Talk to me about IUI

ShallowSeas

I found out this week that my Day 3 labs all came back normal and my HSG showed that my tubes were completely clear.  DH's SA results came back excellent.  My RE's nurse called me yesterday with this information and asked me what DH and I were thinking for the next step of treatment since we've been trying since 12/2014.  She mentioned starting Clomid and timing sex since our labs all came back normal, but also mentioned Clomid + IUI.  I understand the process and idea around IUI, but I guess I don't understand how and if its more effective when there are no sperm issues? Maybe I just don't understanding it as well as I think I do. I've not been able to talk to my RE about this and the nurse just told me to call back by CD1 next cycle if I'm not pregnant this cycle and let them know what treatment plan we've decided to try first.  Any advice, experiences, or knowledge is appreciated.

This is all new to me and it's a lot of information to absorb.  I'm just trying to better educate myself without calling the RE office every day with questions.

wifeinraleigh28

Hey @severmilli12!  It's really up to you what you would like to do, between TI and IUI.  TI is a little less effective but a lot of people start with that.  The benefit of doing IUI over TI is that the clinic will do sperm washing (which removes any sperm that aren't moving) so that only the healthiest, motile sperm are inserted.  And the sperm get inserted right into your uterus, which eliminates part of their journey.  There is no right way to go with this, and you guys just need to do what you feel is right for you.  A lot of times couples start with TI for a few cycles and then move to IUI if they don't have luck with it.  Since you are both healthy and have passed the tests, TI might be a good place to start!  You've been trying for awhile now though so I can also understand if you decide to jump right to a more effective treatment.

ShallowSeas

@wifeinraleigh28 thanks! I'm more inclined to do TI for a few months and see what happens, but then the nurse mentioned IUI and was like, "hmmm...that doesn't sound too bad" but more so because I'm just impatient and tired of waiting for it to happen.

From lurking around these boards I've seen people like me jump straight to IUI so I wondered if there was more benefit from it than just TI when there's no real dx. 

wifeinraleigh28

@severmilli12 Well that sounds like a great place to start.  Are they going to trigger you along with the clomid and monitoring?  You may find this is all you need to get your BFP!  

ShallowSeas

@wifeinraleigh28  I'm going to talk to the nurse more about when I call back.  She mentioned a trigger shot along with Clomid as an option and told DH and I to think about it.  I hate making decisions on things I'm not well educated on.  When I call back I'll probably ask what they would suggest at this point.

wifeinraleigh28

@severmilli12 I would definitely recommend a trigger shot with TI (or IUI) in order to ensure optimal timing!  Personally, I wouldn't want to go through fertility treatments (meds, ultrasounds, etc) and not have perfect timing!

ShallowSeas

@wifeinraleigh28  thanks for advice! That does make sense.  I would definitely feel better knowing the timing was right.  I have a binder full on info from the RE, including the Clomid and trigger shot, so I'll go over it tonight with DH and talk to my nurse about it.

turtle148

@severmilli12 You are in the exact spot I started. I decided to go with clomid and ti. I'm in my 3rd round tww. My first round was a bust as my cycle lasted 18 days total. My lining was too thin and that triggered midcycle bleeding before I even o'd. Dh has no problems but I have lpd. The two other cycles I've used it to evaluate if clomid is successful in causing a stronger o. When I took it last time on cd 5-9 I o'd on cd15 and my 7dpo progesterone level was 22.2 ng/ml. This time I took it cd 3-7 and I o'd on cd 22 and my 7dpo progesterone level was only 16.9 ng/ml. So now we have started discussing iui and know how my body reacted to the different days.
The good part that I'm thinking will accompany iui is all the extra work is shifted to the dr office. No reason in checking cm because iui gets around that issue of clomid drying it up. Then using a trigger shot would be awesome but my provider only uses those with iui (good bye poas obsession). Now the pain is the increased office visits and cost. But heck we all are spending all of our time and money on ttc anyways.

BrightenMySky

My acupuncturist called Clomid + IUI "a little boost for each of us" (meaning DH and me).  For us, IUI was recommended because of a sperm issue, but I also felt that if I was going to be taking meds, going to the RE office for monitoring all the time, etc., I wanted to do whatever the RE recommended as giving us our best shot.  

One thing that you might want to consider is insurance.  Do you have any fertility coverage?  We have some coverage for 6 IUIs and then IVF through DH's insurance, but it's at a temporary job, so we basically decided with our RE to get through the IUIs so we could do IVF while still covered, if necessary.  

ShallowSeas

@BrightenMySky
Thanks for you advice.  My insurance only covers testing, not treatment, so an IUI is not covered. Clomid/Femara is covered however through my rx plan.  That is the reason I'm more inclined to try meds and TI first for a couple months before moving onto IUI.  I have yet to call my RE office back about all of this Still holding out hope for this cycle.

ale9687

DH and I just had an apt with our RE this morning. We were given the option of clomid, a trigger shot and then doing TI or IUI. We're going with IUI. The re said out chances of conceiving with IUI would be 21% and about 15% with TI. The % isn't much higher with IUI but we wanted the best chance possible.

nuttymask

When I took a second opinion, the gynae put it this way- 
There are some people who conceive easily
Others who have a little trouble- so can go for boosts like CLomid/injections/IUI
And finally those who have a great deal of trouble TTC- who can benefit from IVF.

He pointed out that at least IUI will give closure hopefully. Otherwise it's just month after month of TTC...
Am trying a couple of cycles with a new gynae. So far, so good. Otherwise, she has also suggested IUI.

When we tried to time BDs, sometimes DH was tired/my CM was sticky/ endometrial thickness was too thin- seen that last time I had taken a Clomid type thingie (Egg Sure). This time too, it was thin- this gynae has also prescribed Emgra and it has thickened. O today as per follicular monitoring, am all set to BD...so let's see

ShallowSeas

@ale9687  Good luck with the IUI!
@nuttymask Good luck to you!