6 August 2012, by Tan Yi Lin

Stage 4: HAPPY NURSES’ DAY!

1 August 2012

We were scheduled for the embryo transfer procedure at 9.30am. Today, we would find out how many embryos made it from the 22 eggs that were introduced to the hungry army of sperm on 30 July.

The weather was nice and sunny. I was feeling great. Rather hungry. So I chowed down on a bowl of cereal. Mmmmm. Good.

Oh wait. Oh crap. I forgot to fast. Panic.

The husband was unsympathetic: “You had better confess to the nurse that you ate!”

On the way to the hospital, the radio deejays generously doled out shout-outs to all nurses, “HAPPY NURSES’ DAY!” Dan took it upon himself to wish the nurses at KKH when we saw them later. What better way to show our appreciation to these wonderful people than to wish them in person?

At KKH IVF Centre

We bumped into my friend again, who was waiting to have her ultrasound scan to track the size of her follicles for her upcoming IUI procedure. Isn’t the IVF clinic becoming such a friendly place? Lots of familiar faces now!

The nurse at the reception warned us that it was going to be a long wait. Nonetheless, I gulped down cup after cup of water. A full bladder is required for the embryo transfer. I hadn’t read the patient instruction sheet too carefully the night before and forgot that I was suppose to have drank all that water before I left home for the hospital (Note to Self: Being a repeat IVF patient does not give one the excuse to get complacent and not read the instructions given!)

“HAPPY NURSES’ DAY!”, announced Dan. The nurse looked surprised – and pleased.

I got my blood sample drawn, which the nurse explained was to test for OHSS – Ovarian Hyper-Stimulation Syndrome, a possible uncomfortable side effect of the IVF drugs.

The minutes ticked by. Oh.My.Gosh. This was going to be a long wait indeed. My bladder was bursting. Dan told me to summon up the memory of how I lasted 20 hours on a bus journey in South America without a toilet break (because I absolutely refused to use the one and only toilet on the bus.) But that was different. I don’t gorge myself with water on long bus rides.

My guess was that my doctor probably had a delivery (not of the pizza kind) to attend to. My thoughts floated back to when Coco was born – 9.27am on a Monday. I must have pissed off my doctor’s patients by holding her up in the delivery room on a typically crowded Monday morning. There must have been more than one anxious woman waiting for an embryo transfer while clutching a watermelon-sized bladder.

So it’s true. What goes around, comes around.

A nurse finally called my name and escorted me into the procedure room.No sexy pink bare-backed gowns for this round. Just strip off your undies, hike up your dress/skirt and you’re ready to go.

The Embryo Transfer

The nurse scanned my tummy:

Nurse: Wah, bladder very full.

Me: Yes! But… *squinting at the screen*... how do you tell? What am I looking at?

Nurse: *pointing* The black area pressing down on the white part – that’s your bladder pressing onto your womb. When lying horizontal, the womb usually pops up like a little hill, which makes inserting the catheter (containing the embryos) difficult. A full bladder presses the womb into a horizontal shape, allowing catheter to be inserted straight in.

Aaaahhh. *realisation* All these years and months where I had been obediently sitting around, with bladder bursting at the seams, I never asked. Now I know.

I decided to confess that I had breakfast.

Me: I, erm, forgot to fast today. Is that okay? What’s the reason for fasting since no sedation is required? (I’ve no idea why I have never asked this question either.)

Nurse: Fasting is a precautionary measure just in case you need to have the procedure done under G.A., which requires a fasting period of minimum six hours before the surgery. But since you didn’t have any problems for your previous embryo transfer, you should be alright.

Phew. Minus points for greediness. But other than that, I was going to be okay.

Me (to Dan): You do know what your job is, right?

Dan: *nods enthusiastically* Yes! To check your name and IC number when it appears on the screen!

Me: And you do know what my IC number is right? It’s not 8888. Nor is it 1234567.

Dan: Yes, yes, I know. And my other job is to scan your head! What do you think will appear on the screen? *grabs the scanning-thing that the nurse was using on my tummy and TRIES TO SCAN MY FOREHEAD*

Me: *silent scream* STOP IT! YOU SCAN YOUR OWN TUMMY LAH!

My doctor arrived before he could unbutton his shirt (thank god).

Doctor (to nurse): Happy Nurses’ Day!

Dan: Happy Nurses’ Day! Aiyah. I forgot to wish her earlier! Must show initiative, you know? (To nurse) You all had a party already right? Will you still be celebrating today?

Nurse: Yes, there will be another party later.

Dan: Wah. You are quite party animals here ah.

*Cringe*

The doctor informed us that we have FIVE usable embryos from this cycle (yaaay!) She intercom-ed the embryologist (in the adjacent room) to feed ‘live’ video footage of the first two embryos to the screen in our room.

Dan (exclaims): WOW! SO MUCH HAIR! (which is utter rubbish of course. There is no such thing as a hairy embryo.)

Me: Oh hello babies! You look like your father already. Oh joy.

On a serious note, the embryos from this cycle appear to be of much better quality than the four from the previous cycle. You can see from the photo below how cleanly-divided the cells are (at the four-cell stage) and how translucent the embryos are.

Embryo Transfer, 1 Aug 2012

The ones from the first cycle look so fragmented and dark in comparison. One of them was Coco.

Embryo Transfer (Frozen Cycle), 3 Dec 2011

The embryologist later told us that the embryos transferred on 1 August were of Grade 4 and Grade 3 (I assumed that Grade 5 was the best, thus this was meant to be good news). I didn’t even know the grades of my first four embryos. The embryologist then didn’t tell me. Nor did it occur to me to ask. I didn’t even know there was such a thing as embryo grading. Not that the scores really mean anything. There have been IVF attempts using top-grade embryos that failed. There have also been occasions where low-grade embryos miraculously blossomed into beautiful, smart and funny babies. Coco is a living, breathing example of the latter.

After Dan verified that my name and IC number were correct, the embryologist brought the embryos, sucked into a catheter, to my doctor.

My doctor proceeded to insert the catheter and release the embryos into their new home.

Dan: *hums The Imperial March from Star Wars. Also known as Darth Vader’s theme* den den den dendenden dendenden….

Doctor: Oi. Don’t make me nervous lah.

Nurse: *pointing to screen* See, you can see the embryos inside the womb.

Dan: *squinting* Errrrrr. Okaaay. Whatever you say. I believe you!

With the embryos safely in, the embryologist popped out again to give us the IVF report:

22 eggs extracted

15 successfully fertilised

5 embryos suitable for transfer

2 embryos transferred

3 embryos frozen for future use

It’s not a bad haul. In fact, very similar to my first cycle. But look at the pattern here: out of the 14 and 15 fertilised eggs from each cycle, only one third made it to become usable embryos. This is why IVF is not a sure-win solution to fertility issues. This is what most people don’t understand. The numbers, while not exactly dismal, don’t promise anything.

“HAPPY NURSES’ DAY!” Dan chimed to the embryologist. He glanced at her name tag.

Dan: Oh wait. You’re not a nurse. Ooops.

Embryologist: It’s okay. We have Embryologist Day too, coming up soon.

We thought she was half-joking. My friend sent me a photo of the new display at the IVF centre two days later. Apparently, the embryologist wasn’t bluffing:

Spot the fertilised egg.....

The doctor prescribed the same progesterone supplements as the last round to support the uterine lining during this critical period. I asked why KKH prescribed that Utrogestan be inserted vaginally, instead of consumed orally as per the manufacturer’s instructions. My friend’s gynae (from a private clinic) had told her to eat them and she was quite grossed out to discover that she had been swallowing, what to other women are, vagina pills.

My my, I sure was in an inquisitive mood that day. The explanation was that, if swallowed, the capsules would first have to be digested and then further processed by the liver, thus reducing the actual dosage of progesterone reaching the uterus. When used as suppositories, the pills dissolve and the progesterone is absorbed through the vagina walls, which are rich in blood vessels, directly into the bloodstream, and reaches the womb through a more direct route.

So now you (and I) know. Utrogestan: Best Shoved; Not Swallowed.

By now, it was almost noon and Dan had to rush back to the office for a meeting. But not before proudly flashing the photo of the embryos at a nurse, declaring, “See! My sons!”

We fed our new babies with a hasty, calorie-rich meal from Macdonald’s and willed them to grow. I know, burgers, fries and soft drinks are not the most nutritious of foods. The natural food purists and old folks will just flip at the act of drinking ice-cold Coke after an embryo transfer. But hey, if these babies are anything like their big sister, they’re going to grow up without a fear of cold temperatures, even if they weren’t frozen babies like Coco was. Plus, I went with the relatively healthier option of a Fillet O’Fish in hope that it’ll grow us some brainy babies.

**************

Before we left the clinic, the nurse remarked that it was heartening that our frozen cycle had succeeded and that it was not common for IVF to yield baby girls. Assisted reproduction techniques favour male babies, as the fastest and strongest sperm – usually the ones carrying the male chromosome – would penetrate the best eggs to form boys.

This makes me realise how heavily the odds were stacked against Coco, even before her life began. A sperm carrying the female chromosome had won the fight against its stronger, faster competitors. She was (what most embryologist might call) a poor quality embryo. She was deemed to be second choice and relegated to the freezer, to standby as our extra hope. She was frozen for three months before being thawed – with no guarantee of survival. Coco, to us, embodies Hope – and as her name means, Victory (no, Cho Colette didn’t really stem from Chocolate. That’s just Dan’s idea of a brilliant pun). Not just our Hope, but others’ too. Even before her first birthday, this little girl has shown other couples that they, too, have a shot at becoming parents, even if the odds are against them. I received an email from a reader last week telling me that our story inspires others and gives them hope. That is one of the nicest things that anybody could ever say. This is what makes keeping this blog meaningful and worth every minute that I’ve spent on it.

The pregnancy test is scheduled for 17 August. So now, we wait.

And talk to our future babies:

Dan: Hello Kenobi!

Me: You only said hello to one of them! How about the other one?

Dan: Erm, hello Kenobi! Hello Obiwan! You are Cho Bi Wan, Kenobi and you are Cho Bi Two, Obiwan.

Me: What?!?! What sort of crappy name is Cho Bi Two?!?!

Dan: What? I am only expecting one of them to make it. I hadn’t prepared another name yet!

Yes, my husband is quite THE Name Master.

I have more faith than he does. I want both of them to make it. And if they do, we have a good 36 weeks to come up with better names.

In the meantime, would anyone like to engage Dannie’s naming services for their newborns? $88 only.

Anyone?

Tags : ,

Posted on : August 6, 2012

Filed under : Planning For Baby

9 Comments

Tan Yi Lin

Yi Lin

January 29th, 2014 at 9:11 am    


Hi Vivian,

I’m so sorry that I missed your comment waaaaaaaaaaay back in Jul 2013. I only just saw it while revisiting this entry that I had linked to the latest one. Sorry!

It’s probably too late to provided the answers that you needed now. In fact, I DO hope that it IS too late – and that your IVF attempt has been successful.

In any case, I didn’t do strict bedrest for both cycles. In fact, I tried to sit and lie down as much as possible during our first attempt. When that attempt resulted in failure, I just decided to live my life normally and not restrict my movement so strictly, although I was still careful not to tire myself out.

I didn’t do any accupuncture. Just ate, slept, rested and try not to go crazy duing the 2 week wait!

Vivian

July 10th, 2013 at 10:28 pm    


Hi Yi Lin!

I’m very new here and just did my IVF transfer. 🙂 Need some pointers from you..

Did you do strict bedrest for both Coco and Claire’s cycle? And if so, for how many days? What else did you do (e.g. acupuncture etc) that makes the cycle successful?

Truly appreciate your advice! 🙂

Tan Yi Lin

Yi Lin

August 10th, 2012 at 4:06 am    


Thank you EVERYONE for your kind wishes!

I am enjoying my 2ww. Unlike the last two rounds where I was too worried, anxious and focused on the results, this round I’m calmer and happier, and am learning to enjoy the journey instead. I guess it’s because of Coco and no matter what happens, I already have my baby here with me.

I still worry, of course. Such as whether it’s okay to carry Coco and move around so much. But it’s so hard to refuse her outstretched arms and requests to go down the slide or into the pool. Grateful to have lots of helping hands, ready to take her on whenever I need a break.

Twins would be pretty crazy. We haven’t forgotten how tough life was with a gassy newborn. Much less two. But hey, we’re young(ish) and healthy, our parents are youthful and energetic, our siblings don’t have kids yet to compete with ours for the grandparents’ attention – what better time than now to be blessed with more children?

I apparently misquoted Dan when it came to naming them though: They are Obi-wan and Obi-two. Whatever. Still just as corny.

Hi sophy,
I’m seeing Dr Sadhana Nadarajah at KKH. I think she’s great. Plus, it’s a bonus that she seems genuinely amused by Dan’s humour and antics. We like a doctor who can laugh!

Gillian

August 9th, 2012 at 4:08 pm    


Wishing you good luck and success, Yi Lin and Dannie. 🙂

Lifeng

August 8th, 2012 at 3:37 am    


TWINS! 🙂

Mandy Loh

Mandy

August 7th, 2012 at 4:31 pm    


Woohoo! Yes let’s pray for TWINS!!!

sophy

August 7th, 2012 at 7:53 am    


Enjoy your 2ww!! Who’s your doc?

rach

August 7th, 2012 at 4:39 am    


u guys are way too funny!
rest well, eat well & sleep well these 2 wks.
hope u managed to grab the bird by its neck big time.
best of luck!!

Teresa

August 7th, 2012 at 3:26 am    


ALl the VERY best to you & Dan!!!

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