Injectables/IUI vs IVF

cls78

My 3rd round of Clomid plus IUI just ended with a BFN. I have what I guess you call the WTF appointment this Thursday. From what I heard from talking to the nurses they will most likely suggest 3 rounds of Injects and IUI. We have maxed out the little IF coverage we had for the year and will be out of pocket. Is it worth doing injectables? We had started out with some MFI, but somehow my husbands counts have approved greatly since our first consult. My numbers are great and I responded good to the clomid. (50 mg each cycle on days 3-7). I am starting to just think my age is what is hurtng us. (I turned 35 in Sept. . ) Also when looking for stats at clinics for IVF what are the most important things to consider. I like where I am, but I don't know if I would condider doing a IVF cycle since they are at number 11 for success rates in my age group. Thanks for any help!

jlr96

We did 3 Clomid IUI's & 2 inject IUI's prior to moving to IVF.  If I were you, I would maybe try 1 inject IUI but not sure I would do 3.  I'm 36 & didn't want to waste time doing anymore IUI's than I had to.  Looking back, I wish we had moved on sooner than we did.  Good luck!

RunCC37

We always had a 'beautiful response' from our clomid IUIs. Everything was perfect... except for the BFNs. We decided to do a lap and an inject cycle before moving onto IVF, but our insurance coverage situation was different. If we were 100% OOP, then we would have gone right to IVF.

Good luck making your choice!! It's so personal, so think about it as long as you need and listen to your heart.

ksgsmu

I agree with @ jlr96  - I would do atleast 1-2 IUI's with injects but not 3 if OOP.

cls78

My husband and I were thinking that we would only want to do 1-2 inject cycles since we are oop. My husband only wants to do one IVF cycle. (that is a lot considering he didn't want to do any at the start of out if journey). It is scary since I have been reading that it can take multiple IVF cycles to get a BFP. How do you pick a clinic for IVF? I have been lookng at th stat websites, but it is overwhelming. My clinic is not in the top 5, so I am thinking if we do a IVF cycle we will go somewhere with better stats.

leavehouse

I wish I wouldn't have wasted any time/money on our IUIs. Our IUIs were covered by insurance, but meds were OOP. We spent $4,000 per cycle on meds (i'm a slow responeder). I wish I would have spent that 8K towards our IVF.

ronniesgirl1981

I'm sorry that you're at this crossroad. We had a good response to clomid and my husband's numbers were awesome. We were given the option to move onto IUI with injects, but the RE advised moving right to IVF. He said that given our good previous cycles, the most likely outcome of an IUI with injects cycle was cancellation due to risk of HOM. He also said it would not raise our chances of success much (15% to 18%). Given that, we made the choice to move right to IVF where our chance are more than 50%. Good luck with whatever you decide.

Lady2010

My RE also recommended we move to IVF after our 3 failed IUIs.  I had a good response to the Clomid, and our RE said she didn't think that we would have much better odds with injects; therefore IVF made sense to us.  We are 100% OOP, so we also preferred to put our $$ towards something with a greater chance of success.  

In terms of what to look for in a clinic, I would say to make sure you like them and you find them to be responsive and answering your questions.  Definitely look at the SART data - specifically look at what they say for your diagnosis type and your age group.  My gynecologist recommended me to the Fertility & RE department at the medical practice I go to.  They partner with a clinic for IVF.  In my case I only talk to my RE and her nurses, and all the monitoring is done at the medical center/practice.  And the only time I deal with the clinic is for payment, the ER and ET.   I compared their stats to a the others in the area and they were all right in the same range.  If you have concerns, then definitely ask your primary or your gynecologist for recommendations and their thoughts.

Good luck!

pblge

One argument for doing at least one round of IUI+injectables is that the docs will have a better idea how you will respond to the meds in advance of doing IVF. It's a bit more information for them, but since the response they want in IVF is so different, the first cycle ends up being an experiment either way. This is a really tough decision, as there are good arguments on both sides.

In terms of choosing a clinic, there are a few things to consider. One is that the big name clinics tend to be much more expensive, and for most people a run-of-the-mill clinic might suffice. It's also a grueling process, so being near home can be good. Additionally, the SART data lags by a couple of years, so be sure to ask for more recent stats for any clinic you're considering. You should also examine by age and diagnosis, as that can vary a lot.

Good luck!

beachy6

My best advice it to just go straight to IVF. Our RE said that he was comfortable doing 3 iui's with injects after our many(I don't really remember the exact number after all these years!) Clomid iui's. We had beautiful response to all of the meds, both Clomid and injects. But, DH had an underlying DNA frag issue that we didn't know about until just recently. All of his other tests were perfect! Count was perfect, morph, etc were all perfect.

What we found out is that between the 3 iui's with injects, we spent almost as much as we would have on one IVF. We are 100% oop, too. We had no idea how much the iui would actually end up being. Because of the cost of those, we had to wait an entire year to save up for IVF. So, if you're oop, you have to weight the money as an issue, too. I sure wish someone would have been that upfront with me before we spent all the money!

ronniesgirl1981

Also, when looking at SART data, check out the twin rate.  This is not something that even crossed my mind before.  Some clinics with really awesome live birth rates also have a really high twin rate.  Good luck! 

cls78

Thank you so much ladies. We are looking between 3 clinics. We are in NJ and about 2 hours from RMA. ( so far for us and pricey though). We have a lot to think about.

gnl42

Sorry to jump in, but I also need advice on IUI/injectables vs IVF. 

Background is a bit different... I'm 31 and we have been trying for about a year, with the last 3 cycles on clomid (no IUI, just peeing on sticks and ultrasounds to determine best timing). I also responded very well to the clomid with 3-4 follicles each time, but sadly, no luck. Our work up has been negative thus far, so I guess we would be in the "unexplained infertility" category.

I had my first consultation with RE last week and she gave us 3 options - IUI w/ clomid, IUI w/injectables, or IVF. My initial gut instinct was to go middle of the road and try IUI w/injectables... but after thinking about it some more, I'm now leaning towards just going to IVF. The success rates are just SO much higher. It seems like there are so many people who wish they did not waste their time with IUI. 

I know a year isn't THAT long considering some other people's journeys, but we are frustrated and impatient. Thankfully, our insurance covers both and finances are not an issue. 

So... would you go ahead and make the jump to IVF? 

cls78

My head is spinning and I am in shock. The RE has told me my best bet is IVF with icis. I only got a 40% chance with ivf, 20% with injects/iui, 10% with clomid/iui and 3% natural. I never thought I would be in this situation and thought I would be KU within a few months of trying.

dreambig1021

I did 3 rounds of injects + IUI all OOP wish I didn't waste time or money on that at all. Now going to IVF I will be 32 this year and I shouldn't have taken so long to figure it out. I would say after 3 or 4 time to move on. 

@gnl42 - if insurance and finances are a non issue I would definitely move onto IVF. I wish that was my situation we have been saving up cash for IVF, our insurance covers zero. 

gnl42

Thanks @dreambig1021 and @sportschick33 ... that helps me feel even better about my decision. IVF it is! Best of luck to you both. 

@cls78 try not to get discouraged. I expected to get pregnant on my own too. I'm sure most of us did. It's not easy, but all we can do is look forward and work with what we have. My RE gave me similar numbers, except slightly higher for IVF. Still, 40% chance for you is a good chance (and I assume that means 40% PER CYCLE). I know we all wish the first cycle will be the one, but if not, there is still hope. I'm trying to be optimistic, but also realistic...