27 August 2010, by Tan Yi Lin

Jab Jab Revenge

Ahh, so in my last couple of posts, I mentioned that I’ve been getting rather good (*beam*) at administering my own jabs.

In fact, so good at it that on Day 15 of the daily jabs, the doctor decided that I could graduate to self-administering TWO jabs a day….

Jab jab. Sounds like something yelled out by the instructor in Body Combat or kickboxing class. Jab jab!

Also sounds like one of my favourite iPhone games, Tap Tap. And when you get really good at Tap Tap, you graduate to Tap Tap Revenge! Thank goodness the IVF process doesn’t require the syringe to be plunged to a rhythm. Just imagine… jabjab jabjabjab jabjab jabjab jaaaaaaab!

The second drug is Puregon, which basically stimulates the ovaries to produce multiple follicles. I was sent to the KKH pharmacy with a prescription for Puregon and returned to the IVF Centre with quite a stash.

Woo hoo! Christmas has come to town. Unfortunately, Santa thinks I haven’t been good – so I get needles only. Sigh.

I was given two tiny vials of the drug. The first one was labelled 900 units, but actually contained 1,000 units. The second said “300 units”, but actually contained 400 units. YES – it was all bloody confusing. Especially since I had to keep track of the balance amounts in both cartridges as I drew on them for my daily dose.

Puregon is incredibly expensive. The 900-unit vial cost a precious $600. But since I’m using the government grant for Assisted Reproductive Therapy (ART) and Medisave to pay for the IVF, I could breeze out of the pharmacy, bag in hand, without having to pay a single cent at the cashier. It’s almost like being authorised to shoplift!

These two babies, plus the third vial I got later on, cost a whopping 1,000 plus bucks!

Puregon is administered using a special ‘pen’:

Step 1: load the cartridge into the bottom half and screw on the top

Step 2: snap on a needle at the tip and turn the dial at the top end to 150 units. The dosage may vary from hospital to hospital, or even patient to patient.

Step 3: remove the protective plastic cap from the needle and get ready to fire!

The big yellow Puregon pen compared to the slim disposable syringes used for Lucrin

Because it is administered using a pen, Puregon injections are supposedly easier to handle. Mainly due to fact that unlike Lucrin, I didn’t need to prep individual syringes and draw the Lucrin from the bottle each time. With Puregon, it’s simply a dial and jab procedure.

I didn’t think it was simpler though:

– Patients are given new pens. The dialling mechanism on new pens is rather stiff, although it smoothens with time and usage.

– Puregon, like Lucrin, has to be refrigerated. I popped the entire pen containing the cartridge into the chiller (yups, right next to the butter!) So in our lovely hot and humid weather, condensation occurs whenever I remove the pen from the fridge. Handling a cold, wet, slippery pen (and needle!) is really not the easiest thing in the world to do. The alternative would be to refrigerate only the cartridge, but that would mean having to load and unload the pen every morning. Clear, transparent cartridges lying around the kitchen is not good idea, especially if you forget to pop them back into the fridge after use. Bye bye $600.

– The dial rotates when compressed, meaning you get a wet, slippery rotating pen. Tricky!

– And finally, the needle used in conjunction with the pen is thicker than the one used for Lucrin. It is, it is! The difference may look minuscule but I swear it’s bigger ­čÖü

Step 4: aim for belly (the fatter the better) and insert needle. Compress dial. Count to 5 and remove.

The pen is in me… (Okay, sorry, rude joke. Couldn’t resist!)

My new hobby: collecting used needles. The orange-capped syringes are for Lucrin. The white caps contain used Puregon needles.

And so continued the two-jabs-a-day ritual for another 10 days. As of 24 August, I had given myself 38 jabs over 27 days.

On that day, after a series of almost daily ultrasound scans, the doctor decided that I was ready for “egg pick-up” in 3 days time. The scans results showed that I was responding well to the Puregon and had produced more than 20 follicles in total in both ovaries! *applause* Well done, my little ones!

The dominant few had grown to 16mm in diameter, which is the minimum size for harvesting. How egg-citing indeed!

I was scheduled for a massive dose of 10,000 units of Pregnyl the following day, which would stimulate the onset of ovulation. The dose had to be administered at 10pm, so Dan and I headed for the 24-hour clinic to get it done.

Pregnyl comes in two vials of powder and two vials of solvent, which the nurse mixes.

2 + 2 = 20 eggies please!

While waiting for the nurse to prepare the dose, Dannie decided to have a go at playing Doctor…

Come, let Dr Dan feel your chest pulse now…

Yes, yes, nice beat you’ve got there

The game ended when the brusque nurse bustled in, wielding a damn frickin’ long thick needle, and stabbed me soundly in the THIGH – and a mightily muscular part of it too. Most painful jab for IVF ever. My left leg went numb seconds after and I limped back to the car. End of story.

Well, not quite the end yet:

I found myself wondering how sperm would react when they found themselves introduced to 20 eggs at one time, instead of the usual ONE. Would they think, “Wow! So many choices, which one do I pick?” Would they be disoriented, giddy and confused?

I mean, how natural conception works is that the sperm is naturally programmed to know where to go i.e. swim up up and away through the vagina and into the womb. There is only ONE way to go (to infinity and beyond!) The strongest, most dominant sperm (let’s call him Super Strong Handsome Hero Sperm) would hunt down the egg, hone in, take aim and penetrate it with its sharp little arrowhead and create an embryo, no?

Now what if SSHH Sperm gets indecisive? He’s the first to arrive in the petri-dish. His in-built GPS system still means that he can sniff out the egg. But which egg? What if he gets choosy and can’t make up his little mind which egg he wants? The slower swimmers would then close in on the gap and cosy up fast with all the eggs! So instead of SSHH Sperm getting the lady, he wanders around aimlessly looking for available eggs until he shrivels up and dies *wail*

That said, I’m sure God is fair and the slower-swimming sperm do have their fair share of talents. Like singing, dancing salsa, telling jokes and doing stand-up comedy…

Singing Sperm. Salsa Sperm. Funny Sperm.

I think this is the point when I stop obsessing over sperm and entertain only sane and positive thoughts (like SSHH Sperm getting the prize egg.)

Next stop: Egg Pick-up Day!

Someone tell the boy that that’s not a reading lamp please….


Tan Yi Lin

Yi Lin

September 20th, 2010 at 2:21 pm    

Haha, yes, ‘you’ is not the best of liquids for ivf! Eeee-yerrrr. I know whatcha mean lah. Well, all that is now done and over with. Waiting to hear from the doc on the next step. Stay tuned for the next post…. sometime this week. Have no idea what I’ll be writing about yet. But I’ll figure it out.


September 19th, 2010 at 9:40 pm    

You guys are so funny! Very cute pictures as always.

Geez, I just decided to drop in and binge read today. I didn’t know you were going through all this.

JIA YOU! (Clearly other liquids would be more suitable for the purpose, but you know what I mean ­čśë

Tan Yi Lin

Yi Lin

September 1st, 2010 at 2:27 am    

Well it really helps when your husband tells corny jokes at every stage to entertain you. Also helped that I didn’t get full-blown Ovarian HyperStimulation Syndrome (OHSS) from the drugs, just minor side effects. I saw some pretty miserable-looking women at the clinic. One was even in a wheelchair. The husband looked pretty unhappy too. Mine, on the other hand, burst out into song in the waiting room…. more on that in my next entry.

Celine Yeo

August 31st, 2010 at 12:50 am    

You’re a hoot! Love your positive attitude towards sooo many needles! May the best eggs and sperms win!!

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