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?**
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