IVF Workup in Taiwan (Part 13) : The 2-Week Wait Period

continued from…  IVF Workup in Taiwan (Part 12) : Menstrual Cycle Day 17 Embryo Transfer (ET) Day

After the Embryo Transfer (ET), I need to inject 2 vials of progesterone in the mornings and use vaginal progesterone in the evenings everyday.   Dr. Robert Lee Kuo-Kuang said there is no need for bed rest after ET, in fact, after 3 days you can go back home and do normal activities.  However, I voluntarily obliged myself to take extra care.  This was due to my previous IVF procedures in Manila where I was asked to take bed rest for the entire 2 weeks.  I wanted to follow this just to be sure.  Anyway there is nothing to lose and after all the intention of staying in Taiwan for a month is to get pregnant.  Most of all, this is going to be my last pregnancy workup, better be careful than to regret.

My husband stayed until 4 days after ET.  With him around, I did not have to walk to Mackay Memorial Hospital everyday for my injections.  This was not our first time to do pregnancy workup, my husband, through the many workups we had had learned to do my injections. 

During those 4 days I just stayed home, husband takes home food for me or buys my food first before going out with my daughter.  When they were both out, it’s my quiet time.  I did not get bored at all as there was Internet access and there were so many Chinese Telenovelas I can watch.

The day before my husband left, my mother came over to take over my husband’s duty.  However, she cannot do my injections.  So when my husband left, I started to walk to the hospital everyday for my injections.   You might be wondering why I just walked to the hospital and not take a bus or a taxi.  At 1-kilometer distance, it is too short for a ride, it is even longer to wait for a bus to come.   Since I walk to and from the hospital, logically I can walk to the nearby restaurants to eat.  Therefore there was no need for my mother to get me food.  However, she needs to help me look after my daughter while I seemed to be incapacitated.

The normal 2 weeks wait until pregnancy test was shorter this time.  Dr. Lee instructed me to take the hCG blood test on May 22 at 8:00 am.  I should have the result by 10:00 am.  If positive, I need to get his letter to my doctor in Manila from the IVF Lab.

to be continued… IVF Workup in Taiwan (Part 14) : The Pregnancy Test

IVF Workup in Taiwan (Part 12) : Menstrual Cycle Day 17 Embryo Transfer (ET) Day

continued from…  IVF Workup in Taiwan (Part 11) : Menstrual Cycle Day 16

On my Day 17, May 11, I was half excited half nervous as we walk to Mackay Memorial Hospital for the Embryo Transfer (ET).  Excited because finally we are getting there but nervous since only 2 embryos were fertilized, as what was relayed to me.

When we entered the IVF Lab, the embryologist gave me a thumbs-up sign and was very happy.  I was puzzled by her reaction.  She came to us and explained the grades of the embryos. 

Out of 8 eggs retrieved, 7 embryos were fertilized not 2.  All embryos that day looked good and had grades of 1 and 2.  However 3 of the embryos, as explained to me in layman’s term, may not be as good because during observation stage the embryos did not divide in the normal sequence i.e. one cell becoming two, two cells becoming four, and so on.  Either they missed it during observation (timing was not right) or there were really abnormalities during development.  But come day of Embryo Transfer all had divided beautifully.

I was delighted of the good news when I entered the room where Embryo Transfer was done.  This could have helped in the success of my IVF as I was in a very good mood during ET.

The IVF Lab staff prepared me and after a few minutes Dr. Robert Lee Kuo-Kuang came in.  He told me that he would be transferring 4 embryos to me, 2 grade ones and 2 grade twos.  While Dr. Lee was checking on me, preparing for the transfer, 4 IVF Lab staff stood beside him.  When he was ready, the lamp Dr. Lee uses was turned off, one staff looked at her watch timing the transfer from the time the embryologist took out the embryos until Dr. Lee had completed the Embryo Transfer.  I cannot remember how long the transfer should be completed but I know it must be quick as explained to me by Dr. Lee. 

I asked Dr. Lee if I could have a photo of the embryos he transferred to me as a souvenir because I normally have it from my IVF procedures here in Manila.   He said it could not be done because embryos are very sensitive to exposure to light like flash from the camera.  This was also the reason why during ET he had to turn off the lamp.

After the procedure he explained to me that the other 3 embryos would not be stored anymore; that even though all has high grade, development were not good.  I would only waste NT$10,000 for storage fee.  He wished me luck and said hopefully that one of the 4 embryos would be successful.  I was not regretful of the 3 embryos to be discarded, as I did not want anything for me to come back for anymore.  This is it, be it successful or not, this is my last pregnancy workup.

He then told me that I could do pregnancy test 11 days after, which was on May 22, Sunday, a day before my scheduled trip back to Manila.  Again, since it was a Sunday, I need to go to the Emergency Room to request for the hCG blood test.

He repeated the instruction for me to inject 2 vials a day of progesterone and use once a day vaginal progesterone, Crinone 8%.  Since he had already given me all the injectable progesterone during Ovum Pickup, he counted the number of Crinone I would need to buy, plus extra 10 more of it so if I tested positive, I will have time to source it here in Manila after I arrive.

I was left in the room lying down for more than half an hour.  Since there is Wifi anywhere in the hospital, I was e-chatting with people in Manila.

My husband and daughter waited at the IVF Lab.  My husband was able to talk to Dr. Lee and expressed his concern of multiple pregnancies because 4 embryos were transferred to me.  Dr. Lee said not to worry, in fact at my age, 40 turning 41, we should be happy if I even get pregnant with one.

My husband went to pay our bill of NT$37,607.00, breakdown as follows:

	NT$	Php
Medicines	5,315.00	8,042.66
Treatment	31,650.00	47,892.78
Laboratory	576.00	871.60
Medical Supp	6.00	9.08
Pharmacy Service	60.00	90.79
	37,607.00	56,906.91

This was our last bill in the entire IVF workup.  Post IVF procedure medicines are all included in our bills already.

That day, for the first time we took the cab back to KT Star.

to be continued… IVF Workup in Taiwan (Part 13) : The 2-Week Wait Period

IVF Workup in Taiwan (Part 11) : Menstrual Cycle Day 16

continued from…  IVF Workup in Taiwan (Part 10) : Menstrual Cycle Day 15 Day After Ovum Pickup

May 10, 2 days after Ovum Pickup, we were supposed to go to Window on China (小人國) or Leofoo Village (六福村主題遊樂園).  However, I need to check first if Embryo Transfer (ET) will be done this day.  At 9:00 am, I called the IVF Lab of Mackay Memorial Hospital to find out, I was told that Dr. Robert Lee Kuo-Kuang said to just do the procedure as scheduled the next day, Day 17 at 10:00 am.

Due to the news we received the day before from the IVF Lab, that out of 8 eggs retrieved only 2 embryos were fertilized, we chose to just stay in the city and not to tire ourselves or not to tire me in preparation for the Embryo Transfer.

That day, we just strolled around the city and went to Miramar Shopping Mall (美麗華) located at Neihu District and is most notable for it's big Ferris Wheel.  Aside from shops, the mall has movie theaters, supermarket and food court.

Miramar Shopping Mall (Photo by Google Images)

To go there you can take the MRT to Jiannan Road Station (劍南路) found at the Brown line.

to be continued...  IVF Workup in Taiwan (Part 12) : Menstrual Cycle Day 17 Embryo Transfer (ET) Day

IVF Workup in Taiwan (Part 10) : Menstrual Cycle Day 15 The Day After Ovum Pickup

continued from… IVF Workup in Taiwan (Part 9) : Menstrual Cycle Day 14 Ovum Pickup Day

The day after Ovum Pickup, we planned to go to Wulai (烏來) to see the waterfalls.  But before heading there, we had to do our duty first, go to Mackay Memorial Hospital and have 2 vials of progesterone injection.

After the injection, we went to Hankyu Mall in Taipei City Hall station along the MRT blue line.  Had our lunch there and visited Eslite Bookstore first. 

Wulai (烏來) is a small town in Taipei County, Taiwan, famous for its hot springs and aboriginal culture.  Going to Wulai is not hard.  By MRT, go to Xindian Station at the South end of the Green Xindian Line.  From there take Bus No. 849 to Wulai.

Going to Wulai Waterfalls, you will pass through Wulai Old Street where you will find delicacies and restaurants.  At the end Wulai Old Street, there are vendors selling different sorts of BBQs like their local hotdogs.  From there you will cross a bridge where you will see the hot springs where some locals and tourists bathe.

Reading from some websites about Wulai Waterfalls, it said not to take a taxi ride as it will be a nice stroll of less than half an hour.  So we walked…  We saw a lot of hotels along the way where they offer bathing in hot springs.  At first we were enjoying the walk taking pictures along the way however the road, called Lover’s Path, is uphill.  We were with our daughter in her stroller.  We had to push her up while walking uphill.  The good walk was no longer a good one anymore!  Though the weather was good, we were perspiring and getting tired.  As we walk, we see people coming down from the other direction, when asked if the waterfalls is still far, they would say no, just keep walking it's a good walk.  We wanted to give up already but we were already halfway so we keep going and going.

At 4:00 pm we stopped to call the IVF Lab as we were instructed the day before to check on the number of embryos fertilized.  I was informed that only 2 embryos were fertilized out of the 8 eggs retrieved.  I was saddened by the news.  I asked how come only 2 embryos were fertilized, the embryologist explained probably due to my age, the quality of the eggs retrieved were not as good anymore. 

The embryologist said since only 2 embryos were successfully fertilized, Dr. Lee might opt to do the Embryo Transfer (ET) the next day, Day 16 at 10:00 am, instead of Day 17.  The reason behind this, as explained to me by the embryologist, since there were only 2 embryos we are not waiting for other embryos to fertilized anymore so might as well put the embryo back to the mother’s uterus, the earlier the better for the embryos to develop.   So I was asked to call the IVF Lab the next day at 9:00 am to check if we are pushing through with ET.

I felt down at that moment realizing that I am not that young anymore.  My husband consoled me saying all we need is 1 embryo, so be happy that there were 2.  I was just thinking at that time what if these 2 embryos were not so good too?  Then the chance of getting pregnant becomes smaller.

We continued to walk up the trail going to the waterfalls, we were both silent that even our daughter felt the sadness in me.  While walking I was thinking if our out of town trip to Ye Liu the day before Ovum Pickup could have affected the quality of my eggs since we were tired with the long trip.  And if the Embryo Transfer pushes through the next day, would I be too tired from the day’s walk?

Finally, we reached the end of the walk, we saw the waterfalls…my daughter’s first time to see an actual natural waterfalls.  I cannot remember how long we walked that path but I am sure it was not just half an hour and the distance as I came to know was 3 kilometers. 

Feeling all tired, we took the train back and started to head home…hoping to be able to rest well that night and recover from the tiredness of the long walk we just had in case we are pushing through with ET the next day.

to be continued… IVF Workup in Taiwan (Part 11) : Menstrual Cycle Day 16

IVF Workup in Taiwan (Part 9) : Menstrual Cycle Day 14 Ovum Pickup Day

continued from… IVF Workup in Taiwan (Part 8) : Menstrual Cycle Day 12 Doctor’s Consultation

We woke up early this day for my egg retrieval.  Part of me excited or anxious to get it over with after 2 weeks of busyness with going to and back from the hospital for my daily injections and doctor’s consultation. 

My daughter had been very cooperative all these time, walking 1.0 km. to the hospital with me for my daily injections and cheering me up saying "加油" while I am being injected.  She wakes up early without fuss the last few days for my early blood tests and this very important day.  While I dress her up, husband did his sperm collection in the comfort room (of course!).  I felt good then after all it was Mother’s Day and what day could be a better day for Ovum Pickup. I thought to myself, God is giving me a special gift, a baby on Mother’s Day!

We went to Mackay Memorial Hospital with the collected sperm and gave it first to the IVF Lab located at the 6^th floor.  Then we proceeded to the Delivery Room, the nurse let me in and gave me a set of hospital gown and cap.  My husband and daughter waited outside.  After changing, I met them at the window, they wished me luck and off they went to have their breakfast.

At the Delivery Room, I chatted with the nurses inside while they were preparing me.  They asked me how long have I been in Taiwan.  I reluctantly said 2 weeks and that I came to Taiwan just for the workup.  They were surprised as they thought I have been living in Taiwan for sometime because I can speak Mandarin.  So I explained my educational background, studied in Saint Jude Catholic School for 13 years, how could you not speak the Language?

Then the nurse informed me they are putting me to sleep now. I knocked off! 

When I woke up, it’s done and Dr. Robert Lee Kuo-Kuang was also gone.   The nurse handed me my clothes so I can change.  I was starving!  My husband and daughter were there to meet me after I changed, with a sandwich.  Husband had anticipated I should be very hungry as I did not take anything that morning due to fasting from 12 midnight onwards and it was already lunchtime then.

While I was asleep, my husband paid the hospital bills and got all the medicines from the pharmacy.  Dr. Lee gave him instructions for the next few days.  I need to inject 2 vials of progesterone every day and use vaginal progesterone, Crinone 8%, once a day starting after Ovum Pickup.  Other medicines given were antacid, pain reliever and antibiotic.  On the day of Embryo Transfer (ET) I need to bring 1 Crinone to be used right after ET.

My hospital bill was NT$42.196.00, breakdown as follows:

	NT$	Php
Registration	100.00	151.32
Dr. Examination	300.00	453.96
Medicines	2,999.00	4,538.09
Treatment	828.00	1,252.93
Surgery	26,361.00	39,889.47
Anesthesia	4,338.00	6,564.26
Medical Supplies	7,210.00	10,910.17
Pharmacy Service	60.00	90.79
	42,196.00	63,850.99

This time I could not breakdown the cost of the medicines anymore but it includes 12 pieces each of antacid, pain reliever and antibiotics and 5 pieces of Crinone 8% (vaginal progesterone) and 32 vials of injectable progesterone to be injected 2 vials each day until positive pregnancy test. 

A total of 8 eggs were retrieved.  I was to call the IVF Lab the next day at 4:00 pm to find out how many embryos were fertilized.  Tentative date of Embryo Transfer (ET) was 10:30 am of May 11, 2011, my Day 17.   This means we have 2 days vacation from our workup.  Oh well, not totally a break as I still need to have progesterone injection in the mornings.

to be continued... IVF Workup in Taiwan (Part 10) : Menstrual Cycle Day 15 The Day After Ovum Pickup

IVF Workup in Taiwan (Part 8) : Menstrual Cycle Day 12 Doctor’s Consultation

continued from…  IVF Workup in Taiwan (Part 7) : Menstrual Cycle Day 11 Doctor’s Consultation

May 6, my Day 12, husband is coming but since his flight is arriving at 10:00 am, he will reach KT Star by 11:30 am already.  He definitely will not make it to that day’s doctor’s consultation.

As early as 8:00 am, I had my blood extracted for E2 test and went to the Injection Room for my Cetrotide shot.  Next I went to the Ultrasound Room.  By this time, I am becoming friends with the Sonologist in the Ultrasound Room.  She told me places where I can go sight seeing with my family.  Because we can take the opportunity to go farther from Taipei City between egg retrieval or ovum pickup day and embryo transfer day, as there won’t be any injections to do.  I’ll talk more about these places later on, in the meantime I’ll finish up my blogs on my IVF workup first.

The follicles in my right ovary became 4 but the additional follicle found was less than 1 cm.  The sizes of my follicles on my right ovary were 1.32 cm., 0.93 cm., 1.37 cm. and 1.22 cm.  The follicles in my left ovary were more appropriate in sizes, 1.96 cm., 1.7 cm., 2.02 cm., 1.74 cm. and 1.85 cm.

Dr. Lee said it was about time.  I need to be injected 1.5 vial of Ovidrel that night at 10:00 pm.  Since the Injection Room will be closed by then, I have to go to the Emergency Room and have it done there.

4/27	4/28	4/29	4/30	5/1	5/2	5/3	5/4	5/5	5/6
Day 3	Day 4	Day 5	Day 6	Day 7	Day 8	Day 9	Day 10	Day 11	Day 12
2 vials HMG Menopur / day			2 vials HMG Menopur/day		2 vials HMG Menopur/day		3 vials Menopur	2 vials Menopur
225 IU Gonal-F / day				225 IU Gonal-F/day		225 IU Gonal-F	120 IU Gonal-F		1.5 vials Ovidrel
						0.25 mg Cetrotide		0.25 mg Cetrotide	0.25 mg Cetrotide

He scheduled my Ovum Pickup on Sunday, May 8, Mother’s Day at 8:00 am.  We have to be at Mackay Memorial Hospital’s Operating Room found at the 7th Floor of the old building by 7:30 am for preparation.  I need to fast from 12 midnight onwards.

After the consultation, I was led to another room where I need to sign documents for my Ovum Pickup.   Since my Ovum Pickup fell on a Sunday, a non-working day, all fees are up by 30%.  Plus I need to pay additional NT$11,000 for ICSI (Intracytoplasmic Sperm Injection) and another NT$11,000 for AH (Assisted Hatching).

My bill this visit was NT$2,914.00, breakdown as follows:

		NT$	Php
Registration		100.00	151.32
Dr. Examination		300.00	453.96
Ovidrel 2 vials	1,195.00	2,390.00	3,616.55
Treatment		42.00	63.55
Medical Supplies		22.00	33.29
Pharmacy Service		60.00	90.79
		2,914.00	4,409.46

Before leaving the hospital I went to the IVF Lab where they handed me a sterilized bottle for husband's sperm collection.  He may opt to do it at home and bring the bottle to the hospital.

There was no further instruction or any injections to be done on Day 13.

To be continued… IVF Workup in Taiwan (Part 9) : Menstrual Cycle Day 14 Ovum Pickup Day

IVF Workup in Taiwan (Part 7) : Menstrual Cycle Day 11 Doctor’s Consultation

continued from… IVF Workup in Taiwan (Part 6) : Menstrual Cycle Day 10 Doctor’s Consultation

As instructed I was back to Mackay Memorial Hospital the next day, May 5, Day 11 at 8:30 am and went to the Ultrasound room for my usual scan.  Then went to the IVF Lab at the 6^th floor where the staff called Dr. Robert Lee Kuo-Kuang to report on my ultrasound result.

My follicles in my right ovary were all at 1 cm. sizes, 1.13 cm., 1.0 cm. and 1.25 cm.  Follicles on my left ovary grew even bigger at 1.7 cm., 1.78 cm., 1.74 cm., 1.76 cm. and 1.64 cm.  all at good sizes.

Dr. Lee’s instruction was:

Day 11 – inject 2 vials of Menopur

Day 12 – 0.25 mg of Cetrotide in the morning; E2 blood test at 8:00 am and Ultrasound.  E2 blood test takes 3 hours to process, hence should be taken at the first hour so he can have my result by the time I reach his office.

4/27	4/28	4/29	4/30	5/1	5/2	5/3	5/4	5/5	5/6
Day 3	Day 4	Day 5	Day 6	Day 7	Day 8	Day 9	Day 10	Day 11	Day 12
2 vials HMG Menopur / day			2 vials HMG Menopur/day		2 vials HMG Menopur/day		3 vials Menopur	2 vials Menopur
225 IU Gonal-F / day				225 IU Gonal-F/day		225 IU Gonal-F	120 IU Gonal-F
						0.25 mg Cetrotide		0.25 mg Cetrotide	0.25 mg Cetrotide

My bill for this visit was NT$6,282.00, breakdown as follows:

		NT$	Php
Registration		100.00	151.32
Dr. Examination		300.00	453.96
Medicines
Menopur 2 vials	1,140.00	2,280.00	3,450.10
Cetrotide 1 pack	2,160.00	2,160.00	3,268.51
Treatment		84.00	127.11
Laboratory		1,284.00	1,942.95
Medical Supp		14.00	21.18
Pharmacy Service		60.00	90.79
		6,282.00	9,505.92

Next consultation is the next day, May 6, my Day 12.

To be continued…  IVF Workup in Taiwan (Part 8) : Menstrual Cycle Day 12 Doctor's Consultation