IUI + Injectables Question

FraggleChic · August 2011

After our third failed IUI, MH and I decided to start saving for IVF. We were going to try a few more cycles of Femara+ TI while we're waiting/saving for IVF. I have a lap scheduled for later this month and so we're taking this cycle (and possibly next cycle) off meds. I still plan on having the lap done no matter what. Now my brain is playing tricks on me and I'm wondering if we made the right decision to move right to IVF. I'm starting to feel like maybe we should try a few rounds of injectables and IUI before going on to IVF. I don't know though.

One doctor at the clinic said he didn't like to do it because of the risk of overstimulation, having to cancel the IUI because of the risk of multiples. The other doc did present it to us as an option but we elected to do the lap/IVF route since he told us that there would not be an increased chance of success with the IUI + injects. I know you're most likely to be successful within the first three IUIs but since we'd be changing the protocol would my success rates start fresh? (I hope that's not too confusing)

I know this is a personal decision but I'd like some input from people who have done IUI+injectables. Heck, I don't even know if I'd respond to the meds considering my hormone levels. I haven't seen my doctor since I got the results of my labs back but I'm fairly certain that I will be dx with DOR next appointment. So...input. Thoughts. Please!

irishbaby0708 · August 2011

I just had a lap done a few weeks ago and really wished I would have done it prior to doing IUI since it was OOP for us.

I Did Ti and FSh injectables and got pg with my son 3 years ago and it worked my 2nd cycle of TTc it that way after 15 months TTc on our own. This time around it didn't work for me so we tried the IUI and afte that we did the lap. The lap found I had tons of scar tissue and folded and twisted bocked tube that was not totally not working I wish I had done the lap 1st but, every one is diffrent.

They montior you very closeley and there is always the chance of Over stimulting it did happen to me once but, only once in all the time I have been TTC.

Ifyour looking for advice I would say go for the lap especail if you think you might do IVF at some point. After the lap try TI and Injectiables and than go for the IUI and Injectiables.

Good Luck,,,,,

BeeBee08 · August 2011

I'm sure for everything I'm about to say, there is an equally compelling argument against it, however, my clinic prefers to do injectible IUI cycles and I believe your success rates do start "fresh" when you change protocols. I think there is actually less of a chance of overstimming because the dosage can be controlled so much better - I responded significantly less to the injects than I did to clomid (I did not use oral FSH) just fyi. I don't know, YH has superstar counts...doing injects might be worth a shot giving consideration to costs. would you consider doing the lap and then the inject/IUI cycle? (as crazy as it sounds, I think we're going to sneek in another IUI right after the lap before IVF). Good Luck, Fraggle, I know you're struggling with a million options right now!

FraggleChic · August 2011

irishbaby0708:
I just had a lap done a few weeks ago and really wished I would have done it prior to doing IUI since it was OOP for us.

I Did Ti and FSh injectables and got pg with my son 3 years ago and it worked my 2nd cycle of TTc it that way after 15 months TTc on our own. This time around it didn't work for me so we tried the IUI and afte that we did the lap. The lap found I had tons of scar tissue and folded and twisted bocked tube that was not totally not working I wish I had done the lap 1st but, every one is diffrent.

They montior you very closeley and there is always the chance of Over stimulting it did happen to me once but, only once in all the time I have been TTC.

Ifyour looking for advice I would say go for the lap especail if you think you might do IVF at some point. After the lap try TI and Injectiables and than go for the IUI and Injectiables.

Good Luck,,,,,

I'm planning on having the lap done whether we move on to IVF right away or not. I'm just doubting our decision to skip over the injectables + IUI step and move right to IVF.

FraggleChic · August 2011

bfarrell:
I'm sure for everything I'm about to say, there is an equally compelling argument against it, however, my clinic prefers to do injectible IUI cycles and I believe your success rates do start "fresh" when you change protocols. I think there is actually less of a chance of overstimming because the dosage can be controlled so much better - I responded significantly less to the injects than I did to clomid (I did not use oral FSH) just fyi. I don't know, YH has superstar counts...doing injects might be worth a shot giving consideration to costs. would you consider doing the lap and then the inject/IUI cycle? (as crazy as it sounds, I think we're going to sneek in another IUI right after the lap before IVF). Good Luck, Fraggle, I know you're struggling with a million options right now!

I'll still have the lap on the 25th. I'm lucky they got me in for an appointment so I'd hate to cancel, decide to move to IVF and then them not have any availability for months. The military's motto is "hurry up and wait."

sarahtoledo · August 2011

You can see my history in my siggy... I am planning 3-4 more cycles of injects + TI or IUI. IVF is not an option for us, mostly because of cost, and because we've always liked the idea of adoption.

My RE feels very optimistic that "superovulation" (more than one mature follie, due to injectable meds) and TI/IUI have a good chance of working for us. hth

Mrs.McIrish · August 2011

I don't know what your FSH/AMH levels are but I think the risk of getting overstimulated (producing too many follicles for IUI) is low if you are DOR. If you are really are DOR, you won't produce many follies. I think I would be tempted to try an injectible cycle after the lap to test it out. GL in your decision.

jessican08 · August 2011

I did 3 injectible IUI cycles. The highest number of follies I had was a maybe 4th follie on my last cycle. My RE had me on a pretty low dose (75 IUs) though. GL with your decision hon.

babina868 · August 2011

I'm doing one IUI + injectables before moving on to IVF. My RE gave us a 10% chance of success using Femara + IUI and a 20% chance of success using injectables.

We're only doing one round with injectables because injectables are really expensive and we're OOP for them, and I'd rather put the money we'd pay for the injectables toward IVF.

My RE said that the one good thing about doing an IUI with injectables before IVF is that she will get at least some idea of how I respond to injectables before I go for IVF (I could be a poor responder just based on my AMH and day 3 b/w). But she has this whole thing about how IUI + injectables leads to a higher chance of multiples even with good monitoring because sometimes mature follies aren't visible in an u/s.

srkm · August 2011

I don't remember my FSH levels but my AMH are super high at 18.6!! I tried a low dose injects cycle with IUI (75IU Menopur for 6 days) and REALLY overstimulated! I had 12-13 mature follies by cd9!! I got cancelled. I think this is worth a try...you never know how you will respond. Good luck!

FraggleChic · August 2011

Mrs.McIrish:
I don't know what your FSH/AMH levels are but I think the risk of getting overstimulated (producing too many follicles for IUI) is low if you are DOR. If you are really are DOR, you won't produce many follies. I think I would be tempted to try an injectible cycle after the lap to test it out. GL in your decision.

I guess that would be useful information, huh? i added it to my siggy. AMH is .85 and FSH is 8.02, which I understand is a little high for my age.

Mrs.McIrish · August 2011

FraggleChic:

Mrs.McIrish:
I don't know what your FSH/AMH levels are but I think the risk of getting overstimulated (producing too many follicles for IUI) is low if you are DOR. If you are really are DOR, you won't produce many follies. I think I would be tempted to try an injectible cycle after the lap to test it out. GL in your decision.

I guess that would be useful information, huh? i added it to my siggy. AMH is .85 and FSH is 8.02, which I understand is a little high for my age.

The FSH looks ok but yes, the AMH is low. Being young though, I think I would try an injectible cycle because your egg quality is probaby good. GL sweetie!

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