Decisions, decisions.

stephanie34-2

I recently posted about being diagnosed with PCOS and an HSG confirming a blocked right fallopian tube. We met back up with the fertility specialist to discuss our options this past week and I'm a bit torn. She says that everything is perfect with DH's semen analysis and I have a good quantity of eggs. We just have to figure out how to induce O as Clomid didn't work for me. She would like to try me on Letrozole but here's where I'm conflicted. She gave us the options of either
a) Letrozole and monitoring for the best time to do BD or
b) Letrozole, monitoring and IUI.
She says the IUI would give us a few more percentage points but isn't convinced that timed intercourse won't do the trick. DH would like to opt for option A as he feels confident .. how, I don't know. I'm torn because it's been such a long, mentally/emotionally draining process as it is and the thought of increasing our chances is appealing, although (of course) more expensive. I would feel more confident in option A if it wasn't for the blocked tube.
I know there's no way to say what the right answer is but what would you do?

srh18

Hello! I started with the same options as you-TI or IUI. In our case, which sounds similar to yours, IUI didn't give us a significantly better chance of conceiving so we chose to do three rounds of TI before moving onto IUI. I didn't have a blocked tube. Did they talk to you about unblocking the tube at all? I would be worried about eggs not growing on the unblocked side, which means neither option would work. 

Turned out for me that PCOS dramatically affected my egg quality as well and we are heading into our fourth IVF cycle. My RE said that my situation isn't common, but we wouldn't have known if we hadn't chosen to move on to IVF. She was very confident that we should have conceived with TI otherwise. 

I hope your stay here is short no matter what you choose!

liljoy-2

A blocked tube is tricky, because you have to know on which side you are ovulating. No point doing TI or IUI if you follicle is on the blocked side. 

JESSABER0414

@Stephanie234 I am sorry you find yourself here. But you've come to the right place for opinions of people who've had to make these decisions! Looking back,  I would say the TI cycles had some advantages but those 3 months were the hardest on my marriage. Once we were unsuccessful and moved to IUI, we both felt like that control helped take the pressure off. That being said,  it wasn't until the IUI samples that we realized how much male factor we hadn't considered.  I'm not dealing with a blocked tube, but I agree with @bestofjoy, the Letrozole could work beautifully for you but on monitoring you find out it's producing follicles on your blocked side (which is not necessarily every other time ) you might feel more disappointed. 
I was hoping so much for the least invasive option, of course TI didn't cost us anything, I'd just say set your expectations appropriately because it's a roller-coaster! 
Best to you in this decision.

PCOSat25

I really agree with @JESSABER0414. My DH and I spent 4 cycles on TI before moving to IUI and then 3 on IUI before moving to IVF. In hindsight the TI cycles where the most stressful and the least productive. I honestly look at them as a waste of time and wish we had been more agressive at the onset. I completely understand wanting to try the least invasive/expensive options first. But IF they don't work all of those expenses add up and you end up looking at receipts for thousands of dollars in treatment wishing you had just saved it to go towards ivf. 

I also have PCOS and a blocked tube. Twice I had cycles canceled because the folli was on the wrong side. I also had cycles canceled due to not responding to stims or over responding to stims (thanks pcos). 

I can can be a long process. Before making a decision I recommend having a conversation with your husband and your doctor setting guidelines for how many tries you want to have at each level. Example: 2 months TI then move to IUI. Max 3 IUI. Etc. having a plan in place might make you feel you have more control over the situation. 

AFM: I am 3 years into this journey staring down my first FET in Friday. Cannot wait for the joy/comfort of knowing there is actually a viable embryo in my body!!!! Hopefully it feels sticky!!!

stephanie34-2

Thank you all for your advice! I am definitely concerned about follicles developing on the right (which is the side that is blocked). She will of course be monitoring closely and if that occurs, we have no choice but to be patient for another round to see if it happens again. We have not discussed unblocking it at this time because our Dr feels strongly that given all other test results, we have a good chance.
I strongly agree with the idea of the IUI taking a lot of the pressure off. I have tried to explain this to my DH (not that he is unreasonable, that's not the case at all) but he is persistent about wanting to try TI first. I just feel like it's so much weighing on our shoulders and I don't want that on us. We have enough going on and although I know it could be worse, a year and a half of trying has taken its toll already.
Best of luck to you @PCOSat25!

AandDM2014

@Stephanie234 Just chiming it with a bit of advice from someone who finally found success. I was diagnosed with PCOS, but both my tubes are open. We were never actually given the option of TI, and if we had been, I would have said no and done IUI. DH can put his "man pride" aside for this process.

stephanie34-2

@AandDM2014 thank you for the advice! That's interesting that it was never an option for you. I will definitely be relaying this to him. I think hearing from others with experience and success with IUI will be helpful.