Question for ladies who've done injectibles

whispergrrl

Ok, I am consulting Dr. Google on various things right now...and woas just reading on the advancedfertility.com site that after 3 unsuccessful injectible cycles, the success rates for continuing injectibles goes down (I don't remember if they said this was for everyone, or just for PCOS ladies). This is for injectible + TI or injectible + IUI. It also said something about IVF being a better option for PCOS ladies - having higher success rates with less liklihood of higher order multiples,.

So, my question is this...how many of you did more than 3 inject cycles with either TI or IUI? How many moved on after 3 (or before 3)?

I'm just trying to figure things out so I can go into my Doctor's office prepared with some questions and info. I'm not sure if I want to do more inject cycles...this was my 3rd unsuccessful one. I kinda feel like I'm wasting time with it. But...I don't want to give up to soon, either.

Any advice?

Thanks! 

Dragonfly1226

My RE's general rule is to move on from any treatment after three failed cycles. I did 2 Clomid + TI cycles, 3 injectable + IUI cycles, and then I moved to IVF. (I'm unexplained.)

GL hon  

sweetky_06

Most REs (From what all the ladies on the board have said) set "3 times" for anything as their number. 3x clomid + IUI, 3x injectables + IUI, whatever.

According to my RE, with the exception of IVF - most assisted reproductive methods show steady or climbing success rates through the 3rd try (I think for IVF it's the sixth) and at that point they level off.

Supposedly there are women who have inflicted themselves to dozens of IUIs and the data has panned out that if using a given protocol you aren't pregnant by the 3rd time, you're not likely to get pregnant with that protocol

I only did one IUI with injectables before moving on to IVF. Honestly, the thought of HOM scared me. 

NYC1216

Since I responded very well to clomid (had 3-4 follicles each time), I never used injectables.  After 3 IUI, my RE recommended moving on since the chance was so low.

lmc5004

I have had 2 drs tell me that its 3 then something new BUT you can do it like this: 

3 injects with TI

3 injects with IUI

then move on. Here is what we have done so far

4 Clomid and TI

4 Clomid and IUI (2 cancelled and converted to TI "just in case")

2 Injects and IUI ( 1 was cancelled at the get go for cysts)

What they told me is that they like to get 3 "good cycles" for each treatment. So you if you dont respond well then sometimes they will give it an extra go.

As for what you read about IVF, it ALWAYS has better success rates and ALWAYS has a better chance of controlling HOM. No matter what your situation it is always that way.... however it is more traumatic to the body and very expensive.

 I know that you have done quite a few injects with TI but you have only had 2 times with good follies right? Thats kind of how I am.... most of hte time I didnt have any good mature lead follies. I want to get it right and get those lead follies and get some BFNs before I want to consider IVF because of the cost etc. 

Also arent you still with your OBGYN? I think you DEF need to cycle with an RE before moving to IVF.

 

love ya! xoxo 

 

 

ashlyrose

I have done many injectables cycles all being TI. I did 1 IUI inwhich I wanted to know DH's SA again so why not do IUI & get that info at the same time. We have no MFI so TI & IUI are the same chances for us. My RE has the same quote "try 3 times & time to move forward" but I respond really well with injections & I don't do the same dosing each month. He changes the dosing so I feel like I'm doing something new. I do have PCOS & DH does not want to pay for IVF at this time since we are OOP.

patchen30

I did 4 injectible IUIs and then moved on.  My RE said the rates decline after "3 or 4".

LnR70707

My RE also suggests moving on after 3 cycles.  We only did two, due to lack of insurance.

scubalaura05

I only ended up doing one injectable cycle and it was cancelled because my E2 level skyrocketed. Since that was my fifth attempt at iui (4 clomid) we collectively decided it was time to move on to IVF. 

 

maddie789

I've done 3 injectible IUI's, and our RE wants us to do one more. I switched RE's in the mix of all that, and have switched which meds I was on and how much I was on. Otherwise we would have probably moved onto IVF. Whatever happens, this will be our last IUI.

Are you responding well to your injectibles? I am a slow responder, and one different thing my new RE did as opposed to my first RE was to really increase the dosage to see if I would respond better. That is what we will do with this next cycle too. GL!!

whispergrrl

To answer your questions, Linds....

I did 1 cycle with clomid - no response.

I did 2 cycles with femara - no response.

I did 1 cycle with 75iu gonal-f  - had 1 good follie measuring 18 (triggered cd11), confirmed ovulation with blood test, BFN.

I did a second cycle with 75iu gonal-f - had weird response - right side was showing progress early on, then it stopped responding and all of a sudden left side started responding (this was the only time lefty has done anything...everything else that has shown up has been on right side previously). Triggered with a follie at 18 on CD 18. confirmed NO ovulation that cycle.

This was my third cycle. Started out on 75iu gonal-f CD 3-6. Had follie check, and was responding somewhat. Increased gonal-f to 150iu from then until CD 11. Had another follie check. Steadily growing, so doctor wanted me to keep going on the 150iu. Then had my last follie check yesterday, CD 16. He was very happy with my dominant follie that was measuring 20 (biggest yet), and that my cyst was being reabsorbed. However, this is the first time he has done an estradiol test on me (I asked him about whether it should be done when I first started this cycle, since I had read about it on here), and he said yes, he was going to test it this time around. So, I have no idea what my estradiol was on previous cycles, but something must've concerned him enough to test it this time around!

So, basically, I've had "good" follies each of my 3 inject cycles. The first one we triggered, and had successful ovulation. The second we triggered and didn't ovulate. This third time, no trigger due to estradiol being too high.

So, I'm guessing only the first one would count as a "good cycle" since I had a mature follie, ovulation, and TI?

I'm really torn on the whole RE thing. I know I've talked about it on here several times....but I'm kinda worried about moving on to an RE due to cost! I know I don't have IF coverage....but I've been lucky so far that everything through my ob/gyn has been covered (all office visits, testing, ultrasounds, and meds). I guess I'm worried that if I move on to an RE, we won't be able to afford the treatment for a while...and at least with the ob/gyn I feel like I'm doing something (instead of taking a break and saving money). Of course, we are still anticipating our tax return (we've been waiting for it forever...we are getting the first time homebuyer's credit, so it has been delayed), so it is possible we will be able to use that if needed (instead of using it for paying off a few other things were were planning on doing...)

Ugh. I suppose I should call my insurance to find out definitively what I can anticipate being covered. I keep thinking that if I talk to them about it, though..that maybe they will stop covering stuff that they had been covering! I know...irrational thoughts... 

lmc5004

whispergrrl:

To answer your questions, Linds....

I did 1 cycle with clomid - no response.

I did 2 cycles with femara - no response.

I did 1 cycle with 75iu gonal-f  - had 1 good follie measuring 18 (triggered cd11), confirmed ovulation with blood test, BFN.

I did a second cycle with 75iu gonal-f - had weird response - right side was showing progress early on, then it stopped responding and all of a sudden left side started responding (this was the only time lefty has done anything...everything else that has shown up has been on right side previously). Triggered with a follie at 18 on CD 18. confirmed NO ovulation that cycle.

This was my third cycle. Started out on 75iu gonal-f CD 3-6. Had follie check, and was responding somewhat. Increased gonal-f to 150iu from then until CD 11. Had another follie check. Steadily growing, so doctor wanted me to keep going on the 150iu. Then had my last follie check yesterday, CD 16. He was very happy with my dominant follie that was measuring 20 (biggest yet), and that my cyst was being reabsorbed. However, this is the first time he has done an estradiol test on me (I asked him about whether it should be done when I first started this cycle, since I had read about it on here), and he said yes, he was going to test it this time around. So, I have no idea what my estradiol was on previous cycles, but something must've concerned him enough to test it this time around!

So, basically, I've had "good" follies each of my 3 inject cycles. The first one we triggered, and had successful ovulation. The second we triggered and didn't ovulate. This third time, no trigger due to estradiol being too high.

So, I'm guessing only the first one would count as a "good cycle" since I had a mature follie, ovulation, and TI?

I'm really torn on the whole RE thing. I know I've talked about it on here several times....but I'm kinda worried about moving on to an RE due to cost! I know I don't have IF coverage....but I've been lucky so far that everything through my ob/gyn has been covered (all office visits, testing, ultrasounds, and meds). I guess I'm worried that if I move on to an RE, we won't be able to afford the treatment for a while...and at least with the ob/gyn I feel like I'm doing something (instead of taking a break and saving money). Of course, we are still anticipating our tax return (we've been waiting for it forever...we are getting the first time homebuyer's credit, so it has been delayed), so it is possible we will be able to use that if needed (instead of using it for paying off a few other things were were planning on doing...)

Ugh. I suppose I should call my insurance to find out definitively what I can anticipate being covered. I keep thinking that if I talk to them about it, though..that maybe they will stop covering stuff that they had been covering! I know...irrational thoughts... 

If your insurance covers your visits and ultrasounds and blood work at your OBGYN they should cover it at an RE too. And if your meds are covered it doesnt matter who is prescribing.... they see what the meds are, if was a med that wasnt covered it wouldnt be covered no matter who prescribed it. I think you should go to an RE and they can do what is called a "Pre-Determination" to see what is covered. Thats what mine did to check about ultrasounds and blood draws. 

Edwina.McDunnough

two

Missy0708

Our original plan was to do 3 IUIs but after 1 failed attempt, my Endo was back in full force so my RE suggested we move straight to IVF.

fotyluv4

I don't have PCOS, but had my 1st RE appointment yesterday where some of this got addressed.  She told me doing IUI with injectables gives me a 20%, 40%, then 60% chance on the first 3 tries.  She said after that the percentages go down and we'd go straight into IVF at that point.  Sounds like it's pretty similar to what you're finding on the internet.