Need Advice Please: Take a Break or Push Through with IUI cycle?

emgem819

Hi ladies.  Need some advice here if you can help out!  I just got home from my RE appointment and here's the story:

• I've been on 3 medicated cycles TTC with TI along with follitism injects, femara, and HSG trigger shot.  All I had one large follicle, good looking lining, but all ended in BFN's.
• My DH's SA just came back (long story but we didn't do it before due to insurance reasons) with 450 million count, 69% mobility, but LOW morph at 2%.

With his morph that low we thought we were headed straight to IVF, but RE says we have a few options:

1. We could do one cycle of IUI NOW.  She said it's more like 12% we will get pregnant with IUI (versus 8% doing TI) and with low morph counts it's not completely hopeless--she considers it more probable since his other numbers are good.  So it's a chance but not huge percentage of course.  If we do one cycle of IUI we'll be able to see if it's worth doing more cycles to try again or if we should take the next step and go forth with IVF which is more of a 58% chance with his good numbers and my good AMH levels it will be a very good chance with IVF that we'll get a BFP.  Financing wise, my insurance doesn't cover injectibles (approx. $300/cycle) or IUI ($400) so we'd be putting money into this as well. 
2. We could have DH start taking Fertilaid NOW to increase his morph as recommended by the RE but this won't take effect for 10 weeks at least so we'd take a break for 10 weeks then have him take another SA test and proceed with the one cycle of IUI if his numbers were increased.  Then we'd also be able to tell if the IUI would work and if it's worth doing more cycles to try again or if we should take the next step and go forth with IVF.
3. We could go forth with IVF NOW.  This would be something we'd have to financially get ready for (take out a loan) so it wouldn't happen likely for a few months anyway and with the craziness of the holidays coming, we might opt to start this in January.

Any advice on which direction we should head?  I'm leaning towards #2 but not exactly sure how much better our chances would be if he takes Fertilaid since there aren't many studies done yet.  IVF would be a sure bet but I'd like to try IUI one time before we rule it out. 

Thank you ladies for your help!

-Emily
P.S. I enclosed the info about supplements she gave us to increase sperm morphology.

smitty18

Hi Emily- don't rush into anything.  I'm not familiar with that drug for males, and 2 different REs never even suggested it for us, and my DH % morphology is also 2%. I'd get some more opinions on that.... but I would say, i always like to go with the RE's recommendation, as they know you best.  Especially don't rush IVF yet, especially if you've never done one cycle of IUI. They clean and wash the sperm in the IUI so statistically speaking the healthiest ones are put into you. IVF is taxing in many ways...

 

emgem819

Thanks @smitty18 what are you doing right now to TTC? I really hate to have to take a break since I have my heart set on trying more.

katie121209

@emgem819 our RE started us on clomid with trigger shot and iui waiting to see what the results of our second round are. My DH also has low morphology which is why the Iui was recommended over TI. I asked if we could do anything to improve morphology, and that supplement (nor any others) was recommended.

Has clomid been an option for you? I know it's a lot cheaper than Injectables.

emgem819

@katie121209 thanks for the reply! I'm on femara which is comparable to clomid. My re prefers it because it doesn't thin the lining as much. I tried just femara without injects and did not get any big enough follicles so unfortunately I need the injects! Fx that your second round is a success!

brazenbiblio

My first instinct would be option 1 because I always rush into everything. I think the best option is number 2 though because you'll have some time to research the supplement, see if it works, and get a better idea of your chances for IUI success.

Whatever you choose I wish you good luck.

Rachd110

Hi Emily, after more than a year of TTC with no luck, DH wanted to move directly into IVF because of the better success rates. RE recommended 3 rounds of IUI before IVF. I was able to convince DH to do two cycles of IUI, both failed. Rather then doing a third IUI we moved forward with IVF. I just had my ER this morning. IVF is very taxing on your body. Even if this first try gives us our BFP, I'll still be glad we tried IUI first even though DH thinks we should have done IVF right away.

The meds for IVF are much more expensive than IUI because your dosage is higher. I'm fortunate that my insurance covered most of my meds. Without insurance you can possibly pay $3000-$6000.

They wash the sperm during IUI, so only good sperm are put back. I've heard of women getting pregnant with very low numbers being put back in.

Good luck to you and your hubby!

Stepmomttcmy1

I think option 2 makes the most sense financially, esp since you would need to save up for ivf anyways. My Dh has low count, motility and morphology. We did 3 rounds of IUI because my insurance requires it before moving on to IVF. I did Clomid, trigger and progesterone, my RE doesn't do injectables for IUI cycles.
I got 1 follicle the first 2 cycles, 2 the last cycle. All 3 were BFN. We are on a break until at least Jan because of work schedules but I do want my dh to take either Fertility Blend or supplements during our break. I don't know if my insurance will cover any of the costs of ivf, as we have a lifetime cap on treatment costs, so our break could be even longer. I am 37, dh is 52 so time is not on our side so a break is not ideal but our schedule is too hectic right now for multiple Dr appts with little notice.
I hope you have peace with whatever choice you make and wish you good luck!

Whiggrrl65

I would go with #2. Good luck!!

HBamama2B

For us, we did two IUI, but that was only Bc we were waiting for the second SA, a consult with a reproductive urologist, a more in depth different type of SA and to see if his morph came up at all. DH's reproductive urologist did recommend a supplement more like a male prenatal, but nixed any more IUIs saying our chances were down to 5% and that was with my 3-4 nice, large follies.

I'd recommend a different option- have DH see a reproductive urologist. REs focus almost exclusively on us and try to solve challenges from our female perspective but only a urologist can give you a complete picture and discuss the supplement and other options. We were told there is little that can be done to improve morph, depending on the cause. The cause of the morph (genetics, lifestyle, variocele) is as important as the number and drastically affects the odds of IUI success. (For instance, low morph related to variocele has a reduced rate of IUI success even at higher percentages and higher counts/motility but can be corrected through a small procedure in most cases.)

mskeenan

Hi there!!

I like the idea of doing #1 while you think about the other options for a little bit. That way, you can still feel like you are trying-and who knows you could totally get pregnant from that! But it would give you the time to research #2 and mentally and financially prepare for IVF. I almost jumped into IVF paying out of pocket and now I'm so glad I didn't. Still not pregnant but I feel like you have to really be ready for that decision. That's just me though!

I know IUIs are still not cheap but they are a lot cheaper than IVF. You could give it a couple rounds and see how it goes if that's affordable.

Let us know what you decide to do!! Good luck!

riveridgional

I think #1 based on things you said you wanted. 1- you didn't want to take a break yet; 2- you want to try IUI once before IVF.

You could always try IUI now. If that doesn't work, DH can try the supplements while you work on saving money. it would take at least 90 days based on the life cycle of sperm to see any effects. I believe it can only help you re: ivf. If he gets another SA at least 90 days later and his count has improved, then you can reevaluate IUI v IVF at that time.

emgem819

Thanks everyone for all your helpful comments! It helps so much to get all of your knowledge and experience!

We have pretty much decided to go with #2 based mainly on the fact I got AF yesterday and we are going out of town tomorrow so staring iui and a medicated cycle right away would be not possible. We've ordered DH's supplements and they'll arrive Sunday (gotta love Amazon Prime) so he will start taking those then. I still haven't ruled out doing IUI next month and moving to plan #1 but I think it will be good to reassess our finances and figure out if we can even afford a few cycles before he takes another SA and the supplements kick in (if they do anything). I do think we won't jump into IVF and try IUI a few times at least.

agriffin92013

@emgem819 good luck and have a safe trip

emgem819

Thanks @agriffin92013 let me know your next steps too...if I do take a few months off id love to stay in touch!

vssbrm

Good luck! For what it is worth, I think you made a good decision.

agriffin92013

I will @emgem819. I go back to re Thursday and I have an appointment today to see acupuncturist. Yea keep in touch

mskeenan

That sounds like a great plan ! I wish you the best of luck !! Yes - I think it's hard to jump into IVF when a cheaper option could totally work ! Have a wonderful and safe trip !!

KLake42

I think it's good to take a cycle off every few rounds, when you're doing the medication, just to give your body a rest.  If you do go for IUI next cycle, don't be too discouraged by the statistics.  Those are the same stats for all women, including those with all kinds of problems you may not have.  It really is impossible to predict success for these technologies, since we are all so different.  IUI will give you a boost, since the sperm wash concentrates the best sperm, and gets them over the hurdle of getting through the cervix, so maybe that's what you need.

Enjoy the break! 

agriffin92013

@emgem819 update on my next steps.  Saw RE Thursday.  He said that since I have decided to not move onto IVF and December will be the last month I seek fertility treatments that he will try another IUI with Femara 7.5mg days 3-7 and Gonal F on days 7 and 9. Because I couldn't get into his office until CD10 I had to take this month off from meds.  I have a month to think about it.  The Gonal F will cost me between 300 and 500 and with everything being out of pocket I wish he would of done this with the last IUI like I asked the nurse about.  I have done 2 sessions of acupuncture so I hope this will help.   DH thinks I should be done with the treatments but will support me in whatever I decide.  I hope things are going well for you

emgem819

@agriffin92013 thanks for the update. Looks like we are both out this cycle so let's hope the month off does is both good. I'm glad to hear the acupuncture is going well for you...I've heard a lot of positive things about combining that with medicated cycles so I hope it helps! I can't remember...before had you ever done any injections or just the femara? I was able to get a discount via Good Start for 50% off follitism which my re said could substitute for gonal-f which I'm normally prescribed so it cut the cost way down. If you are interested I can send you the info...its just based on income and you have to send them tax return documents as proof. I'm so sorry that nothing has worked so far. You must be beyond frustrated. Please don't give up completely. If iui doesn't work for us, we also can't afford ivf but not sure if we would completely give up. It'd be tough for both of us to get to that point and make that decision but I also don't want to go into serious debt before we even have a child. It's a tough decision. Hang in there. I'm crossing my fingers for you that this next cycle is the one that works!

agriffin92013

@emgem819 the only injections I've taken is the trigger shot.  FX for you as well.  Who knows maybe taking the month off and not worrying about any of it might be what we need

emgem819

@agriffin92013 here's that website: https://www.villagefertilitypharmacy.com/firststeps to get a discount for follitism (can substitute for gonal-f)

agriffin92013

Thanks