First Step to Taiwan IVF (Part 2) : Medical History Interview

continued from...  First Step to Taiwan IVF (Part 1) : Arrival at Taiwan

On our second day, February 16, Wednesday, we went to the 6/F of Mackay Memorial Hospital where the IVF Lab is.  There, Ms. Tsai, the assistant of Dr. Lee met us for medical history interview.  Most people in the lab speak English so it is very convenient for overseas patients to communicate with them.  I told them that I can speak Mandarin, I see a sign of relief from them, at least they need not have a hard time speaking to me as we can mix English and Mandarin in our conversation.

I gave her all the test results that Ms. Vanessa Lin asked me to bring such as:

1.    My TSH, Prolactin, Human Immunodeficient Virus (HIV) and Syphilis test results, which I had just before I left for this trip

2.    Husband’s Semen Analysis, HIV and Syphilis test results, which were also done just before I left for Taiwan

3.    Hysterosalpingogram (HSG) Film

4.    My passport and driver’s license (bring original) and husband’s photocopy of passport and driver’s license

5.    Marriage certificate (NSO copy) – this is very important to get enrolled in their IVF program

6.    Previous IVF and IUI work up history

7.    Laparoscopy report when I had an ectopic pregnancy in 2008

While Ms. Tsai is reviewing the documents, she interviews me.  She jotted down all the littlest details she could squeeze out from me.  The interview was long, I felt like its taking forever since I had to answer so many questions, good thing I can still remember most of the things she asked me about.

After the interview, we went to have our lunch in a nearby restaurant, as we need to go back for my first consultation with Dr. Lee at 1pm.

To be continued… First Step to Taiwan IVF (Part 3) : The Consultation with Dr. Robert Lee Kuo-Kuang

First Step to Taiwan IVF (Part 1) : Arrival at Taiwan

We arrived Taiwan Taoyuan International Airport (桃園機場) on February 15, 2011 at around 10:00 am.  We took the CitiAir Bus (大有巴士) to Bailee Hotel (百利飯店).  Adult fare is NT$90 while senior and child fare is NT$45. 

You may refer to this map for directions I will be describing here.  Print out the map for your reference, I'm sure you will find this very useful.

Mackay Memorial Hospital Vicinity Map

The bus stop to get off is Ambassador Hotel (國賓飯店) (I) along Zhongshan North Road (中山北路).  Actually the bus stop is not in the hotel itself, it is across the hotel but that's the name of the bus stop.  The station before Ambassador Hotel is Tatung University (大同大學) (H).  Mackay Memorial Hospital (A) is between Tatung University and Ambassador Hotel.  When you see the hospital you get off at the next bus stop.

From the bus stop you need to walk back to the hospital and turn left at Jin Xi St. and look for Bailee Hotel (C).

After checking in, it was already lunchtime and we were starving.  There are restaurants near the hotel.  We chose to have shabu-shabu as the weather at that time was cold.  An order of pre-set shabu-shabu meal costs between NT$100-120.  Rice, cold or hot tea and ice cream are self service and unlimited.

After our first satisfying meal in Taiwan, we went to the hospital to check the place out.  It is hard to get lost for our appointment the next day.  I called Ms. Vanessa Lin and she met us at the ground floor.  She toured us to the 6^th Floor where the IVF Lab is located, to the 2^nd floor where Dr. Robert Lee holds clinic, the G/F where the Injection Room, Blood Test Counter and Pharmacy are.  These are the only locations you have to be familiarized with.

Since we have nothing on our agenda that day, we asked her where the service apartment, KT Star (基泰之星) is, we might as well visit the place.  To know more about KT Star, please refer to my blog on KT Star Service Apartment.

To be continued…First Step to Taiwan IVF (Part 2) : Medical History Interview

Initial Taiwan IVF Inquiry

The hospital where my cousin had her successful IVF is Mackay Memorial Hospital (馬偕紀念醫院) and the doctor’s name is Dr. Robert Lee Kuo-Kuang (李國光).  For initial inquiry you need to get in touch with their International Medical Service Center (馬偕醫院國際醫療中心).  The email address is mmhimsc@ms2.mmh.org.tw and the contact person is Ms. Vanessa Lin. 

When I emailed Ms. Lin, I gave her an overview of my infertility treatment history.  My first inquiry was how to go about it, what historical data Dr. Lee needs and more or less how much would be the cost.

I received a reply with an attached standard letter and here are the lists of things they will need from you:

1.   Reports on TSH, Prolactin, Semen Analysis, Human Immunodeficient Virus (HIV) and Syphilis tests done within the last 6 months.

2.    X-ray films of Hysterosalpingogram (HSG), can be in picture file or in USB drive or CD, test must be done within the last 2 years.

3.   Infertility treatment history including the dose of FSH or HMG and its response to your ovary, number of follicles and operation report

The first on the list can be done here in the Philippines at any laboratory.  The second, which is the HSG film, is not easy for those who have not done this before.  It will take sometime for you to request your local OB-Gyne to do this, however this is not impossible.  As for me, fortunately I just had my third HSG 6 months ago, before we underwent our last IUI.  Without my readily available HSG result, I would have been discouraged already (unless Dr. Lee can still evaluate me without HSG, which I didn’t try to find out since I have my recent HSG film anyway).  The third requirement is easy, I just gathered all my past transvaginal ultrasound reports.  Hmm…..everything seems to be easy for me…it’s a sign, things are falling into place J

The letter indicated the budget of roughly US$4,500 for the entire IVF procedure.  Not so bad, as it is only about Php200,000 compared to the cost in Manila which I think would reach at least Php500,000. 

I was asked to go to Taipei anytime to take the Anti-Mullerian Hormone (AMH) test.  This is a blood test to predict the ovarian follicle reserve.  Other things needed are Marriage Certificate (NSO copy) as proof of marriage, original passports and driver’s license of both husband and wife.  They are very strict with the Marriage Certificate before they can enroll you to their IVF Program.

Since it was easy for me to prepare all the requirements needed, I scheduled my flight to Taipei on February 15, Tuesday, accompanied by my mother.  My husband did not come along this trip anymore since all his tests can be done in the Philippines. 

My first consultation with Dr. Robert Lee was scheduled the next day, February 16, Wednesday.  Dr. Robert Lee's clinic time is Monday, Friday and Saturday mornings and Wednesday afternoons.  You have to make sure that you check Dr. Lee’s clinic hours before booking your flight.

We requested Vanessa to book us in a hotel near the hospital, Bailee Hotel (百利飯店).  This is where they usually book their patients as it is just walking distance to the hospital.  Room rate is at NT$1,480/night for 2 staying-in guests.  Vanessa offered transfers from the airport to the hotel but knowing we can get by by bus, I declined the offer.

What Triggered Me to Go to Taiwan for IVF?

I am thinking which of my 2 IVF (In-Vitro Fertilization) experiences should I write about first.  Since many are requesting and asking about IVF in Taiwan, I better start with my Taiwan experience.

After my successful IVF workup in the Philippines in 2005 and giving birth to my first child, I said to myself I would not do this whole thing again!  Primarily because I prayed and asked the Lord to give me at least one baby and my wish was already granted.  If I get pregnant again (hopefully the natural way), then it is an additional blessing. When we underwent the IVF procedure, I felt like it was our last resort and a desperate move to have a child, hence we will only be doing it once be it successful or not.

The second reason is that over the years of pregnancy workups, I have had lots of pregnancy shots to allow my body to produce more eggs.  After which, follow up shots to control how big my follicles should grow and when is the right time to ovulate.  These human interventions on how our natural body is supposed to work made us worry about side effects.

Third is, with our busy work schedule, it is difficult to allot time for workups.  Everyone knows how it is waiting for your turn at the doctor’s clinic.  Lastly, of course, is the cost it entails.

However, as a parent I cannot help but think about the future.  When we are gone, who will be the closest relative my daughter can run to in case of emergencies? Who she can go to for support, for protection, for comfort?  Because of this scary thought, every year as my birthday comes near, I get reminded that if we want to give our daughter a sibling, it is now or never as my body clock is ticking. Yearly, I end up doing IUI workup near my birthday. 

On each failed IUI, I comfort myself that I have done enough throughout the years and maybe this is God’s will, for us to only have one child.

In January 2011, my sister persuaded me to try another IVF procedure in Taiwan. Since my cousin was going there for frozen embryo transfer (FET), why not go together?  I was hesitant since I just had a failed IUI 6 months ago (July 2010).  My husband and I have already decided that that was the end of our journey to be blessed with another child. I was already 40 years old and it is not exactly the perfect age anymore to be pregnant, not to mention all the reasons I indicated above.  I was not willing to do IVF again, more so to do it in a foreign country.

However, the desire to give my daughter a companion inside me never died.  My daughter, at that time, was also asking us for a baby girl.  With this, I asked for the contact person in Taiwan (Taipei) and tried to send an inquiry through email.  I have no intentions yet to pursue IVF again but anyhow will inquire.  If everything falls into place, meaning the requirements needed by the Taiwan doctor is easy to supply and if it leads me to Taiwan then maybe I will or we will go for it.

How Hard Can It Be?

I am writing this blog to inspire couples who are having difficulty in conceiving.  A friend and an infertility blogger encouraged me to write about my experiences and to share them so that people may use it as a guide in their pregnancy workup.  Or at the least, serve as an inspiration to couples not to give up on trying to have their own bundle of joy.  

My husband and I had a long journey before we become a family of 5.  We are now parents to 3 children; 2 girls and 1 boy.  How long was our journey?  14 years!  Can you imagine all those years of waiting?  It was not easy!  At one point we have already accepted that maybe it is just the way the Almighty wants us to be.  But honestly, in our hearts, we never stopped hoping and believing that God will give His blessings to us in His time.

Truly, after 8 years of waiting, God blessed us with our first child, a daughter.  Enjoying parenthood and wanting her to have a sibling companion in the future, we continued our pursuit for another baby.  Again, it was difficult for us, we could not conceive without help. 

However, since we have a child already, the pressure of having another is not as great.  Nevertheless whenever I think of my child’s future without us, I could not help but worry. Hence we tried to work up for another.  The second successful pregnancy came after 6 years. This time God blessed us with more than what we prayed for. We have twins! A boy and a girl.  God is really good! 

Our journey started 1 year after marriage.  We saw a number of OB-Gyne’s and went through countless workups.  We have been through a lot of anxieties especially during the 2-week wait periods. From ovulation to the end of the menstrual cycle, to find out the result of the month's workup, it was always the longest 2 weeks of my life!  During the wait, I feel every little change in my body such as tenderness of breast, pain in the abdomen, high body temperature, the feeling of being bloated and wondering if these are signs of pregnancy or premenstrual symptoms.  Then finally after the 2 weeks wait, the pain of knowing that the workup failed again gets me depressed.

I have seen couples in the same situation as we were.  However, one by one they get positive results. Some were successful in their workups and some just got pregnant naturally after stopping from their continued workups.  It pains me to see my period come every month even if we did not undergo any workups that cycle.  I was always hoping that this could be it, just like the others, a miracle may happen.  It went from a lot of friends sharing notes to just us left with the dilemma.

Our work ups started with taking the fertility pill, Clomid, monitoring the size of the follicles and determining when to try.  When this kind of workup failed for several cycles, we went to Intrauterine Insemination (IUI) or Artificial Insemination (AI). This is a procedure where sperms are washed and placed inside a woman’s uterus via a catheter to facilitate fertilization.  This increases the number of sperm cells that reaches the fallopian tubes and subsequently increases the chance of fertilization.

After many failed attempts, we went to an Immunologist.  An Immunologist is a doctor that studies the structure and function of our immune system, innate and acquired immunity, the bodily distinction of self from non-self.  It was explained to us that I might have antibodies that rejects the sperm hence cannot conceive.  We went through a battery of tests that the doctor requested us to do.  We even had our blood extracted and sent to the US for laboratory procedure.  It took us about 3 months to receive the results while on the side we were working up with our OB-Gyne and Urologist.  However, after receiving the complete results we never went back to find out if we needed to work on our immune system.  Primary reason was fear of the entire procedure, secondary reasons were the cost it entails and if we actually believe in it.

As a last resort, we agreed to give In Vitro Fertilization (IVF) a try. And this is where my actual story begins …