TI vs IUI? **TTCAL lurker**

kbedfox

Hi ladies, I've been an active member of TTCAL since our loss in Feb 2013 and have some questions about possible courses of action with my RE, and I'm hoping someone here will have some advice.
DH and I had every test the RE suggested, and everything is great except that I don't ovulate. I have done one cycle of Clomid (50 mg) + trigger + TI and while I had 1 mature follie and triggered CD18, it was a BFN. I developed a large cyst and am currently waiting for AF, then will have the CD3 monitoring and hopefully we can move forward. The RE mentioned doing 100mg Clomid on CD 5-9 instead of 50mg CD 6-10 this time around.
I'm wondering if it's worth doing an IUI instead of TI, or just make one change at a time? I can't find a whole lot of info about success rates of Clomid + trigger + IUI at my age (26) with no MFI or other issues, vs. Clomid + trigger + TI. If it's the same percentage of success, I guess we'll stick with TI, but I want to do whatever I can to get the best odds! If anyone has some good resources or statistics, I'd love to see them.
Thanks in advance ladies, I really appreciate your help and hope to join you soon!

MNgirl326

We did two cycles of fermara with TI, one with fermara and a trigger and TI an two cycles of IUI's.

For us, we decided to move to IUI's because DH's SA came back with low morphology.  So my doc suggested moving things along to an IUI to help the sperm along.

The IUI that gave us a + was a good follicle, an IUI, a round of sex a few hours after the IUI and also a round the next morning, and me eating Pineapple Core ( Old wives Tale).   So, I don't really know what it was "this" time that helped

 

Overall my opinion is go big or go home.  Meds +OPK's +  triggers are expensive, so an IUI isn't that much more expensive to add on if it helps raise the success rate and get it done faster.

IUI's do help raise the success rates, not a ton, but they do help.   It also depends on what your doc recommends

Good luck on your decision!

 

brittneyandadam

I was in the same boat as you, dx wise. I have PCOS and was not ovulating on my own. I was on Femara instead of Clomid, and my RE didn't want to mess around with TI and we went straight to IUI. He said they wanted to give us the best chance possible; the best sperm are put exactly where they need to be. I'm glad we didn't mess around, because it took us 5 IUI's to get pregnant.

GL and I hope you get your BFP soon!

ttuprincess

My RE told us we could try TI for a cycle or two of injects since we weren't dealing with MFI issues. My husband felt very strongly that unless my RE wanted us to move to IUI he wanted to do TI.  My bfp cycle we did injects + TI. I think it is a very personal decision based on each person's circumstances. I know when I decided to do TI instead of IUI there were a lot of opinions that we were wasting our money, but in the end it worked out.  My advice is to do what you, your husband and your RE and comfortable with.

Good luck!

kbedfox

I'm so thankful for all of your responses! Like I said previously, my only issue is not ovulating which is easily corrected with Clomid and HCG so I'm not sure that IUI will significantly increase our chances. DH's SA was excellent (the RE made a huge deal out of how great DH's numbers were lol) so I wonder if the IUI is unnecessary. Unfortunately all treatment is OOP, and Clomid + TI runs about $650 while Clomid + IUI is $975, plus the cost of all medications.

I guess I'll talk to the RE and see if he thinks it's worth skipping ahead to IUI. I have read that success rates decrease with an increased number of the same treatment and therefore more aggressive treatment like IVF may be required. Has anyone else heard of that? Or maybe it's common knowledge-- I never thought I'd have to know so much about infertility, and it sucks. Thanks again for all your input, ladies!

BabyKsMommy

Yes success rates do decrease. Most REs try something 3x and then move on. I did 3 iui clomid cycles then moved on to a iui clomid/menopur. That cycle failed miserably, didn't even make it to iui. So then we did 4 menopur iui cycles but only 2 made it to iui. Then we switched to Femara IUIs did 2 and I'm pg with twins.

Our diagnosis is low sperm count so we needed IUIs to try and help that sperm along. I would def talk to your RE. I know mine thought we would be successful eventually without ivf, it did take a year though. But he was willing to try different things so it was nice dealing with someone who wasn't pushing me towards ivf.

From a money stand point I would do 2 more cycles with TI to save a few hundred dollars. Then if it doesn't work then move to iui.

Allison7

My dx is way different than yours and my story is complicated, but ultimately, TI worked for us. We did not have MFI issues, but the second IUI produced a smaller amount of washed sperm and it was not ideal. When I reflect about it, I think that the IUI process really stressed DH out. He refused to give the sample there and insisted on driving it in...which was always cutting it close. I think DH's stress over the whole procedure really did impact his "donation."

Since you are only 26 and they have identified the problem, you do have time on your side. You wouldn't be harmed by doing 3 cycles of TI and then moving onto IUI. I would say the money and your comfort level are the biggest considerations. If you do 3 TI cycles, will you still be able to do 3 more cycles of IUI if you need it? How do you and YH feel about IUI and all that is involved? 

kbedfox

Thanks ladies -- you're right, since my issue is easily corrected (assuming I keep responding to Clomid) and we're still in our 20s, maybe TI is the way to go for now. DH is on board with whatever will give us the best odds of having a baby. From what I've read about the IUI procedure, it doesn't seem much more invasive/uncomfortable than some of the tests the RE has already done -- is that accurate?

Honestly the biggest factor is money since this is all OOP and I'm trying to finish grad school at the same time. Financially we'd be just fine if it weren't for all these RE bills ~X( -- but I'm sure I'm preaching to the choir on that!

BabyKsMommy

The IUIs are not bad at all. Sometimes there's a little cramping but that's it. It is kind of a pain to have to take off work to do it but if that's what has to happens you will do it.

Unfortunately money has to be an issue. I think if the SA came back fine then I would give it a couple more tries.

My dh has sperm issues so we went straight to IUI but I got pg on clomid and Femara. I also tried injects but honestly my body didn't respond well to them. I thought injects were supposed to work better but for me they didn't, half my cycles were cancelled due to no response. I responded much better to clomid and Femara.

Allison7

I didn't find the IUIs painful at all. My RE had me stay laying down for 20 minutes after the procedure and then I could return to normal activities. I usually took the whole day off and just relaxed. I wanted to give it best possible chance

ang2016

I have PCOS and didn't ovulate regularly. Dh had great sperm count so we were going to do 3 cycles TI before moving to IUI and cycle number 2 was our lucky one! We increased the clomid in the 2nd cycle and had 2 follicles to work with.