to go scan one time, on day 12 of my menses.Then subsequently I can choose myself to transfer anytime between day 15 to day 19 of my menses.
I asked him if my lining is not thick enough on day 12 ,Then what will happen?

He says increase medicine dosage. But no need scan anymore.

The info is so different from what I imagined previously

Is this what the sistas here Who have done fet also experience? How come if lining not thick enough no need scan anymore?

Also, today is day 3 n He never scan me too. He says no need check for lining now

Hi ttc77,
How u knew u r not ovulating. Were u told to use test urself using pregnancy test kit?

 

[Lititia]

Hi Ladies,
I'm a new here, just starting the IVF journey.
I'm 32 now, have ttc for about 2 years. January 20 is my first IVF consultation, so I decided to start reading through this forum to make myself more familiar with the process and see the real stories. I feel a bit stupid coz often do not understand what you are talking about, it took me a while to figure out what TTC stands for, and I don't know most of other abbreviations, but it's a learning curve, right?

I was considering IVF for about a year, very reluctant, as I hate anything hospitals- and doctor-related. But as there was no luck for the past two years I've decided that it's time. Initially I did not want to browse any mother-to-be forums, because I was afraid that it will make me more stressed, but I realized that I lack the knowledge and friendly advise, and that's why I'm here.

Looking forward to IVF adventure (trying to think of it this way makes me less scared).

 

[littlejo]

May I ask how old r u?
Maybe it's gotta do with my attitude in everything. It's almost like a cockroach you can't squashed to death ( translate to chinese, may sound better) lol.
We wanted to go all the way out n if it doesn't still work out, we know we already tried everything we could n no regrets.

Yes 7 cycles are not cheap. 1st three fresh are partially subsidized in KKH, thaw fully paid on my own and of course rest of cycles. I did once in Msia n twice in Bangkok and the last gave me my son.

I'm not sure if it's unexplained infertility, I had pretty normal Amh, afc etc to ascertain my fertility but my cycles yielded me very few viable eggs. Hence, we decided to go for donor egg in Bangkok. It was the best decision we have ever made. Most non successful Ivf cases are due to "bad eggs".

Hi Ashley11, what is amh? I'm 39 already.

 

[babyloveyou]

I've seen dr Yu too, she's a very experienced Ivf specialist. If I were u, I will switch centre and dr to eliminate or alleviate doubt that sthg could be wrong with the lab, ur luck with this dr etc. the other way is to visit a dr that you potentially want to do the next cycle with, hear his point of view and then decide to continue with dr Yu or new dr.

Btw, did your eggs fertilize? U did go to et stage right?

Side track, why did u choose dr sf loh as your advisor? I was under him 3 tries in KKH and his attitude sucks!! Arrogant, uncaring and don't have time for patients. and I feel that leopard will not change his spots, I think he is more like a dr, or more compassionate in TMC as he is representing a Pte hospital where patients pay much more. My sister had a very bad experience with him too. When she confided that she is feeling unwell after getting pregnant from his Ivf, he said to her "you asked for it, right?" I was like.......wth.....

I agree Dr Loh has attitude issues. I did my 1st IVF with him at KK and when i see him for review when I failed, he was suggesting to try FET etc..so I asked him how much is the cost and he smirked and replied me 'how I know I'm not the cashier' I know I was silly and shouldn't have asked him that, as a doc he won't know but I'm already so depressed and lost from a failed cycle. It doesn't help with him being so sarcastic.

 

[babyloveyou]

Jmec, u did ur ET already? How many embryos transfered?

Transferred 2 God Bless! but the rest of the eggs cmi..none frozen. I'm grateful to get thru to this stage though

 

[fr0stie]

Dr Loh is my gynae and my IVF doc for my first cycle. He is just being very direct and too direct at times actually. He is not one who say sweet things. He already treat his patients very well compared to the nurses. I know he is very fierce to them. At KKH, he often skip his meals and when I see him at 4pm he hasn't taken his lunch. When I needed his help like bleeding when preggy, he is willing to see me as long as I'm willing to wait. Nurses wanted to turn me down but as long as I sent him an email, he will reply to me that I could see him without an appointment - so nurses no choice but to register me as the last patient- thats at KKH. For this round I felt so crampy in my 2ww that I just banged my hands on the bed and wanted to hit my head on the wall, I emailed two docs and only Dr Loh replied as other KKH doc was out stationed. Dr Loh called me the same day my email was out to talk abt my condition even though I have not seen him for about 2 years now. I guess its that he is now into private practice that he has more time and able to manage better. At KKH its like a mass production with sooo many patients and with all the protocols, his hands are tied up at times and I guess that's why the bad mood at times. Not just you but I know several others have a bad experiences with him. Well he does have his good mood too like, will ask me to recommend tuition teacher to his kids. Lol. I guess most govt hospital docs are very overworked especially him who is such a workaholic at his job thats a passion to him. His nurse ever told me he almost work all 7 days with little rest and sleep.

 

[ashley11]

Dr Loh is my gynae and my IVF doc. He is just being very direct and too direct at times actually. He already treat his patients very well compared to the nurses. I know he is very fierce to them. At KKH, he often skip his meals and when I see him at 4pm he hasn't taken his lunch. When I needed his help like bleeding when preggy, he is willing to see me as long as I'm willing to wait. Nurses wanted to turn me down but as long as I sent him an email, he will reply to me that I could see him without an appointment - so nurses no choice but to register me as the last patient- thats at KKH. For this round I felt so crampy in my 2ww that I just banged my hands on the bed and wanted to hit my head on the wall, I emailed two docs and only Dr Loh replied as other KKH doc was out stationed. Dr Loh called me the same day my email was out to talk abt my condition even though I have not seen him for about 2 years now. I guess its that he is now into private practice that he has more time and able to manage better. At KKH its like a mass production with sooo many patients and with all the protocols, his hands are tied up at times and I guess that's why the bad mood at times. Not just you but I know several others have a bad experiences with him. Well he does have his good mood too like, will ask me to recommend tuition teacher to his kids. Lol. I guess most govt hospital docs are very overworked especially him who is such a workaholic at his job which is also passion to him.

I'm afraid I do not buy the excuse that being overworked means you can be rude and insensitive.
Dr tan HH n dr sadhana are as busy, but never this kind of attitude.

 

[littlejo]

Transferred 2 God Bless! but the rest of the eggs cmi..none frozen. I'm grateful to get thru to this stage though

Hee...yday I already guessed u could get through it cos if they didn't say anything yday u should have something acceptable to transfer. Enjoy ur 'holiday'!

 

[ashley11]

Hi Ashley11, what is amh? I'm 39 already.

Chk this out

http://www.advancedfertility.com/amh-fertility-test.htm

 

[littlejo]

I agree Dr Loh has attitude issues. I did my 1st IVF with him at KK and when i see him for review when I failed, he was suggesting to try FET etc..so I asked him how much is the cost and he smirked and replied me 'how I know I'm not the cashier' I know I was silly and shouldn't have asked him that, as a doc he won't know but I'm already so depressed and lost from a failed cycle. It doesn't help with him being so sarcastic.

Jmec, currently under dr loh too. And yes, he is very ya ya but used to it. During the ER, he told my hubby the wrong day on producing sperm for fertilising. Lucky my hubby found out from TFC otherwise can't produce enough swimmers loh.

 

[old aunty]

Woah, I've never imagined any woman over 30 producing blastocysts! Mine barely made it to day 3. U have one good chance!! Jia you!! @old aunty

I hope so but after the first failure it is very hard to stay positive esp when I am so old.i am now racing with time. As for blastocyst,my dr did say it is very encouraging for old aunties like me to have many follicles and 10 eggs to reach blastocyst stage though eventually only 4 can b used. However this cannot guarantee good quality eggs tt wil results in implantation . Chromosome issues can't b seen with naked eyes . But I told myself fann Wong and many other celebrities as old as 45 can b preggies , I must try too!

 

[vitaminkin]

TWW begins today! Any sisters also in their TWW?

Yes! Me Me ... did my FET on 03.01.2015 @ SGH Care too.

 

[old aunty]

I agree Dr Loh has attitude issues. I did my 1st IVF with him at KK and when i see him for review when I failed, he was suggesting to try FET etc..so I asked him how much is the cost and he smirked and replied me 'how I know I'm not the cashier' I know I was silly and shouldn't have asked him that, as a doc he won't know but I'm already so depressed and lost from a failed cycle. It doesn't help with him being so sarcastic.

Y he so rude ? I am very sure he roughly knw hw much it cost for each procedure.ask u to refer to cashier can Liao no need b so rude ma...

 

[fr0stie]

Like us, if we work in service line, we also must control ourselves and pretend to be cheerful when we talk to customers even though we may have a very bad day. Some can control it better than others bah.

Just find a gynae or doc that most suit your peference and you're most comfortable with.

Not the first time... everytime u will hear patients feedback about his attitude lah.. very common lah... I think I also kena once but cant rem already cos other times he has good moods too.

 

[hopeful13]

Hi all, just started my stim today after 17 days of lucrin. Do u all roughly know how many days of stim is roughly required for a long cycle in kkh? Am having some issue at work as 19th that week I will have some major issues that I need to be around on 19th or 20th. My boss is away on long leave fr 19th to 2nd feb. & I will be the only person left in the team. Haii which also mean I will likely to need work most part of tww. Just hope my eggs will grow slightly slower and drag until at least 21st for ER. Feeling stress just to think abt the work.

 

[babyloveyou]

Hee...yday I already guessed u could get through it cos if they didn't say anything yday u should have something acceptable to transfer. Enjoy ur 'holiday'!

Ya I was so scared they will call me and give me bad news. This morning they called and I thought oh no..then they just asked me to go earlier..I'm like phew..Now I felt like I just passed another paper and now waiting for my final exam lol

 

[babyloveyou]

Hee...yday I already guessed u could get through it cos if they didn't say anything yday u should have something acceptable to transfer. Enjoy ur 'holiday'!

Ya I was so scared they will call me and give me bad news. This morning they called and I thought oh no..then they just asked me to go earlier..I'm like phew..Now I felt like I just passed another paper and now waiting for my final exam lol

 

[babyloveyou]

Yes! Me Me ... did my FET on 03.01.2015 @ SGH Care too.

Yay! All the best to u!

 

[ttc77]

Hi ttc77,
How u knew u r not ovulating. Were u told to use test urself using pregnancy test kit?

Cos I never ovulate last cycle after my failed ivf

Hence I'm scared I won't ovulate again so I asked for medicated fet

 

[babyloveyou]

Y he so rude ? I am very sure he roughly knw hw much it cost for each procedure.ask u to refer to cashier can Liao no need b so rude ma...

Exactly..haiz..that bad experience made me stalled my IVF journey for few years.

 

[Lititia]

Normally, can you choose the doctor yourself, or you are assigned the doctor during consultation?

 

[old aunty]

we all wish to see a kind nice doctor but I think what my hubby said is also true . I always complained abt the nurses and Drs and He asked me to b focused on our ultimate goal and if this dr can help us achieve that , we shouldn't b too bothered by his or her attitude . We r seeing a fertility dr not aunty agony. There r many more unpleasant thingsthat we hav to go through in our ivf journey ..so now I complain less hahah

 

[ashley11]

Thanks Ashley11. Yup, i'm referring to dr loh sf. Deep down, I feel it would be my egg issue more than the lab as I have seen many of the ivfers in sgh conceive successfully.. or maybe he felt the protocol dr yu gave me is not suitable..Dr yu is my dr in sgh..

How much does it cost now to do fresh cycle in sgh?

 

[ashley11]

Jmec, currently under dr loh too. And yes, he is very ya ya but used to it. During the ER, he told my hubby the wrong day on producing sperm for fertilising. Lucky my hubby found out from TFC otherwise can't produce enough swimmers loh.

How much does it cost now for fresh cycle with dr loh in TMC?

 

[Lititia]

Hi, old aunty, do you mind sharing how much should be paid by cash? I've heard that cannot pay for everything with medisave. Is it true?

 

[old aunty]

Ar

How much does it cost now to do fresh cycle in sgh?

around 13 k

 

[old aunty]

I paid 6 k medisave and 6-7 k cash

 

[Lititia]

thanks.

 

[bbpooh81]

I've seen dr Yu too, she's a very experienced Ivf specialist. If I were u, I will switch centre and dr to eliminate or alleviate doubt that sthg could be wrong with the lab, ur luck with this dr etc. the other way is to visit a dr that you potentially want to do the next cycle with, hear his point of view and then decide to continue with dr Yu or new dr.

Btw, did your eggs fertilize? U did go to et stage right?

Side track, why did u choose dr sf loh as your advisor? I was under him 3 tries in KKH and his attitude sucks!! Arrogant, uncaring and don't have time for patients. and I feel that leopard will not change his spots, I think he is more like a dr, or more compassionate in TMC as he is representing a Pte hospital where patients pay much more. My sister had a very bad experience with him too. When she confided that she is feeling unwell after getting pregnant from his Ivf, he said to her "you asked for it, right?" I was like.......wth.....

For both fresh cycle, 7 of my eggs fertilised but slow growth. 1st cycle, 1 embryo is 2-celled and the other 3 celled on day 2. 2nd cycle, 1 embryo at 2-celled and the other 6 celled + fragmentation on day 3. I did past the et stage but during both et, dr and embrologistics were not too positive about it.. so I guess the quality was really bad.

I agree abt Dr loh's attitude, he seems ya ya to me. But he does suggest additional supplement for me to take for my condition such as dhea and arginine on top of coq10. I went to look for him mainly to seek the dosage for dhea upon a suggestion from a fellow ivfer and also seek 2nd opinion for a condition like mine as given his high success rate in kkh.

One funny encounter I had with him was I asked if the embryo does not grow, is the issue with the hubby or the wife. He said it might be the hubby.. then I added that from my understanding from dr yu and the internet, it seems to point to the wife. He kept silent thereafter.. then I further asked if my hubby shld take any further supplement for sperm issue (if any), he said ur hubby sperm is ok. I am confused...