Is IVF worth it for unexplained infertility?

TheLabyrinth

Our RE hasn't been able to determine what is causing our fertility problems and we've done 4 cycles of IUI, a few cycles of just clomid before that, and years of just not using BC.  It seems like the next step would be IVF.  However, I'm nervous about subjecting my body and my pocketbook to this process when our doc doesn't even know what the issue is and whether this will really treat it.  For people who have been in similar situations, how did you make the choice?  Any advice?  How likely is it that IVF will work when nothing else has so far and they don't know why?

KidShrink

If that's a possibility for you, I'd see if you could get a second opinion. My RE doesn't believe in unexplained infertility; unexplained was a temporary diagnosis for us until he decided there was no reason for it not to have worked with Femara (which I was responding really well to) and TI (no MFI, PCT was also fine). The plan was therefore to do a hysteroscopy and possible laparoscopy (both were done in the end), and two issues (endometriosis and slight t shape uterus) were found and fixed, and we were able to conceive.
My RE advertises on his website that his strategy is to find what the issue(s) are to reduce the emotional and financial cost associated with more intense treatments like IVF.

TheLabyrinth

I am going to try another opinion too (unfortunately the next closest doc is an hour away :<).  With both my DH and I being under the age of 30 and everything looking great in each of these cycles, we're pretty frustrated.  I'm glad your doc figured out your issue.  Hopefully a similar result will occur for us.  We've done a bunch of tests already though, and nothing has been the "aha' moment yet.

Whiggrrl65

@TheLabyrinth Sounds like you and I are in the same boat. My RE mentioned IVF due to my age (turning 38 in December). I have PCOS but all the oral meds have worked and produced one mature follie each cycle. In my mind, there should be no reason why we keep failing and RE says that my age has reduced our chances.

I get my beta tomorrow after my third IUI but took a FRER this am and it's negative so I am sure I'm out this cycle.
Have you tried injectibles yet with the IUI? That is what the next step is for me so that I can produce more follies and increase chances.

MrsBwIVF

No one can tell you if ivf is right for you or worth the money, unfortunately. It'll have to be something you and DH will have to weigh the pros and cons on.
I agree with PP that if you are having doubts that the long process and money may not be worth it, definitely go for a second opinion.
For us, it was all totally worth it. We had unexplained infertility after a LONG time on clomid with a regular OB and no Bfps, we decided to see our fertility specialist. They ran loads of tests, lots of procedures and we did two unsuccessful iuis. Our doctor was very frustrated that nothing seemed to work and because we got strung along too long on clomid with my ex ob, she allowed us to decide to go with 1 or 2 more iuis or proceed with ivf. We too looked at all of the info, the expensive price tag, the long time line and the extensive list of medications. We weighed our options and decided for us, it was best to just go all in. We also were/are very confident in our doctor and knew we could trust her instincts and professional opinions.
We did a fresh cycle in October of last year and were blessed with a bfp and identical twins. Unfortunately, the embryo did not split correctly and we lost the pregnancy. It took a while for my body to reset and in April, we did our first frozen cycle. We transferred two embryos and are currently 23w2d pregnant with fraternal twins.
The ivf process is not easy but it is extremely doable. It seems daunting and never ending but now that we are on the other side of it all, it seems so small of a process in order to get to this part of our journey.

I'm sorry you have come to this cross road, you two need to do what is best for you. Good luck on your journey!

jnissa

I will say this. If I were under 30, there is no way I would do IVF. Because age is on your side in a big way. The only real benefit IVF would have is if you spent the money for pgd and found that you have an egg quality issue. And even then there wouldn't be much that you could do except wait to find the lucky egg. 

That said, IVF success rates at your age are really good. Which is something to consider. 

TheLabyrinth

@kmetcalfe77  We have not tried injectables as we have had amazing cycles each go for iuis with 3-4 mature follicles and another 4-6 smaller ones when we used Clomid.  You'll have to let me know how your experience goes.  Fingers crossed!

TheLabyrinth

@jnissa  With age being on our side, it's great.  However, we've been off BC for 4 years, been trying seriously for about 3 years, and have been seeing an RE for over 1 year.  Everything always looks great and we're still not getting pregnant.  It seems like the likelihood of getting pregnant the normal way or even with just drugs is really low.  That being said, I don't want to do IVF and find out whatever is wrong with us won't actually be resolved by IVF...   It has gotten extremely depressing to keep hearing from doctors that this next "thing" is going to get us pregnant - no problem! - and then nothing happens.

FatPony

I think it would be worth it to get that second opinion. Just because your current RE is located conveniently close to you, doesn't necessarily make them the most qualified. My gyno refused to refer me to the closest RE bc of their terrible reputation. I ended up having to go to a clinic 6 hours away! I met a lady there that did 4 rounds of IVF at the 'closer' clinic, then switched to the other clinic and got pregnant on her first IVF there. 

Anyway, good luck to you. 

TheLabyrinth

I'm also hoping that this second opinion will be better because there are 4 doctors their and their company has 4 separate sites in my state.  I'm hoping that the combined expertise and experience of all these doctors will be beneficial as well.  My current doc has just his practice, no other doctors.  I question how much he is checking around to see if others have had similar experiences and what options on next steps should be.  Fingers crossed.

bsckgb7

TheLabyrinth said:

@kmetcalfe77  We have not tried injectables as we have had amazing cycles each go for iuis with 3-4 mature follicles and another 4-6 smaller ones when we used Clomid.  You'll have to let me know how your experience goes.  Fingers crossed!

I was going to comment about not trying injectables.  My RE says injectables have a higher success just because they are injectables.  Follistim eggs are stronger and healthier and more likely to fertilize as opposed to just Clomid/Letrozole eggs.    I had the same number of follicles this cycle with Follistim that I did last cycle with Letrozole.  We considered canceling the IUI cycle for that reason (the stronger/healther part)

riveridgional

@TheLabyrinth there are some things that just can't be diagnosed but the issues can be bypassed with IVF. For example, there could be something wrong with how the tubes and filabrae are operating and they aren't able to grab the egg or push it down and through the tube. As far as I am aware, there are no tests for this. The HSG can only tell if your tubes are clear. It can't confirm they are working properly. I'm still in the unexplained category but have an expected ovulatory disfunction. My doctor stated that my hormones indicate I have a good number and quality of eggs, but he believes something is off with my ovulation and the eggs are not maturing properly despite my follicle sizes at and around O. I'm still confused on how he has come to that conclusion. Anyway, he recommended I try injectables because as pp has said, they are supposed to develop better eggs. If this doesn't work, I'll either give injectables one more shot (wound up being cheaper than expected) or move on to IVF. I'm 30, btw.

TheLabyrinth

@riveridgional how do the injectables work in this type of scenario?  Do you just have to give yourself a shot for about the same length of time as taking Clomid?  If you don't mind me asking, about how much were the injectables?

I have my second opinion on Monday next week.  Hopefully I'll have a better idea on a next step.

riveridgional

I had my husband give me the first shot, and I did the rest mainly because my provided time frame (4-6) basically left me with doing it at work. Everyone's protocol is different, but mine was as follows:
125IU Gonal-F on 8/30-9/1
Had u/s only on 9/2 and dose decreased to
50iu Gonal-F that afternoon
U/s & BW on 9/3 50iu Gonal-F that afternoon
U/s & BW on 9/4 25iu Gonalf-F & 1 Ganirelix prefilled syringe
U/ & BW on 9/5 50iu Gonal-F & 1 Ganirelix prefilled syringe
9/6 1/2 dose (5000) HCG trigger shot between 8-10 am ( I did it around 9:30).

I responded very well to the injectables and had a LOT of follicles, so they had to monitor me every day. I don't think that is normal protocol, though, and I think the length you stim for depends entirely on how you are responding.

I recently wrote a post to someone about the cost. I'll try to find it and post it.

riveridgional

Found it!! And, as mentioned in the below, I did have an entire pen (300iu) unused and only used 175 out of 300 of the other. I technically have 2 pens plus the remainder of the 3rd in my fridge since my dr. Gave me a 300 iu sample due to issues with my med delivery.

I don't have insurance for any infertility costs, so I'm paying everything out of pocket. My doctor ordered mine from Freedom Pharmacy online. The total cost for the meds I've paid is $1,283.70 after a $120 mail-in rebate. I was told most people spend between $1100 and $1500 on medications. My doctor does a flat fee for OOP patients for all ultrasounds, bloodwork, and office visits. That ran us $1,215, but I'll definitely get my money's worth out of that! I've been responding very well, so I think I'll probably wind up with at least one full Gonal-F 300iu pen left (really 2 because my med shipment was delayed and my RE gave me a sample to hold me over). If I get pregnant this time around, I can't get a refund for them, but at least I can put my name on a list at my clinic in case anyone wants to buy it from me at a discounted rate. It was a little overwhelming to me at first (the cost and actually giving myself the injections), but I'm actually preferring them to Clomid. I've had no side effects. I just have a heavy feeling almost like I'm carrying two small water balloons in my stomach, but I thinks it's because I have so many follicles growing.

 Oh yeah, just to give you a better idea, the amount I spent covers 900iu of Gonal-F RFF Redi-ject (3 of 300 each), 2 Ganirelix 250mcg/0.5ml, and 10,000iu of Pregnyl (trigger shot). They also gave me all the needles, alcohol swabs, gauze and disposal container for "free" and they ship the meds overnight (but no Sunday) delivery.

If you google Freedom Pharmacy, you can see their prices online. Though, if you have any sort of insurance coverage for the medications, I think they will charge you more.

knottieda3efbb548c0ae47

My wife and I just finished our final/last IVF attempt , after six failed, Blighed Ilvum, Atopic,etc whatever kick to the heart and the teeth we good get, we got. We switched over to Boston, IVF, one of the best in the country, did some genetic testing, and our last attempt and embryo took our babies is due in seven weeks. You have to stick with it, it's in Number's game, i'm the husband, and I know firsthand how bad the devastation is. As long as you're working with a good doctor/clinic with cutting edge protocols, I am confident that unless there's an underlying condition that it just takes several/many attempts. If you have any questions about the Gonal Reddi Ject 900, not sure if that was mentioned, but an absolute crucial medication, let me know. Not sure if that was mentioned somewhere.

knottieb463142d8be7d820

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knottie923b8d336c6a7c96

I've never done IVF, but have consider it due to the fact that I have a genetic disorder. Have they run any tests for you and your partner?

littlestepss

it depends on a clinic, but most clinics will do