IUI versus IVF

msstephanielynn

I have been doing some research in prep for my RE appointment so I don't go cross-eyed when they start going over results/plans etc (educating myself on IUI and IVF)... but I can't wrap my head around the success rate of IUI... the success rates seem so low to try multiple cycles on? Is there something that I'm missing other than the cost factor between the two? Do some insurance plans require failed IUI before coverage on IVF? I tried to research the board, but most of the recent topics on this were from 2011-2014...

For couples with unexplained infertility, the pregnancy rate for each natural IUI cycle is about 4 to 5 percent, and when fertility drugs are used, the pregnancy rate is about 7 to 16 percent.

The live birth IVF success rate for women under 35 who start an IVF cycle is 40 percent.

MMD1986

IUIs have worked for some people on this board, but the success rates are definitely low. I think cost and insurance definitely play into why so many couples try IUI before moving to IVF.  IUIs are also a lot less complex than IVF.  I don't regret the two I did even though they failed because it led my doctor to what was causing my infertility. 

msstephanielynn

@mmd1986Thanks- That's a very interesting point that I had not thought of. I'm glad you got some answers from it I just feel so naive starting this journey.

prudence9-2

@msstephanielynn IUI is not as expensive, less meds, more natural... so I think that's why I kept trying it... I ended up with 5 failed IUIs. I don't regret doing it. But I wish I didnt try 5 times...

cashewchicken

@msstephanielynn - I ended up doing IUI first because I was paying for fertility treatments out of pocket and IVF was so much more expensive, and also more invasive. Unexplained infertility is a tricky one. Because you don't know the reason for your infertility, you end up taking stepwise approach instead of skipping straight onto IVF. If you end up doing IUI, make sure to set a limit on how many you are going to do. Three is usually the limit before RE recommends you move onto IVF. Another thing I recommend is that even if you are doing IUI first, research IVF clinics now.  Some popular IVF clinics have a waitlist and you don't want to lose precious time waiting for the spot to open up. That was my mistake. My clinic had a 9-month waitlist and I wouldn't have had to wait had I got myself on the waitlist when I started my IUI with my first RE.

@Prudence9-  Same here. I ended up trying 6 times, though 3 of those were done under not so ideal conditions (thin lining, low sperm count). In hindsight I should have moved on to IVF sooner but at least I feel like I gave it a shot and don't have any regrets about moving onto IVF. 

prudence9-2

@cashewchicken because it's so much cheaper and doesn't include months of injections I think we get sucked into it. I also had some of my IUIs not in an ideal conditions... which is also why I agreed to a medicated FET to make sure the conditions are ideal in time of transfer!

J1006

The tricky thing with success rates is that there are so many reasons why people do IUI, but they group us all in to one giant statistic. We are dealing with severe MFI in which we decided to use a sperm donor with IUI. My doctor told me my chances of success are 20-25% per cycle. The same chances anyone else has trying naturally every month.  She also gave us limit of 4 cycles. She said if it doesn't work within four, most likely there is an underlying cause with me that we are unaware of and should move to IVF. 

msstephanielynn

@prudence9 @cashewchicken @j1006

*TW loss mentioned*:  I posed this on another thread but it really applies here too. Thank you all for your input. I hope I didn't come off the wrong way in asking this question, just generally curious because I'm in the wanted a baby yesterday boat (as I think everyone who is here is also) and thinking from a stats perspective right now of what will get me to the end goal as fast as possible. It will be interesting to see what the Dr recommends as part of my plan since I'm coming off my 3rd miscarriage. Like J1006 said, perhaps my mc history would lean more towards one or the other, but I won't know that until I speak with the Doctor. Either way I think I have a better understanding  Thanks again ladies. This community has been amazing as I start my own journey

kris031409

My insurance required 6 IUIs before they would cover IVF

greenhillgirl

@msstephanielynn It's a good question. For me, I can get 100% insurance coverage on IUI and 0% on IVF and because we have mild MFI we have that same 20%ish chance that "regular people" have per cycle. To have any IVF coverage I will have to switch to his insurance and we pay for 25% of it. For IUI I have just paid a $3.75 copay for my first medication. 

Another reason is that it is less intimidating and less complicated. Our IVF packet (when we had diagnosis of severe MFI) including 30+ pages and you have to sign for what happens to any embryos if you die or get divorced. IUI feels simpler so we want to try it a few times.

Those are our two factors in trying IUI first.

LadyMillil

Cost was a factor for us for doing medicated IUI first. In addition, with our specific diagnosis at that time we had a good chance of it working because IUI would "fix" our issues. The success rate for a medicated IUI is up to 15% whereas a natural cycle has a 20-25% success rate which wasn't a huge difference in my opinion so we decided to try it.

msstephanielynn

@kris031409 This is what I'm scared of... since we don't seem to have a problem getting pregnant, just staying pregnant.

@greenhillgirl @ladymillil Thanks ladies. Both really valid points

Sugarbreak

@msstephanielynn Not sure anyone has mentioned anything similar to this, but I thought I'd share my path to IVF.

IUI was never an option for us. I didn't start trying for a baby until I was about 36, so already late to the game by baby-making standards. Fast forward 4 years and at least one miscarriage later and now I'm 39.

In that time we discovered a blocked tube. Stage IV endo was discovered in my ovaries during retrieval for IVF cycle #1! I was never really encouraged by my Dr. or the RE to search for endo. I had some symptoms, like painful periods, but no one ever seemed alarmed at that. Like a lot of women, I grew up thinking that pain was normal. And because I'm self-employed, working primarily from home, it was easy to take the time I needed from the pain. But I digress....

Now it's apparent that we probably would've never gotten pregnant via IUI, so I'm glad we went straight into IVF. But looking back I wish I'd spent more time with diagnostic tests instead of jumping straight into IVF. I just wasn't educated enough and my Dr's did not steer me in that direction. Hindsight and all.

Do you have an infertility diagnosis? Does your partner? Do you suspect anything else going on, like endo/PCOS? There's also age, time, cost to think about too. Always so much to think about with these decisions!

nmd9168

@msstephanielynn I had the same feelings before I went in for my first IUI a couple of weeks ago. I'm still waiting until Saturday to POAS, but the success rate really didn't make me feel all that warm and fuzzy inside. I felt like it was a little bit of a waste of time, but I know that they are supposed to be cheaper and most insurance doesn't cover IVF, so I'm guessing that's why it's recommended first. I've already told myself that 3 IUI's is the limit. I will not put myself through any more than that. 

kaseycoco

@msstephanielynn sorry to hear about your losses. It sounds like you've got it now, but just wanted to chime in and say when you meet with your RE for the first time they will likely have some type of finance coordinator meet with you to review your benefits. I found that so helpful because she knew all the things to ask for from the insurance company and put my benefits in layman's terms  
I hope your doctor can help figure the best path for you!
Good luck!

nmtay

If it helps, my doc's rule of thumb was to try a lower-med less invasive approach (like IUI) 3 times before reevaluating and possibly moving on to IVF or at least doing extra tests. Hopefully yours will give you good advice based on your initial screenings, and I bet they will do extra tests based on former miscarriages. After my miscarriage on my first IVF they had me do an endometrial biopsy to see if they could diagnose a reason for the miscarriage. It came back normal, so they said that if I have another one, then the next thing to do would be genetic testing, ideally on the embryos, which for you would definitely mean IVF and ideally ICSI (apparently conventional IVF can make genetic testing less reliable cause it can make the embryo "contaminated" with your husband's DNA, and there's no research to say how likely it is, so if you know you want to do the genetic testing, make sure you do ICSI too! 

Good luck!!!

liljoy-2

It depends on the suspected diagnosis. If it's diminished ovarian reserve/age or advanced endometriosis, with no pregnancies before, then it's probably IVF. 
Endo is a bitch, I was relatively young, with great ovarian function, yet I never got pregnant after advanced endo surgery. IVF was offered as the only solution...I did do IUIs to no avail.