Has anyone here skipped IUI and gone straight to IVF?

DinaLINY · November 2009

Hi everyone,

This is actually my first post on this board. I normally post on TTC over 35.

I saw an RE last week for the first time. He recommended that due to my age (40) and that we only have $10K for fertility procedures, and because DH?s SA was really good, that we skip IUI and go straight to IVF. I happen to agree with this aggressive approach. He said that if I decide to go that route, I won?t need the dreaded HSG. So in other words, I will have limited diagnostics done and I may never find out what my fertility issue is, although I am 99% sure it?s an age factor.

I was just curious if you ladies agree with this approach, and if any of you have gone this route.

The reason I ask is because my best friend is also going through IF and just had her second IUI, after not producing enough follies for IVF. She said that at least these cycles did not go to complete waste and she was only able to do that because she had the HSG, obviously her tubes are clear. I would like to get your input.

Thanks

AlissaCell701 · November 2009

Yup, I never did IUI. Went straight for IVF due to DH's MIF...

KoCoLoCo · November 2009

We went straight to IVF due to mild endo and limited ins $$, although I had a lot of diagnostic work done as well with no issues, and the length of time DH and I had been trying, RE reccommended the aggressive approach. I am glad we did, IUIs would have been a waste of my time and money.

anna2006 · November 2009

Yes, I did. I did 4 rounds of clomid and TI, then went straight to IVF due to my age and MFI.

However, I disagree with not doing the HSG. How do you know your uterus is normal? I did 4 rounds of clomid without knowing that I had a polyp that was interfering with implantation. If I had done IVF without the HSG (and subsequent hysteroscopy), it would have been money down the drain and heartache because either the embryos would never have implanted or I would have miscarried in the first trimester.

Please make sure you get some imaging of your uterus (not the tubes) before you start ivf. No one likes those procedures but they are vital to your success.

DinaLINY · November 2009

Thanks to those who answered so far. Did you skip the HSG too?

KoCoLoCo · November 2009

I had the saline/ultrasound HSG like thing (saline sonohystogram) and the HSG.....but if you are doing IVF, I don't think the state of your tubes would really matter, so you probably don't need this. However, if you have polyps and whatnot inside your uterus, has your RE mentioned a hysteroscopy or D&C prior to IVF?

DinaLINY · November 2009

anna2006:

Yes, I did. I did 4 rounds of clomid and TI, then went straight to IVF due to my age and MFI.

However, I disagree with not doing the HSG. How do you know your uterus is normal? I did 4 rounds of clomid without knowing that I had a polyp that was interfering with implantation. If I had done IVF without the HSG (and subsequent hysteroscopy), it would have been money down the drain and heartache because either the embryos would never have implanted or I would have miscarried in the first trimester.

Please make sure you get some imaging of your uterus (not the tubes) before you start ivf. No one likes those procedures but they are vital to your success.

I actually have another appt set up for next week with an different RE (I didn't like the first one I saw). I spoke to this other Doctor on the phone and he said that he would look at my uterus with a camera - I forgot the name of the procedure.

KoCoLoCo · November 2009

KoCoLoCo:
I had the saline/ultrasound HSG like thing (saline sonohystogram) and the HSG.....but if you are doing IVF, I don't think the state of your tubes would really matter, so you probably don't need this. However, if you have polyps and whatnot inside your uterus, has your RE mentioned a hysteroscopy or D&C prior to IVF?

Ok, I don't know where I read that you had polyps...maybe that was another post. But I think you can skip the HSG and have your RE do the saline sonohystogram (it is quick and they do it in their office)

sliz · November 2009

we never did IUI - we did 2 rounds of clomid (one producing my twins that we lost), 2 rounds of femara and one round of injectibles...all with TI

we did an HSG and saline sono after the loss to check my tubes and uterus...everything came back good...

we skipped iui because we dont' have coverage for them and DH has great sperm...plus we got pg with twins with TI so there was no real point - so if we were spending the money, we wanted the procedure with the best odd...

i do recommend the hsg/saline sono because you can check for a hydrosalphinx (that might harm the embryo) and your uterine cavity for fibroids/polyps first....both of those can be done in the same cycle i think and are relatively easy

DinaLINY · November 2009

I just googled the procedure and it's called hysteroscopy

aplus816 · November 2009

We skipped IUI after we were dx'd with MFI. We only have a limited amount of $$ for infertility treatments under our current insurance policy and our insurance did not require IUI's prior to IVF. Our RE felt that we would have a much better chance for success if we went right to IVF, so we went for it!

sliz · November 2009

DinaLINY:
I just googled the procedure and it's called hysteroscopy

that is different - that is when they put a scope up your uterus to check for fibroids/scarring/shape of the cavity etc...

the hsg (hysterosalphinogram) checks for open tubes and the sonohysterogram (SHG) fills the uterine cavity with saline and is another way to check the uterine cavity for anything that could cause a m/c or prevent implantation....

AlissaCell701 · November 2009

We still had to do the HSG..they needed to check and make sure everything was fine with me...If it was me I would def get the HSG done; it;s fairly painless..Then you can make an educated decision on what the next best steps are for you..

DinaLINY · November 2009

AlissaCell701:
We still had to do the HSG..they needed to check and make sure everything was fine with me...If it was me I would def get the HSG done; it;s fairly painless..Then you can make an educated decision on what the next best steps are for you..

really? I heard that it was extremely painful for a lot of women. then again, we will all HOPEFULLY experience child birth, which I am sure is a million times more painful.

I really appreciate all this feedback!

KoCoLoCo · November 2009

DinaLINY:

AlissaCell701:
We still had to do the HSG..they needed to check and make sure everything was fine with me...If it was me I would def get the HSG done; it;s fairly painless..Then you can make an educated decision on what the next best steps are for you..
really? I heard that it was extremely painful for a lot of women. then again, we will all HOPEFULLY experience child birth, which I am sure is a million times more painful.
I really appreciate all this feedback!

It isn't really painful at all, some mild cramping and a little uncomfortable, but nothing a little ibuprofen wont fix. Good luck!

ginger67 · November 2009

If I had any insurance coverage I would have done IVF right away.

rachel06 · November 2009

KoCoLoCo:
DinaLINY:

AlissaCell701:
We still had to do the HSG..they needed to check and make sure everything was fine with me...If it was me I would def get the HSG done; it;s fairly painless..Then you can make an educated decision on what the next best steps are for you..
really? I heard that it was extremely painful for a lot of women. then again, we will all HOPEFULLY experience child birth, which I am sure is a million times more painful.
I really appreciate all this feedback!

It isn't really painful at all, some mild cramping and a little uncomfortable, but nothing a little ibuprofen wont fix. Good luck!

I will say that mine was very painful so I think it kind of depends. But I also think mine was painful because of the way my OB/GYN did it. We did 3 rounds of clomid with no response & then moved onto IUI with injectibles but it was canceled due to my response. So we are moving forward with IVF due to the advice of our RE.

bmagsgirl · November 2009

We are going straight to IVF without IUI due to MFI. We still did all the diognostic work to make sure I was OK. FSH tests, blood tests, HSG, the works.