Question about IUI and injectables...

kerivp · September 2011

I just had my 'next steps' appt with RE and I'm so confused about what to do. IUI vs IVF...(with low AMH)

I don't completely understand how IUI is much better than trying naturally. I know the sperm gets deposited closer, but what exactly do injectables do? How do they increase your chances of conceiving?

Thanks for any help.

Blueyed228 · September 2011

The injectables stimulate your ovaries to produce follicles. The trigger shot causes you to ovulate. The benefit of doing IUI vs trying naturally is that they know exactly when you ovulated and they put the sperm inside of your cervix instead of it having to swim its way up there.

Basically they put everyone in the same room at the same time and hope they want to dance.

Daisies1706 · September 2011

Well, the injectables stimulate your lady parts to create more follicles. So not only are you getting a better crack at the pinata, but you also get bonus pinatas.

MandaS08 · September 2011

Daisies1706:
Well, the injectables stimulate your lady parts to create more follicles. So not only are you getting a better crack at the pinata, but you also get bonus pinatas.

This! If you ovulate on your own, you're probably only ovulating one egg, but with meds you could ovulate 2-4 eggs, giving you a better chance.

moosegal · September 2011

What PP said. I see in your siggy that you have been able to get pregnant before -- was it naturally? My RE says that the injectables can also help to increase the quality of the eggs you produce compared to a natural cycle. Considering you were able to get pregnant naturally before, I might be inclined to try 1 or 2 inject/IUI cycles before moving on to IVF since they will cost less and be less intense on your body.

What did your RE recommend?

kerivp · September 2011

moosegal:
What PP said. I see in your siggy that you have been able to get pregnant before -- was it naturally? My RE says that the injectables can also help to increase the quality of the eggs you produce compared to a natural cycle. Considering you were able to get pregnant naturally before, I might be inclined to try 1 or 2 inject/IUI cycles before moving on to IVF since they will cost less and be less intense on your body.
What did your RE recommend?

Honestly, he's on the fence. If we had IVF coverage, he would absolutely recommend IVF. But since we're OOP, he's not sure what to do. He said that we could try IUI with injectables once, and see how I respond. But my RE charges A LOT for IUI's, along with everyone else in NYC and Connecticut. So that's why I'm wondering if it's worth it...given that we will be potentially 'wasting' our HSA money, and my AMH could continue to fall.

moosegal · September 2011

kerivp:
moosegal:
What PP said. I see in your siggy that you have been able to get pregnant before -- was it naturally? My RE says that the injectables can also help to increase the quality of the eggs you produce compared to a natural cycle. Considering you were able to get pregnant naturally before, I might be inclined to try 1 or 2 inject/IUI cycles before moving on to IVF since they will cost less and be less intense on your body.
What did your RE recommend?
Honestly, he's on the fence. If we had IVF coverage, he would absolutely recommend IVF. But since we're OOP, he's not sure what to do. He said that we could try IUI with injectables once, and see how I respond. But my RE charges A LOT for IUI's, along with everyone else in NYC and Connecticut. So that's why I'm wondering if it's worth it...given that we will be potentially 'wasting' our HSA money, and my AMH could continue to fall.

That is a tough call, for sure. Did your RE give you any success rates for IUI vs IVF at his clinic?

My RE said an injects-only IUI cycle would have ~20% success rate vs. ~70% IVF success rate for someone in my age bracket. My AMH level is not out of the normal range though, so I'd feel more comfortable trying a few IUI inject cycles.

It honestly will come down to a personal preference and determining how comfortable you are with spending $$ for IUI vs IVF. From what my RE has told me, AMH, AFC, etc. levels don't plummet overnight, so if you wanted to take one month to see how you responded to injects for an IUI cycle, you should still be in a similar position health-wise if you decide to move to IVF. However, I don't think anyone would blame you if you moved straight to IVF. Does your clinic offer any sort of refund options for IVF if you aren't successful?

kerivp · September 2011

moosegal:
kerivp:
moosegal:
What PP said. I see in your siggy that you have been able to get pregnant before -- was it naturally? My RE says that the injectables can also help to increase the quality of the eggs you produce compared to a natural cycle. Considering you were able to get pregnant naturally before, I might be inclined to try 1 or 2 inject/IUI cycles before moving on to IVF since they will cost less and be less intense on your body.
What did your RE recommend?
Honestly, he's on the fence. If we had IVF coverage, he would absolutely recommend IVF. But since we're OOP, he's not sure what to do. He said that we could try IUI with injectables once, and see how I respond. But my RE charges A LOT for IUI's, along with everyone else in NYC and Connecticut. So that's why I'm wondering if it's worth it...given that we will be potentially 'wasting' our HSA money, and my AMH could continue to fall.
That is a tough call, for sure. Did your RE give you any success rates for IUI vs IVF at his clinic?
My RE said an injects-only IUI cycle would have ~20% success rate vs. ~70% IVF success rate for someone in my age bracket. My AMH level is not out of the normal range though, so I'd feel more comfortable trying a few IUI inject cycles.
It honestly will come down to a personal preference and determining how comfortable you are with spending $$ for IUI vs IVF. From what my RE has told me, AMH, AFC, etc. levels don't plummet overnight, so if you wanted to take one month to see how you responded to injects for an IUI cycle, you should still be in a similar position health-wise if you decide to move to IVF. However, I don't think anyone would blame you if you moved straight to IVF. Does your clinic offer any sort of refund options for IVF if you aren't successful?

Thanks for your response. He said that IVF success rates are definitely better than IUI, but it's hard to say exactly for poor responders (maybe around 25-30%). I have no problem trying an IUI with injectables, but it'll probably be $4,000 with the highest dose of meds for DOR. And then we'll only have ~$2,000 left in our HSA that we can put toward IVF. My clinic does not offer any sort of refund options for IVF.

*sigh* This sucks.

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