IVF Workup in Taiwan (Part 4) : Menstrual Cycle Day 6 Doctor’s Consultation

continued from... IVF Workup in Taiwan (Part 3) : Menstrual Cycle Day 3 Doctor's Consultation

On my Day 6, the first thing I did when I arrived Mackay Memorial Hospital was to go to the Ultrasound Room.  I handed the Ultrasound request and I was called in right away for my scan.  After I got my result, I waited again for my turn outside Dr. Robert Lee-Kuo Kuang’s clinic.

My 5-year old daughter who was always with me when I go see Dr. Lee did not get bored while in the hospital.  Each time I sat down to wait for my turn, she went around and played with the water vending machine.  From afar, I hear the vending machine repeatedly goes 請用溫開水 (Feel free to use warm water).  I know it was my daughter playing with it, drinking all the water she gets.  Then later, she will come to me to ask me to go the comfort room with her to pee.  As a consolation, she learned to say the phrase 請用溫開水 articulately J.

My follicles on Day 6 got a little more and a little bigger.  My right ovary’s follicle grew from 0.33 cm to 0.57 cm while my left ovary had more follicles.  There were 4 follicles in my left ovary that were significant 0.8 cm, 0.76 cm, 0.75 cm and 0.88 cm.

This time the instruction of Dr. Lee was to continue to inject 2 vials of HMG Menopur for 2 days, Day 6 and 7 and 225 IU of Gonal-F for 2 days, Day 7 and 8.

4/25	4/26	4/27	4/28	4/29	4/30	5/1	5/2
Day 1	Day 2	Day 3	Day 4	Day 5	Day 6	Day 7	Day 8
		2 vials HMG Menopur / day			2 vials HMG Menopur/day
		225 IU Gonal-F / day				225 IU Gonal-F/day

My bill for this visit totaled to NT$12,991.00, breakdown as follows:

		NT$	Php
Registration		100.00	151.32
Dr. Examination		300.00	453.96
Medicines
Menopur 4 vials	1,140.00	4,560.00	6,900.19
Gonal-F 1 pen	7,080.00	7,080.00	10,713.46
Treatment		84.00	127.11
Laboratory – Blood test E2		420.00	635.54
Ultrasound		360.00	544.75
Medical Supp		27.00	40.86
Pharmacy Service		60.00	90.79
		12,991.00	19,657.98

Injections to be done on Sundays are administered in the Emergency Room as the Injection Room is closed on Sundays.  Just the same, you need to bring your passport with you for identification purposes.

Dr. Robert Lee Kuo-Kuang asked me to return 2 days after, May 2 Monday, which was my menstrual cycle Day 8.  Aside from the usual ultrasound prior to Doctor’s consultation, I was also asked to take a blood test to check on my Estradiol (E2) at 8:00 am.  E2 test result comes out in 3 hours which is about 11:00 am.  This is the reason why Dr. Lee instructed me to have it done at 8:00 am so he could see my result by the time I go to his clinic.

To be continued...  IVF Workup in Taiwan (Part 5) : Menstrual Cycle Day 8 Doctor's Consultation

IVF Workup in Taiwan (Part 3) : Menstrual Cycle Day 3 Doctor’s Consultation

continued from...  IVF Workup in Taiwan (Part 2) : First Doctor’s Visit with Dr. Robert Lee Kuo-Kuang

April 27, 2011, Day 3 of my menstrual cycle, I went to see Dr. Robert Lee-Kuo Kuang at Mackay Memorial Hospital.  Before going to Dr. Lee’s clinic, I have to go to the Ultrasound room, which is located at the rear end of the Second Floor area where the Doctors hold clinic.  After my scan, I waited for my result, which takes them only a few minutes to prepare.

I took my result to the nurse at Dr. Lee’s clinic and waited for my turn outside.  By the way, the hospital has free wifi internet access hence you can bring your gadget and chat with someone back home or surf the internet while waiting for your turn.  This will surely keep you busy while waiting to be called.

As you can see from my Ovulation Monitoring Sheet (誘導排卵監測單) there is 1 follicle each on my right and left side ovary.  The sizes are still very small at 0.33 cm and 0.38 cm, respectively.

I was instructed to inject 2 vials of HMG Menopur each day for 3 days starting Day 3 to Day 5.  At the same time I need to inject 225 IU of Gonal-F for 4 days also starting Day 3 to Day 6.

4/25	4/26	4/27	4/28	4/29	4/30
Day 1	Day 2	Day 3	Day 4	Day 5	Day 6
		2 vials HMG Menopur / day
		225 IU Gonal-F / day

My bill this visit was quite high as I started to take home fertility medicines.  Total bill was NT$22,751.00, breakdown as follows:

		NT$	Php
Registration		100.00	151.32
Dr. Examination		300.00	453.96
Medicines
Menopur 6 vials	1,140.00	6,840.00	10,350.29
Gonal-F 2 pens	7,080.00	14,160.00	21,426.91
Treatment		906.00	1,370.96
Ultrasound		360.00	544.75
Medical Supp		25.00	37.83
Pharmacy Service		60.00	90.79
		22,751.00	34,426.81

Gonal-F is a pen type injection where needle is very thin and is injected in the tummy area.  This is easy hence must be administered by yourself.  The nurses at the Doctor's clinic taught me how to do it.  But, injection is still injection.  For someone who is so afraid of injections, it is still hard to get me to poke a needle to myself.  For a video Gonal-F injection guide, you may visit this YouTube site http://www.youtube.com/watch?v=4CRw3vf1oz4.  Menopur, on the other hand, is intramascular injection this is done in the Injection Room found at the Ground Floor of the hospital.

Important reminder, you need to bring along an identification document like your passport before the nurse will perform the injection on you.  It is important for them to be able to identify you first.  No identification no injection!

After my consultation with Dr. Lee and paying my bill, I went to the Pharmacy to pick up my medicines.  They gave me some ice to keep the medicines cold on my way home.  These medicines should be stored in the refrigerator.  Due to the medicines that I need to take home almost every after my Doctor's consultation, I go back first to KT Star before heading anywhere else.

Remember to bring ice also together with your medicines whenever you carry your medicine to the hospital for injection.  Also, always have your injection everyday at almost the same time.  I do mine between 10-10:30am.  This gives me enough time to have breakfast and to prepare myself and my daughter to go out.

My next Doctor's consultation was after 3 days, April 30, 2011, my menstrual cycle’s Day 6.


To be continued...  IVF Workup in Taiwan (Part 4) : Menstrual Cycle Day 6 Doctor's Consultation

IVF Workup in Taiwan (Part 2) : First Doctor’s Visit with Dr. Robert Lee Kuo-Kuang

continued from...  IVF Workup in Taiwan (Part 1) : Arrival at Taipei

We were up early on Monday, April 25, 2011 for my first doctor’s appointment with Dr. Robert Lee-Kuo-Kuang at Mackay Memorial Hospital.  That morning, 3 days after my last pill of Gynera, I still did not have my period.  However, I have to meet Dr. Robert Lee Kuo-Kuang to get instructions on what to do when my period comes.

Husband, as per Dr. Lee's instruction during my initial visit last February, needs to do semenalysis.  He did his sperm collection at home and just brought it to the IVF Lab.

The first visit was short.  He gave me this sheet of paper that I have to bring along with me each time I see him, as this is where my workup details will be logged. This form is called 誘導排卵監測單, in English, Ovulation Monitoring Sheet.

Mackay Memorial Hospital Ovulation Monitoring Sheet

I was asked to return to him on my Day 2 or Day 3 menstrual cycle depending on his clinic schedule.  For this short visit, my bill was NT$760.00, breakdown as follows:

		NT$	Php
Registration		100.00	151.32
Doctor Examination		300.00	453.96
Ultrasound		360.00	544.75
Total		760.00	1,150.03

Actually the Ultrasound fee included in this bill was for my Ultrasound on my next visit.  Every visit, Dr. Lee gives instructions on what to do the next few days including request for Ultrasound on the next visit.  Hence the Ultrasound fee is paid on the day the request is made.  On the next visit, I need to go straight to the Ultrasound room, get the result which takes only a few minutes to get, and go to Dr. Lee's clinic for consultation.

My period came late that day therefore I had to return to him on Wednesday, April 27, my Day 3 which was Dr. Lee’s nearest clinic hours.

After my first visit with Dr. Robert Lee Kuo-Kuang, we took the MRT to Zhongxiao Dunhua (忠孝敦化) Station along the blue line and had lunch at Din Tai Fung (鼎泰豐) at the green Sogo building.

鼎泰豐  Din Tai Fung at Zhongxiao East Road

That afternoon, we also visited Taipei 101 and shopped at Uniqlo in Taipei City Hall (市政府) station also along the MRT blue line.

Since my husband has no business anymore to stay in Taipei until around Day 12, he left the next day morning for Manila.  I was left with my daughter to explore Taipei City while doing my workup.

To be continued... IVF Workup in Taiwan (Part 3) : Menstrual Cycle Day 3 Doctor's Consultation