Showing posts with label 4th round. Show all posts
Showing posts with label 4th round. Show all posts

Friday, August 12, 2011

Latest Update

We have decided not to do a 4th round of IUI.  I would have had the scan this past Monday with intrauterine insemination on Wednesday, but we have weighed the pros and cons and decided against it.  Our RE said that she has seen many successful pregnancies happen with the 4th round, but there were just too many cons to consider.  My thought process was that I did not want to be pregnant in Ghana in case I -
  • have severe nausea
  • have an ectopic
  • have a SAB (spontaneous abortion/miscarriage)
  • need a D&C
I also was concerned because I will have to take anti-malarial tablets and of the 3 kinds that are recommended for Ghana - Malarone, Mefloquine or Doxycycline - none are safe during the 1st trimester.  I definitely do not want to contract malaria whilst I am there, but I also do not want to cause undue harm to my unborn child.  Which, I guess in theory, could happen with not taking anti-malarials and contracting malaria AND with taking anti-malarials.  According to the WHO, pregnant women are more vulnerable to malaria as pregnancy reduces the immunity to malaria (an immunity of which I have none of) and increases ones attractiveness to mosquitos due to hormones and pheromones.  Contracting malaria in pregnancy increases risk of illness, severe anaemia and death.  Maternal malaria also increases the risk of a SAB, stillbirth, premature delivery and low birth weight, which is the leading cause of infant mortality in Ghana.

All these thoughts culminated in us skipping our last round of IUI.  

We met with our RE this past week, and told her our decision.  We discussed doing a 4th round when I return from Ghana, but we are already booked for an IVF start date of 27 October, so there was not a way to squeeze in both the IUI and IVF start in October, especially with having to take anti-malarials for 2 weeks post-return.

So, we now are set for the following schedule, some of which has been completed:
  1. Husband do pre-IVF infectious disease blood work 
  2. Re-apply for Springstone IVF financing at end of August
  3. Leave for Ghana beginning of September
  4. Husband donate sperm for freezing on 2-3 separate occasions during September
  5. Return from Ghana early October
  6. IVF counseling 3 October
  7. Husband leave for 6 months
  8. Begin IVF cycle 27 October
I know there are many more steps between 3 October and 27 October, but I do not know what they are yet.  We will find out on the 3rd!  I know I do need to let Attain know that we are beginning our treatment on the 27th.  They are providing us four rounds - 2 fresh and 2 frozen - for $16,000 USD.  I also need to work out our financing.  Our clinic wants the money up front, so we are going to go through an IVF financing company called Springstone.  We applied earlier with them and were approved for the IVF amount with monthly payments of $300 for 60 months, $335.97 for 48 months, $412.44 for 36 months or $573.50 for 24 months.  It IS quite expensive, like a monthly car payment (which thank goodness, we do not have), but we are going to have to use the financing route as we do not have $16,000 in cash to pay up front by October.  Unfortunately, our application was only good for only 60 days, so we will now have to re-apply.  I hope we are able to secure as good of a rate and financing for the whole amount when we reapply at the end of this month.  

It's nerve-wracking thinking about all that needs to be done and the possibility of not having a successful outcome whilst being out $16,000.  I am trying to be positive, of course, but the fear is still there.  I had a dear friend who just went through her 4th failed IVF attempt.  It is heart breaking.  I am truly hoping and praying for success on the first go-round.  I'd like to get our money's worth, but really, I'd much prefer early success.

Saturday, July 30, 2011

Rounds

This week has been all about rounds and rounding.

On the trying to conceive front, Friday was my day 1.  I'm beginning my 4th and last round of IUI treatments.  I pick up my Clomid today to begin taking days 3-7.  I have my US and blood work on Monday, August 8, and then my IUI will probably be 2 days later if all goes well.

This week was my 2nd week in hospital and I did heaps of rounding on postpartum patients.  I saw 4 patients and their teeny, tiny, adorable babies.  Four patients may not seem like a lot, but postpartum rounding takes a long time.  It is the first and only time the patient sees a midwife during the day and they have loads of questions stored up to ask on top of all the questions I need to ask them and the exam I need to complete.  Then there is also time I have to allot for discussion of their birth and fielding any complaints they may have.  The pressure arises as the clock tick-tocks away knowing that I have patients one floor down in labor that I must get back to and round on as well.  It is a great juggling act of time management, to say the least.

This week I caught 3 babies (bringing my total to 4) and they all went so much easier than last week.  I was able to both protect the perineum, provide space for the baby if needed in the vagina, and coach the patient on breathing and pushing.  I really feel like it is coming together so nicely.  All of my babies had nuchal cords - one I lifted over the baby's head and the other two I helped the babies slide through them.  The transition from catching to tummy is going smoothly now too.  No more fuddling and fussing.  We had a few lacerations (or lacs as we call them), and I began to learn how to repair.  I have not yet attempted it on my own, but I experienced a lot of relaxed teaching time.  I look forward to my first hands-on experience.

All in all my clinicals are going quite well.  I am learning heaps every day and growing by leaps and bounds in my practise and knowledge.  I am also working at the same time with the new OB/GYN interns that have just started and that is a neat experience.  It is fun to be "babies" at the same time and grow up together.  My midwife preceptor teaches the interns as well on the low risk side of labor & delivery, so we are learning side by side.  Hopefully one day what these new interns learn from the midwives about normal, low risk births will make an impact in their own practise with women.  I already hear some interns calling what they do catching instead of delivering.  Wow!  So exciting!  The word of midwifery is spreading.