My IVf Journey Part 3: Moving from Public to Private
- You can keep track of only IVF related posts using the IVF tag.
- Timelines (if indicated) are rough estimate based on my memory.
Part 3 Takeaway: Knowledge is power. I mean this in a positive way. I learnt so much more about the IVF process by going private (and I thought I'd already read as much as I could before my public hospital experience). And this in turn helped me process my journey better, even the many disappointments that continued to pile up.
I procrastinated on this post because I was trying to figure out how to write it. I didn't really want it to be a step-by-step on how I changed doctors kind of post.
This post isn't to convince you to change from public to private either. Rather, I hope this gives you additional information about what you can ask for, or things you can advocate for, that you may not have know about or get tested for during the chaotic and slightly impersonal process that going through the public route can be.
~~~~~~Another long post ahead~~~~~~
Changing from Public to Private IVF
We decided to seek a private consultation at NUH to speed up the consultation process, and use that entry to queue again for IVF at NUH where we could still be eligible for some level of subsidy. We really liked the doctor, and seriously considered continuing with NUH.
Concurrently, I got many recommendations from the IVF support group I was in, and decided to consult one of the recommended doctors as he was located closer to us and was not too expensive. While I wanted to see the NUH process through because of the subsidies, I really enjoyed the consultation with the private doctor. Choosing him was a decision we did not take lightly because we are not rich or high income earners by any means. But we are thankful that we could offset some of the upfront cost through Medisave, and if private did not work out, we could still go back to the subsidised route.
One of the key reasons we chose this doctor was also because he could see through the entire process from IVF to birth. Some doctors are only fertility doctors, and they will hand you over to a gynecologist once the IVF pregnancy stabilises.
(I'm happy to share the clinic if you need somewhere to start. Please email me at mummingaround.sg@gmail.com!)
New Discoveries and Lessons
I hope this section is useful. These are some things I learnt that I wish I knew to ask for when I was going through the public process (where your protocol and medication is pretty much standardised). I hope it gives you more things to look out for and ask about:
- Vitamin Deficiencies: I learnt that I was Vitamin D deficient. I was not told about Vitamin D at all and was not asked to do any tests to check for deficiencies before. While it is only a correlation, and has not been proven, some smaller studies have shown better implantation outcomes with Vitamin D supplementation.
- Supplementation: I was also asked to take CoQ10 to improve egg production and quality. This wasn't something I thought about since my AMH levels were very healthy.
- Sperm Quality: We learnt that there is more to sperm than low motility and morphology. You can also check for DNA fragmentation.
- Polyps: Even though I did a HYFOSY, I only found out later that I had polyps. This may or may not have been present during the HYFOSY, but in my follow up consultation in KKH, they did not indicate they wanted to do a re-check of my uterus. Polyps may affect implantation.
- Improving the Protocol: Protocol can be altered mid-stimulation cycle! Having direct communication access to both the IVF doctor and the embryologist was a game changer. While my doctor provided the base protocol, at our second scan, when it was clear the follicles were not growing at the rate it should (same problem in Cycle 1), the embryologist asked to look at my embryos and numbers from Cycle 1. She immediately pointed out that the prescribed protocol needed intervention to get me up to speed, spoke to my doctor, and prescribed an additional jab.
Results
My second stimulation resulted in 19 eggs retrieved (previously 16), 12 eggs fertilised (previously 10) and 5 embryos for freezing (previously 0). I took every every small win from every check up and update I received.
Due to the number of eggs retrieved, and considering my previous failed transfer was a fresh one, my doctor told me to take the time to recover, and only come back for the frozen transfer when I feel physically and mentally ready.
I will list the protocols from both my cycles in my next post. Stay tuned!
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