Anyone try IUI and then move on to IVF? Need some advice.
DH and I are at a crossroads. Here is our background. I can't figure out how to put this in the bottom of my posts. Sorry in advance for the length of this post.
We were married in March of 2008. We didn't want to jump on the baby bandwagon right away, despite our ages: I was 38 and DH was 35 when we married. I went off the pill later that year and we had the "whatever happens happens" attitude. My doctor has never felt like I would have any issues conceiving, even at my age.
DH was married previously and he and his first wife tried for children for quite a while with no luck. In 2009, DH found out that she now has a family of her own and DH started to wonder if he had any fertility issues. So my OB/GYN sent us to a specialist he works with and they put us both through the whole round of tests. Everything looked good on my end, I have good ovarian reserves ("you ovulate like a 30-year-old") and all my tests came back normal. DH has what they call a "subnormal" motility. He makes plenty of sperm, but are categorized as what I like to call, "bronze metal swimmers." We were perfect candidates for IUI.
So that is what we have done so far:
IUI #1 July 2010: 50 mg Clomid, 5 days, Pregnel trigger = BFN CD 28
IUI #2 August 2010: 100 mg Clomid 5 days, Ovidrel trigger + Acupuncture = BFP CD 31
MC at 5w
IUI #3 December 2010: 100 mg Clomid 5 days, Ovidrel trigger + Acupuncture = BFN CS 27
(I had two really large follicles this round, 22mm & 20 mm.)
IUI #4 January 2011: 100 mg Clomid 5 days, 3 injections of Menopur, Ovidrel trigger, Progesterone CD 17-26 + Acupuncture = BFN CD 30 (this morning)
My period has yet to start and I am never this late, but we are beyond getting our hopes up at this point.
So my question for you is this: when do you give up the IUI bus and hop on the IVF train? We know that no one has a crystal ball, but are starting to feel like our protocols haven't been aggressive enough. I believe one of our doctors (we'll call him Doc1) is looking at our numbers and wondering why it hasn't worked at this point. He even commented that he thought IUI #3 was sure to be successful. We asked about IVF last time and Doc1 said he would also recommend ISCI, which makes sense, if you are going through with all that, you need to go big. But if we need to do ISCI, then why were we ever given IUI as an option? Or am I over-thinking that? The other doctor in the group (Doc2, whom we don't see as often) said that because of my ovarian reserve, I am a good candidate for IVF.
We have decided to make an appointment with Doc2 to discuss our options. Doc1 is a nice person has been a big help, but at this point we just seems too relaxed about the whole situation - he prescribed the progesterone at my request, not his recommendation.
Financially, we can probably only afford one round of IVF, which is a concern for me. DH keeps telling me to remove the finances from the equation.
I would love to hear your stories about transitioning from IUI to IVF. What questions should I ask Doc2? We have tried to be patient with this whole process. But I am now 41 and we know we want to have more than one child. DH and I both grew up in situations where we had much older and much younger siblings, which can at times be a lonely childhood. We want our kids to be close in age. We feel like our window of opportunity is slowly closing.
Any information you can share is greatly appreciated. Once again, sorry for the long post. Thanks for reading.
blonde_artist
Re: Anyone try IUI and then move on to IVF? Need some advice.
I have a pretty similar story. DH and I got married 2 years ago when I was 38 and he was 34. I have two children from a previous marriage and dh has none. I wasn't so worried about getting pregnant but did go off birth control when we got married in Jan 2009. After 6 months of no luck I made an appt to see an RE and in between our first appt and our testing I got pregnant (age 39) I miscarried at 18 weeks and went back to the RE about 4 months later. We did three IUIs with Femara - I had a decent response to the Femara but after three my RE said to stop. The stats show that your chances are best during the first three cycles and he didn't understand given my great FSH, AMH #s and history why it didn't work. He suggested we do IVF with PGD to see if there were some chromosonal issues going on. We are OOP for everything and managed to scrape up the $ for two IVFs. I had a great response on the first IVF 16 follicles retrieved but the PGD showed all our embryos abnormal. Basically at 40 while I had a great egg reserve all my eggs were shot. We decided to spend the money for our second IVF on donor cycle.
So my advice, from my experience, would be that at 41 - you don't have alot of time to "wait and see". Three IUIs was probably enough. I would talk to Dr 2 about being as agressive as possible. Also check the clinics stats on www.sart.org and specifically ask if you can see their stats for over 40 year olds.
Good luck - I hope that IVF is the solution you are looking for
Hi blonde-artist I was a regular poster here but have moved myself to lurker since my BFP. I just wanted to comment that reading your story was like reading my autobiography!
I had a very similar situation only my age is different. At 30 decided to start actively TTC and did 3 IUI's over a course of 3 years with some breaks for cysts and (surgery to remove) all were BFN. At 33 I had pretty much given up hope. Took a break from the RE and started acupuncture and got PG with DD the next month. A total fluke.
I really wanted my children to be close in age and with my age creeping up I couldn't risk TTC taking three years again. We went back to the RE after 6 months trying and hit it hard with three rounds of menopur injections and three failed IUI's all while doing acupuncture too.
I was so much on the fence about IVF but my hubby, like yours, kept telling me that IVF was a "no brainer investment" and not to worry about the money. I was so worried that if we spent the money and it didn't work. He kept telling me that the percentages of success rates for our age group made it so we at the very least had to try. I'm so glad that I did.
After talking to the NP that was doing our IUI's she told me the same thing your Dr told you that if I wasn't PG doing that after 3 tries the chances that it would work for us were slim. We then set up a consult with my RE and he went over all the costs and percentages of success rates for his clinic and we felt so comfortable with him we agreed to do it. The very next week I had all my meds and started cycling. I know we are very lucky that it worked for us the first try and we even have 5 frozen embies to add to our family (hopefully) in the future.
GL with whatever you decide and PM me if you have any questions.
JM
For us, we only did one IUI before moving onto IVF. We moved to IVF so soon for many reasons.
#1 - We were unexplained infertility, so we weren't sure if fertilization was our issue, and that would be known if we did IVF. (BTW - It wasn't an issue.)
#2 - We were paying out of pocket, so we just couldn't see paying $2000-$3000 on several rounds of IUI when we might need IVF anyway. We could use the IUI money towards IVF and have a much higher rate of success.
#3 - I am an impatient woman, and I really couldn't handle the month after month of disappointment. I needed to get a BFP or focus my attention on adoption.
Could we have gotten pregnant if we tried more IUIs? Maybe. But for us, IVF was the right choice. Good luck on your decision. I know it isn't easy!!
Baby #2: 12 cycles, 1 failed FET, natural miracle but m/c at 9 weeks then another natural miracle that stuck! 9-30-09
TTC #3 - 4 cycles - no BFP yet!
You're story sounds similar to mine. We tried on our own, tried with clomid, moved to IUI. After the second round of a failed IUI, DH and I had a long talk -- looked at our odds, our finances and decided to go for it. After we made the decision, our nurse and our RE both told us individually that they thought this was the right choice.
I just started and won't start on the drugs for a few weeks. It's scary. I'm nervous -- but I am more nervous getting a call from my doctor telling me IUI failed again. It is a tough decision and a crazy expensive one. I have struggled with it for a long time.
Good luck making your decision! I will keep you posted on how the IVF goes, as I go through it!
I tried two IUIs before moving to IVF. I didn't want to waste the time and money. My first IVF was cancelled (no follicles even though I had good follicle development for IUIs so it's a mystery). I hope to try IVF again soon. I agree that you do need to try to remove finances from the equation. It is just too much stress and pressure to have it all riding on one IVF. Especially when anything can happen (like it could get cancelled like mine). Our bodies are pretty unpredictable. Good luck I hope our stories help you!
-Pix
I say go for the IVF! I'm 40 years old did 5 sets of IUI's with Chlomid and injectables. I had 2 chemical pregnancys on Chlomid. Spent lots of money to end up in IVF. You can't wait, because your egg reserve and egg quality go down every month. They took 25 viles of blood and tested me for everthing possible and everything was perfect. My husband was checked and he's perfect too. The only thing the gave him male prenatals just in case to help out. One thing is for sure you need to be on baby aspirin to help the blood circulation and also on pregesterone. It helps with the linning and implantation. The only explanation they could give me about not getting pregnant was my age. That my egg quality is going down. So I switched to IVF. After $5,000 in meds I had 5 eggs of which only 4 got to the right size. They retrieved 4 eggs and fertilized 3 of which only 2 fertilized with ICSI. The nurse told me not to worry about it, that it's not about quantity it's about quality. Well on day 3 they were both quality 4 and 8 cells making them perfect eggs. They implantated the 2 and they called me yesterday to tell me I was pregnant. My number is high so it may even be twins. I am 4 weeks and 1 day!! So I say go for it. Many doctors want you to keep doing IUI's so they can keep making money. You need an aggressive doctor. So there is a light at the end of the tunnel. P.S. My doctor had a plan called Assurance it's for women over 35 it gives you 2 IVF cycles for a little bit more over the price of one. It includes ICSI, assisted hatching, and freezing of extra embryos for a year. Hope this wa helpful....