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

continued from… IVF Workup in Taiwan (Part 5) : Menstrual Cycle day 8 Doctor’s Consultation

On my Day 10, May 4, I had to go to Mackay Memorial Hospital twice.  Once in the morning for my Cetrotide injection and in the afternoon for my doctor’s consultation since Dr. Robert Lee Kuo-Kuang’s clinic on Wednesdays is at 2:00 in the afternoon.

As usual I had my ultrasound done first as I arrive in the afternoon.  Since I was nearing my ovulation, my follicles are now bigger and monitoring of my follicles were now done daily.  My right ovary’s follicles now became 3, 1.31 cm., 0.88 cm. and 0.86cm.  Only the 1.31 cm. is significant although still not as big as my follicles in my left ovary.  The 5 follicles in my left ovary are now 1.61 cm., 1.58 cm., 1.33 cm.,  1.62 cm. and 1.34 cm.

My day for egg retrieval was nearing.  I informed Dr. Lee that my husband’s flight is 2 days after, on my Day 12 and asked if he will be in Taiwan just in time.  He said no problem as he can adjust the dosage of my shots.  Since my hubby’s flight is arriving around 10:00 am on Day 12, egg retrieval cannot be performed that day anymore, the earliest day we can do the egg retrieval is on my Day 13.

Instructions of Dr. Lee were getting more but not complicated:

Day 10 (which was the day of my visit) - 3 vials of HMG Menopur.  He asked the nurse to put together in a syringe all the remaining Gonal-F from the pens I brought with me.  The nurse collected 120 IU, Dr. Lee did not like wasting medicines, especially that of Gonal-F which is quite expensive.  He calculates the dosage I still needed each time he prescribed it to me to know whether I need to buy another pen or not.   Dr. Lee then instructed the nurse to inject all the remaining (120 IU) Gonal-F to me.

Day 11 – I should continue with 0.25 mg Cetrotide in the morning.  At 8:30 am, I need to do my ultrasound.  Since Dr. Lee has no clinic on a Thursday, I was asked to bring my ultrasound result to the 6^th Floor or the IVF Lab.  The staff in the lab will call him for further instructions.

4/27	4/28	4/29	4/30	5/1	5/2	5/3	5/4	5/5
Day 3	Day 4	Day 5	Day 6	Day 7	Day 8	Day 9	Day 10	Day 11
2 vials HMG Menopur / day			2 vials HMG Menopur/day		2 vials HMG Menopur/day		3 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

My bill for this visit was NT$6,498.00, breakdown as follows:

		NT$	Php
Registration		100.00	151.32
Dr. Examination		300.00	453.96
Medicines
Menopur 3 vials	1,140.00	3,420.00	5,175.14
Cetrotide 1 pack	2,160.00	2,160.00	3,268.51
Treatment		84.00	127.11
Ultrasound		360.00	544.75
Medical Supp		14.00	21.18
Pharmacy Service		60.00	90.79
		6,498.00	9,832.77

As mentioned above, I need to be back the next day, May 5, my Day 11.

to be continued…  IVF Workup in Taiwan (Part 7) : Menstrual Cycle Day 12 Doctor's Consultation

IVF Workup in Taiwan (Part 5) : Menstrual Cycle Day 8 Doctor’s Consultation

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

As per instruction of Dr. Robert Lee Kuo-Kuang, I went to Mackay Memorial Hospital on my Day 8, May 2, 2011 at 8:00  am to have my blood extracted for my Estradiol (E2) test.   It takes about 3 hours for the result to come out, that is why Dr. Lee wanted me to take it as early as 8:00 am so he can have the result in time for my consultation that morning.

Since we were out so early we did not have breakfast.  My daughter and I went to the nearby store selling freshly made dumplings and had our breakfast.  

Taiwan's Freshly Made Dumplings

When we went back to Mackay Memorial Hospital, we proceeded to the Ultrasound Room.  There were now 2 follicles in my right ovary, 0.86 cm and 0.67 cm.  On my left ovary, there were 5 follicles, the largest is 1.32 cm., the rest were 1.05 cm., 1.25 cm., 1.12 cm. and 1.1 cm.  My E2 result was already at Dr. Lee’s clinic when I saw him, it was 461 pg/nl.  According to ivfconnections.com, if the level of E2 is between 150-500 pg/nl on day 8, this is a satisfactory measure.  And if it doubles about every 48 hours, follicle growth remains on track and is promising.

This time Dr. Lee asked me to continue with 2 vials each day of HMG Menopur for 2 days, Day 8 and Day 9.  Dr. Lee gave me another medicine Cetrotide (Cetrorelix Acetate) 0.25mg/day for Day 9 and Day 10.  Gonal-F still at 225 IU on Day 9 and to bring  the leftover of Gonal-F on the next day’s visit.

4/25	4/26	4/27	4/28	4/29	4/30	5/1	5/2	5/3	5/4
Day 1	Day 2	Day 3	Day 4	Day 5	Day 6	Day 7	Day 8	Day 9	Day 10
		2 vials HMG Menopur / day			2 vials HMG Menopur/day		2 vials HMG Menopur/day
		225 IU Gonal-F / day				225 IU Gonal-F/day		225 IU
								0.25 mg Cetrotide

My bill for this visit was NT$9,897.00, 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
Cetrotide 2 packs	2,160.00	4,320.00	6,537.02
Treatment		168.00	254.22
Ultrasound		360.00	544.75
Medical Supp		29.00	43.88
Pharmacy Service		60.00	90.79
		9,897.00	14,976.14

My next Doctor’s consultation was after 2 days, May 4, 2011, my Day 10.

To be continued…