IUI questions - Letrazole VS Injectables and Sperm Analysis

juliehollz13

Hi All,

I'm migrating over from TTC board with a couple of questions about IUI's. We got the SA results for DH, his sperm count is good at 57 million but his morphology is at 2%, which they said was a low but pretty typical. We have 3 monitored stimulation cycles with or without IUI covered by our insurance, and the clinic is working on getting us discount pricing on injectable medications if we wind up using those. My question is, (if my HSG comes back fine) since we only have limited # of IUI's and DH's morphology is low, should I give Letrazole a shot or "go all in" with injecatbles, or would that be a waste of money if RE says it's "up to me"? I have a follow up appt next week with the RE, but thought I'd try to get a little bit of information so I can make a better informed decision. 

Also, is there anything that can be done to improve morphology? 

EML2011

I recognize you from TTC! This board isn't particularly active so you may have more luck posting on the infertility board. There are many ladies who use both types of medications for IUIs. I would probably try a cycle with letrozole and then move on to injectables if you don't produce many follicles. I personally didn't respond well to it but I know many women do. I don't remember your history and can't see signatures (mobile), are you seeing an RE for MFI or are there other issues as well? I had very few side effects on letrozole and it's so much cheaper than injectables.

We recently discovered that DH has slightly low morphology, but our RE didn't give us any suggestions. I'll probably ask him more about it if this cycle is unsuccessful. I've seen some women post about there DHs taking multivitamins but I'm not sure how effective that is.

juliehollz13

EML2011 said:

I recognize you from TTC! This board isn't particularly active so you may have more luck posting on the infertility board. There are many ladies who use both types of medications for IUIs. I would probably try a cycle with letrozole and then move on to injectables if you don't produce many follicles. I personally didn't respond well to it but I know many women do. I don't remember your history and can't see signatures (mobile), are you seeing an RE for MFI or are there other issues as well? I had very few side effects on letrozole and it's so much cheaper than injectables.

We recently discovered that DH has slightly low morphology, but our RE didn't give us any suggestions. I'll probably ask him more about it if this cycle is unsuccessful. I've seen some women post about there DHs taking multivitamins but I'm not sure how effective that is.

Yes, we're now seeing an RE and a Medical Endocrinologist. DH's sperm count is great but morphology is at 2% so unless the RE is insistent, if given the option we will forgo the monitored cycles with timed intercourse and go straight to IUI. We've been not preventing since August of 2014 and have been "actively trying" (bbt, opk's etc.,) since May. I have been diagnosed with hypothyroidism, high DHEA-s and PCOS, and now they're checking for adrenal tumors (high dhea) as well as adjusting my thyroid dose and checking to see if my pelvic kidney caused any uterine abnormalities. Thank you for responding! 

wifeinraleigh28

@juliehollz13 - Hello, and welcome!  So is your RE saying that it is entirely up to you which route to take (letrazole versus injectables)?  If that's the case then I would probably go with what the PP said about trying a cycle on letrazole first and then moving to injectables if you don't respond well to letrazole.  If there were any other issues with the SA other than just morphology, I would recommend going straight to injectables.  Statistics show that far more pregnancies result from injectables versus oral meds when there is MFI.  But the research is inconclusive with morphology.

Best of luck to you!

juliehollz13

wifeinraleigh28 said:

@juliehollz13 - Hello, and welcome!  So is your RE saying that it is entirely up to you which route to take (letrazole versus injectables)?  If that's the case then I would probably go with what the PP said about trying a cycle on letrazole first and then moving to injectables if you don't respond well to letrazole.  If there were any other issues with the SA other than just morphology, I would recommend going straight to injectables.  Statistics show that far more pregnancies result from injectables versus oral meds when there is MFI.  But the research is inconclusive with morphology.

Best of luck to you!

Thanks for the response!

@wifeinraleigh28, our RE would like to try letrazole but is willing to take as aggressive approach as we want because of our insurance limitations. I also read that the statistics of conception were higher with injectables, so I guess what I'm curious about is, is that because they produce better quality eggs or just alot of them? 

P.S -we're in NC too!

wifeinraleigh28

@juliehollz13 - Ahhh, where in NC are you and which clinic?

Injectables do work better statistically, and I think it's a combination of both of those reasons!  I've also heard some people say that injectables give them fewer side effects, which seems strange.  I've only done injectables though and didn't have side effects, so I guess I believe it!

juliehollz13

wifeinraleigh28 said:

@juliehollz13 - Ahhh, where in NC are you and which clinic?

Injectables do work better statistically, and I think it's a combination of both of those reasons!  I've also heard some people say that injectables give them fewer side effects, which seems strange.  I've only done injectables though and didn't have side effects, so I guess I believe it!

We're in Charlotte and we go to REACH