the journey of ups and downs

So I thought I would get the trigger on Tuesday and get the egg retrieval done on Friday. By noooooo that was not the case. I went back to the clinic on Tuesday afternoon and all I got was "wait, the blood test results aren't back yet". So I waited till 6pm and nurse V asked me how I was feeling. I said good, except for a bit of nausea earlier in the day and of course, bloatedness. I also had a teeny weeny bit of cramps but it could just be because of something I ate? She trotted off to find Dr T and then came back and said nope, no trigger. I was so frustrated I wanted to cry. Really. I begged her but she said Dr T would not let me trigger because Pregnyl (the trigger drug) may make me feel worse. I told her I only had VERY mild nausea, it could just be nothing! But Dr T refused. SIGH.

I got another jab of Cetrotide (nurse V mixed it up there and then) and went home, feeling awful and frustrated. I told myself I won't postpone the flight to Saturday as that means arriving back in HK only on Sunday evening and that's just way too late for me. I need to be home ASAP - I have been away too long.

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This morning I went back in for another blood test and another one at 1pm. I got quite worked up when I went back to the clinic just before the second blood test because another nurse whom I've never seen before took my case and said she can't say if I'm triggering tonight or not. I felt so mad I could feel the blood rising and I knew all that energy had to go somewhere somehow, but I'm not allowed to go for a run. How frustrating! While waiting for my turn for the blood test I paced around cursing at the incompetent system of the ARGC - of course not out loud, for the exempletives I used were most colourful. F***!

After walking from Oxford Circus to Piccadilly and having done almost all my Christmas shopping, I trudged back to the ARGC. Finally I saw nurse V and really, at that point I wouldn't have taken no for an answer. If Dr T wouldn't give me the trigger, I'd personally marched upstairs to his office and put a knife to his neck. Or break into a pharmacy and get the Pregynl. Or just fly back to Hong Kong. Heck about the eggs.

Nurse V then gave me the good news - I will trigger this evening at 7:15pm. T finished work just then and came to meet me and we went back home together, braving the awful downpour. Before I left, I gave Nurse V a goodbye hug. As frustrated I was with the ARGC, she has been great. I will miss her.

Pregnyl isn't an easy drug to mix. It's actually more difficult than Cetrotide because this time it's just two ampoules in the box. By the time we got home it was almost time and I poked myself at 7:19pm. Total of 7500 IU of Pregnyl. Once I got them in, T gave me a warm hug. She is just the nicest and sweetest person, really. All the support I received has been amazing and I truly truly want her to get pregnant and have lots of kids.

Tomorrow will be my day off so I will finally get the chance to sleep in and take it easy. Off to the Natural History Museum in the afternoon! Yay :) All I have to do now is to drink a LOT of water (one glass every hour). The end is near. Very near.

poke #10 - almost at the end of the road!

I went in this morning for the usual blood test, had coffee at the Patisserie again, and was called back for a second blood test. I was told to come back for a scan at 2:30pm and it was none other than Dr T, the famed doctor of the ARGC! It was such a privilege and even the women in the same queue as me found it such an honour. Obviously this man is held in very high esteem and to get him to do our scans today was like striking the mini jackpot (the large jackpot is of course getting pregnant and giving birth).

Dr T actually has a sense of humour. He asked me if I'm keeping up with my fluids, I said yes, and he asked if it's 30 or 40 litres. Ha! Then he looked at my ovaries - how full they are! My follicles are huge. I asked how many eggs he thinks I have and he replied in a offhand manner, "Oh, about 300 or so" and broke out in a grin. Heh. I like him.

He then gave me the good news that I will most probably do the trigger tomorrow which means egg retrieval will be on Thursday! Yay! I will have to go home straight away and poke myself with Cetrotide. Oh joy.

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Here is a step by step guide to poking Cetrotide, you know, just in case if you ever find yourself at the verge of ovulating 300 eggs.
[No, you know the rules: please do NOT try this at home. These are powerful drugs you are messing around with with potential serious side effects.]


Step #1: Open one alcohol swab



Step #2: Open the lid of the vial with the white powder and use the alcohol swab to wipe the top of the vial



Step #3: Remove the cap from the syringe containing the clear liquid



Step #4: Screw the yellow needle onto the syringe



Step #5: Poke the vial and inject all the liquid in



Step #6: Leave the needle in the vial and gently dissolve the white powder until all that remains is a clear liquid. Try not to shake the vial too hard as the less air bubbles we have, the better.



Step #7: Turn vial upside down and draw all liquid back into the syringe. It is essential that all liquid is drawn.



Step #8: Remove any air in the syringe



Step #9: Remove the yellow needle and put the grey needle on the syringe



Step #10: Use the remaining alcohol swab to wipe the injetion area, which should be below/around the belly button



Step #11: Poke!


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More stats:
Friday, 27 Nov 2009 PM: Oestradiol 5159
Saturday, 28 Nov 2009 AM: LH 9.2 IU/L Oestradiol 10,353, Progesterone 2.6
Saturday, 28 Nov 2009 PM: LH 5.9 IU/L Oestradiol 12,440
Sunday, 29 Nov 2009 AM: LH 0.3 IU/L Oestradiol 4853, Progesterone 1.4
Sunday, 29 Nov 2009 PM: LH <0.1 IU/L FSH 3.7, Oestradiol 4161
Monday, 30 Nov 2009 AM: LH 1.6 IU/L Oestradiol 11,410

how many more days? i can only guess

Today is day 9 of stimulation. I went in early (enough on a Sunday) for a blood test, then had coffee and a fabulous chocolate eclair at the Patisserie at Marylebone High Street while waiting for the ARCG to call back. Another blood test at noon and back home now. Instructions for today is 75 units of Gonal-F immediately.

Yesterday was a bit of a strange one though. I went in for the usual blood test and the results must have been crazy because I was then told to poke myself with Cetrotide, a different drug. What this drug does is to delay the LH surge, which means it just delays my body from ovulating. My eggs are not mature yet - they need to grow just a bit more - so LH level has to come down.

Cetrotide comes in a big box with two alcohol swabs, a large syringe, two needles and a vial with white powder. It's like doing Chemistry at O Levels all over again! After mixing the solution I poked myself below the belly button and it was actually quite painful, and painful to watch too as it was a large syringe and everything had to go in. I decided I don't like Cetrotide very much.



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I had bouts of nausea that come and go but today was better. The only side effects of all the drugs (so far) are the sore area where I poked the Cetrotide, the bloatedness where my ovaries are and a bit of a headache. But the latter can be just because of the cold. I actually woke up to hailstorm this morning! Rubbish London weather indeed.

But everything I go through is nothing compared to the joy and happiness that T and G will have if this works. I saw a pair of twin boys at the Patisserie this morning and it reminded me of what T told me - that she thinks she will have twin boys from my donated eggs. I wonder how they will look, with a little bit of myself and G mixed together. Hmm.

Dr C told me last week when I was still in Hong Kong that the first recipient of my donated eggs, M, got pregnant but subsequently miscarried. I was really disappointed but I'm sure M will be trying again soon. I just hope that my seeds of labour will bear fruit. Really, spending time with T and G just made my realize how some people are destined to be great parents - and if anyone deserve to be parents, it's them.

Fingers crossed!

in London (again) - gear two!

After sitting through a stifling flight on Cathay Pacific - what is comfortable about the new "clam-shell" seats?! - I finally arrived in London. Every time I visit this city there is usually beautiful weather and I was proven right again with a rare bright autumn day greeting me.

I was driven straight to T's place and what a wonderful, big, lovely house it is. The guestroom on the third floor was enormous; the bathroom itself is bigger than my study in Hong Kong! Neat. And the house has a large garden, complete with an apple tree (!), plum tree, lavender shrubs and a 2 metre-high trampoline. It is paradise for T's precious adopted daughter, B, 5 years old. It is paradise for me. I'm 28.

We went straight to the ARGC to get in queue; they have a maddening system of patient management which I have to accept. No specific appointments, just go in and queue. So T and I queued for almost 3 hours before we saw Dr A (all doctors are your doctors - that's the motto!), had a scan and blood test. LH level is finally down to 5.9 so I can finally start stimulation.

My suspicions that the ARGC wanted me to be in London before I start the injections were proven right when we were waiting for our turn to see the doc. Part of the waiting game means you hold on to your medical file and wait - which means I get to see everything in the file. There was a memo inside which says that since I will be in to see the clinic on Saturday, I may as well start stiumulation then. Ha! They are unbelivable, aren't they.

This means that I will have to remain in London till 4 December at the very least. Sigh. As much as I love London, I need to be home soon...

Anyway, we are set in gear two now. Poke #1 tonight!

to London, and back

The trip finally happened - it was all a bit of a flurry of events, one after another, a quick succession of outcomes, but isn't life just like that. T was a wonderful host who planned my stay extremely well and all the little nice touches (making sure the hotel is aware I will have a very early check-in; having a driver to greet me at Heathrow; planning to meet me only after I have enough rest to get over jet-lag, etc) made me appreciate her more. We finally met at a bustling restaurant overlooking Covent Garden on Thursday lunch-time. She is a beautiful and terrific woman, and is everything I expected of her through our numerous correspondences over email.

On Friday morning I made my way to Baker Street to meet the counsellor for the mandatory counselling session. It was a great session - words flowed easily and she went through pretty much all the questions I have thought of previously. She is quite the opposite of the stoic doctor who counselled me in HK. There were a few points she brought up which were a surprise to me, e.g. the child born from my donated egg has the right to sue me once he/she turns 18 should I not disclose any pre-existing medical condition that I am aware of. But of course I have my entire family's medical history disclosed so it's more likely a case of knowing a little too much!

I was then off to the clinic (the ARGC), housed in a nondescript building right at the end of the street just like any row of identical houses in London. It wasn't as crowded as I thought it would be and in fact I found it quite quiet. T arrived soon after and we had the meeting with one of the head nurses - no doctors as they were too busy - and she talked us through the egg donation procedure together. It seemed that the ARGC needed me to do a lot more than my procedure with Dr C and I found myself wondering if it was all necessary. Of course T and myself just wanted everything done and over with but there is so much to do: first of all I had to undergo the whole series of blood tests, then choose a monitoring cycle to be done in September, followed by the actual cycle in November. We decided that November will be better for the both of us for the actual cycle as it will give us more time to work out several logistical issues.

I was told that I have to go on the nasal spray when I begin ovulating prior to the actual cycle. After about ten days of the spray my period should start and I will then begin the injections. At this stage I will still be in Hong Kong and going in to Dr C for (more) blood tests and monitoring. On day 5 of my injections I will then fly to London for the rest of the treatment, which by then will just mean about a week left to the egg retrieval.

There is a lot to digest and work out, like the timing of my injections while I'm still in HK. With the previous egg donation, I injected at about 8-9pm and this made sense as the last jab will have to be exactly 36 hours before the retrieval (which is usually scheduled for 9am). With the 7-hour time difference between Hong Kong and London, I will have to inject the Gonal F at about 3-4am while I'm in HK! That will be quite a task indeed.

It was a short walk to the other clinic for the blood tests and once that was done, T and I parted ways. We said our goodbyes and I gave her a warm hug - she has been nothing short of gracious and wonderful - and deep down, I am truly delighted to know that my donated eggs will have a mom like her.

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Now all I have to do is to enjoy my summer (a lot of travelling!) and wait till September when I will begin my monitoring cycle with Dr C. Hopefully the blistering hot humid summer of HK will pass soon. I can't wait for autumn!