Infertility

Low AMH - IVF vs. IUI/??

Anyone know which ultimately is the better option. I know it depends not the individual and that generally IVF is better but curious what others think.

I have low AMH and a high FSH (12.4, last cycle)  We did IUI this month to see how I would respond to meds if at at all.  I did 5 days of letrozole (Femara) and then 4 injections of 150u Gonal F with an ovidrel trigger.  I got a blood test yesterday at 9 days post IUI for something not baby related so the dr did a pregnancy test too. He did say if it was negative it doesn't mean i'm out for the month because it's early but it was negative and I just do not feel positive about it.  So I am looking ahead.

Do I stick with IUI's a little longer or go to IVF or even mini IVF...it's so hard to be patient when all you want is a baby.now! ahhh

Any advice you have would be great

Re: Low AMH - IVF vs. IUI/??

  • This is really your and your husbands call. For me I have to go through 6 IUIs before moving onto IVF according to my insurance.
  • I have 6 IUIs with my insurance. So, I am doing that first. It makes the best financial sense for us.  
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  • Me too!! Same exact thing here. I have to do 6 before insurance covers my 4 IVFs. Hopefully it doesn't get to that point though.
  • our insurance covers IUI and IVF without having to do one over the other..Howeve the medications for both are not covered.  So this month of IUI cost us about $550 not including copays every visit to the dr.  

    I just don't want to waste the money that IVF would cost (I believe the meds would cost more) if with my numbers my chances don't increase as much.  
  • If I was in your situation, I'd probably just go to IVF. The chances are better in general. I am on IUI #5 so it makes sense that I'd have that opinion (if I got a BFP on #1 or #2, I wouldn't feel that way, I am sure). If there was an option that had more expensive meds but had greater odds, I'd do it. 
  • jnissajnissa member
    edited July 2015
    So obviously this is a decision that only you and your DH can make - but I can tell you what my attitude on it was. That said, you didn't mention your age and if you are younger then time is on your side and I wouldn't jump to IVF (which is what I did). Also, I don't think of an FSH of 12 as all that bad. It's high, but it's not *crazy* high. You didn't mention how low your AMH was. So I think age is ultimately a big factor in what you decide.

    For us, I was already 39 with a low amh and an FSH of 17, so we felt like there wasn't time to do anything but be aggressive. Which is why we went straight to IVF and we're very glad that we did (obviously). We're doing a cycle to try to TTC a sibling right now and my FSH is actually a lot better but my AMH is just as low, so keep in mind that that number can be variable. 

    And if finances for meds are a concern, that's really valid - especially if you end up being a poor responder. I spent $5500 OOP on my first cycle. This second cycle we have over ten thousand dollars of meds sitting in our dining room just waiting for us to start. You may not need that much, but you will be looking at much more than $550 for a single cycle. So that's a really valid concern and you should get an idea of your protocol and price the meds as part of your consideration process. 
    Me: 41, DH 38, Diagnosis DOR
    Started TTC 12/2013
    First Trip to RE: 11/2014
    IVF Round 1: 2/2014 - BFP
    DD Born 11/9/2014
    TTC a Sibling Started 5/2015
    First IVF Round 8/15 - BFN
    Taking a break to go on vacation + enjoy the holidays before FET and/or another IVF round in 2016!

  • I am 32..my amh has been as low as 0.1.  My FSH was 20 at its highest during a clomid challenge.  My AFC is low as well..IT seems my left ovary is small for my age and has shown follicles at my baseline but none that grow. My right AFC is anywhere from 2-6.  The dr said with our numbers we would need high does meds for IVF looking at 5000-8000 dollars..We have the money to spend on it but it won't leave us with much after.  We have a 2.5 year old son who we had no issues getting pregnant with at all.  Found out these issues after trying for #2 for 8 months..finally getting pregnant and then miscarrying.  

    The dr told us we had a 50/50 chance of responding to meds so that is why we did IUI this month, less aggressive and less money to help us see if I would respond to those meds.  I did..I had a AFC of 2 on my right side..had 2 follicles grow and then we actually found 4 follicles on that side at my last ultrasound. One lead follicle the rest were smaller.  
  • jnissajnissa member
    Wow. That's a tricky one for sure. But you *did* get pregnant in 8 months even if it was a MC. And you're reasonably young. I'd honestly have the same confusion if I were you :(
    Me: 41, DH 38, Diagnosis DOR
    Started TTC 12/2013
    First Trip to RE: 11/2014
    IVF Round 1: 2/2014 - BFP
    DD Born 11/9/2014
    TTC a Sibling Started 5/2015
    First IVF Round 8/15 - BFN
    Taking a break to go on vacation + enjoy the holidays before FET and/or another IVF round in 2016!

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