why we're moving on to IVF — The Bump
Trouble TTC

why we're moving on to IVF

The discussion of when and why to move from IUI to IVF seems to be a common thread on here, so I'll outline my rationale for anyone interested.

1. DH's motile sperm count was only 2 million for both of our IUIs, though I seem to respond well to meds. My best estimate is that gives us a 5-10% chance of ongoing pregnancy each cycle (12% at most). That is not high enough to make it worth it when we could have a >50% success rate with IVF. (I tried asking my current RE a couple of times about his estimate of our chance for success using IUI and he did not answer either time. No idea why.)

2. It also seems like one round of IVF may be less cumulative wear and tear on me than half a dozen rounds of IUI. Each cycle takes a toll, both physically and emotionally. I much prefer one really rough month to death by a thousand paper cuts. Since I am very active, the meds pretty severely hinder my lifestyle and make me act bipolar for a week or two each cycle.

3. We are mostly OOP to the tune of about $1000 per IUI. Finances are a concern. Looking at the cost for a take-home baby, IVF may be cheaper overall than IUI. We also plan to do this again in the future to expand our family, so we hope to have frozen embryos for future use, which would also reduce the cost of future IVF cycles (rather than paying for many rounds of IUI all over again).

4. DH is 53 and I'm 29. Though it may not seem like it to those outside IF, time is an issue. We don't want to waste time waiting to see if DH's numbers will improve or if IUI will work. DH wants to be able to chase around his kids until they're grown and hopefully chase a few grandkids after that. He is in *great* health, so we have decades to work with, but the more time we have the better. On my side, I'll be 30 at the end of the year. That's not old, but I may be pushing the magical and dreaded 35 for future pregnancies. I would like to have all the kids we're going to by then (if we can) to avoid the complications of being an "older" mother.

***adult children mentioned, not mine***



All this means we will be switching REs so we *might* be able to get some insurance coverage for diagnostic or monitoring procedures for me. DH is disqualified from insurance coverage for IF since at one point he underwent voluntary sterilization (since reversed). Our new patient appointment with the new RE is Sept. 22. I think the timing will work out well. It will give me a break from meds and give us time to deal with some issues with DH's two "adult" sons. 

(Not relevant to the discussion, so skip if you'd like) About DH's sons: Our goal is to have both of them in apartments on their own by late September. I get along okay with the older one (22yo) and only rarely with the younger one (18yo), for various reasons. Both of them need to learn to live independent of DH for different reasons. I already told DH that I cannot go through IVF while either of them still lives with us. It has already been difficult for me to go through the ups and downs of IUI with them around. Neither of the boys know that we are doing these treatment cycles. The 18yo is far too volatile to trust with that kind of information, and the 22yo has had enough problems with his younger brother that he doesn't understand why anyone would want to have more kids (particularly DH).

The woman I talked to on the phone said I would probably be able to start the IVF cycle (with ovulation suppression and/or FSH shots) within a month or two after our new patient consult. She said that since I am young and have a high antral follicle count (PCOS), the doc would probably want me to take birth control pills before starting the stim cycle. If it looks like I have a follicle developing, they'll wait until after my next period to start me on BCP. If labs and u/s show that I have no follicles getting ready for ovulation, they may start me on BCP right away.

I'm a little concerned we will run into the holidays for the ER and/or ET, but maybe we can somewhat control the likely time period in which we plan to do those by adjusting the length of time I'm on the BCP. I'm not sure how that works yet.

DH and I will have to compile our list of questions over the next month. I'm sure it will be extensive.

**Would anyone on this forum be interested in having me update this post with our questions as we generate them?**


***siggy warning***

Me: 29; DH: 53
TTC since February 2013 --- mild thin PCOS (or not, depending on which RE you ask), MFI

TI#1: BFN (April 2014; Clomid 50mg x5 days, Estrace x5 days, Clomid 50 mg x4 days)
IUI#1: c/p (May 2014; Letrozole 2.5 mg x5 days, Estrace x5 days, Bravelle 75 IU x10 days)
IUI#2: abandoned... O'd early & DH hormone issues (June 2014; Letrozole 2.5 mg x5 days, Bravelle 75 IU x2 days)
IUI#2.1: BFN (July 2014; Letrozole 2.5 mg x5 days, Bravelle 75 IU x4 days)

Moving on to IVF. (Why we're moving on to IVF)

IVF#1 (w/ICSI): BCP 9/9-9/23. Gonal-F, Ganirelix, Low-dose HCG (antagonist protocol). 41R/35M/32F... 2 transferred on 10/14, 14 frosties! On cabergoline to help avoid OHSS. BFN, possibly because of 90% drop in estrogen and progesterone a few days after ET.
FET#1: Transferring 2 on January 8. BFP! beta#1 (1/17): 408, beta#2 (1/20): 1310, first u/s scheduled 2/5

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RNCrystalKam10[Deleted User]

Re: why we're moving on to IVF

  • That was a helpful read. Good luck, both with starting the IVF process and with your stepsons!
    Baby Birthday Ticker Ticker


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  • Thank you so much for sharing your reasoning! It sounds like an excellent choice for you for many reasons.

    I'm also 29 and have the exact same thoughts about my age. It might seem like a healthy age to start TTC for someone without IF, but it really doesn't give enough of a cushion for multiple kids by IUI! And, the cost analysis makes so much sense. Everything I read says the chances of one IVF cycle outweigh the chances of 5-6 IUI cycles for those with MFI. 

    I'm sorry about your SSs. That age is so hard. My bro/sis just went through that and are kind of coming out on the other side now but they are just so self-centered at that time and don't care who they affect! 

    I hope the timing works out perfectly, so you can get things calmed down at home for you, but also avoid the holidays. :)
    January 3T Siggy Challenge - New Year's Resolutions
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    Me (29), DH (30) TTC actively 54 55+ cycles | All BFNs
    MFI (low everything) | Endo Stage 1 & Stenotic Cervix (treated) | PCO
    Married - July 2008 | Started TTC - Jan 2009 | RE Visit #1 - Mar 2014 
    IUI #1 ICI #1 - June | IUI #1.1 Laparoscopy - Aug
    IUIs #1.2, 2, 3 - Sept, Oct, Nov (Letrozole) - BFNs 
    IUI #4 - Dec (Bravelle) | IUI #5 - Dec/Jan (Bravelle) - 5 follies + TI - BFNs
    IUI #5.1 - Jan (Bravelle) Cancelled 
    Planning to start IVF in March!
    ***All Welcome***
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  • This was super helpful! Thanks for posting! I've been struggling with this decision for a bit so it's nice to hear rational! My husband is also a bit older then me so I feel I should get the show on the road- I'm headed to work so my redponse is kinda short but again thanks for posting!
    Married July 2 2011
    Not trying Not preventing since 2011
    Me: Ovulate on my own (but poorly) DH: Low count and poor motility
    Oct 2013 Uterine polyp removed
    Feb 2014 First round Ferama, trigger and IUI...BFN
    March 2014 Second round Ferama, trigger and iui
    Waiting....
    Trying to Conceive Ticker
  • I'm on the same page as you and enjoyed reading your rationales (similar to mine and DH's but a low count with 0% morph). It took us a few weeks of discussion and a few more tests to realize that IVF would be our treatment of choice. All that's involved with IVF sounds overwhelming and took us a little while to process. But whatever it is that we have to do will be totally worth the chance of success. :) I would definitely be interested in reading any questions that y'all come up with as you go. It sounds like we may start around the same time (we're scheduled to start after Thanksgiving), so definitely want to keep updated with your experience. Hope it all goes well!!

    Me:29 DH:34
    Married 2010
    TTC: 11/2012 - 5/2014 + 4 month break during
    June 2014: First RE appt
    June 25th: HSG normal
    Dx: After 3 SA's, MFI (low counts, 0%morphology)
    Currently: Scheduled for IVF-ICSI cycle #1 in October
    10/31/14 ER 13R, 9M, 9F
    11/5/14 ET of two 5d blasts
    Beta 11/13/14!


    Hollowvic
  • tweetyknicks--thanks for sharing all that! I definitely want to hear more from you as you go through everything.

    DH and I have decided to try one IUI--but we may also move to IVF-ICSI soon. (We keep going back and forth!)

    Good luck!



    *** SIGNATURE WARNING ***

    Me & DH, early 30s
    Married 2008
    Excitedly expecting baby #1 - 5/15/2015

    We are PAIF-MFI

    BabyFruit Ticker

    All Welcome
  • I am trying to decide whether to try more IUIs or just go for IVF at this point also. DHs numbers are similar to yours. Time is not on our side either as I'll be 39 in a couple of months. DH is 29 here we thought my age would be the issue, joke is on us! Good luck with whatever you decide, I know exactly what you're going through!


    TTC #1

    Me: AMA, DH: MFI

    Official DX - MFI due to Hemochromatosis

    IVF #1 Nov. 2014 - ER 11/10 (10R 6M 6F) - ET 11/13 

    3DT of 3 embies - no frosties - CP = BFFN!!!!

    ****All Welcome****

    imageimage



  • I think making a decision about your plan is awesome and its a good step in this journey. Good luck to you on the IVF and the younger step son. I understand that stress can really impact the process. I'll be possibly trying IVF in the coming months so I would very much like to see you update this thread as well.

    ME - 31, DX with dual hydrosalpinx (2012) , confirmed again in 2014, starting IVF 1st Cycle Dec 2014

    Bloodwork done 8/8/2014 LH - 2.8, FSH 6.1

    DH - 31, testing scheduled for 8/22/2014, 60-70% motility, no problems found

     

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  • Just saw this after I replied to your post on my board! Good luck, and I'd be very interested in what questions you have foe the RE and their response.
  • Thanks for the reference Naria.

    I'll update here when DH and I start our brainstorming. Thanks for the well wishes!

    @rainbowbridge14: I'd hesitate to have only one child myself. All the single children I've known have been a little strange... :-P


    ***siggy warning***

    Me: 29; DH: 53
    TTC since February 2013 --- mild thin PCOS (or not, depending on which RE you ask), MFI

    TI#1: BFN (April 2014; Clomid 50mg x5 days, Estrace x5 days, Clomid 50 mg x4 days)
    IUI#1: c/p (May 2014; Letrozole 2.5 mg x5 days, Estrace x5 days, Bravelle 75 IU x10 days)
    IUI#2: abandoned... O'd early & DH hormone issues (June 2014; Letrozole 2.5 mg x5 days, Bravelle 75 IU x2 days)
    IUI#2.1: BFN (July 2014; Letrozole 2.5 mg x5 days, Bravelle 75 IU x4 days)

    Moving on to IVF. (Why we're moving on to IVF)

    IVF#1 (w/ICSI): BCP 9/9-9/23. Gonal-F, Ganirelix, Low-dose HCG (antagonist protocol). 41R/35M/32F... 2 transferred on 10/14, 14 frosties! On cabergoline to help avoid OHSS. BFN, possibly because of 90% drop in estrogen and progesterone a few days after ET.
    FET#1: Transferring 2 on January 8. BFP! beta#1 (1/17): 408, beta#2 (1/20): 1310, first u/s scheduled 2/5

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  • I wish you the very best of luck with IVF. I hope things work out with our stepsons also. (((HUGS)))
    Love 2010 | Marriage 2011 | TTC #1 since 2012
    PCOS | Anovulatory | Metformin + Letrozole
  • Like others have said, thank you for sharing your thought process. This line of reasoning could probably be applied to making a decision between any two treatment options. It is not only about what the doctor recommends but what best suits your preferences, ages, finances, timelines, etc.

    I like logic so I love this!!

    Me: 28  MH:35

    Married September 2012. TTC since September 2013

    June 2014 - Dx w/ significant PCOS and referred to RE.

    July/August 2014 - Testing complete: Testosterone & AMH very high, FSH slightly high, Vitamin D low, tubes and lining all lovely. DH SA: A+

    Cycle 1 (Nov 2014): 2.5 mg Letrozole/Ovidrel/TI = BFN

    Cycle 2 (Dec 2014): 5 mg Letrozole/Ovidrel/TI - BFN

    Cycle 3 (Jan 2015): 5mg Letrozole/Ovidrel/TI - BFN

    WTF consult scheduled for 1/29

  • I think those are really great reasons for moving on to IVF. It is really odd that your RE won't give you the stats for a successful IUI. I love the fact that you are outlining the reasons. I am a very organized person and it sounds like something I would totally do. And good luck with your stepsons, it sound extremely trying. My stepson is only 11 and everyday it is a real struggle, I could only imagine dealing with him if he were an adult. (((Hugs)))
    Me: +35 DH: +35
    TTC: Since January 2013 
    DX: PCOS. Severe Endometriosis, Unicornuate Uterus w/only left tube and left ovary, Pedunculated fibroid (on the outside of uterus) and Anovulation. All conditions diagnosed 8/13
    TX: Metformin
    DH DX: MFI - low morphology, low motility
    Ultrasound shows both kidneys in spite of UU. 
    HSG showed clear tube on the left side. 
    Lap Surgery performed 1/9/14 to remove fibroid and endo (Stage 3)
    • IUI# 1 June 2014 started 100 mg of Clomid - 7dpiui Progesterone: 13: BFN
    • IUI#2  July 2014 started 100 mg of Clomid - 7dpiui Progesterone: 5.75: BFN
    • Natural Cycle - so shocked to be in 2WW - 7dpo Progesterone: 15.5: BFN
    • Working with new RE starting injectables in late August.
    • IUI #3 August 2014  w/ Menopur: BFN
    • Finally ovulating on my own!!
    Waiting to start IVF hopefully
    **********All Are Welcome**************
    3T January Siggy Challenge: New Year's Resolution
    image

     
  • @TTCBaby: RE did finally get back to me. I guess he didn't notice the question the first time and was out of town for the weekend the second time. He said 10-15% per cycle at best, and probably quite a bit lower with MFI.

    The two IUIs we did were very educational, both in terms of how I react to meds and how the IF medical community works. I think it's allowed me to make a better informed decision about my IVF doc.


    ***siggy warning***

    Me: 29; DH: 53
    TTC since February 2013 --- mild thin PCOS (or not, depending on which RE you ask), MFI

    TI#1: BFN (April 2014; Clomid 50mg x5 days, Estrace x5 days, Clomid 50 mg x4 days)
    IUI#1: c/p (May 2014; Letrozole 2.5 mg x5 days, Estrace x5 days, Bravelle 75 IU x10 days)
    IUI#2: abandoned... O'd early & DH hormone issues (June 2014; Letrozole 2.5 mg x5 days, Bravelle 75 IU x2 days)
    IUI#2.1: BFN (July 2014; Letrozole 2.5 mg x5 days, Bravelle 75 IU x4 days)

    Moving on to IVF. (Why we're moving on to IVF)

    IVF#1 (w/ICSI): BCP 9/9-9/23. Gonal-F, Ganirelix, Low-dose HCG (antagonist protocol). 41R/35M/32F... 2 transferred on 10/14, 14 frosties! On cabergoline to help avoid OHSS. BFN, possibly because of 90% drop in estrogen and progesterone a few days after ET.
    FET#1: Transferring 2 on January 8. BFP! beta#1 (1/17): 408, beta#2 (1/20): 1310, first u/s scheduled 2/5

     image 
     image    image
    TTCBabyJ
  • Thanks for taking the time to share all of that. I know it's a decision that many of us struggle with. For me, my coverage with IUI is really good, but IVF would be completely OOP. So I keep chugging along wtih IUI, but I do still feel that clock a-tickin'.

    @rainbowbridge14, I totally get it. I'm not sure if I would be up for another round if I can ever get this one to work! (And I'm 35 already--blargh.)


    Me:
    Dx, PCOS
    Began TTC Mar 12 both @ age 33.
    HSG and SA Dec 12: All good.

    9 completed medicated cycles so far (*BFP and loss mentioned*):
    Clomid 50mg, TI, BFN.
    Clomid 50mg, HCG trigger, TI, BFN.
    ~Break~
    Clomid 50mg, HCG trigger, IUI#1, BFP. M/C @ 7 weeks.
    ~Break~
    Clomid 50mg, IUI#2, BFN
    Clomid 100mg, IUI #3, BFN
    Clomid 100mg, HCG trigger, IUI #4, BFN
    Started Metformin
    Clomid 150mg, HCG trigger, IUI #5, BFN
    Clomid 150mg, HCG trigger, IUI #6, BFN
    Letrozole 7.5mg, HCG trigger, IUI #7, TWW...
    ~Break~

    Gathering info for IVF...
    [Deleted User]
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