The 2-week wait

This is probably the longest 2-week wait of my life! This period can be nerve-wracking for women who are trying to get pregnant. This time of the cycle is usually called the luteal phase.

Luteal Phase (Source: http://www.ovulation-calendar/hlp-d04-luteal-phase.html)

The luteal phase, also referred to as 'days past ovulation' or 'DPO', is the part of the cycle that starts at ovulation and ends the day before your next period. The luteal phase is named after the corpus luteum (Latin: "yellow body"), a structure that grows on the surface of the ovary where a mature egg was released at ovulation. The corpus luteum produces progesterone in preparing the body for pregnancy. Your luteal phase must be at least 10 days long to support pregnancy.

The length of the luteal phase determines the time of ovulation within your menstrual cycle. Ovulation can be delayed by a number of factors, such as stress, increased activity or medication, but the length of the luteal phase is usually constant. Taking this into account, you can calculate the time of ovulation within your cycle by subtracting the length of your luteal phase from the length of your cycle. For example, if your cycle is 28 days long and your luteal phase is 12 days long, the ovulation will occur on day 16 of your cycle (28-12=16). Ovulation Calendar uses this formula to calculate your time of ovulation.

Although I am now on 9dpiui, it's hard to tell when I ovulated. Maybe I would need to wait longer than 14 days to know about the result of the IUI. I promised to distract myself with other activities, but seriously it's hard not to think about whether I conceived or not. I'm claiming it! Still I can't help but wonder. As the end of the 2-week wait nears, I am thinking about making myself unreachable to everyone who knows about my IUI. I don't really look forward to getting messages asking me if I were pregnant already. I hope they would just wait for me to give the news. I know everyone is excited as I am, but it is so stressful at the same time. 

*9dpiui: 9 days past IUI

Here are some interesting videos that can help us understand more what happens inside the woman's womb: 
http://www.babycenter.com/2_video_10354435.bc
http://www.babycenter.com/fetal-development-images-3-weeks

DOs and DON'Ts after an IUI

After my IUI procedure, Dr. Fernandez said I can go back to my daily routine. She explained that the cervix doesn't remain open, so once the sperm is injected into the uterus it does not fall out. There's also no harm in doing exercise, although it should not be vigorous.

DOs and DON'Ts After IUI: (Source: http://www.ivfinpune.com/treatments.htm)

• Though the cervix will close after the IUI, keeping the newly deposited sperm where it should be, it is encouraged to continue lying down for 20-30 minutes post the IUI procedure. Feel free to get up and move about after that as like mentioned above the sperms will remain right in place.
• There is no restriction in activity. There is no need for bed rest, diet and travel restrictions.
• The couple may continue to have sex if they desire after the insemination procedure is over. In fact, it may aid conception. 
• Pain killer like buscopan can be taken, which the doctor will prescribe in case any pain or cramps is experienced after the procedure. NSAIDs like ibuprofen should be avoided though.
• After IUI, the woman will be asked to take some medications which help provide hormonal support and implantation of the embryo. These can be in the form of oral medications or suppositories. These should be taken as advised. 

      *NSAIDs: Nonsteroidal anti-inflammatory drugs

My IUI experience

On February 16, I had my TVU for follicle monitoring on CD12 of my cycle, it showed that I had two dominant follicles on both ovaries. Dr. Fernandez said my endometrium was on the right thickness and one of the follicles has the right size, so she said we were ready for IUI.

We had to do the IUI at St. Luke's Medical Center - Quezon City because CARMI in Global City was open only on weekdays. It was already around 10:30 a.m. when our consultation with Dr. Fernandez finished. We had to be at SLMC-QC before 1 p.m. because the cut-off for sperm analysis and washing on Saturdays in the Advanced Reproductive Care Unit (ARCU) was 1 p.m. (2 p.m. on weekdays).

We were scheduled to do the procedure at 2:30 p.m. because it would take two hours to do the sperm analysis and sperm washing. I did it at 3:00 though because Dr. Fernandez had to finish attending to her other patients.

The procedure went fairly well. Although it hurt a bit when Dr. Fernandez inserted the vaginal speculum, it was tolerable. She gave me a Pregnyl shot after the procedure.

Pregnyl or Human chorionic gonadotropin (HCG) is a hormone that supports the normal development of an egg in a woman's ovary, and stimulates the release of the egg during ovulation. HCG is used to cause ovulation and to treat infertility in women, and to increase sperm count in men. HCG is also used in young boys when their testicles have not dropped down into the scrotum normally. This can be caused by a pituitary gland disorder. (Source: http://www.rxlist.com/pregnyl-drug/patient-images-side-effects.htm)

     Graphic representation of the mechanics of doing intrauterine insemination (IUI)
    (Image source: http://www.acfs2000.com/basic_services/intrauterine-insemination-iui.html)

Intrauterine insemination, or as it is commonly called, IUI, is when the semen sample is "washed" or passed through a density gradient, separating sperm from semen; then concentrating the sperm and injecting it into the uterus by passing the vagina and cervix.

Putting semen in the uterus without "washing" it first can cause violent uterine contractions, the risk of anaphylactic shock and death; and, sperm can not fertilize as long as they are in semen. By washing semen and separating out the sperm, it is an extremely safe and effective means of putting sperm into the uterine cavity with a zero risk of complications. (Source: http://www.acfs2000.com/basic_services/intrauterine-insemination-iui.html)

I hope hubby's spermies found my egg/s and met...and develop into our baby/ies...baby dust to me and to all who are trying to get pregnant!

Our test results: HSG, TVU, SA

HSG: hysterosalpingogram
TVU: transvaginal ultrasound
SA: sperm analysis


The result for each of the HSG and the TVU comes with a CD and a document.

I had my HSG on February 11 and here is the result:

I had my TVU for follicle monitoring on February 16 and here is the result:

An anteverted uterus is when a woman's uterus tilts forward, toward her bladder. This condition is opposite of a retroverted uterus, which is titled backward, toward the rectum. Typically, a tilted uterus does not pose a problem, and in fact, many women do not even know they have this condition. In addition, it is the most common variation of the position of theuterus. (Source: http://www.wisegeek.org/what-is-an-anteverted-uterus.htm)

During the proliferative phase in the uterus, the wall of the endometrium begins to thicken. This phase of the uterus begins at the end of menstruation and lasts until ovulation, when the egg is ejected from the ovary. 

(Source: http://science.jrank.org/pages/4232/Menstrual-Cycle-Proliferative-phase.html)

A piece of advice for anyone who wants to have her TVU at SLMC-GC, be there early because the result of the TVU is available one hour after the procedure.

Dr. Fernandez said that based on the result of my TVU, I was ready for the IUI. She scheduled us  for the IUI on that same day. Hubby had his SA and here is the result:

St. Gerard's 9-day novena

St. Gerard is known to be the patron saint of motherhood. Some have claimed that after doing the 9-day novena, their wish to conceive came true.

Novena to Saint Gerard 

(Source: http://www.saintgerard.com/nineday.html)

Strive each day to practice in the virtue indicated in the petition.

1st Day

Saint Gerard, ever full of faith obtain for me that , believing firmly all that the Church of God proposes to my belief, I may strive to secure through a holy life the joys of eternal happiness.

Then say Nine Hail Marys, with the following Versicle and Prayer.

V. Pray for us, O Saint Gerard.

R. That we may be made worthy of the promises of Christ.

Let us Pray

O Almighty and everlasting God, who didst draw to thyself Saint Gerard, even from his tenderest years, making him conformable to the Image of Thy Crucified Son, grant we beseech Thee, that imitating his example, through Jesus Christ our Lord. Amen.

2nd Day

Saint Gerard, most generous saint, who from thy tenderest years didst care so little for the goods of earth, grant that I may place all my confidence in Jesus Christ alone, my true Treasure, who alone can make me happy in time and in eternity. 

Then say Nine Hail Marys, with the following Versicle and Prayer.

V. Pray for us, O Saint Gerard.

R. That we may be made worthy of the promises of Christ.

Let us Pray

O Almighty and everlasting God, who didst draw to thyself Saint Gerard, even from his tenderest years, making him conformable to the Image of Thy Crucified Son, grant we beseech Thee, that imitating his example, through Jesus Christ our Lord. Amen.

3rd Day

Saint Gerard, bright seraph of love, who despising all earthly love, didst consecrate thy life to the service of God and thy neighbor, promoting God’s glory in thy lowly state, and ever ready to assist the distressed and console the sorrowful, ob5tain for me, I beseech thee, that loving God the only God and my neighbor for His sake, I may be hereafter united to Him for ever in glory. 

Then say Nine Hail Marys, with the following Versicle and Prayer.

V. Pray for us, O Saint Gerard.

R. That we may be made worthy of the promises of Christ.

Let us Pray

O Almighty and everlasting God, who didst draw to thyself Saint Gerard, even from his tenderest years, making him conformable to the Image of Thy Crucified Son, grant we beseech Thee, that imitating his example, through Jesus Christ our Lord. Amen.

4th Day

Saint Gerard, spotless lily of purity, by the angelic virtue and thy wonderful innocence of life thou didst receive from the Infant Jesus and His Immaculate Mother, sweet pledges of tenderest love, grant, I beseech thee, that I may ever strive in my life-long fight, and thus win the crown that awaits the brave and the true.

Then say Nine Hail Marys, with the following Versicle and Prayer.

V. Pray for us, O Saint Gerard.

R. That we may be made worthy of the promises of Christ.

Let us Pray

O Almighty and everlasting God, who didst draw to thyself Saint Gerard, even from his tenderest years, making him conformable to the Image of Thy Crucified Son, grant we beseech Thee, that imitating his example, through Jesus Christ our Lord. Amen.

5th Day

Saint Gerard, model of holy obedience, who through thy life didst heroically submit the judgment to those who represent Jesus Christ to thee, thus sanctifying thy lowliest actions, obtain for me from God cheerful admission to His Holy Will and the virtue of perfect obedience, that I may be made comfortable to Jesus, my Model, who was obedient even to death.

Then say Nine Hail Marys, with the following Versicle and Prayer.

V. Pray for us, O Saint Gerard.

R. That we may be made worthy of the promises of Christ.

Let us Pray

O Almighty and everlasting God, who didst draw to thyself Saint Gerard, even from his tenderest years, making him conformable to the Image of Thy Crucified Son, grant we beseech Thee, that imitating his example, through Jesus Christ our Lord. Amen.

6th Day

Saint Gerard, most perfect imitator of Jesus Christ our Redeemer, do thou whose greatest glory was to be humble and lowly, obtain that I too, knowing my littleness in God’s sight, may be found worthy to enter the kingdom that is promised to the humble and lowly of heart.

Then say Nine Hail Marys, with the following Versicle and Prayer.

V. Pray for us, O Saint Gerard.

R. That we may be made worthy of the promises of Christ.

Let us Pray

O Almighty and everlasting God, who didst draw to thyself Saint Gerard, even from his tenderest years, making him conformable to the Image of Thy Crucified Son, grant we beseech Thee, that imitating his example, through Jesus Christ our Lord. Amen.

7th Day

Saint Gerard, unconquered hero, most patient in suffering, do thou who didst glory in infirmity, and under slander and most cruel ignominy didst rejoice to suffer with Christ, obtain for me patience and resignation in my sorrows, that I may bravely bear the cross that is to gain for me the crown of everlasting glory.

Then say Nine Hail Marys, with the following Versicle and Prayer.

V. Pray for us, O Saint Gerard.

R. That we may be made worthy of the promises of Christ.

Let us Pray

O Almighty and everlasting God, who didst draw to thyself Saint Gerard, even from his tenderest years, making him conformable to the Image of Thy Crucified Son, grant we beseech Thee, that imitating his example, through Jesus Christ our Lord. Amen.

8th Day

Saint Gerard, true lover of Jesus in the Blessed Sacrament of the Altar, do thou who didst kneel long hours before the Tabernacle, and there didst taste the joys of the Paradise. Obtain for me, I beseech thee, the spirit of prayer and an undying love for the Most Holy Sacrament, that thus receiving frequently the Body and Blood of Jesus, I may daily grow in His holy love and merit the priceless grace of loving Him even to the end.

Then say Nine Hail Marys, with the following Versicle and Prayer.

V. Pray for us, O Saint Gerard.

R. That we may be made worthy of the promises of Christ.

Let us Pray

O Almighty and everlasting God, who didst draw to thyself Saint Gerard, even from his tenderest years, making him conformable to the Image of Thy Crucified Son, grant we beseech Thee, that imitating his example, through Jesus Christ our Lord. Amen.

9th Day

Saint Gerard, most favorite child of heaven, to whom Mary gave the Infant Jesus in the day of thy childhood, to whom she sweetly came before thou didst close thine eyes In death, obtain for me I beseech thee, so to seek and love my Blessed Mother during life, that she may be my joy and consolation in this valley of tears, until with thee, before the throne of God, I may praise her goodness for all eternity. Amen.

Then say Nine Hail Marys, with the following Versicle and Prayer.

V. Pray for us, O Saint Gerard.

R. That we may be made worthy of the promises of Christ.

Let us Pray

O Almighty and everlasting God, who didst draw to thyself Saint Gerard, even from his tenderest years, making him conformable to the Image of Thy Crucified Son, grant we beseech Thee, that imitating his example, through Jesus Christ our Lord. Amen.

My HSG experience today

Hubby and I got to St. Luke's Medical Center - Global City at around 10 A.M. We went to Dr. Jing's office to inform her assistant of my HSG. Dr. Fernandez was in the OR at that time and there were three other patients waiting. We paid for the doctor's fee (because Dr. Fernandez will do the test herself) and headed to the X-ray room for the procedure. 

When we got there, we had to pay for the fee before the actual procedure. The amount due was P3,570 but I got a discount of P571.20. I'm not sure why, but maybe because of the referral from Dr. Fernandez, so we just paid P2,998. An additional fee of P1,000 was also paid for the radiologist.

While waiting for Dr. Fernandez inside the X-ray room, the radiologist took an x-ray of my pelvic area. 

The way the test is done is the following:

(Source: http://www.advancedfertility.com/hsg.htm)

• The woman lies on the table on her back and brings her feet up into a "frog leg" position.

• The doctor places a speculum in the vagina and visualizes the cervix.

• Either a soft, thin catheter is placed through the cervical opening into the uterine cavity or an instrument called a tenaculum is placed on the cervix and then a narrow metal cannula is inserted through the cervical opening.

• Contrast is slowly injected through the cannula or catheter into the uterine cavity. An x-ray picture is taken as the uterine cavity is filling and then additional contrast is injected so that the tubes should fill and begin to spill into the abdominal cavity. More x-ray pictures are taken as this "fill and spill" occurs.

• When both tubes spill dye, the woman is often asked to roll to one side or the other slightly to give a slightly oblique x-ray image which can further delineate the anatomy.

• The procedure is now complete. The instruments are removed from the cervix and vagina.

• The woman usually remains on the table for a few minutes to recover from the cramping caused by injection of the contrast.

• The results of the test can be immediately available. The x-ray pictures can usually be reviewed with the woman several minutes after the procedure is done.

I did not feel any pain or cramping during and after the procedure. It felt like a normal pap smear. Thanks to Dr. Fernandez, she was very careful and caring! 

A piece of advice, bring sanitary pad for any bleeding or dye coming out after the procedure. 

Dr. Fernandez patiently explained to us the result of the test. She said that my uterus was healthy -- there were no cysts, polyps, or any abnormality found so far and both my tubes are patent. So far so good at this point of my cycle.

This is an image (not mine) of HSG with normal/good result. 
(Image source: http://ucfertility.com/about-infertility)

It shows that the dye flows freely through the Fallopian tubes. The white triangular image is the uterus. Any grayish spot within the uterus area may mean there is an abnormality.

This is an image of a blocked Fallopian tube.
(Image source: http://dephiefilofax.wordpress.com/2012/03/10/my-1st-hsg)

The dye in the right tube seems to stop flowing, compared to the dye in the left tube.

Dr. Fernandez prescribed me antibiotics to avoid any infection or allergic reaction from the procedure. I should take it for 7 days, 1 tab every 12 hours. It costs P74.25/tab x 14 tabs = P1039.50 from Mercury Drug store.

I'm on my last day of Clomid today. Our next schedule with Dr. Fernandez is on Saturday, which I will be having my first transvaginal ultrasound for follicle monitoring. I just hope that my body is responding well to Clomid.

When everyone is getting pregnant except you

The first three years of trying to conceive were the hardest and most stressful. 

I hated going to gatherings or family reunions. It was just so stressful hearing people ask, "Why aren't you pregnant yet?" or "Don't you want to have children yet?" Believe me, I so wanted to have a child right after hubby and I got married. People would even joke, "Do you know how to do it?" or sometimes people could be so insensitive by giving unnecessary comments. This happened every time. I tried hard to control my feelings and maintain my composure, but deep inside I was hurting, angry, and crying. Normally, I would just smile and try to change the topic for conversation, but sometimes they wouldn't just stop. Now I just smile and turn away from them to discourage further discussion. When there are times that people would tell me about the number of children or grandchildren they already have and ask why I couldn't catch up, I just smile and say, "Good for you" and turn away from them. I don't mean to be rude, but I hope they know when to stop.

We're just glad that our parents (hubby's and mine) have been always supportive. I know they feel the stress too when they're asked by their colleagues or friends about having grandchildren with us, but we are just thankful that our parents understand our situation.

I got so jealous every time I heard someone I knew got pregnant. In my previous workplace, one or two colleagues would get pregnant every year. I always asked, "When's it my turn?" Even the single ladies got pregnant.  Some were even a surprise -- they had complications with their reproductive system, but then they conceived!

Oh well. Everything happens for a reason and in God's time, He will give us our baby. Hubby and I just need to keep the faith and wait.

Today is my third day on Clomid. Also, I am scheduled for my HSG tomorrow. I hope everything goes well.

The beginning of our journey

Hubby and I are both 35, and at this age studies say that it would be more difficult for women to conceive...tsk...tsk...What to do, what to do?

We decided to go for medical intervention, so I searched the Internet about fertility doctors in the Philippines. I came across CARMI and looked for a doctor available on Saturdays for consultation. There were two of them and I chose Dr. Ma. Asuncion "Jing" Fernandez. Usually people would go for the most popular ones, but I would rather be taken care of by someone who has enough time to explain everything and really cares about his/her patient.

On January 19 we went to her clinic at St. Luke's Medical Center - Global City. I got there at 9:30 A.M. and I was 8th on the list. Hubby got there from work at around 10:30 A.M. We had our turn at around 1:00 P.M. Dr. Fernandez spent at least 30 minutes for each of her patient. It was worth the wait though because she was very patient in explaining everything from conception to our best options to conceive. She talked to us for almost an hour!

Because of our situation, Dr. Jing recommended us the Intrauterine Insemination (IUI). Intrauterine Insemination (IUI) is the placement of washed or processed sperm inside the women’s uterus at the time that she is ovulating. It is commonly performed after failure of natural conception or in instances of mild to moderate sperm problems. (Source: http://stlukescarmi.com/services/intrauterine-insemination)

Dr. Fernandez made us a plan for our first try of IUI. I hope everything goes well. So here is our schedule for now:

• CD1 : inform Dr. Jing
• CD3-CD7 : take Clomid, 2 tabs/day (50 mg each) at bed time

• between CD5 & CD7 : HSG (when period is over)
• CD12 : TVU for follicle monitoring

*CD1 = Chart Day 1 (first day of period)

*HSG = Hysterosalpingogram

*TVU = Transvaginal ultrasound

A hysterosalpingogram (HSG) is a special kind of x-ray. Hysterosalpingogram is pronounced /he-ster-o-sal-ping-o-gram/. It is an outpatient procedure, which takes no longer than a half hour. It involves placing an iodine-based dye through the cervix and taking x-rays to help evaluate the shape of the uterus and whether or not the fallopian tubes are open or blocked. (Source: http://infertility.about.com/od/infertilitytesting/a/hsg.htm)

(Source: http://100infertilityquestions.blogspot.com/2010/03/question-12-what-is-hysteroscopy-and-do.html)

I took Clomid yesterday at 8:30 P.M. From my readings, Clomid is best to take at bed time to minimize its side effects. More common side effects of Clomid are:

Twins and Multiple Pregnancies 

Hot Flashes

Bloating and Abdominal Discomfort

Weight Gain

Mood Swings

Nausea and Dizziness

Headaches

Abnormal Menstrual Bleeding

Breast Tenderness

Vaginal Dryness or Thick Cervical Mucus

(Source: http://infertility.about.com/od/clomid/tp/clomid_side_effects.htm)

So far I have only been experiencing headaches (tolerable w/o med), hot flashes (annoying), and mood swings (thanks to hubby, he's been very patient with me!). Today is my second day of Clomid.

Our "history"

Whoever said that getting pregnant is easy? Maybe for some, but not for others like me. Six years of marriage and here I am still waiting for that little gift from God every couple would want to have. 

I got married in 2006. In the beginning we were not so anxious about having a baby. We just enjoyed our time as a couple, thinking the baby would come eventually. Almost two years had passed, still no baby. 

In 2008, we decided to see a doctor. We live in Makati area, so I searched for a doctor who was available on the weekends since hubby and I both have work on weekdays. We went to Patient First Medical Center in Glorietta and met Dr. Lani Buenconsejo. I underwent some tests (blood, pap smear, HSG, etc.) and the usual follicle monitoring to see if I was ovulating and producing viable eggs. Results were okay. 

No luck on our first month. On the second month, Dr. Buenconsejo gave me a Pregnyl shot to assist with ovulation. Still no luck on our second month, so on our next visit to Dr. Buenconsejo I asked her about IUI and she didn't encourage it yet. She advised hubby to have a sperm analysis. 

Hubby took the test at St Luke's Medical Center in Quezon City and found out that he had teratozoospermia which, according to Wikipedia, is a condition characterized by the presence of sperm with abnormal morphology that affects fertility in males. On our next visit to Dr. Buenconsejo to show the result of hubby's SA, she recommended hubby to go to Dr. Jose Prodigalidad, a urologist.

On hubby's visit to Dr. Prodigalidad in Makati Medical Center, he was prescribed medicine to be taken for three months. Hubby also had an ultrasound on his genital area and found out that he has varicocele. 

Varicocele is an enlargement of the veins within the scrotum, the loose bag of skin that holds the testicles. It is similar to a varicose vein that can occur in the leg. It is a common cause of low sperm production and decreased sperm quality, which can cause infertility. (Source: www.mayoclinic.com)

After 3 months of meds, hubby took the SA again. Results were the same. Not much improvement. Dr. Prodigalidad explained that surgery may be an option to correct the vein but it does not guarantee that his sperm count and morphology would improve. We did not want the surgery.

After almost two years of consultation with no luck, hubby and I decided to stop seeing doctors and taking medication for a while. We just focused on trying to keep our bodies healthy, hoping and praying for a baby to come.