IUI mommas, need some help!

trigirl79

So we've done 3 rounds of IUI (Clomid 100 mg CD 3-7, then Ovidrel trigger). This was the protocol that works for Alexa but obviously hasn't so far. I'm unexplained IF and we head to meet with the RE next month to discuss other options. Since IUI is at least partially covered through insurance, we're hoping for IUI injectables at least for one round, rather than having to make a decision about IVF. 

Can you talk to me about your protocol and meds? I know there's a lot of variation and I've tried to research some online, but there's so much info out there. Also, am I right that sometimes the timing is longer than the typical 28-30 day cycle?

BabyKsMommy

I also was successful with iui+clomid for ds. For #2 we tried 3 rounds and then moved on to menopur. The re was super conservative with my dosing on menopur because my AFC is easily 20+. I started with 1 vial a night and then had to cancel that cycle due to no response. Well my follies would get to about a 12 then they would just stop. This happened with up to 3 vials and it was about 5 or 6 cycles and I ended up with only 2 IUIs completed.

My insurance was also covering my meds with just a co-pay but then it was January and it suddenly changed and my OOP for just meds was about $800 plus another $800+ for monitoring.

So I had one RE suggest Femara so we decided to give it a try. I took 7.5 mg and on the second month I ended up pg with twins.

I would def talk to your re about your options and the cost. My injects cycles were about $800 before the price change in my meds then it was going to be about $1600 a cycle with menopur and I felt like it wasn't worth it since I didn't respond well to it.

It was really a Hail Mary trying the Femara but it actually worked. I typically O around CD 18 or so. I didn't use a trigger for clomid or femara but I did for the menopur.

mcgeeva

Clomid never worked for me at  all. Do you know if your follies are getting to the size they need to be to release eggs? You can read the drugs I used in my signature below. I needed stims to be able to get my follies large enough to release eggs with the trigger shot. If I were you I would try stims with trigger and forget the clomid. I have PCOS and have 45+ day cycles only when forced. When I did stims I had to do 13+ days for my follies to get large enough. No treatments were covered and it cost me about 350 a vile and I had to have a new vile every other day depending on how much I needed. 

Ruthie04

You are at SG, right? I did one round of clomid (1/2 a pill) with them, but moved to injectables for my next attempts because Clomid thins my lining. They started me at 75 IU of Follistim (it's a pen- super easy to inject). I overstimulated with that dose and was lowered to 35IU the next time and 50IU after that. I think I went in for a baseline on CD2 or 3 and then came back 2 or 3 times more before trigger. They triggered me around 18mm. I triggered the same way as I did for the Clomid cycle and used Prometrium after the IUI. I don't remember it being any longer than any other cycle, but it's been 3.5 years. I think I triggered around day 12. HTH!

mcgeeva

Ruthie04 said:

You are at SG, right? I did one round of clomid (1/2 a pill) with them, but moved to injectables for my next attempts because Clomid thins my lining. They started me at 75 IU of Follistim (it's a pen- super easy to inject). I overstimulated with that dose and was lowered to 35IU the next time and 50IU after that. I think I went in for a baseline on CD2 or 3 and then came back 2 or 3 times more before trigger. They triggered me around 18mm. I triggered the same way as I did for the Clomid cycle and used Prometrium after the IUI. I don't remember it being any longer than any other cycle, but it's been 3.5 years. I think I triggered around day 12. HTH!

I went to SG as well. I can pretty much say I did the same thing as Ruthie. The injects I used for baby number one made my lining too thin yet I held the baby. Switched drugs second time to avoid the same issue and all was fine. If you respond to drugs too fast they have to lower the dose and it can take you longer to avoid hyperstimulation or having to cancel the cycle. So really the amount of days on stims is really unknown. One friend of mine was on stims for 23 days. 

blueberries8

My inject + IUI cycles I was on a very low dose of FSH (25 IU-50 IU/day...I am pretty sure I would require more now than I did then). I got 1-2 follicles each cycle and iirc, the first two cycles I triggered on CD 11 and the third cycle I had a more difficult time getting a good response and I think I triggered on CD 15 or 16. When you trigger will definitely depend on how you respond, but if you respond well I would assume the average range would be CD 11-13 for trigger with IUI on CD 13-15. 

If you have coverage for it, I think it definitely makes sense to try at least once and see how you respond. The first injects cycle is always a bit of a crapshoot, though, in terms of seeing how you respond to stims and navigating the line between a slow/stubborn response vs. an over-response that results in too many follicles. However, there is always the option to convert an IUI cycle that's go into overdrive into an IVF cycle.

TJ1979

Personally, I would recommend trying femara once.  I had no response to clomid (other than scary side effects) but femara worked beautifully for me.

trigirl79

Thanks everyone. I really appreciate the info. @Ruthie and @mcgeeva yes I am at SG. The follies are usually good size, but I do think last time around they were bigger than this time (though I could be remembering wrong). 

In any case, I am definitely feeling like IUI with injectables is a good next steps for us. Let's hope the doc agrees and also hope we can get this appt moved up!

itsmevkb

I agree with trying Femara and also you could ask about doing a hybrid cycle. My IUI that worked was Femara on cycle days 3-7 and then smaller doses of Follistim on days 8-10. That way I was less likely to over-stim and the meds didn't cost me nearly as much as a full injectable cycle would have.

MJC1116

I'm a little late to the party but wanted to share my experience. I was unexplained as well and RE told me DH had super swimmers, so a medicated IUI would have raised our chance of conception to 25-30%. I did two medicated IUI cycles, the second being the one that worked and gave us J. I was on a very low dose of Follistim (50 IU). I triggered with Ovidrel. I want to say that the Follistim cartridge that I received had enough in there for 2 cycles (since I was on such a low amount), so when the first IUI failed, we figured we may as well keep trying until the cartridge ran out. I ended up having about 125 IUs left at the end. Anyways, it helped for us because we were completely OOP. Good luck to you!