How many IUI attempts would you do?

jakraft837

I would just like to hear others thoughts on the topic.  We are in 2ww of 2nd IUI and i caved and took a test this morning (11dpiui); BFN.  Beta is scheduled for Tuesday.  I know i'm not necessarily out of the game just yet, but kind of getting myself prepared for negative results.

So i called insurance this morning just to find out coverage on how many IUI's we can do and get coverage info for IVF.  I am very blessed that our coverage does not have a limit on IUI attempts and we get 4 IVF attempts, with 6 attempts max (get 2 extra attempts if IVF results in live birth).

Given that, how many IUI's would you try before wanting to move on to IVF?  How did you come to that number? I figured originally 3 or 4, but im not sure if this insurance information changes that opinion. 

MrsZ816

I have the same coverage as you minus the 2 extra attempts. I did 4 iuis before ivf. My RE was very insistent that we do at least one iui with injects before ivf so they would know how I respond. I was glad that i did because there were a lot of dosage changes to get it right.  I did 3 with injects because my personal preference was to do more iuis before going to ivf. I'm actually now doing a 5th iui after ivf failed while I'm waiting to do another ivf. 

Neesey

I am heading in for IUI #3 today. We are on cycle 4 with meds. If this cycle doesn't work we are meeting with the doctor to reassess. I'll trust his judgement on what he thinks is best for us. We have no insurance coverage but we will just keep plowing on. I try not to think about all the fabulous things we could have done with what we've spent so far but I know it will all be worth it in the end!

notquiteblushing

Ok this is long, bear with me.

My original plan per the RE was this:

3 Clomid + trigger + IUI cycles

3 injects + IUI cycles

Then IVF.

In an ideal world that is what would happen.  But my insurance only covers six medicated cycles.  I'm totaly grateful for that of course but it made us rethink our strategy.  I didn't respond to my second Clomid cycle. I sort of/maybe responded to Femara but my RE wasn't too thrilled with it.  So next step is injects, which I am only going to do once because 1) my insurance will sign off on IVF after three failed IUIs and 2) I'm really scared of a multiple pregnancy.

So I guess my answer is it really depends on how you're paying for it, how you respond, what you feel comfortable with, etc.

JBDamonM

I don't know much about the world of IUI's but from what I do know is I would say 3 or 4.

If this one fails - I would push the RE to do something different (I know you said she did not change the treatment plan.) And I'd absolutely do at least one or two with injectibles!

Sorry about the BFN - hoping it was just too early! And you are VERY lucky - that is awesome insurance coverage

JBDamonM

notquiteblushing:

Ok this is long, bear with me.

My original plan per the RE was this:

3 Clomid + trigger + IUI cycles

3 injects + IUI cycles

Then IVF.

In an ideal world that is what would happen.  But my insurance only covers six medicated cycles.  I'm totaly grateful for that of course but it made us rethink our strategy.  I didn't respond to my second Clomid cycle. I sort of/maybe responded to Femara but my RE wasn't too thrilled with it.  So next step is injects, which I am only going to do once because 1) my insurance will sign off on IVF after three failed IUIs and 2) I'm really scared of a multiple pregnancy.

So I guess my answer is it really depends on how you're paying for it, how you respond, what you feel comfortable with, etc.

Just an FYI for you - I"m in the midst of IVF 1 right now, if our embryos make it to blast then my dr is only putting one back...... This is primarily based on my age... If my memory serves me correct we're around the same age (as we both just had our 10 year college reunions?)......

I'd still try the IUI's the way you have outlined - but just a positive thought for you if you end up in the world of IVF.

notquiteblushing

JBDamonM:

notquiteblushing:

Ok this is long, bear with me.

My original plan per the RE was this:

3 Clomid + trigger + IUI cycles

3 injects + IUI cycles

Then IVF.

In an ideal world that is what would happen.  But my insurance only covers six medicated cycles.  I'm totaly grateful for that of course but it made us rethink our strategy.  I didn't respond to my second Clomid cycle. I sort of/maybe responded to Femara but my RE wasn't too thrilled with it.  So next step is injects, which I am only going to do once because 1) my insurance will sign off on IVF after three failed IUIs and 2) I'm really scared of a multiple pregnancy.

So I guess my answer is it really depends on how you're paying for it, how you respond, what you feel comfortable with, etc.

Just an FYI for you - I"m in the midst of IVF 1 right now, if our embryos make it to blast then my dr is only putting one back...... This is primarily based on my age... If my memory serves me correct we're around the same age (as we both just had our 10 year college reunions?)......

I'd still try the IUI's the way you have outlined - but just a positive thought for you if you end up in the world of IVF.

Thanks!  Yes I'm 32 (and a half!).  I met with my doctor to talk about the next step and the one after that and he agrees we can do a SET if all goes well.  I know most women our age transfer two but it really doesn't improve the rates (at least at my clinic) and we have a pretty small place right now.

JBDamonM

notquiteblushing:

JBDamonM:

notquiteblushing:

Ok this is long, bear with me.

My original plan per the RE was this:

3 Clomid + trigger + IUI cycles

3 injects + IUI cycles

Then IVF.

In an ideal world that is what would happen.  But my insurance only covers six medicated cycles.  I'm totaly grateful for that of course but it made us rethink our strategy.  I didn't respond to my second Clomid cycle. I sort of/maybe responded to Femara but my RE wasn't too thrilled with it.  So next step is injects, which I am only going to do once because 1) my insurance will sign off on IVF after three failed IUIs and 2) I'm really scared of a multiple pregnancy.

So I guess my answer is it really depends on how you're paying for it, how you respond, what you feel comfortable with, etc.

Just an FYI for you - I"m in the midst of IVF 1 right now, if our embryos make it to blast then my dr is only putting one back...... This is primarily based on my age... If my memory serves me correct we're around the same age (as we both just had our 10 year college reunions?)......

I'd still try the IUI's the way you have outlined - but just a positive thought for you if you end up in the world of IVF.

Thanks!  Yes I'm 32 (and a half!).  I met with my doctor to talk about the next step and the one after that and he agrees we can do a SET if all goes well.  I know most women our age transfer two but it really doesn't improve the rates (at least at my clinic) and we have a pretty small place right now.

I'm 32 and 11/12ths! HAHA!

I hear ya - we have space for multiples - but absolutely do not have the $$ for childcare.  I'm a twin myself which would be ironic - but i"m all set! Let's save the irony on that one.

That being said not sure how I'll keep myself in check if we end up with a 3dt (putting 2 back)...... I just keep telling myself we WILL make it to 5!

I've been told the same thing - that it doesn't increase the rates. I've never totally understood it but my dr is such a big believer in a single transfer- that I"ve never pushed it!

jakraft837

JBDamonM:

I don't know much about the world of IUI's but from what I do know is I would say 3 or 4.

If this one fails - I would push the RE to do something different (I know you said she did not change the treatment plan.) And I'd absolutely do at least one or two with injectibles!

Sorry about the BFN - hoping it was just too early! And you are VERY lucky - that is awesome insurance coverage

Interesting, i didn't even factor in IUI with injectables (don't really know anything about it).  My dr said i respond to the meds well.  I have had good size follicles each time, P4 blood work is good at 7dpiui. i have been on clomid, trigger, progesterone with HCG booster shot at 5dpiui.  When you are on injectibles, is it same meds just delivered via injection or would the meds most likely change?

Excitedtostart

We're doing #3 this month then moving to IVF. I'm 35, we need to move forward. My RE said adding injects increases our chances by 5%. Statistically, if IUI is going to work it will work in the first 3 cycles. Success drops off after 4. We have insurance fir IVF, so we're pushing ahead. If I were under 33, I would do an additional IUI. But not now.

KdgTeacher

I did 4 total

1 with Clomid + Trigger and 1 IUI

2 with Clomid+injects and B2B IUI

1 with injects and single IUI

eandk18

We are only on our first IUI but depending on how I respond to this month we will do 3-4 IUIs with injects.  We are very fortunate to have good infertility insurance coverage for IUIs/injects.

Our RE gave us a 20% per cycle (we are unexplained/ovulation disorders) for pregnancy plus I've heard the same rule as PP, after 3-4 IUIs the chances go down.  If not pregnant by then we will move onto IVF probably after a several month break.  I'm 31 right now so I'm not in a HUGE rush, but of course time is on my mind.  My FSH, AMH and antral follicle count are great so I feel like I have a little time to play with.

If I were you I'd definately try injects with IUI before IVF depending on your diagnosis and insurance coverage.  

Good luck in your decision! 

KMac570

My RE is already hinting at IVF, apparently because of MH's sperm (although this last IUI was pretty good).  I do not have insurance, and for a number of reasons, I do not believe that IVF is justified yet in any event.  We will probably do up to 6 IUIs, and then re-assess for financial reasons, as these medicated cycles are pretty pricey!

Sony22

It sounds like your fertility issues are due to PCOS. If you feel that you have the time to spare, I would shoot for about 2-3 IUI's before moving to IVF. Your IUI chances should be pretty good if your DH's SA is normal AND of course, if you are ovulating with meds.

For us, we have MFI- really low on all factors. So, our chances at a successful IUI where so slim that we opted for IVF.

Killer Tomato

I have somewhat similar coverage, with less for IVF. I tried 4 IUI (probably would have stopped at 3 if timing of things had been different.) My opinion is that IUI is much less invasive, and I do think about everything they do to the egg in IVF. I wanted the best shot at a minimum intervention pregnancy before I was comfortable moving to IVF. The less stress on my body and the egg/embryo, the better.

After 4 IUIs, the odds of success say "move on," and I feel like it is time. I asked about injects, and was told they would only really up my odds if I wasn't responding well to clomid/femara. My RE said it sold I've him some additional info on how I responded to the meds, but he had a pretty good idea where to start anyway. So we are moving on instead of doing an injects cycle.

Unless finances were the only thing stopping you from doing IVF, I would stick with your original plan. GL! 

JBDamonM

jakraft837:

JBDamonM:

I don't know much about the world of IUI's but from what I do know is I would say 3 or 4.

If this one fails - I would push the RE to do something different (I know you said she did not change the treatment plan.) And I'd absolutely do at least one or two with injectibles!

Sorry about the BFN - hoping it was just too early! And you are VERY lucky - that is awesome insurance coverage

Interesting, i didn't even factor in IUI with injectables (don't really know anything about it).  My dr said i respond to the meds well.  I have had good size follicles each time, P4 blood work is good at 7dpiui. i have been on clomid, trigger, progesterone with HCG booster shot at 5dpiui.  When you are on injectibles, is it same meds just delivered via injection or would the meds most likely change?

Instead of clomid you would take either folitism or gonal F for the development of Follicles.

I don't know much more than that- but my BFF has PCOS - she got pregnant on her first IUI with injectibles round 1 - and second round for her second child - which did result in twins....

 

maggie2324

It really depends on many factors. We only did 1 because we are OOP and our MFI gives us terrible odds. Even with terrible odds, we would have done 3 if insurance covered it.

If our male factor was less of an issue, I think 6 is an appropriate amount. Maybe 3-4 with Clomid and 2-3 with injects. I wouldn't move to IVF with doing less than 6 unless the odds are low. I think you need to be fairly certain that IUI isn't going to work for you before making the leap to IVF. 

lovelainie

I think we'll be stopping after four IUI's. I only have two clomid cycles left, which means possibly one cycle with injects after that. IVF isn't financially feasible for us for at least another two years. 

Blueyed228

My insurance covers IUI's in 3's.  We did 3 inject IUI's before moving to IVF.  We were approved for another IUI but chose to skip it.  My insurance will also cover IVF.  The approve them 1 at a time so from what I remember I think they will cover at least 6, and then possibly more after that.

We chose to move to IVF because my RE said that after 3 failed IUI's the chances of it working go down dramatically.

sarah_e87

Prior to the loss of my left tube, I felt really comfortable with 6 IUI's. However, since I've loss my left tube and when I move forward with treatment, I will be using DS, I'm no longer okay with the idea of that many IUI's. My RE did say that he thought I'd be successful with IUI (provided that I respond to the meds), but that it would likely take 6-10 IUI's and with partial insurance coverage and my increased risk of ectopics, he's recommending IVF on the premise that it would be more economical and give me the best odds.

katib77

My RE insists on only doing 4 unless you have to do more for insurance reasons.  I have done three so our next one in Jan/Feb will be our last before IVF.  And personally, with all the waiting we've had to do in between treatments and our age (dh is 40 and I am 34) I am fine with this plan.  By the time we do our fourth IUI we will be a year older and then we will try IVF maybe twice (with one FET) before giving up.