After BFP

March - April 2013
at 4 weeks  – I felt very warm specially my head was heaty just like it is before cold and right side sharp pain

15^th day post D2 Transfer – HCG 117 line of blood!

16^th day post D2 Transfer – Line of blood with stretchy mucus

17^th day post D2 Transfer – Brown spotting!! Am I getting my period?

18th day post D2 Transfer – Intra vaginal scan to confirm pregnancy but no embryonic sac seen! HCG 722

at 5 weeks – Yolk and sac seen. Relieved….Can I finally be happy that I’m pregnant. At least I will till the next scan.

at 7 weeks – Heartbeat seen, finally I can call myself pregnant. DH started to think about baby names. Not me as I’m more wiser on this whole journey and aware of the hurdles on the way.

7 weeks image

Since my last scan, I was occasionally nauseous bloated some cramps on right side.  However on Sunday and Monday I felt a bit more cramps. My next scheduled appointment is only on Thursday.

at 8 weeks - Dr scanned in several angles to detect the heartbeat but no heartbeat seen. Dr informed it is a spontaneous miscarriage most likely fetus stopped developing 5 days before. Perhaps this was the reason for cramps.

This was when heart beat could not be detected anymore

I should say even though it was hard to accept I was reasonably brave. I asked Dr about the next attempt for FET. First step is to wait for a natural miscarriage to happen. I started bleeding on the following week on Saturday. It was unbearable pain and blood flow was so heavy that I used 4 pads in an hour. By the time K went to pharmacy and got the pain killers it had come out. If you wish to see how it looked like click on this link. Warning image could be disturbing!!!!

Update - IVF Attempt No 3 with Dr Pavic

Feb 2013

New doctor (Dr Nenad Pavic, Fertilitas) in a new country with a new procedure. I was on long protocol which means more injections. Started on injections from Day 21 wait for the period and start stimulating. Egg retrieval on Day 21.

D1 - Egg Retrieval day – I was put on half anesthesia which means I was half awake when they retrieved eggs. Which was unusual compared to my past experiences.  Nurse will push my lower abdomen and Dr will basically suck those eggs from my ovaries. They retrieved 14 eggs. Ah haven't got this many in the past.

D2 Received a call from clinic informing that 12 fertilized and 10 will be frozen.

D3 2 4 cell embryos were transferred. Now the wait begins

4 cell embryos in D2

2 Week wait

These are the symptoms I had during the 2 week waiting time.

3^rd day post D2 transfer – noticed pimples, may be due to the increased hormones I had been injecting into me.

7^th day post D2 transfer – Cramps in lower abdomen

8^th day post D2 transfer – Cramps again

9^th day post D2 transfer – Noticed a different smell when I passed urine in morning (More of a flowery cinnamonny smell) very different.

11^th day post D2 transfer – Noticed stretchy liquid from down below

13^th day post D2 Transfer – Blood test day HCG of 75 (Not high as in usual cases) Even though it is positive it is not that high therefore test has to be done again in 2 days to confirm pregnancy! Good news not good enough to celebrate the pregnancy.

Post "BFN" Consultation with Dr Prashant

I was very nervous while waiting for 1+ hour to see Dr. Longest I've waited to see Dr. But Dr also prefered to speak to us last, since its gonna be a long discussion. Which I totally agreed. I was hoping that I don't melt down and create a drama in front of him. Luckily I didn't.....


After my ET Dr mentioned that he'd be surprised if I don't get pregnant. Apparently it's due to 2 reasons.


1. My uterus lining was perfect on the day of transfer (I think it was 8mm)
2. My 8 cell embie was compacting which means edges between the cells are getting blurred, so it's becoming harder to count the number of cells. Compacting embryo has more chances of implanting compared to my 2nd embie which was 6 cell.


Ok, in that case 'Why didn't I get pregnant?' No answer for that. This stage is beyond anyone's control. So we have to leave it to fate.


Could it be due to my dry cough? No you cannot clearly define the cause for BFN.


Dr believes that we should continue to try. He firmly believes that I can get pregnant due to these reasons.


1. Age Factor I'm going to be 34 
2. We got good quality embryos.


But my problem is getting matured eggs, since my eggs were not matured enough it had been difficult to retrieve them.


So challenge now is to get matured eggs. For which Dr recommended I should continue with my medication. 


I want to take a break, I really don't like dumping whole loads of tablets into me. So both of us can start medicine 3 months before our next cycle. And of course loosing weight could help to improve egg quality and uterus lining.


Also it is believed that fish oil, royal jelly, green tea, acupuncture and Co-Q 10 could improve egg quality. But I'm not sure if its ok to take all these together.


Dr recommended a change in approach for our next cycle. Which could be freezing the embryos and transferring them after a natural cycle. Sometimes patients uterus can be sensitive to stimulation hormones. Scan cannot determine this sensitivity. (Japanese usually practice this method)


Also getting the embryos to blastocyst stage and doing D5 embryo transfer is another option. But in my case I'm not sure if I'd get embryos till blastocycst stage, because during past 2 cycles I only got 2 embryos.


Other important factor facilitating implantation is stress levels. More positive, stable and cheerful you are greater the chances of implantation. This is proven in an Israeli research where clowns performed to patients for 15 minutes after the procedure. “Medical Clowning” improved pregnancy rates compared to a group not exposed to a clown on the day of implantation." In conclusion patients who are less stressed and are positive in attitude had better outcomes.  (See source article)


Since having this kind of entertainment is not available everywhere, we can take our own entertainment devise with us to keep us relaxed after ET. Also figure out our own means of being cool and calm during the whole treatment process. It could be meditation, exercise, yoga, acupuncture.....


Ok now my focus is on weight loss and on improving my egg quality.


One major relief is Dr's strong belief that I can get pregnant. sigh....our journey continues...

The Results

After the embryo transfer I came across this wonderful info about "What happens to the embryo after transfer?" from http://www.nyufertilitycenter.org/ivf/embryo_transfer.


3-Day Transfer

Days Past Transfer (DPT)	Embryo Development
One	The embryo continues to grow and develop, turning from a 6-8 cell embryo into a morula
Two	The cells of the morula continue to divide, developing into a blastocyst
Three	The blastocyst begins to hatch out of its shell
Four	The blastocyst continues to hatch out of its shell and begins to attach itself to the uterus
Five	The blastocyst attaches deeper into the uterine lining, beginning implantation
Six	Implantation continues
Seven	Implantation is complete, cells that will eventually become the placenta and fetus have begun to develop
Eight	Human chorionic gonadotropin (hCG) starts to enter the blood stream
Nine	Fetal development continues and hCG continues to be secreted
Ten	Fetal development continues and hCG continues to be secreted
Eleven	Levels of hCG are now high enough to detect a pregnancy

So I kind of knew everyday what would be happening to embies inside my body. So by Day 6 post transfer, I was absolutely certain that I'm not pregnant. My friend challenged me, telling that I could be wrong. My answer was I'm 100% certain. My hubby believed what I said. How can I be so sure of my results, when my test is due only on Day12 post transfer?

When implantation occurs, there is increased blood flow to the uterus, and increase in hormone production i.e. estrogen and progesterone. This results in increased creamy cervical mucus(CM). In my case till D6 post transfer since ET day it had been very dry.  Usually it is the case after ovulation for me i.e. from mid cycle it's always dry till I get my menses  Since CM  was completely dry I was absolutely certain that I did not succeed.


Besides I did not have any other pregnancy symptoms, although these can be mimicked by lutel phase hormone support medicine. For example these medicine causes abdomen cramps, breast tenderness and bloatedness.


I cried, cried and cried; I could not take it, why does it always have to be like this? I've never experienced, the feeling of being pregnant. Will I ever experience? How many times do I have to go through IVF before I succeed? We both hugged and cried not knowing what to do?


I'm determined to do one thing before my next attempt i.e. "loose weight". My BMI is 26.6 I want to bring it down to 24. My thought behind it is, at least I'll do whatever is manageable i.e. within my control. Coz obviously pregnancy is something beyond my control.


Only time can answer if loosing weight could bring me success......

On Beta Test Day - Today

Went to the clinic by 9.30 am, did the blood test. And was hanging around in nearby mall. Decided to do a hair treatment while waiting. I was very nervous, even-though I knew my results. By the way yesterday morning I did a HPT which was 'negative'. Dreaded call never came till 12.30pm even-though they said that they'd get the results in 2 hours.


I called them at 1pm, and nurse said they have just got the results and will call me back. I spoke to my hubby and we almost guessed it. Because if it was positive they would have immediately congratulated me right?

Hubby told no point in hanging around, he told me to just go home. It's confirmed now. So I finished small errands in the mall and was just getting into the car, when I finally received the call confirming that my cycle didn't work out.


So now what? I really want to loose weight and improve my egg quality before I do my next cycle. So please share with me any tips you have


1. To improve my egg quality
2. Improve DH's sperm count
3. How to succeed in IVF ?


I hope and pray I too can be pregnant and become a mom for healthy babies one day.......

Celebrities who have gone through IVF

I came across this blog post by Nicole, Australia. It's summarizes the information about all celebrities who have done IVF. Check out this interesting post. "Celebrities & IVF, those who have been honest about it"

Giuliana Rancic's Breast Cancer Discovery During IVF Attempt no 3

I started watching this reality show "Giuliana & Bill" since they too are going through IVF to have their babies. She was lucky to get pregnant in her 1st IVF attempt, but miscarried in 8 weeks. On her 2nd attempt she got OHSS after egg retrieval and was admitted in hospital on the same night. Hence they did a FET and it was BFN.


Giuliana & Bills latest season showed them going to fertility clinic to start their IVF 3. So I was curious to know if she suceeded in IVF 3. I googled " Giuliana's IVF 3 results". I was shocked to see the news about her new battle with breast cancer. It took me a while to digest this news  and I was in tears. Oh my Gosh, why do some of us has to battle with all these challenges on our journey towards becoming parents.  In the mean time I do envy some others whose life is so simple and perfect. However, It's not the case for me neither for poor Giuliana. I always have to battle to get what I want.....


She was on IVF stimulation, when her Dr ordered a mammogram for her. Because if she got pregnant, pregancy hormones would  aggravate cancer, even if there is  a small risk of cancerous cells. Unfornately test results came out positive. When she got her results she was on D7 of IVF treatment. Dr's had advised her to go ahead with egg retrieval and then do the breast cancer treatment. Now she has undergone surgery, and would be going through radiation treatment for 6 and half weeks. 


There is lot of debate and concern if IVF and cancer is related. I wish to point out below thoughts shared by Dr Nancy Snyderman & Dr. Mark Perloe, medical director at Georgia Reproductive Specialists. (Giuliana's IVF 3 Dr).

• Could Rancic's breast cancer be connected in any way to the fertility treatment she had undergone?  
  "No," said Dr. Nancy Snyderman. The hormones used in both in vitro fertilization and birth control pills have been studied and "there's no known cause and effect," .
• Should we all do mamogram before IVF?   “We certainly want people to have a full health evaluation before beginning fertility treatments,”  “But we wouldn’t recommend a mammogram unless there was a family history of breast cancer or a genetic risk.” As for routine mammograms in infertile women aged 26 to 36, Perloe said, that would be a mistake. That's because mammograms come with some radiation exposure. "So you have to balance the risk of exposure to radiation from testing against the likelihood that there might be something there," Perloe said.  

• Despite the hormone paranoia, it's even possible that IVF might be protective. “The evidence is that IVF has no effect or lowers incidence, said Adrian V. Lee, a professor of pharmacology and chemical biology and director of the Women’s Cancer Research Center at the University of Pittsburgh’s Magee-Womens  Research Institute. “The largest study in Sweden -- of 25,000 women who had IVF compared to 1.4 million without  -- showed a 25 percent reduction in breast cancer and a 40 percent reduction in cervical cancer in those who had IVF.”

Source - Doctors : IVF not to blame for Rancic's breast cancer 

What I still don't know is "Why did Dr ordered Giuliana to do a mammogram?" Please let me know if any of you'll know the answer.

2 Week wait

As soon as I came home after ET, I lied in bed for few hours, later had my lunch watching TV, and again lied down after inserting progesterone pills.


1. I spent a lot of time on internet, reading ivf blogs and early pregnancy symptoms. Infact I created this blog during this time.


2. Watched TV, but for me internet is more interesting than TV. These are some of my favorite TV shows. Kardashians, MasterChef, America's next Top Model, Guliana & Bill, some tamil soaps etc., 


3 Watched a comedy flick with my husband and laughed out loud.


Oh I have this worrying dry cough, even on ET day I had this cough, its very strong I fear when I cough, I squeeze my stomach and cough out, I worry I might de-stabilise my embies. I took Prosphan a herbal dry cough syrup and drank lot of hot water.


4. I drank around 10 cups of hot/warm water flavored with lemon juice, ate healthy, took only plenty of fruits and milk with 'ensure' for dinner.


5. Sorted out digital photos which had piled up in my camera and computer.


6. Updated our expenses including amount we spent on our Baby endeavor till now.


7. Did simple work at home like sweeping the floor, ironing, cooking (hubby did all chopping, and washing)


8. I had some choclates lying in my fridge, on and off had them. (I was avoiding caffeine so chocolates only on and off)
Even in mornings I did not take coffee, instead switched to milk flavored with milo and 'ensure'.


9. Hubby gave some sit, search & update assignments which I had to do lah...


Note : during my 2 ww I hardly had any pregnancy symptoms, not even the one's mimicked by progesterone and estrogen pills :(, so with each passing day I'm becoming more and more certain that I'm not pregnant. One of the very early symptoms of pregnancy is increased creamy discharge. This should happen after implantation. Formation of mucus plug in cervical canal, and increased blood flow, and increased production of progesterone and estrongen resulting from pregnancy are the causes for increase in cervical mucus. In my case it's very dry down there. It's usually the case for me, before I get my periods. 


So readers, this is the reason I'm becoming more and more certain of my results again a BFN. Sigh..................Oh God will ever become pregnant? I'm not going to give up! "Winners never Quit, Quitters never Win" 


(heard this quote from Bill Rancic, Gulliana's hubby)

IVF Attempt No 2

Sep 2011


D2 scan revealed around 20 follicles on both side (because of PCOS). Dr said he will be starting my treatment with Menopur 300iu. But before I was ordered to do a blood test to check my progesterone and estradiol levels.  Only if hormones are within the range I can start the treatment. I went to bangsar village and was window shopping till I get the results. 


After around 2 hours nurse called me to  inform that I could pick my medicine. I did my first injection in the clinic and continued with same dose from D2-D4. On D5 & 6 my dose was Menopur 225iu. During this time I felt very bloated, I drank a lot of water, consumed one or two eggs daily, and continues with my exercise routine. (1 1/2 hours cardio and 1/2 hour weights every other day) From D6, I also started my second daily injection, Cetrotide 0.25mg to prevent me from ovulating.


I was very nervous for my D6 scan, thinking of my previous experience of not responding to stimulating medicine very well. Scan revealed 3 follicles on L and 6 on R ovary.


From D7-9, I continued with same dose i.e. Menopur 225iu. Again I was nervous for D9 scan, because last scan Dr told big ones are on left, so I was thinking what if, like my first attempt if others did not grow. And considering the fact that Dr has reduced my dose.


Scan revealed 3 on L and 5 on R, which Dr said is exactly what he's looking for and was happy with my scan results. I went with my bladder full that day as Dr also did an abdomen scan to check my uterus lining. It was 6.8mm and Dr said above 6 is ok.


D10 my dose was 150iu & D11 no menopur only cetrotide. D11 scan revealed 8-9 follicles and again abdomen scan reveled my uterus lining was ok. 


On D11 night I also had to take Ovidrol shot to release my eggs, for egg pick up scheduled after 36 hours from injection time.


I was very nervous before egg pick up, considering my previous experiences. I kept thinking repeatedly 'what if, if they are empty sacks like last time'. My blood pressure spiked before my egg pick up.


I was little relieved to see confident Dr, cheerfully wishing me before my egg pick up.


While I was slowly getting back to reality after egg pick anesthesia, I heard someone calling my name. It was Dr, he came to inform me that I had 7 eggs. My next question was 'how are their quality?' (I didn't know that time Dr would not know about the quality till next day) Dr's answer was 'ok'. (May be he said that to relieve me)


After I was fully recovered from sedation and had a cup of milo, I was ready to go. (Nurse in the ward commended that I was very quick) I went upstairs to Dr's clinic and met with the nurse. Dr also made a quick visit to ask if I'm feeling ok. Dr was very confident he was telling that I might have some embryos to freeze this time. Well my answer was 'Well Dr, that depends on egg quality and sperm', Dr was 'Let's hope for the best'.


After I came back home I had severe cramps, it was almost as if I could not stand straight, and it was painful when I was coughing or laughing. After a days rest, next day I was feeling absolutely normal.


Due to my past experience, I asked nurse to inform me about the progress next day. From morning I nervously waited for the call from clinic. I was so nervous, I really can't recall me being so nervous in recent pass. Except 16 years back I was nervous like this when I was waiting for my GCE O/L results.


Finally around 9.30 am embryologist called me, (that was quick) ' you have 4 matured eggs, 3 fertilized'. I was quickly doing my math and comparing my results to other patients whom I know.


Patient 1 got 15 eggs, 12 fertilized, 6 good quality on D3
Patient 2 got 15 eggs, 11 fertilized, 2 transferred on D2, balance frozen


OMG my results is nothing compared to them, norm is 80% fertilization, in my case only 42%. From that point onward I was very stressed thinking if my embies would survive till D3.


I had two days before scheduled embryo transfer, first day I went shopping and did hair color  second day whole day I was busy cooking as we were hosting dinner for some friends at our place. It was a good distraction for me.


On embryo transfer day I arrive at the clinic, I emptied bladder one hour before scheduled transfer, and started drinking water. I took 2 glasses of water, when I changed cloths went in to the procedure room for abdomen scan, embryologist told my bladder was full. Thank God, this limit is bearable for me. 


My hubby was allowed to sit with me during transfer, but he too has to wear special cloths. He looked very funny with it, I was laughing at him. Good, some distraction for me.


After few minutes Dr came, he informed that 3 eggs had some chromosomal issue hence they could not inject sperm into it, and out of 4, 3 fertilized and 2 survived till Day 3, 3rd one did not divide into cells.


Dr said those two are good quality embryos and he'd be surprised if I don't get pregnant. I asked 'how many cells' & 'how about fragmentation'. One was 8 cell and other was 6 cell, fragmentation nil. Ok I'm satisfied with the results. I was hoping if all 3 survived till D3, it'll be good to transfer all 3, which means more chances of pregnancy. But 2 is ok.


Inserting speculum inside me is very very painful, even though some women don't feel any pain or only minor discomfort. May be it took around 10 minutes to do the transfer and it was done.


I brought my ipod and eye mask with me. so while I was resting I asked them to turn off the lights and was listening to music. Didn't even realize 10 minutes passing by. Afterwards I was allowed to pass urine, and rest another 30 minutes in recovery room.


We changed cloths, went to the clinic to get Lutel phase support medicine.(Duphaston (Oral Progesterone), Utrogestan (Vaginal insert Progesterone), and Progynova (Estrogen to start from 5th day post transfer)  Friendly nurse wished me luck and I am required to go back for my blood test 12th day post transfer.




Word of Caution - Maximum 2-3 glasses are adequate to have your bladder full, start drinking from an hour before the procedure. Don't over do because you will not be able to relax after embryo transfer if your bladder is very full.


For egg retrieval we are supposed to go fasting, you may feel uncomfortable if you have not emptied bowel in the morning. My tip is eat plenty of fruit and drink 8-10 glasses of water on previous night and  so that you can pass motion without any trouble. I ate one big guava which works well for me.

Appointment with Dr Prashant Nadkarni

April 2011 - Sep2011

We both went to see Dr P. One good thing is, this clinic is closer to my hubby's office, which means he'll accompany me for all the appointments. During last two attempts I always go alone and my hubby comes only during procedures.

Dr listens to our history and shared that PCOS patients respond differently to IVF medicine. Not in a predictable manner, hence my past results. Dr asked me to do fasting blood test to check my insulin and vitamin D levels.

Hubby has to take Vitamin E, multi vitamin, Co-Q 10, Vitamin C & D. These medications will prevent DNA damage in sperms. For both of us its recommended to take Omega 3. We opted for flaxseed oil capsules.

I also did accupuncture, may be for a month and after a while I could not take needles any more, so I stopped.

Dr also told that having normal BMI i.e. below 25 is essential, because higher the weight is higher the rate of miscarriage.

My insulin levels were high, it has to be below 11. Insulin plays an important role in egg quality. Hence Dr prescribed glucophage xr500mg twice a day, along with metformin 500mg twice a day.

I took metformin after lunch  and dinner, and glucophage xr (extended release of metformin) after dinner and managed to bring down my insulin levels within the range.

Next is Vitamin D, my vitamin D levels were way below required levels. Vitamin D levels are important for uterus lining. So Dr prescribed GNC vitamin D 400 iu capsules 3 in the morning 3 in night, totally 2400iu daily to bring my vitamin D level under normal range. He also recommended I do swimming and be outdoors to get enough sunlight, which I'm not so fond of considering hot, humid, sweaty weather in kl.

By June 2011, my test revealed my Vitamin D levels are within the range. Dr said now I'm ready for my IVF.

We were hoping to do our IVF in July, but got interrupted by unforeseen travel opportunity. So we thought of doing it in end of August.

But after I returned from my holidays, due to my binging, my insulin levels had spiked up again. So I waited till Sep so that I can regulate my insulin levels.

Yes I managed bring my insulin under control and I'm ready for my next IVF.

Oh how about my frozen embies?

March 2011

I prepared my self to do frozen embryo transfer. Went for a scan on D2 to check if my uterus lining was below 4mm and started on estrogen pills to build up my lining.

And on D14, I went for a scan again, Dr revealed my lining is not optimum. A common problem with PCOS patients, still its ok and we can go ahead with FET.

Next day is thawing day, I nervously waited for the call from Co-ordinator. I remember it was a Thursday. Yep finally she called to inform that 4 cell embryo did not survive and it lysed. And the other one has not divided into cells, hence not suitable for transfer.

I was devastated, but no choice. We decide to see Dr again. Dr patiently listened to me, my weepings and explained to us. I wanted to try another cycle soon. But Dr recommended I try out another clinic, with another Dr. Dr Mahesh is such a nice Dr, I don't think most of the Dr's in town does this but he recommended me to one of this colleague or he also gave an option that we try it at KKH in Singapore.

I was very firm that I wanted to try my next cycle with same Dr, because I was very comfortable with him. Dr's point was; different Dr's will have different views, and their approach differs, so what works for one patient might not work for the other.

After we came home, we both talked and decided we try out this Dr recommended by Dr Mahesh. So I contacted co-ordinator and requested letter briefing my treatment summary.

And I also make an appointment to see Dr Prashant Nadkarni at KL Fertility Centre.