4th IUI or IVF?

NDGOIRISH

Hi ladies,
 
I'm usually a lurker, but I am at a crossroads and need some advice.
I know you can't tell me what to do personally, but I'm interested in what you think from your own experiences.

DH and I are on cycle 22 - all BFN's. We've done 3 IUI's with clomid/ follistim/ hcg/ prometrium. My DH's numbers post-wash have been OK... not great. They average around 3 million with 75% motility. I just had my AMH test come back at 2.33, so I know I'm not in the danger zone for low ovarian reserve. The only other issues I suspect are possible endo and I've always had a luteal phase of around 9-10 days when not on prometrium.

Our doctor has said a 4th IUI is not unreasonable, but IVF would give us a much better chance as success. I have enough insurance left to cover one IVF and we do have a back-up fund ready if we do the 4th IUI and go over for IVF.

Anyway, any insights you have on helping make this decision would be appreciated!

Best of luck with your pregnancies!

[Poll]

IttyBittyBaby

I had 3 IUI and got pregnant on my 2nd IVF.  If I knew then, what I know now, I would have went straight to IVF the first time (but i was too scared).  Go for it!

mandalinn25

We moved on to IVF.  The chances for an IUI to work were just not enough for us to keep throwing money that way.  We also were using DS so that made it more expensive that normal and we only had one vial left (our donor retired).  Our ages played a part too.  We are very happy that we did go to IVF since we got our BFP that way and we do have three frozen embies left (although we probably aren't going to use them personally, we will donate them later).

Good luck in your decision.

mdiblasi10

The only reason we tried a 4th IUI was to give the injectables a try. Since you have already added those in with the Clomid, I would move on to IVF, if I were in your situation.

Good luck and I hope to see you here soon!

drubie

You sound like me! My husband's numbers were always borderline, so they "let" us do combo cycle IUIs (clomid, follistim, trigger), and I also have moderate endo (though no real symptoms except for the cyst on my ovary that they had to remove before cycling). None of our IUIs worked, and we went forward with IVF, figuring it was better than sending money into more unlikely IUIs. It worked, and we have 2 frozen blasts. 

Most of the info that I've read says that you should try 3 cycles/times of each step before moving onto the next, that after 3 tries, you're very unlikely to get pregnant on a 4th.  

jessican08

Our Re was pushing us toward IVF after our third failed IUI but since we had coverage for 3 more IUIs, we went that route after my lap hoping for a miracle before moving on to IVF.

FWIW - a lot of REs won't really consider you for IUI unless you have around 10 million motile sperm. My DH's counts were between 3 million at our lowest and 15 million post wash at our highest. The odds were even more against us because we had morph issues too.

kobrie01

After one unmedicated IUI and two IUIs with clomid, our RE told us the next step would be IUI with injects. DH and I decided if we had to do injects we'd move on to IVF, b/c of much higher chances and we have good insurance coverage.  We did one last hail mary unmedicated IUI in Nov/Dec b/c we didn't want to start stims for IVF until after the holidays.  Good luck!

kelnyc

We did the 4th IUI and then moved on to IVF, but honestly, it was wasted money. We only did it because our clinic's stats were based on doing 4, plus it didn't eat much of our insurance money because I Oed well on femara alone. There are just so few things that they can actually test for. If after this many cycles and 3 IUIs it hasn't worked, something is going on. We are unexplained (maybe borderline DOR, but it looks like the outer shell of my eggs just hardened with age and the sperm were having trouble getting through, which we wouldn't have known before doing IVF... we got 100% fert rate by doing ICSI!) I say, save your money and use the insurance for IVF. Given your mild diagnosis, it will probably work out well for you. GL!

limpetfan

We went to IVF after Clomid, partly because we lost faith in IUI and partly because I had insurance coverage for the IVF cycle.  We learned a LOT from doing IVF - like doing IUI was basically a waste of time and money for us because my eggs were crappy, and so were most of the resulting embryos (this is the reason it took 3 IVFs to get here).  If I had known that going in to treatment, we would have skipped IUI completely. 

 Good luck!

 

Blueyed228

We did 3 inject IUI's and then moved on to IVF.  We were going to do a 4th IUI but looked at the stats and our dx and just decided to move on.  I got pg on my first IVF.

Mrs.Adam

My RE talked us into moving right to IVF after our 3 cycles with clomid IUI's didn't get a BFP.  I know it could have worked if we held out long enough, we had a daughter born in 2010 that it took only 1 cycle of clomid and IUI.  I am so blessed to finally get my BFP after FET after many many failed or cancelled cycles but I wish I pushed to try IUI with injections, even though my RE thought the risks of multiples was too high to chance it with my spinal problems.  I think if I had to go back I would give it another few cycles before moving to IVF.  Good luck!

 

pb_bride

We have unexplained IF.  Did a few cycles of clomid + IUI all BFN. Moved to inj+IUI and got pg on cycle #1 but that ended in m/c.  We did 2 more cycles of inj+IUI hoping that it would work but both were BFN.

At that point, our RE really pushed for IVF.  DH was a bit reluctant at first, but our RE basically told us we could continue to "waste time" with IUI (10-15% success rate) vs moving on with IVF (30% success rate). 

We finally decided to go with IVF for 2 main reasons:

1) Our ins may no longer pay for IUI; but it does pay for IVF, and

2) I turn 39 this summer so time is really ticking for me, and we should not waste any more time.

This current pg is from IVF #1.  GL to you!

P.S. Of course, our decision is easier b/c infertility Rx is covered by ins in MA, including IVF. If we had to pay OOP for IVF, we might have gone for another IUI cycle...

amandaleigh1

Well it looks like we are a pretty pro ivf bunch! If you suspect endo could be a factor in preventing you from getting pregnant, all the iuis in the world won't help. As I was confirmed to have endo and oop for everything, I skipped iui altogether. I am glad I did, as ivf #1 worked and we have 3 frosties. 

You are likely to have a good chance with ivf and a good response to the meds. I say go for it! 

lovebug33

My RE doesn't even like to do IUI. He said since we were completely OOP, he wanted us to go right to IVF because he didn't think that IUI would work and we would have wasted money. He said in the future there is going to be no IUI and people will go straight to IVF.

fantine31

A friend of mine who works as a nurse at a fertility clinic said that based on statistics, after 3 IUIs, it is time to try something else.  I'm sure there are factors that play into it that I don't know about, though (i.e. how you responded to the meds in terms of follicles and the male side).  Whatever you decide, good luck to you!

abvernon

IFV lurker here- we have done 6 IUI's and all BFN...we are currently saving to move on to IVF.

Part of me wishes we went straight to IVF however, when we were given the diagnosis, it was just MFI, now we have MFI and DOR.

GL!

nycitygirl1

I think this is a decision you need to make yourself considering finances, emotional toll, and so on. I got my BFP on the 4th IUI, but if it was a BFN we were going to move straight to IVF. We just couldn't take the months of "negatives" anymore. I think everyone has their own timeline. You may want to speak with your RE and see if she recommends trying another IUI but altering the protocol slightly. That's what did it for me.

NDGOIRISH

Wow, you ladies are amazing! Thank you so much for your feedback. DH and I have decided to do IUI #4 only for because we have to wait until June for our initial IVF appointment, so the doctor said we have plenty of time for a 4th IUI. I'm not very hopeful, but I feel like at least I'm doing something while waiting for IVF. If we do not get a BFP, at least I can say I absolutely exhausted all options before IVF.

 

It's very reassuring to hear all your success stories with IVF - thanks again for your feedback! Hopefully I'll be joining you here soon! 

fantine31

Hey- if you have you the time and the money, might as well! Good luck to you! Hoping the 4th time's the charm for y'all