IUI question

briide2be2008

I am doing my first IUI. We are doing unmedicated route first because we're dealing with MFI. Wondering if anyone can offer some insight as I should have asked more questions in planning stage and now it's the weekend!

I thought the nurse told me that whatever day I get a positive OPK no matter what time that I should go in the next day for an IUI. I tested Friday with FMU on a Clearblue Easy (have heard mixed things about whether to test with FMU on those?) and got a negative. Didn't get to test again until Friday 8:30pm and got a smiley. Spoke to a different nurse who said to come in Sunday morning for IUI. I told her I thought I should come in today but she said tomorrow morning was fine.

I know it's not an exact science but my concern is that perhaps if I had tested in afternoon or not with FMU I would have gotten earlier smiley and then they would have advised to come in today. Of course it's the weekend so I'm talking to different nurses - one told me FMU is fine and one said its not as accurate (but I didn't think no to ask if that meant it could give more false positives or false negatives with FMU) - and they only have early morning hours on weekends so I'm not sure if that was a factor in telling me to come tomorrow.

I know no on can tell me exactly what to do or when I'm going to O.. But if anyone can share their experience with timetable of positive OPK to time of IUI and if Clearblue Easy are accurate with FMU I'd be very grateful! Apologies for the rambling and thank you in advance!

wifeinraleigh28

Hello!  First of all, I'm a little confused about your treatment plan.  I haven't heard of REs having you use OPKs to determine time of IUI.  But, the rule of thumb with OPKs is that when you get a positive you will likely ovulate within the next 24-48 hours, so your timing is probably fine.  OPKs aren't the best way to determine ovulation though.

Also I'm not sure why they recommended you do an unmedicated IUI.  Your chances are higher if you do a medicated cycle with MFI.  Meds help you produce more than one egg, which increases your chances if your total motile sperm count is on the lower side.  In fact, the meds can double your chances (with injectables at least).  Think of it as more targets for the little swimmers!

Here's a chart for your reference:

briide2be2008

Thank you so much for the response. DH's sperm morphology was 1% first test and 2% second test.. My RE said that since everything was good on my end we could try some unmedicated IUI's first. I'm not sure why she didn't suggest doing medicated for greater chance.. I have not been the best at asking questions. The practice does have a very good reputation and I like this RE so I will check in with her more Monday about why not trying a more aggressive approach.. But I wonder if it's even worth the money now to do IUI Sunday since our insurance coverage is not very good. Ugh.
ETA - as for OPKs they just said to use OPKs from day 10 and to call once I got a positive. They didn't say anything about checking ovulation any other way. Again now I can only assume it's because all my tests and numbers seem good?

Drove2u

I agree with @wifeinraleigh28 very strange you're doing it unmedicated and depending on opks. Seems like a waste of money and time for you especially since you're dealing with MFI.  Might as well just use opks and TI then. Good luck to you and hope you figure it out with your RE. ps. I had absolutely no issues with all my testing. Everything came out perfect. And my husband had more than average sperm count and motility and I still did 6 medicated iuis and they all failed. I'm onto Ivf now. 

wifeinraleigh28

I'm in a similar situation.  Our only diagnosis is MFI and everything checks out completely perfect on my end and I have regular 28 day cycles.  My RE still had me do medicated IUIs, checked my progress every couple of days via vaginal ultrasound, and then triggered me when my follicles were mature to time the IUI correctly.  I've been on this board awhile and I have yet to meet someone here who is on the same protocol as you, but alas I certainly don't know everything!  If anything, maybe this will be a good place to start with asking some questions!   Fertility treatments are not cheap, so I've always wanted to maximize my chances as much as possible with everything!

Drove2u

Yes I 100% agree with you @wifeinraleigh28. 
@briide2be2008 keep us updated on your progress. It would be amazing if you got pregnant this way. Will be thinking of you. Fingers crossed!! 

briide2be2008

Thank you for the insight. Sounds like I have to ask more questions. This feels like a waste now this month but I've been waiting so long I'm desperate to just try something different. 

calfherder

We did non-medicated IUI last year. Our DX is MFI so for me to be on medication would not have increased our chances. I was monitored by ultrasound and the IUI was done one day before I ovulated. It's not a waste for you, it would be a waste to put you on medication you don't need if your follicle can be monitored by U/S and possibly just given a trigger shot to help time ovulation. Good luck fingers crossed!

LadyMillil

My RE has me use opks to detect O because I've had success using them in the past and it saves me having to go in for multiple ultrasounds, and it's all OOP so we wanted to keep costs down. It worked the first cycle so we've kept with it for IUI #2 and will be doing it this way for IUI #3 as well. We have male and female factor IF so taking clomid is part of the treatment for me. My RE generally does medicated IUIs for everyone, but if MFI is the only problem she gives you the option to do unmedicated IUIs because it's lower risk of multiples, and no meds means no side effects (the daily ones suck) and no risk of the more serious side effects like thinning uterine lining or cysts.

wifeinraleigh28

@calfherder Statistics show that being on meds does increase your chances with MFI, as long as the meds help you produce more than 1 follicle.  The risk of multiples isn't as high if you have MFI since your chances of fertilization are still slim to begin with.

calfherder

@wifeinraleigh28 that's great but with 0% motility and 80+% dna fragmentation it would not have increased our chances. I get what you're saying but I see so many on this board going through months of medicated IUI's for MFI and still end up on the IVF train. Each RE is different and mine was honest that putting me on medication for my husband's IF would be a waste of time and money for us.

dani4est

I did my first IUI last year unmedicated... I had the same issue- my husband had a low motility rate. Since everything appeared to be fine with me, we decided to do the IUI unmedicated. I got a BFP the first try. Trust your RE and their advice, and take these suggestions with a grain of salt. Everyone's situation is different, don't stress about others treatment plans, chances are they have different circumstances then yours.

Also, as far as timing, my RE recommends that you do the OPK first thing in the morning. Then call for to be inseminated the next day. I wouldn't stress about doing the timing with the IUI, as long as you are being inseminated within 24 hours, you should be fine.

Good luck to you!!!

wifeinraleigh28

@calfherder That makes perfect sense for your particular situation!  All in all, I feel like IVF is the best route to take for MFI.  We would have gone straight to IVF if we didn't have insurance coverage for 3 IUIs.  IUIs are kind of a crap shoot even if everything is perfect with both parties!

briide2be2008

Sorry for the ridiculously slow response.. But thank you all for your insights. Unfortunately IUI #1 was unsuccessful but my RE assured me that since everything on my end looks good she didn't want me to take drugs thy could stimulate too many eggs because any more than 3 and the cancel the cycle due to risk of multiples.. So I will try unmedicated a couple more times and the reevaluate. Thanks again!