26 Oktober 2012

Chemical pregnancy – Natang mende nih?

Natang mende chemical pregnancy neh?

Beberapa bulan lalu, masa 2ww aku ade test UPT untuk confirmkan status menses aku. Lewat sebab pregnant ke sebab tertinggal bas? Huhuhu… Aku end up dapat dua kali (cycle berlainan) faint lines kt UPT. Kali pertama aku dapat, aku ingat mata aku KERO. Aku biar seharian je UPT tu, bile balik keje aku tengok eh ade lagi la line tu. Memula jual mahal takmo tunjuk kat hasben sebab nanti dia ingat aku ni nak sgt line tu muncul. Last2 bile hasben baru nak tido, aku rase aku dah nak separuh gile dok pikir pasal faint lines tu, aku trus tunjuk kat dia.

“Eh betol la baby, ada 2 line samar”

Huh, lega sah aku tak gile.

Pastu aku tido dengan aman tak berapa aman. Dalam kepala aku dok ingat UPT tu dah expired. Tapi tarikh ok lagi. Ke ade chemical interruption?

“Ah abaikan” – Ye aku abaikan sebab TAK TAHU pun ovum & sperm dah berjaya fertilized. Sebab tak tau pun pasal chemical pregnancy.

Selang 3-4 hari, AF datang. Tambah konfius aku.

Ok sah UPT tu buat lawak.

Then selang 2 bulan, aik??? jadi lagi? Kali ni bulan puasa dia jadik lagi. Aku rase pelik. Tangan aku ni ‘choi’ ke asyik dok beli UPT sengal je. Last2 aku google.

Keluarlah perkataan Chemical Pregnancy.

Defination:
A chemical pregnancy is the clinical term used for a very early miscarriage. The word "chemical" refers to the pregnancy being too early to confirm except through biochemical means.  – Laa...aku dah peknen ke time tu? Oh wujudnya perkataan chemical tu sebab kite hanya boleh confirmed keadaan ni biochemical test (UPT).

Ape symptom sebelum period?

                    UPT tests reveal decreasing hCG levels rather than increasing – try hari lain, UPT jadi negatif plak.
                    Breast tenderness – ada rasa tapi buat tak tau sebab ingat nak period
                    Morning sickness and nausea – jadi masa second chemical pregnancy, asal sahur je muntah.
                    Fatigue – Ingatkan penat sebab muntah lepas sahur, so puasa perut kosong.

Ape symptom selepas period?

                    Small clots in the blood – ADA
                    Increased amounts of blood – ya betol! Hari pertama dah terus merah pink darah makkk.
                    More severe cramping – Agak cramp juga la.

Isk-isk tak boleh jadi ni, nak tau camne dia jadi?

Meh tengok gambar tu.

credit: http://humanphysiology2011.wikispaces.com/

Day 0 – Masa ni hari ovulasi (dalam tempoh 12-24 jam), sperm baru jumpa ovum. Pastu nucleus yang ada DNA papa masuk dalam ovum.

Day 1 – Masa ni kromosom (DNA) papa & mommy dicampur aduk.

Day 2 – Start sifir pembahagian sel. Sel membahagi dua.

Day 3 & 4 – Then bahagi empat.

Day 5 – Then bahagi lapan.

Day 6 - 7 – Sel membahagi byk! Dan masa ni la zona (karung luar zigot) mula kecut & pecah.

Day 8 – Zona dah pecah, sel yang terdedah senang nak menempel kat dinding uterus.

So, time Day 0 bila ovum dah fertilized, otak beri signal suh tingkatkan hCG badan sikit demi sikit. Pasal tulah kat hari ke 6-8 maybe kita cek UPT jadi positif tapi hari ke 8-9 mungkin paras hCG dah kurang sebab baby tak melekat. Kemungkinan keguguran ni berlaku sebab sel tak berjaya membahagi dengan banyak, maka TAK jadilah blastocyst sempurna. Atau, lapisan zona tak pecah, sel tak terdedah & tak boleh menempek kat dinding uterus.

Nape boleh jadi camni ek?

Chromosomal abnormalities in the developing baby – yang ni berlaku awal lagi kat step Day 1.

credit: http://www.fertilitycenter.com/
Lapisan zona keliling fertilized ovum.
                    Zona (the shell around the egg doesn't soften and tear (called hatching) the cells inside can't attach to the lining. - lapisan zona tak pecah, sel tak terdedah & tak boleh menempek kat dinding uterus.

                       Semakin women age or their eggs are exposed to toxins, the zona hardens – oh nooo! Aku da makin tua, kemungkinan zona boleh mengeras.

                    Egg just doesn't find a resting stop – kena wat bus stop ni… hahaha

                    Gravity is tumbling the attached egg down along with the mild contractions that the uterus consistently has – Yang ni kita susah nak prevent.

                    Growths and scar tissue can prevent a resting area for attachment – Hurm kalau kita ada cyst or fibroid, susah dia nak lekat la ye.

                    Immune issues can cause at early attached egg to die off – tu pasal kalau ada keputihan atau jangkitan, cepat2 treat.

                    Low progesterone or low estrogen in the begining of a cycle can lead to a poor lining, preventing the egg to attach – Yup! That’s me! I have low progesterone level.

                    Other hormones like thyroid or glucose can prevent implanting. Lack of certain vitamins like the B6 and B12 can cause problems – Nope, I takde ni.

                    Infection or illness causing high temps can prevent implanting by damaging the embryo – ni berlaku time first chemical pregnancy. I demam teruk lepas kena urut.

                    You might ovulate and the egg might fertilize but if your body is stressed, it won't support a pregnancy – sumpah tak mo stress dah. Tu yang pegi ngurut…hahaha.

Kena pantang ke pas gugur awal kehamilan ni?

Tapi korang tak payah risau, lepas jadi chemical pregnancy korang tak payah pantang2. Takde pun gap untuk teruskan usaha TTC. Sebab pregnancy yang macam ni tak considered pregnancy. Kalau tengok bawah abdominal ultrasound / TVS, takde pun nampak karung atau ‘peanut’.


Bile aku tahu je pasal chemical pregnancy ni, aku takde la sedih sangat. Aku rase happy lagi ade lah. At least aku tau aku memang boleh ovulate dan fertilized the egg. Yang paling mengharukan dan sebak bila hasben cakap

“B, maknanya askar-askar orang takdelah lemah. Boleh je dia jumpe telur baby.”

Kesian hasben, dia risau sangat ada masalah pada askar dia. Padahal wife die yg ada pcos

19 Oktober 2012

Clomiphene (clomid) Berkesan Tak pada Aku?

Clomid Mechanism - Aku design ikot yang aku paham apa aku baca.

Clomiphene (clomid) Berkesan Tak pada Aku?



Jawapannya berkesan.

Tapi jangan salah anggap, clomid ni berkesan buat aku ovulate tapi aku masih lagi belum berjaya pregnant. Sebelum aku cerita pengalaman aku amek clomid dan kesannya pada keadaan PCOS aku ni, agak-agak korang tau tak macam mana mekanisme clomid ni buat kita ovulate dan meningkatkan peluang untuk pregnant? Aku caya selama ni mesti kite semua dok dengar pasal clomid ni ubat kesuburan.. dia bantu kita subur.. dia bantu kite ovulate.. tapi macam mana tak penah la pulak Dr terangkan. Kalau ada antara Dr korang terangkan dari segi tindakan molecular dia, perghhh Dr tu memang terbaik.

Aku ni sebenarnya seorang researcher. Keje hakiki aku wat research dan bidang aku biokimia. So aku dok pikir

“Awat la hang ni buduh naa Joanna, hang kan wat research drug mechanism.. Awat la buduh tak mau baca”

Ok sesi maki diri sendiri tamat. Hahaha...
Hari ni aku baca mende2 menatang clomid ni, haaa baru la aku paham… meh sini aku share kat hangpa.
Sambil aku terang ni, rujuk kt gamba atas.

1) Dalam org PCOS / anovulation cycle, hormone FSH & LH kita tak tinggi. Pasal tula folikel kita tak berupaya nak matang & pecah untuk keluarkan telur. Jadi, dalam treatment clomid, struktur molekul clomid ni hampir sama dengan molekul hormone estrogen.

2) So clomid ni tipu otak kita, dia menyamar jadi estrogen dan melekat pada reseptor estrogen.

3) Bila bende ni berlaku, otak dok pikir level estrogen kita rendah (otak tertipu jahh..). Bile estrogen kununnya rendah, otak pun dok hint kat tubuh supaya hasilkan hormone FSH & LH dengan banyak. Hormon FSH & LH ni pulak memang diperlukan time ovulate untuk matangkan folikel kite yang kecik2 dalam ovary PCOS aku ni ha. Bile dah matang, boleh le folikel tu pecah untuk release telur kite. Maka otometik le boleh meningkatkan peluang kehamilan (kalau tiub tak block).


Errr paham tak? Ke aku terang, korang lg pening...Hahaha…sorry

Okok sambung plak pengalaman aku guna clomid selama 3 cycles. Aku combine je info pasal ketiga-tiga cycle tu dalam satu entry. Tak larat da nak kejar entry sebab, skrg ni aku dah start treatment baru kt hukm (treatment hukm langsung tak hapdet lg dalam entry).

Ok.

Cycle 1

Start                      : May 2012.
Dosage                : 100mg (D2-D6)
Side effect so far aku tak penah rase. Tapi maybe selera aku bertambah tanpa aku sedari..hahaha. Sedar2 je dah gained weight. Bile lari, tiba2 rasa pewot pun tergoncang2 ke depan... hahaha..Pada D17, aku wat TVS untuk tengok folikel matang tak. Haaaa…teruje sgt aku bile tgk ade folikel ni saiz diameter almost 28mm. Mak aihh… gedabaknye. Happy tak yah cakap la. Tapi ada satu je folikel. Dr kata takpe, janji u bersama malam neh. Dr kata insyaAllah sebab endometrium lining aku pun tak nipis (ada 3 layers). Dr ckp, selalunya keburukan clomid dia buat endometrium lining tu nipis pada pcos tegar.

Cycle 1 - 28mm
Aku tengok gamba folikel ni pun dah hepi mcm org len hepi tgk scan baby

Pregnant? TAK! Period datang dengan tepat dan berintegritinya pada D32. Cycle pertama tak lekat, aku ingat sebab folikel matang tapi tak pecah, maybe sebab Dr tak bg pun aku pregnyl utk pecahkan folikel tu.

So proceed second cycle.

Cycle 2

Start                      : June 2012.
Dosage                 : 150mg (D2-D6)

Ha kali ni Dr increase aku nye dose. 3 bijik sehari (150mg). Kali ni, aku rase loya-loya mual. Pada D14 aku gatal pegi jumpe Dr utk wat TVS walhal Dr suh dtg pada D17. Jumpa gak folikel gemok. Tapi sebijik je. Saiz 20mm sebelah ovary kanan. Pastu ada lg Dr tgk 3 ketul folikel tengah nak besar sebab saiz dorang dalam lingkungan 11-15mm. Time ni aku dok berangan kembar la kan..huhuhu… (tak salah berangan kn :P). Cycle ke2 ni aku da siap2 call Dr nak tau stok pregnyl ada tak. Aku minta die enjet pregnyl sebab takmo amek risiko folikel cantik tapi tak pecah..rugi wooo… lepas 36 jam maka gigih le baby dancing.

Cycle 2 - 20mm (ovari kanan)
Haa kat sebelah kiri gambar tu, perasan tak ada beberapa lagi folikel tengah nak matang tapi tak reached >15mm lagi
Cycle 2 - Ovary kiri - nampak tak folikel2 kecik tu? Haa PCOS letew.
Sebelah kiri gambar plak, uterus lining. Kata Dr, tebal. Aku pun tak paham tgk ni.

Pregnant? TAK PASTI – Rasanya aku alami chemical pregnancy sebab aku nye UPT faint lines. Tapi aku decide tunggu hari lain untuk test balik. Alih2 AF datang pada D30. Wah??? Tepat plak kan pulak ko kan dtg time ni AF? cycle aku 30 hari je... (errr patot aku bersyukur bila cycle dah tak tingtong kan... tobat..tobat)

So proceed third cycle.

Cycle 3

Start                      : July 2012.
Dosage                 : 150mg (D2-D6)

Cycle ni aku dah macam berserah je. Aku siap cakap dengan Dr lagi, perlu ke saya amek clomid ni utk third cycle? Saya macam malas da. Dr terkejut dan ckp eh amek la…rugi tak teruskan. So aku amek dengan pasrah. Bile dah amek tak semenggah je perasaan. Alih2 cycle akhir ni langsung takdak folikel matang! Haa.. baru tau, tula sapa suh dok give up? Aku dok wat TVS sampai 2 kali D16 & D18. Sebaik la keje gomen, so sume bill ditanggung. Sedih sangat time tu. Tapi apakan daya. Ni la cycle terakhir aku dah. Dr soh stop and try naturally.

Pregnant? CONFIRMED TAK!

Time ni aku agak fed-up dengan treatment medical dah. Biasalah, time tu aku baru je start TTC. So frustration memang takley elak la. Aku pun tak handle frust aku dgn baik. Nasib baik sekarang aku lebih tenang dan rileks.

Lepas tu aku beralih plak kat traditional method --> mengurut hahaha… suke & takut dengar. Ada sinar harapan lepas aku g mengurut tu tapi resultnya aku hapdet kat next entry… hehe.. kalau korang ada story pasal clomid, meh le share.

17 Oktober 2012

Abdominal & Transvaginal Ultrasounds

Pictures-credit to respective owner and Google.

14 Oktober 2012

First Consultations

28th Feb 2012
As previous entry, after we were worried about the missing AF, we went to visit gynae clinic. During her consultation, she did asked general questions as our conversation below:

Dr           : Your DOB?
Me          : May 1983
DH          : Dec 1983
Dr           : So both of you are 29 this year.
DH & I    : We were just smiling.
Dr           : How many years you been married?
Me          : 8 months; since June 2011.
Dr           : At what age did you start period?
Me          : 12 yrs old.
Dr           : Period pain?
Me          : Nope, never.
Dr           : Usually how many days of period?
Me          : 7-8 days.
Dr           : AF came every month?
Me          : Yup but sometimes they were 7 days late. It became more obvious once I got married.
Dr           : It’s normal because of the hormonal changes.
Dr           : How about husband? ‘Things’ are normal?
DH          : Normal.
Dr           : Sorry if this question makes you feel uneasy. Is there any difficulty to have an ejaculation?
DH          : certainly NOT! (hahahaha…)
Dr           : How many times ‘bersama’?
DH & I    : 1-2 a week, but more than 3 during predicted fertile days (based on the egg white appearance)
Dr           : Ok

12 Oktober 2012

No signed of AF - ‘I iz scard’

 A married life
1st month – no one asked.
2nd month – whenever I said I’m tired, letih, or on fever, they’ll said ‘haaa dah ada letew’ (conceived).
3rd month – no AF, people asked me to do the pregnancy test which was negative in result.

Argghhh… Aku rimas… I’m stress…


10 Oktober 2012

AF word in pregnancy liggo




google


I’ve been reading all TTC blogs in Malaysia and some for others countries, and they keep using AF word.

“Missed my AF…”

“Hello AF”
“Damn, why does AF have to come??”
Well, as I’m reading… I think can predict what it means… My suggestions would be period or menses. But I couldn’t think the exact words behind it. Then, as usual Mr. Google came and rescued.

Oh dear, it means…


AF - Aunt Flo, menstruation, period


Gagagagaga… Now I can start to use AF, DH, SOD in my future entry…
:D


I also found a few other meaning of abbreviations in pregnancy lingo…

9 Oktober 2012

Chronology of TTC Battle



Haish (-.-‘’) It is hard to find time to write on this blog…works… appointments of treatment… other commitments… Took days for me to write this second entry… Anyway, before I start revealing my ttc journey, I would like to highlight on the chronology of my TTC Battle…

Period before married:
Regular!

Engaged
- Oct 2010

Solemnization
- June 2011

Receptions
- Sept & Oct 2011
Periods after married:

- 13 July – 20 July 2011
- 20 Aug – 29 Aug 2011

- Missed period on Sept 2011 – Negative pregnancy test. They said, it’s normal for newly bride. They called it ‘Hormone shocked

2 Oktober 2012

Journey of A TTCian

Hello All,

I'm Joanna...
I'm A Wife...
I'm A TTCian..

Before this, I was a silent reader of a few TTC blog in Malaysia... Reading their blogs for quite some times has inspired me to open an account and start blogging about my journey towards motherhood. Their blogs