You can choose to take the fertility drugs and doing it naturally by having sex on a specified date as advised by your doctor. I’ve tried that two times but to no avail.

So, we decided to go for IUI (Intrauterine insemination).

So, what is IUI?

IUI is a fertility treatment that uses a catheter to place a number of washed sperm directly into the uterus. The goal of IUI is to increase the number of sperm that reach the fallopian tubes and subsequently increase the chance of fertilization.

Although IUI still requires the sperm to reach and fertilize the egg on its own, it is important to make sure that the sperm is healthy and mobile. IUI provides the sperm an advantage by giving it a head start, but it still has to seek out the egg on its own.

They said that IUI is a painless procedure but actually it depends on individual. For me, it hurts so much that I swore not to do it again after the 2nd attempt. Lucky enough, I got pregnant after the 2nd attempt.

How does IUI work?

The IUI procedure is simple and may be performed even if the woman is not receiving medication to improve her egg production. Many physicians will encourage women to take medications to stimulate the ovaries in order to increase egg production and, hopefully, the chance of achieving pregnancy.

An ultrasound will be used to monitor the size of the follicles (follicles develop into eggs). The hormone, human Chorionic Gonadotropin (hCG), is administered to stimulate the release of eggs from the follicles within 34-40 hours.

To help rupture the eggs (release it from the follicles),  you need to be injected with the hcG dose. I was given Pregnyl and instructed to take the injection that night at 9pm.

There are 2 types of ultrasounds for women - abdominal and pelvic. Abdominal scan is usually done to monitor baby in the womb. In our case, pelvic or vaginal scan is carried out. You must empty your bladder before the ultrasound procedure (the nurse will inform this to the first timer).

During ultrasound, the nurse will ask you to take off your pant and panty. And, climbed to lay down on a special chair with both legs rested on the purple foot rest. Your legs will be wide open and covered with a white sheet.

The doctor then put a little blue gel on the ultrasound tranducer which is protected with a protective cover (looked like condom to me). Then she will probe the tranducer inside your vagina.

The ultrasound image is immediately visible on a nearby screen that looks much like a computer or television monitor.

The doctor will move the tranducer to the left and right to see the size of eggs in both your ovaries. Sometimes the movement hurt but not much.

And, you can actually see your eggs in the monitor! The doctor will record the size of each egg and determine its maturity. Sometimes the doctor can see an ovarian cyst (if any) during the ultrasound.

A semen sample will be processed by the lab in order to separate the semen from the seminal fluid. A catheter is used to inject the processed sperm directly into the uterus. This process maximizes the number of sperm cells that are placed in the uterus and thus increases the possibility of conception.

The IUI procedure is short and involves minimal discomfort. The next step is to watch for signs and symptoms of pregnancy.

Before the IUI procedure, your husband need to produce his sperms in a small container with your name on it.

There are two rooms provided on the 7th floor. Both rooms are equipped with a single bed, a toilet, a sofa, a television and a cd player with x-rated videos.

If the husband think it’s hard to do it alone by masturbating, you can actually get into the room with him. You know how to help him, right?

The sperms will then be washed in the lab to separate unwanted residues from the active sperms. Only the washed sperms will be inserted into your womb during IUI procedure.

How successful is IUI?

Younger women usually have higher rates of success compared to women over age 35, but the average success rate for IUI ranges from 10-20% in one cycle. With IUI, as with other methods of artificial insemination, the success is dependent on the health of the sperm and the woman’s body.

The success rate varies. A friend got pregnant after 4th attempt while another one never succeed. As for me, I’m now pregnant after the 2nd attempt. So, please don’t give up!

Since the fertility pills (Clomid) alone coulds help increase my egg counts, my doctor prescribed me with fertility injections (Gonal-F) together with the pills.

I searched the internet to learn more about the injection prescribed by my doctor.

Follitropin alfa is a synthetic form of the naturally-occurring follicle stimulating hormone produced by genetically-engineered Chinese hamster ovary cells. Follicle stimulating hormone is involved in the production and release of eggs from the ovary.

This medicine is used in the management of female infertility and assisted reproduction. It is also used, along with human chorionic gonadotrophin therapy, to increase sperm production in men.

The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

1. Irritation in area of use
2. Over stimulation of the ovaries causing production of many ova (eggs) in the woman.
3. Blood clots in the blood vessels (thrombosis) that may detach and travel in the circulation to another area of the body (thromboembolism)
4. Pregnancy with two or more foetuses

Waa… I’m going to be injected with Hamster’s hormone?

Gonal-f injections cost about RM100 per dose. The doctor may prescribed between 3 -5 injections per cycle, so be prepared with cash of at least RM500 (credit card is accepted).

You can choose whether to take the medicine to a clinic near your house so that the doctor/nurse will do the injection on you or else, your husband carry out the injection.

We decided to do self-injection because it’s not worth travel to the clinic every two nights. You see, the injections need to be done once in two nights at the exact same time. Let’s say you first injected at 9pm, then the following injections must also be done at the 9pm.

These are some of the Gonal-f that I took!

The nurse will teach how to prepare the Gonal for injections and how/which spot to inject. Usually, they’ll ask you to inject around 1 inch under the belly button. The medicine must be mix properly but don’t worry, once you do this, you’ll become an expert like my husband!

He really enjoys pricking the fine needle on my belly. Is it hurts? Yes, a little when the syringe is pushed to inject the medicine.

Hubby Preparing The Gonal-f Mixture!

After the second blood test, I was asked to wait for my next period. As soon as I got my period, I need to call LPPN to set for an appointment with a doctor.

Take note that, you’ll need to call in the afternoon (after 2.30pm) for making appointments. If you call in the morning, they will not assist you.

Another point is, this is the time you can decide whether you want a lady doctor or a male doctor.

I requested to see a lady doctor because this will make me feel more comfortable. You see… it’s your doctor that will perform IUI on you later on!

My husband and I went to LPPKN on 9th May 2007 to see my doctor. Both husband and wife must be present for this appoinment. Otherwise, you’ll not be allowed to see the doctor.

Doctor K then had a look at my HSG result and said my tube is not block, which is good.

However, she said that my hormone level is inconsistent. Perhaps, that what is causing my problem.

But… she was also not 100% sure! Why… because I never miss my period and the cycle is quite consisten 30-32 days. Hmm….

About the pelvic adhesion, she asked whether I had previous surgery but I said no. Normally, pelvic adhesion is caused by surgery. The doctor said this is not a problem, though.

So… to solve my hormone problems she prescribed me with two drugs:

1. Clomid (for the next 5 days)
2. Folic Acid (for one month)

I will need to consume two Clomid tablets every night at the SAME TIME each. Meaning, if I took the first two pills at 9pm, I must take the next pills at 9pm for the following days too.

For Folid Acid, I take one tablet each in the morning, after breakfast.

If the husband’s sperms are in good conditions, it’s time to have a check on the wife.

HSG is primarily used to examine women who have difficulty becoming pregnant by allowing the radiologist to evaluate the shape and structure of the uterus, the openness of the fallopian tubes, and any scarring within the peritoneal cavity.

I went to Tawakal Hospital on 11th April 2007 for my HSG session. My appointment was at 11.30am. But I reached the hospital at 10.15am.

At 10.30am… The nurse called my name and told me that I need to wait because the set of equipment for my HSG procedure is still being “cooked”. Huh…cook? What a scary word! I think they’re just heating the equipment to sterilize them….

Anxiety made me visited the ladies a few times to ease myself…ha..ha..ha

Then…my time finally came!

The radiographer assistant ask me to remove my pant and wear a gown. I didn’t have to remove all my clothes for this procedure. Just the pant & panty.

Thank God… the doctor carrying the HSG is a lady!

The lady doctor was very kind and gentle. She understood my fear and concerns. Who will not fear when somebody is inserting some kind of instruments into your vagina?

I saw the stainless stell instruments on the table. It looks..huh… shiny.

The assistant mixed up some kind of liquid for the HSG. Then, she asked me to held my feet up. The doctor explained what is the procedure and why it is carried out. She assured that it is a painless procedure but I might experience a mild discomfort.

Then.. it started ……

I was placed on an x-ray table and the physician proceeded to place a speculum inside my vagina and insert a catheter with a tiny balloon past my cervix directly into my uterus. I was then placed under an x-ray machine where I could actually see my internal organs on the monitor.

A dye (contrast material) was then inserted via the catheter directly into my fallopian tubes. Doest it hurts? Not really. I only felt some sharp cramps when the contrast liquid began to fill my uterus.

A few x-rays were taken and then it’s over… at least I thought so. But… I was asked to lay down for another 20 minutes on the x-tray table. Alone.

The doctor took another x-rays and then, the HSG was completed.

I got dress and waited for the result.

After paying for the HSG test (RM180), I can claimed my x-tray photo and HSG result.

The following is the written result, signed by the doctor performing the HSG.

No plain film abnormality is seen

The uterus appears normal in size and shape

Both tubes are normal in calibre and peritoneal spill is seen on both sides

The delayed film shows loculated contrast around the tubes and left hemipelvis

Appearances suggest the presence of pelvic adhesions

I’m not a doctor but the first three points seem like a good news. When the peritoneal spill is seen on both sides, it means that there’s no blockage in both of my tubes.

But the word pelvic adhesions got me worried. What is pelvic adhesions? Can it cause infertility? I need to find that out soon!

Fertility treatment at LPPKN has a few steps that need to be followed in sequences.

The first important test is the Semen Analysis or Sperm Analysis (SA). If the Semen Analysis result is negative, the husband will be asked to have a repeat test.

If the result is still negative, the husband will be asked to get help from a specialist.

LPPKN will not proceed with the wife’s test until the Semen Analysis is ok.

This is some information that I get from a website regarding Semen Analysis. Hope it shed some lights for those who’re thinking of getting help from LPPKN.

A semen analysis measures the amount of semen a man produces and determines the number and quality of sperm in the semen sample.

A semen analysis is usually one of the first tests done to help determine whether a man has a problem fathering a child (infertility). A problem with the semen or sperm affects more than one-third of the couples who are unable to have children (infertile).

Tests that may be done during a semen analysis include:

• Volume. This is a measure of how much semen is present in one ejaculation.
• Liquefaction time. Semen is a thick gel at the time of ejaculation and normally becomes liquid within 20 minutes after ejaculation. Liquefaction time is a measure of the time it takes for the semen to liquefy.
• Sperm count. This is a count of the number of sperm present per milliliter (mL) of semen in one ejaculation.
• Sperm morphology. This is a measure of the percentage of sperm that have a normal shape.
• Sperm motility. This is a measure of the percentage of sperm that can move forward normally. The number of sperm that show normal forward movement in a certain amount of semen can also be measured (motile density).
• pH. This is a measure of the acidity (low pH) or alkalinity (high pH) of the semen.
• White blood cell count. White blood cells are not normally present in semen.
• Fructose level. This is a measure of the amount of a sugar called fructose in the semen. The fructose provides energy for the sperm.

This is my husband’s story regarding his Semen Analysis.

He was given a small container to put his semen in after ejaculating.

For this purpose, he was aked to go into a small air-conditioned room complete with a bed, a TV, a cd-player and of course, some erotic @ XXX @ blue VCDs to assist him doing what he was suppose to do!!