IVF Consultation Part 6: Getting the Medicine

Almost done with the whole process...

This time, we have to get the oral pills from the pharmacy located at the Ground Floor of Mackay Memorial Hospital.  This is also near the Laboratory.

Pharmacy of Mackay Memorial Hospital

Dr. Lee gave us a slip of paper which we needed to claim the medicine from the pharmacy.  On the paper, you will see a letter and a number.  In our case it was letter C, so we have to line up there.

The medicine he gave us was Gynera, a birth control pill which I have to take for 21 days from the 5th day of my menstruation should we plan to start the IVF procedure.

Front of the Package

Back - Gynera Oral Pills

When we got there, the package was already ready for pick-up.  

To be continued... IVF Consultation Part 7: Payment

Consultation for IVF in Taipei, Taiwan

After several failed IUI, we have decided to stop treatment.  However, since husband and I were going to Taiwan for a business trip, we also took the opportunity to make a consultation with Dr. Robert Lee Kuo-Kuang of Mackay Memorial Hospital.  Talk about not totally giving up, eh?!?

I would like to share with you our experience with regards to the consultation for IVF.  They usually call this “First Stage”, wherein you go to Taipei for 3-4 days for the infertility evaluation.  On the other hand, the IVF procedure itself is called “Second Stage”, wherein you have to stay in Taipei for a longer period of 23 days or more.

While in Taipei, we also scout the place for possible accommodation.  I’ll post pictures of the place we stayed and another place recommended to me by a Filipino couple we met there.  Apparently, there are so many Filipino couples going to Mackay Memorial Hospital for the IVF.  I met around 4 Filipino couples there.

The consultation went well.  We met Dr. Robert Lee.  He is very kind and he patiently answers our questions and explains clearly.  His staff was very accommodating.  Instructions were very clear. 

Husband had his semen analysis, while I had some ultrasound, and blood tests done on me.  Results will be emailed to us after 2 weeks.  

Aside from the business and the consultation, we also toured around Taipei during our free time.  We visited different tourist spots like Taipei 101, Shilin Market, Ximending, Longshan temple, Danshui, Keelung and many other places.  I enjoyed our trip.  The food there is really delicious and not that expensive.  Transportation is very convenient and accessible.  

Please read my succeeding posts for more details.  Happy Reading!

Related Posts:
Things to Prepare for the Consultation
IVF Consultation Part 1: Clinic Evaluation and Tour of Hospital
IVF Consultation Part 2: Consultation with Dr. Robert Lee Kuo-Kuang
IVF Consultation Part 3: Infertility Treatment Consent Form 
IVF Consultation Part 4: Blood Test 
IVF Consultation Part 5: Semen Analysis
IVF Consultation Part 6: Getting the Medicine
IVF Consultation Part 7: Payment

A Video on APAS (Antiphospholipid Antibody Syndrome)

To help you understand more about APAS, here is a video from the Probe Team.  The obstetrician-gynecologist (OB), Dra. Angela G. Sison-Aguilar and the immunologist, Dra. Lara Theresa Alentajan-Aleta interviewed in this video are both my doctors right now.        

If you are interested to consult with them, here are their schedules:


Angela G. Sison-Aguilar MD FPOGS FPSREI
Obstetrician-Gynecologist, Reproductive Endocrinology and Infertility, Menopause and Pediatric Gynecology, Laparoscopy and Hysteroscopy
1. Cardinal Santos Medical Center
    Rm 277 MAB 3 Wilson St., Greenhills, San Juan, Philippines
    Tel. No. 727-0001 loc 2277
    MWF 10am-12nn
2. St. Luke's Medical Center
    Rm 622 Medical Arts Building, Fort Bonifacio, Global City
    MWF  5pm-7pm
3. Friendly Care Clinic
    710 Shaw Blvd., Mandaluyong
    TThS  12nn-2pm
    722-2968, 722-2990
4. Healthpoint Clinic
    577 Padre Faura St. Ermita
    TTh  4pm-6pm
    527-4290, 527-4268

Lara Theresa Alentajan-Aleta, MD
Internal Medicine, Allergy, Asthma and Immunology
1. Room 215 Don Santiago Bldg. (across PGH), Taft Avenue
    Tuesdays  10am-12nn  
    3915279
2. St. Luke's Medical Center - Suite 1502 North Tower, CHBC
    TTh  3pm-5pm
    721-3498

Happy Infertility!

Femara for Infertility: A New Cycle, A New Hope

http://www.flickr.com/photos/xjrlokix/

Another fertility cycle has just started for us.  With every new menstrual cycle comes a new hope… a chance to start all over again, a chance to make the dream of getting pregnant become a reality…

For this cycle, we will be having a “stimulated cycle” alongside the IUI treatment.  Right now, I am taking fertility drugs, Femara (Letrozole) 2.5mg, 1 tablet a day for 5 days, so that is from Day 2-6.  Femara is a relatively new fertility drug.  It is actually a medication used for women with breast cancer.  It is an aromatase inhibitor meaning it suppresses the production of aromatase, an enzyme that is responsible for the production of estrogen in the body.  By doing so, Femara helps to decrease the amount of estrogen in the body sending a message to the brain to increase the production of the hormones, FSH and LH that stimulate the ovaries.    

Fertility drugs are usually used to induce an egg to develop and be released in women who are not ovulating on their own.  This is known as ovulation induction.  However, in my case, since I ovulate on my own, the fertility drugs are used to increase the number of eggs developing in my ovaries thereby increasing my chances of pregnancy.   This is known as superovulation.

Usually, clomiphene citrate (Clomid, Serophene) is the first fertility drug given by most OBs in the Philippines.  It is generally effective, however, it last longer in the body and may therefore have an adverse effect on the cervical mucus and uterine lining leading to vaginal dryness or cervical mucus changes that interfere with the motility of the sperm.   Some women, especially those with PCOS – polycystic ovary syndrome, also do not respond well with clomiphene citrate.  One important thing to take note in taking Clomid is that it should not be taken for more than 6 months at a time because studies have shown that there is an increased risk of ovarian cancer with 12 or more cycles of clomiphene.   

Femara, on the other hand is usually the second choice of infertility specialists using it only when Clomid did not worked.  Femara is also much more expensive than Clomid and has not been studied as much as Clomid for fertility use.  It costs Php365.75 per tablet in Mercury Drugstore. 

Some say that Femara is better than Clomid because it is metabolized rapidly in the body and is not thought to have significant levels in the blood or tissues for a prolonged period of time.  It is also less likely to cause the lining of the uterus to thin.  Let us see if it will work this time… 

By the way, side effects of both fertility drugs include headache, nausea, hot flashes, night sweats, joint pain, blurred vision, bloating, and fatigue.

I will update you again soon… Check-up with OB on May 24, 2011.  Happy Infertility!

Our "Extra Special" Wedding Anniversary Celebration

Last May 1, 2011 was our 6^th wedding anniversary.  As usual, people kept on asking …Where are you celebrating your anniversary?   Are you going out of town?  Travelling abroad?  Having a candle-light dinner in a 5 star hotel?  Naaahhh… None of the above.

Where were we?!?  We were at Cardinal Santos Medical Center in Greenhills, inside the clinic of our OB for our artificial insemination.  Yes, that was a Sunday, so there were no people in the Medical Arts Building of the hospital, only me, my husband and our OB.  What a way to celebrate our anniversary, isn’t it?

Artificial Insemination, also called AI or IUI (intrauterine insemination) is a method of assisted conception wherein the “washed” sperm is introduced into the woman’s uterus at around the time of ovulation, with the aim of getting the sperm nearer to the egg.  This procedure is often combined with fertility drugs.  However, for our cycle this month, we did a natural cycle + artificial insemination, meaning we did not take any fertility drug.    

So first, my husband collected the sperm and put it inside a sterile container.  Then our OB “washed” the sperm, which means the sperm was separated from the semen and concentrated.  The process took more than an hour with the swim up technique.  After this, the insemination took place. 

The concentrate was injected to me via a catheter that was passed through the cervix and into the uterus.  It was relatively a painless procedure with a little discomfort likened to having a pap smear.  I also felt a little cramping during the procedure, which was just normal.  I rested for 30 minutes and then went home already …

It is advisable to avoid strenuous activities after the insemination.  Though from what I have researched in the internet, it is okay to get up and move around after IUI because your cervix close, keeping the newly deposited sperm right where it should be.  But of course, it won’t hurt to take it easy for a few days.  OB also asked us to contact the following day to help increase the chances of conceiving.

The success rate of an IUI is around 15% per cycle.  The cost we paid for the procedure alone was Php10,000. 

Pregnancy test was asked to be done on May 17, 2011.  It is usually asked to be done after 2 weeks or so.  Unfortunately, my period came exactly 2 weeks after the insemination.  So, that’s another unsuccessful artificial insemination for us…

But life goes on…