Decision time

Country Girl in the City

I just got back from my first RE visit.  I am only on CD-7 so I can't start most of my testing until the next cycle.  She did tell us that pending my HSG and our bloodwork results we look like good candidates for either IUI or IVF.  She told us that we need to start coming towards a decision of if we would like to skip straight to IVF or if we want to try IUI first.  She did telll us to keep trying while we are getting all of the testing done.

My insurance will cover either at 50%.  She told us the IUI is much cheaper but not as successful.  She showed us all of the charts with the success rates for that clinic.  She is not pushing us in either direction but gave us all of the facts about success rates and cost.  Other than money, does anyone know of a reason why we should go with the IUI first?

mtlaurel

FWIW coming from someone who went straight to IVF -

1) Some people might have moral/ethical issues surrounding IVF and the creation and subsequent disposition of embryos. IUIs avoid that.

2) IUIs are usually less physically taxing.

3) $$ related, but some insurance co.s require IUI attempts prior to covering IVF.

Good luck!

Mrs.McIrish

I don't think you should make a decision until you see your results from the HSG and blood work. Also, did DH get his SA back yet? If your tubes are blocked, you need to go right to IVF.  If DH's SA was bad, you would go right to IVF. If your b/w shows nothing and DH's SA is normal, tubes are open, I would not go right to IVF. You really should not decide this until you get the full picture.  You have no  idea if you have any issues.

tst1998

We did IUI's first, and are now doing our first IVF.

Assuming the rest of your tests look ok, and both remain good options, some things to think about:

1. Medications. Will your insurance cover those as well? Even if you have 50% coverage for the procedures, if you don't have good med coverages, IVF will be much more expensive than IUI.  We are 100% OOP for everything, but the meds for IVF have been more than an entire IUI cycle.  

2. Time. IUI cycles are much shorter and less involved than IVF. You start meds shortly after CD1, and we always triggered around CD12. The whole thing was done in a month, with just 2 or 3 office visits, and we could jump right into the next cycle after each BFN. This IVF cycle is going to be 6-8 weeks from start to finish. And I'm in the clinic every other day it seems.  It's rough. 

3. Emotions. I find IVF to be much more emotionally taxing than IUI was. With IUIs I always felt like yes, we had a chance, but if it didn't work there was always IVF. With IVF, yes the chances are better, but there's still a 40% chance this won't work. And then what? I feel like this is the end of the road, and it's scary. 

4. Future family. One of the benefits of IVF in my mind is that if this works and if we end up with embryos to freeze, if we want to have a second child, we can do so with my 35 year old eggs. This was not a reason for me to want to jump right to IVF, but I see it as one of the benefits of doing IVF now, rather than trying any more IUIs.

It's really a personal decision. I'm glad we did IUI first. But I'm also glad we moved to IVF when we did. We did take a few months off before moving forward though. It's an overwhelming process, and we needed some time to wrap our heads around it. Good luck with your decision. 

Country Girl in the City

Mrs.McIrish:

I don't think you should make a decision until you see your results from the HSG and blood work. Also, did DH get his SA back yet? If your tubes are blocked, you need to go right to IVF.  If DH's SA was bad, you would go right to IVF. If your b/w shows nothing and DH's SA is normal, tubes are open, I would not go right to IVF. You really should not decide this until you get the full picture.  You have no  idea if you have any issues.

We won't have to make a final decision until all of our results are back.  DH's first SA was not perfect but still doable for IUI.  The last two times that I had laproscopy it did show that my tubes were open.  It is hoped that it is still the case but I have to wait for this cycle to be over. We already know that I do have issues, it will just be a case of how bad thing are.  I was just trying to see how others have made the decision. 

annalisel

Mrs.McIrish:

I don't think you should make a decision until you see your results from the HSG and blood work. Also, did DH get his SA back yet? If your tubes are blocked, you need to go right to IVF.  If DH's SA was bad, you would go right to IVF. If your b/w shows nothing and DH's SA is normal, tubes are open, I would not go right to IVF. You really should not decide this until you get the full picture.  You have no  idea if you have any issues.

This exactly, but to answer the questions in your response.

We're taking few months to try IUI, even though it is extremely unlikely to work, because of the lower cost (partially covered and so under $1000) and because it is less taxing on the my body.  

We will proceed to IVF after only a couple of IUIs because of my age and clearly decreasing fertility. If I were 35-36, we would probably try a bit longer with IUIs and on our own, again, because of the cost as we are completely OOP for IVF. 

So basically, age and cost are the major factors for us. 

Edited to add: If we had IVF covered at 50% we would be more inclined to straight to IVF. 

Country Girl in the City

Thanks for the input ladies.  This is going to be such a hard decision to make.

Mrs.McIrish

One other thing that I thought I'd mention: my insurance co required be to do 3 injectible IUI's b4 they would pay for IVF. Just check for any requirements on that first.

Reilly626

Im about where you are but I am doing the IUI, Ive had many friends with success this way. My doctor said most people go straight to IVF if their insurance gives a certain amount of money toward infertility and they want to maximize it, and based on their age. My insurance based on my age also says I need to try a few IUI's. I feel pretty positive and upbeat about it as I know so many people it worked for. GL!

Country Girl in the City

DH and I had a long conversation about it last night.  Usually I make the decisions on all things medical because of my education.  However, he is insisting that we do one IUI before we move onto IVF.  Of course if my HSG shows that things have changed and we need to go straight to IVF we will.  I am glad that he had an oppinion on this so that the decision was not just mine like I thought that it would be.