IUI#2 a Bust- should we move on from Clomid to Injects?

Lizarella82

Hi ladies,

Well, IUI#2 is officially a bust. My question now is about whether we should be moving onto bigger and better things like Femara or Follistim-we've done two Clomid cycles: the first (@100 mg) produced 3 follicles, and the second (@150 mg) produced 2 . This seems low to me, but of course given my diagnosis it may be a miracle I responded at all. Our plan is to try 3 IUIs before moving onto IVF. I have no other issues we've discovered other than the DOR.

When did you move onto injectables and why?

Do you think it's worth the extra cost and monitoring to try injects for this final IUI? Should we do another round of Clomid on the cheap or skip it altogether and start IVF in January?

Can you tell I'm struggling with this? DH is equally unsure- we really feel like we're wasting time but don't want to look back and ask "what if we'd followed the plan?".

ejrobbi

Hi - so I do not have DOR but I did not respond well to clomid my send cycle despite the upped dosage.  We are moving to injectables for cycle #3.  Yes I am very nervous about the cost but from what I have read the numbers don't lie - they do offer better chances plus there is more my RE can do if I am not responding, for instance this time around my follicles did not mature after the 5 days of clomid i was sol but on the injectables I can do more to increase maturity.  Plus I will be using ovidrel to trigger.  We are planning on moving to IVF after this next IUI if our insurance allows it.  Again, I don't know what is best for you with your diagnosis but while I had similar reservations to injectables we are going for it.   Best of luck to you!

jlr96

I would definitely try an injectable cycle.  Like the PP said, if you are a super responder, most doctors will switch you over to an IVF cycle.  The way you respond to injects will also give your RE more info about your body if you have to move on to an IVF cycle later.

That being said, I did not respond to injects any better than I did to Clomid.  That is not a "normal" situation as most people respond much better & faster on injects, although, that was not the case for me.  I have not been diagnosed with DOR, although, my FSH, age & no/slow response to meds leads me to believe I could have it (but RE disagrees). 

If you want to do another IUI before moving to IVF, I would go with an injects cycle.  Good luck to you!!

 

Lizarella82

Thanks everyone- I am leaning toward trying injects for all the reasons you have pointed out. As to converting mid-cycle, I am concerned: after the first of the year a portion of our IF treatment will be covered by insurance (lifetime max on medications and procedures of $12k-thank you baby Jesus). I suppose I need to ask the RE if he thinks I'm at risk for overstimulating and whether it's worth the risk to pay OOP for injects and possibly convert to IVF before we get our coverage.

herecomesthesun

I agree with Rumbera too. She's wise.

I'm not DOR but had FSH that has been just under and just over 10 and normal AMH and AFC. I responded well to Clomid but better with injects. I did not over-stim but I had a great retrieval. 

I did not do an inject IUI prior to IVF. I felt like if I was going to pay for the injects, I was going to go all the way, not pay for them twice. Of course, we are 100% OOP. 

If your doc is open to switching from IUI to IVF based on your response to injects, that would probably be a good step for you if you are still unsure. 

Good luck!  It's so, so hard to decide. 

STBMrsMiller

I'm DOR and 100% OOP. The reasons we did our two IUI cycles were because the first was a testing cycle to see what my response to meds was and because they wanted me on DHEA for awhile before IVF. We also have MFI, so TI wasn't doing anything for us no matter how many follies I was producing. I liked that we did an inject combo cycle to give my RE some idea of how I responded to that dosage before trying to work that out during IVF, but it was expensive.

Lizarella82

Thanks ladies. Appt with RE was this morning and we are going to try gonal-f injections for 4 days with an US Friday to see how I respond. His rationale was that this is the last IUI we will do and using an aggressive approach will both give us the best chance to conceive and, failing that, give us information about how I respond and what protocol to use with our first IVF cycle. There's always the (very small) chance I will overstimulate and we can convert to IVF. I am less than excited about injecting myself but very happy to try something new.