Day 2 Blood Test

Went to KK this morning for a blood test. The following will be tested:

1) Follicular-Stimulating Hormone (FSH)
2) Luteinsing Hormone (LH)
3) Estradiol (E2)
4) Prolactin
5) Anti-Mullerian Hormone (AMH)

Results will only be revealed and reviewed on my next appointment with Dr Loh which will be in a month's time.

Decided to find out a little more about all these tests...

1) Follicular-Stimulating Hormone (FSH)

- hormone released by the pituitary gland to start follicle development. If the ovaries do not respond promptly or are producing fewer eggs, the FSH levels will be high. 

2) Luteinsing Hormone (LH)

- a surge in the LH level indicates ovulation

- however, LH level also rises during menopause 

3) Estradiol (E2)

- a sex hormone, used to access ovarian function

4) Prolactin 

- to diagnose infertility

5) Anti-Mullerian Hormone (AMH)

- to test for the ovarian reserve

It's amazing and scary what a small tube of blood can tell us. 

Costs (GST not inclusive):

1) FSH $32.30

2) LH $32.30

3) E2 $34.70

4) Prolactin $32.30

5) AMH $40.00

The Answer...

We seek to find answers to our questions and ask why and sometimes we don't like the answer...

Last Friday, hubby and I went to KK and met our 3rd fertility Dr. He's the 3rd one we've seen in KK within 2 years. He was recommended by a friend who has conceived under his IVF treatment. He was the head of the department and was reputed to be the one with miracle hands.

Before we started on our long journey trying to conceive, we didn't think we would have to 'travel' so far and now to consider IVF. Just like the other appointments we had, we had to wait for over an hour to finally see him. In his office was a large display of photographs of babies and children successfully conceived from IVF.

Finally, Dr Loh came and he was friendly and asked some questions while he flipped through my medical file and noted that I've been through many cycles of clomid and Letrozole. Then just like the other 2 doctors I've seen before him, I was given an ultrasound. But what followed was pretty unexpected. He said that I had small ovaries! Finally, he had found the answer to explain the infertility problem that we're having! Although the other 2 Drs had done the same, all they could say was that everything looked normal. Now, Dr Loh had found something and I don't like what he found.

At that point in time, I didn't know what was the real implications of having small ovaries. But one thing for certain was that I could sense a certain urgency in his decision to let me start IVF as soon as possible, looking at August and with a high dosage of medication. While we were waiting for Dr Loh at his office, I had asked the nurse when was the earliest time we could start IVF and she said October. So August is half the usual waiting time.

But before that, I still had to go through some blood tests to check certain things before we're ready to start IVF.

New Year, New Hopes

The year 2011 has started and we're into its 3rd month already! I've not been updating this blog for quite sometime now. Been kinda lazy :P As it turned out, I'm still not back in school despite my P's attractive offer cos of some rules of MOE. Anyway, keeping my fingers crossed  that I'll still be able to return to school on a part-time basis in Term 3.

Last month, we've managed to see a new gynea at KK who prescribed a new medication- Letrozole that's suppose to be better than Clomid. It costs a lot more too. For 10 tablets to be taken over 5 days, it was about S$100. It was actually a post-breast cancer treatment medication that is also often prescribed over the last decade as a fertility drug. Apparently, the makers of the drug had issued warning letters to doctors against prescribing them as fertility drugs. But nevertheless, I guess Letrozole is still being frequently prescribed. But we've been warned that one has to be absolutely certain that one is not pregnant before having Letrozole as it's detrimental to the development of the fetus.

Anyway, after I've completed my 1st cycle of Letrozole,  I was still spotting and was suffering from a pain and a swell in my right neck. 3 days later, I was still having fever and the swell on my neck was obvious. I was getting worried, hoping that it was nothing serious. I googled and tried to look for reasons to explain my 'sufferings', I called the KKIVF centre and asked if all these were the side effects of Letrozole. I was advised to visit the 24hr clinic at KK to see a doctor.

Finally at 11p.m., we finally went to visit the doctor just to 'buy some peace". After a urine test, doctor spotted a faint line on the pregnancy kit and I saw a glimpse of hope while the dr went on to suggest a blood test to confirm if I was really pregnant. Jerome was horrified! Could his 'sotong' wife started on Letrozole when she was pregnant all along? He had read up on all the side effects of Letrozole. For the first time, he hoped that it's a false positive. Later when I was out of the consultation room, Jerome returned to ask the doctor some questions of his own. The doctors confirmed his fears about all the side effects of Letrozole. He asked her if the pregnancy test is positive, should he be happy or should he worry. Doctor said to take things one step at a time. At least it proved that my egg and his sperm are working.

Along our home home, I kept telling Jerome that it's not possible for me to be pregnant. My menses has just ended and I can't be pregnant before that as I've already used the test kit before starting on Letrozole.
Sometime after midnight, KK called, "Mdm Tan, this is calling from KKH. Your blood test results is out and we are sorry to inform you that you are not pregnant." I had very mixed feeling upon hear this. Kinda disappointed that I'm still not pregnant. Relieved as we didn't have to worry about the effects of Letrozole. So all our worries were for nothing. But I'm not sure if I would try Letrozole for another cycle. I certainly hope I don't have to :)

Another Cycle of Clomid

In February, Jerome made an appointment at KKH-The Private Suite to visit Dr K Loi who specializes in fertility.  After that first consultation, after an ultrasound and a Pap Smear, Dr Loi suggested that I was not ovulating and hence I was prescribed clomid to be taken over 3 cycles and Jerome had to check out his troops. Our next appointment will be after the 3 cycles and after Dr Loi returned from her maternity leave.

The first month I started, I had to visit the hospital for a blood test to check for my Progesterone levels that indicates whether I'm ovulating. But strangely, there was no follow up to that blood test. Just like the Pap Smear I did, there were no calls or mails. What's the purpose of doing the tests if I don't get the results?

After the 2nd blood test, I told the nurse about this. Only then I found out that I needed to get my blood test done at the KKIVF department, not at the Pte Suite. Anyway, a few days later, I received a call from a nurse telling me that I'm not ovulating and that I should increase my dosage of clomid to 2 tablets. So I had to make another trip to KKH just to get the extra tablets. Another blood test after the 3rd cycle confirmed that I was ovulating.

So after completing my first 3 cycles of clomid, we finally visited Dr Loi again in July.  She suggested that  do a HSG test where a radioactive dye is injected through the vagina and an x-ray taken to check whether my fallopian tubes are blocked. So I went for that and cleared the test.

The next visit, after the HSG test, Dr Loi suggested that I try another 3 cycles of clomid. Since I'm ovulating with 2 tablets, I'll just stick to 2. She informed us that she's leaving KKH for her own practice at Paragon so if I want to see her again, we'll have to move with her. Think it's a blessing really. We were thinking of seeing another gynae.

Jerome & I felt that she had not been very professional and most forgetful so we'll not visit her again. On 2 occasions, during the consultation, she said she's going to prescribe some multi-vitamins for Jerome  but she forgot. During a visit, I was told I need to do another Pap Smear during my next visit. And during my next visit, she forgot about it. We had stepped out of her office when I remembered that. We went back in and reminded her. During our last consultation, she said I should stick to 2 tablets of clomid. But when I got the prescription, I was given 3 tablets. Dr Loi made a mistake on the prescription? Both Jerome & I were certain that I were to be on 2 tablets.  Errr... so should I just take 2 tablets since I'm ovulating at 2, or should I be kiasu and take 3? Even the Pharmacist was surprised of my 'high' dosage as she had only seen prescription of 2 tablets so far. So we decided that we'll just stick to 2 tablets and we're definitely not going to stick to Dr Loi.

Anyway, so I've now started on my 5th cycle of clomid. Another cycle of wait and see...

On a brighter note, we've both passed all the medical tests that we had to do. I'm ovulating with 2 tables after my 3rd blood test. I've no side effects from taking clomid.

Jerome says we'll move on to IVF next year. He has also considered adopting.

P/S I was shocked at how cheap clomid is. At KKH, it's less than 20 cents a pill. So for less than a dollar a month, it had helped some many couples conceive. And it seems that many colleagues in school who had their babies took clomid before.