Progress

Friday I had another US and more blood work (having every other day appointments now) and it looks like my follicles are maturing faster than expected.  My RE said we are on track for retrieving 8-12 eggs, but she is not sure if they will all be mature enough.  I am going to have a follow up US and blood work done on Sunday. If the follicles are plentiful and the sizes are good (indicating proper maturity), then I will have my egg retrieval on Tuesday.  My RE says it is a fine balance between retrieving prior to ovulation and ensuring maximum number of follicles possible and that the eggs are mature.

My estrogen is also doubling and increasing nicely.  So far, so good!

I've stayed at 375 IU for Gonal-F each p.m., 1 vial of Menopur each p.m., and 10 units of Lupron BID (twice daily).  Sadly, no decreases in the Gonal-F for me.  This means that I have gone through 3 pens of Gonal-F, and had no more pens after last night.  We never knew the meds would be so incredibly expensive, and when we drained our savings for our 4 rounds of IVF (2 fresh and 2 frozen with Attain), we had no money left.  When the pharmacy called and said our meds would be $3500 and that our insurance would not cover it, I almost had a heart attack.  Literally, I ended up in the ER with PVCs (pre-ventricular contractions).  We ended up having to take a personal loan to pay for our medications.  Our insurance only covered the progesterone and Lupron, so the $3500 was for the Gonal-F ($900 a pen x 3) and Menopur ($80 a vial x 10) alone.  With the RE office not ordering enough pens for me in the beginning (since they are so expensive, they are cautious not to order too many), I was in a panic when I realised I would run out of the Gonal-F on Friday with no way to buy another pen at $900 a pop.  Thankfully my doctor's office donated a pen to me.  Wow - what a blessing and such a relief!  One less thing to worry about.

On the midwifery front, I have made progress in my clincals as well.  I caught another sweet baby boy yesterday increasing my count to 12.  (This count is only my US births and does not count the babies I caught in Ghana.)  My program only requires 20(!) births, which I think is far too low to call myself experienced/ready to practise on my own, so I am setting a goal for myself of at least 60.  I would ultimately like to make it to 100 (they say you feel comfortable with births after your 100th catch), but anywhere between 60 and 100 would be sublime for me.  I also sutured my first patient yesterday with bilateral labial lacs, and a wonderful MD taught me how to tie one handed with my left hand (non-dominant hand).  Now, I can hold my instrument in my right hand and tie with my left without ever having to switch hands or put down the needle.  Woo hoo!  So exciting!

I needed a day like yesterday.  It was such a moral booster.  I made wonderful progress in both my IVF course and my studies this past week.  Excited to see what this next week brings!

Round 2

This past Sunday we went for our 2nd round of IUI. This time I forewent the US and hCG shot to force ovulation thinking that it might go better if I went with the natural rhythm of my body. I used ovulation sticks to detect my LH surge and then went in the day after my surge was detected, which was Sunday.

I did not have any ovarian pain this time around and since I elected not to do the US, I do not know how many eggs were produced. There is at least one, but I am thinking there is not much more than that since I did not have the ovarian pain and tenderness this cycle. I actually felt nothing while on Clomid this time.

On Sunday, my husband's sperm, after washing, was only 4.5 million this time. As aforementioned, below 5 million/ml is not good, but they still went ahead with the IUI since it was close to the 5 million. I was really shocked and disappointed that we went from 9 million the 1st round to half of that on the 2nd round. I know I should be thinking positively, but I am just not very hopeful this go round.

Since my period started earlier than expected this last cycle, the doctor also gave me some progesterone suppositories to give some support during the luteal phase. I am hoping that helps a baby stick!

On Monday, my husband had a follow up urologist appointment that I also attended. The physician was quite knowledgeable and helpful. Of the three repair options for the varicocele, my husband has decided on the laparoscopic procedure as it is minimally invasive and has the highest success rate over the old standard procedure of going through the muscle with a long hernia type scar or placing materials in the veins to occlude them. It is a longer surgery time - up to 4 hours - but it has the highest rate of being successful the first time, it has a faster recovery rate and it has a high success rate for increased fertility. The only drawback is that we cannot pursue any assisted fertility options for 4 months after his operation. That means that we will need to finish up these 4 rounds of IUI before he can have his surgery. This places his surgery in July of this year. The urologist also stated that it can take up 9 months to see a marked improvement in fertility but that up to 60% of patients will then go on to conceive naturally.

I am not sure what is going to happen in our future, but I really truly hope that one of these IUIs are successful and that we do not have to visit the dreaded IVF decision or hope and pray for a spontaneous, natural pregnancy 4-9 months after the varicocele repair.