IUI or IVF

Colleen0516

Not sure what I want to do this month.
Another IUI after 2 failed or IVF. I responded great to clomid and had 5 follicles and millions of sperm each round-- but it didn't work both times.
Not sure if I want to go another round of IUI (above depressed and disappointed again ) or switch to IVF.
Honestly I'm not even sure if I can just switch to IVF this month. My doctor said that it is out next step (but he planning for IVF after the torero undid IUI)

I don't know the steps or break down of IVF. Can anyone explain how it goes (day by day) if you have been through a round of IVF already.
Thanks so much!

Drove2u

In my opinion I would try at least one more round of IUI. I can't even tell you how many people I know or have read about where third time was the charm. And it's less invasive than IVF so might as well. I haven't done IVF yet so can't help there. According to my insurance I must do 6 IUIs before moving on to IVF. I hope it doesn't get that fat though. On my 2ww now of my first IUI.

babyexpress

I haven't been through IVF, but my RE said my chances with IUI were around 11-18% and IVF is closer to 50-60%. I think most people try IUI because it's cheaper, but your chances are much higher with IVF of success. My RE said we are currently running at about 1-3% chance naturally, so IUI seemed like a nice step up from that. Personally, I will move to IVF if clomid doesn't work after 2 tries.

Did you get some of the same feedback around percentages?

MrsBwIVF

You should set up an appt with your re and have them work through the schedule and the magnitude that is ivf. It is basically a 2 month process with constant injections and is extremely expensive, involved, and can reek havoc on your hormones and emotions. You'll have to plan ahead every night with where you'll be, when you'll need to do injections and need to bring them places with you in a cooler. Ivf is a very large commitment, which is completely worth it in the end if successful.
If I were in your shoes, I would do iui one more time and maybe during that process, meet with the re to get the lowdown of that offices actual process. Also, I'd suggest meeting with someone in their office to review their process in regards to any coverage your insurance would give you.

KidShrink

Our plan is to try 2 rounds of IUI before making it to IVF. I have no patience, and the clock is ticking considering all the endometriosis I had. My fertility is increased for 6 months, but then I might be back to square one. Also, most research shows that if a treatment hasn't been successful in 3 trials, it likely won't be successful for you (although there are obviously some exceptions, just like the friend of a friend who got pregnant 'when she stopped thinking about it'). Ultimately, do what you feel is best for you. Before my surgery, I was offered to do one more round of Femara and TI and refused because I couldn't emotionally handle a fourth treatment BFN in a row (I've never had a BFP, but I found the BFN on treatment cycles more difficult to swallow considering how much I had invested myself in the treatment). Now I know it was the right thing to do even though it felt like I was wasting time.

jnissa

While I'm an on-the-record advocate of being as aggressive as you can (which means not much, if any, IUI and right to IVF), there's a lot to consider. You didn't mention your age, so if you're on the younger side time is with you and the jump to IVF might make sense to hold off. Also, it's as much as 10x the cost of IUI, so if you're not insurance covered finances are an issue. Also, just to be frank, if you find the IUI process emotionally draining, it is nothing compared to the IVF process (that's no disrespect to the IUI struggle - but one is fundamentally more physically and emotionally draining than the other).

The benefits are that it is more aggressive, you might get some insight into whether your issues are egg quality related and you likely do have increased chances. Honestly, if I were you and I'd already invested the time into IUI while really getting mentally prepared for IVF. 

Every IVF cycle is different. But the general layout once you *start* the cycle (which can take some time, there are usually a lot of ducks to get in a row first in terms of paperwork (things like what happens to any embryos you create if you or your partner passes away), payment set up, obtaining meds (you can't just get them at your local pharmacy), documenting whether you want things like ICSI, assisted hatching, etc. After all that is aligned, you can expect something similar to this.

CD 3 o or 4: go in for baseline testing. if all looks good, begin stimulation on injectables that night.

Next 8-15 days - depending on how long you stim for, you'll need to go to your clinic *every morning* for blood work (so no leaving town) and US every couple of days. Each of these days you'll have to do an injection both in the morning and the evening, and at some point you will need to add a third injection to keep you from ovulating. Your nurse will call you every afternoon with all of your numbers and medication instructions for that night and the next morning. 

After you're done stimming: You'll take a final injection of a trigger shot (similar to IUI).

2 Days after Trigger: You'll go in for your egg retrieval. This is considered minor surgery and you'll need a partner with you (also your partner will need to give a fresh sample if he doesn't have frozen for you)

3-5 Days after egg retrieval - Depending on how many of your eggs fertilized and the embryo quality, you'll transfer and/or send off for genetic testing and/or freeze. 

I know you're frustrated, but IVF requires a lot of patience and set up. If you have another round of IUI in you, you could do it while starting the IVF process. 

Colleen0516

Thank you for all the advice.
I know that IVF is a lot more emotionally draining, I'm honestly dreading the thought of it. My doctor seemed to think I would eventually need to go that route- so I just don't want to waste time and emotions. If it's inevitable, then I just want to start.
I am very fortunate to have great insurance- I don't pay for anything until I'm pregnant- then I pay co-pays for any visits or procedures I have.

I am most likely going to do one more round of IUI and pray that the 3rd time is a charm. I'm also setting up an appointment with my RE to discuss IVF.

I already am used to the every day bloodwork, it's a pattern with my IUI. I get US & BW day 2 and then day 8 and for whatever reason, the way my body responds to the med's, I'm usually in the office every day until day 15 for BW & US. So that part I can handle- the shots are what I fear. I'm petrified of them- such a silly fear but I can't get over it. I am better with bloodwork (bc of IUI) but shots still get me. One trigger shot with IUI and I'm in a panic the day of trigger.
I will do whatever I need to though. We want a baby, so I can and will overcome my fear for it.

Thanks for all the advice ladies. Today was an emotional day for me, so many decisions to make. Im "unknown fertitly" so it makes it harder. If I knew what the reason was, and new IUI would eventually work, I would just keep going until it worked. But since we don't know why I'm not getting pregnant, it's hard for me to make the decision of which course to take. My RE is obviously okay with both IUI and IVF, and has told me its my decision.

Thanks again for the help!! I appreciate it a lot!

Wicked4589

If shots are not an option for you, IVF is not an option either. I had to do anywhere from 1 to 4 shots every day on my stomach. Then move on to IM in the behind by my husband. It's a long commitment that takes months. We started in December and the first transfer was in March. It failed so we did a frozen transfer which was successful. After that it was 10 weeks of daily injections in the behind. Your doc needs to make this decision with you.

Drove2u

Are you serious? You have to take shots for a couple of months before actually getting the IVF? I had no idea. So it's not on a month to month basis like IUI is?

jnissa

@Drove2u - It depends. If you're estrogen priming, you'll need shots beforehand. I think it's more likely she was talking about all of the other time consuming things like paperwork, protocols, extra testing, etc.) But you will do the IM shots during your TWW, which I think is different than IUI? 

It is a month -to-month process, but usually the very first one takes a long time. Plus, it's harder on the body so most (but not all) people don't stack them right on top of each other. 

MrsBwIVF

For our fresh ivf cycle, I did 3 different nightly injections for a month- the first 2 weeks was 1 shot and then the last 2 weeks before the retrieval, 2 more were added in, all in the stomach. Then after the transfer I did nightly injections in my lower back/butt area.
I did not have a fear of needles but it was scary none the less to see a HUGE box of meds and syringes come in the mail. It is very overwhelming to look at but it is extremely doable once you break it all down to what you need to do when and concentrate on it day by day basis. I got so used to it that we'd be around other people, I'd turn around, do my injection quick and turn back around without leaving the conversation. There were some tough nights but we kept remembering the bigger picture.

Drove2u

Oh my goodness that sounds so scary. More power to you girls. I really hope I don't have to go through that.

Wicked4589

The length of time you are on meds depends on each person and how you respond. IVF is not a simple process. It's not as easy as an IUI. And after the implant it IS months of injections. I used to have a fear of needles too but you get over it. During treatments with my RE I used to have my husband do my shots in my stomach because I couldn't do it. Then when we started IVF, I just did it. You have to get over that issue or it's not going to work. Missing a day could mean missing an entire month. I had to get it into my head that if I truly wanted to get pregnant, I had to suck it up and just do it. So you do.

Drove2u

Yeah it's not the needles that scare me it's the commitment to do it every night.

MrsBwIVF

I know the commitment sounds scary but once you're in the swing of things, it only takes a couple minutes a night. I just set phone alarms so I made sure not to forget. It wasn't too bad, I did mine at restaurants, at the movies, even at weddings- you just do what you have to do.
And @Wicked4589 brings up a good point, it does depend on the person and pregnancy how long you'll need injections. With our frozen cycle, the one that finally stuck, I ended up needed a corrective surgery in the middle of the first "month". I ended up being on the pre transfer injection an extra couple of weeks. Then, after the transfer I was doing progesterone oil shots twice a day through 11 weeks. And honestly, I'm 18w now and I STILL panic some days that I forgot about an injection! It just got embedded in my brain those 4-5 months.

It's a lot, it is but like I said, it's SO DOABLE. But I hope you ladies can get a bfp before you need to go to the extreme.

Colleen0516

@Wicked4589 went to the doctor today-I'm doing one more round of IUI. If this doesn't work (which it will!!! Positive thoughts) then we are starting IVF. I'm beyond scared, but i received a lot of information today. I'm doing my research and preparing for it. I'm better when I know what to expect.
I can handle the commitment, I can handle the emotional struggles and hormones that come with it- the needles scare me (and that's a HUGE part) BUT, I will just have to get over it. I'll take it day by day.
We're set for September start and then we would transfer in October.

For now, concentrating on IUI and acupuncture. Praying this round works!

MrsBwIVF

I'm glad you found out more information and are preparing for it but I'm HOPING you are successful with iui this round! Fx for you.

Colleen0516

@MrsBwIVF Me too!! I have a choice to do a 4th IUI but he doesn't suggest it. Soooo im trying to just follow the doctors lead (after all, he's the expert!) and do my best to stay calm through it all.

jnissa

@colleen0516 - not to worry, IVF will cure you of a fear of needles Before long, you'll be like, "Needles, what needles? All I see is my future baby!" 

kwozniak330

I never tried IUI. Our situation took us straight to ICSI IVF. From what I have read about IUI, if there was any way for me to avoid IVF I would have taken it. We started our stim cycle last February, did our first FET in April and got a BFN. It was/is an extreme emotional roller coaster.

There is only so much your doctor is going to tell you about what to expect because there is no way for them to know how you are going to respond to the treatments. Keep that in mind because the unknown for us is the worst part. We froze all our embryos and are trying our second FET this month. The transfer cycle is definitely not as bad as the stim cycle but it does mean 1-2 or more shots a day for a about 1 1/2 months before and for 10 weeks afterward.

I know it will all be worth it in the end. We just have to put our big girl panties on and battle through. Just imagine how much we are all going to love those little babies when we FINALLY get to meet them!

kwozniak330

@jnissa You are ABSOLUTELY correct! I never had an issue with needles but my husband definitely did. He was so bad he nearly fainted every time he had to do my progesterone shots. He's a pro now!

Last week I went for a blood draw and the nurse apologized for sticking me with the needle. I started laughing at her, really? You think that bothers me anymore???

babyexpress

For the ones that did IUI and then went to IVF, did you do a trigger shot before IUI?  Was that shot similar to the injections for IVF, as far as pain?  Some of you it didn't bother, just more of the commitment.  I did a Pregnyl shot and was in pain in my stomach for about 4 days afterwards.  I felt like i got punched in the stomach and could not do any intense workouts. 

All this information is so great.  I will now probably do IUI as long as my RE lets me

MrsBwIVF

We did trigger shots for iui but in thle back. It was different from ivf because it was.pur first time doing a shot on our own. It did hurt for a couple days but I think it's because I tensed up too much when DH went to do it.

With ivf, the shots weren't too painful and the needles for the stomach weren't very big. The problem we ran into was that when you do three shots a night on your left side then on your right the next day and so on, the area did get sore. So I had problems because of the repetitive nature of the injections. But as I said previously, I got so comfy I could turn my back for 5 seconds and be done with it.

AMT&THC

@Colleen0516 Thanks for the post...I need this info too. We are about to switch to IVF as well. I'm in my last month of IUI. We made our appointment to discuss IVF on 8/19 so I can go over the specifics with the doctor at that time. It felt a little negative making the appointment considering we still have this month of IUI to go, but after reading all of this info I am glad we did and sometimes when I start thinking about something else, stuff happens...so call me superstitious :-) 

@jnissa & @wicked4589 Thanks for the step by step...that is helpful. I had no idea how much more shots and appointments go into IVF. I am a teacher and in September I have to be in my classroom. The needles I have gotten used to with IUI but the time commitment is going be my biggest issue. I appreciate the insight. 

Wicked4589

I hope you don't need to go to IVF either. It's not unbearable but it is more involved. I loved my doctor and the nurses in the office. They did an orientation beforehand with all the new couples. They show you all the meds and how to inject each one. They go through every step with you of the process. You get a binder filled with tons of info. It really helped immensely to make me feel at ease about the whole process. They go one step at a time so it isn't so daunting. And when you look back at it months later, you wonder what was so scary about it. You just get kind of numb to it. The stomach shots were the annoying ones because I had to do those right at 7 pm every night. Valentine's dinner I was in the bathroom of Walgreens giving myself injections. Not exactly romantic. Lol

rachlee2010

@AMT&THC  I am worried about the time commitment as well as I am a teacher too.  The summer has been great and easy to make appointments but once school starts it is so much harder.  It's def a time I wish I had a job with more flexible hours..Like my husband can run out for an appointment and go back or head in a little late..not the case with teaching.  Usually if I can get the very first appointment in the morning and it's a quick U/S and blood draw I can still make it to work on time.  I am going to tell my principal at the beginning of the year what's going on so she is aware, hopefully she is understanding.  I am still hoping for both you and me that we can get pregnant in August and won't have to worry about it in the fall

AMT&THC

@rachlee2010 ME TOO! I am crossing my fingers so hard for both of us. I moved closer to my doctor's office before the summer so that will help. I took half days 2 times a month last year to do my first 3 IUIs. With traffic it was an hour to get to my doc's office in the am so I couldn't make it to my 1st or 2nd period classes. I *should* have an easier time with morning apts now though since the office is only 10 mins from my house. But, obviously, we'd both prefer for it just to freakin happen in August!!! AHHHH! We shall see!!!! 

lilmissslp

I'm a speech therapist in the schools as well and I'm nervous about the same thing. We go back to school in two weeks so I'll have to start taking half days for appointments. It's hard and I know ppl are wondering why I'm leaving so much. This summer I told our new principal that I had personal health issues (maybe later I'll open up to her) and need to take time off for appointments here and there. I'm really nervous if we have to move to IVF how I can keep up with all the appointments.

obizyanka

I might be cynical but imho iui x3 for us was a huge waste of time money and emotions for me. Knowing what I know now I feel lied cheated and robbed by Drs who should have known iui was not going to work for me. Be your own advocate. It you want ivf push for it. There is just as much commitment and stress with iui as with ivf. I personally tolerated the ivf meds better than those for iui.

HBamama2B

Great question. All of these responses are very helpful to many it seems. My hubby an I have 3 rounds of IVF or IUI covered before we have to switch to a new insurance. We've been debating about what the third round should be given his low morphology. Thanks for all the info!

Colleen0516

@HBamama2B Well, my DH And I have done 2 iui's and both didn't work. We are currently on #3. My gut told me go IVF but I'm afraid to go IVF. I wasn't prepared this month.
I am now mentally preparing and planning for it next. Hopefully we get pregnant this month, but, it's hard for me to be positive this round since its playing out EXACTLY how mY last 2 rounds went.
I added acupuncture, so that makes me feel like I'm doing something else and maybe that new thing will work. 8->

If you only have 3 of each one, I would say go IVF (if you can) . It's a lot more involved than IUI but- it has higher percentages (especially when it comes to any issues with sperm).

Best of luck with deciding!

meganfauer

@colleen0516 Let me be someone to add a different take on all. I am someone who did it ALL backwards. We were told only IVF with ICSi was our only option and so we went for it. We had 2 failed IVF's and that stung, b/c I was given all these flashy statistics that people posted above of 50-75% chance it was going to work I was only 31 and healthy and on and on. Fired that RE and went to a new RE well she felt we should do IUI, we already spent $30K on the two rounds of IVF, y'all are so fortunate that any of this is covered through insurance, so we thought well this is less money and she believes in us. We were given the IUI statistics and I went through two unsuccessful IUI's with injections ( i have never done one procedure without injections, used to hate needles now I don't flench, not trying to be rude at all but you will put your big girl panties on and just do it, trust me to become a mother I would of stood on my head and sang kumbaya, you will be amazed what you are capable of) Anyway she convinced us to try one more IUI with injections in 2012 and we got pregnant with twins! We lost a twin but had a beautiful baby boy. And again yes I have seen all of my percentages IVF vs IUI and higher percentages didn't work for me but I have a beautiful baby boy!! Keep your head up and you just never know. IVF is way more invasive and time consuming but its not terrible, as someone mentioned above you get into the swing of things. Take it from me on my 8th round of fertility treatments and injections, i could do all of this with my eyes closed. 

Good luck!!

Colleen0516

@meganfauer thank you!! I know those big girl panties have to come out but they are shy lol

In the end, I know I will amaze myself with what I can do. But thinking about it, and deciding-- it's almost worse that actually doing it! Ugh!

I've come to terms with it. I had my meltdown, and now I'm accepting my situation.
The Pity party for 1 has ended lol

We're on our 3rd IUI now (early in the process)....I would love to find out it worked! 8-> only time will tell!

plumeria05

@Colleen0516 I know what you're going through. I did 2 rounds of IUI with Kaiser earlier this year but didn't work. We then took a break and started IVF in June; unsuccessful however, we're going through round 2 of IVF. Yes I had a meltdown and got depressed after the first IVF failed. It's hard and it sucks. My problem is the quality of the eggs I have but I'm 40 so no surprise there lol. This second time around I'm not too stressed and hopefully it works. Good luck to you. Who knows....maybe third time's a charm

mskeenan

I am debating the same thing . My doctor seems to think that after 3 failed medicated cycles (2 timed intercourse 1 IUI) we should discuss Ivf . I feel like it's too early to throw in the towel especially if there is only about a 20% chance each month . My insurance won't cover ivf so I am really trying hard to avoid if possible . Best of luck to you all !!