honest question: why wouldn't you do an IUI?

CousinVicki · January 2012

especially with clomid, given its ability to make a hostile environment for sperm?

Barring financial issues, which I totally understand, if your insurance pays for it, why wouldnt you just do it? I see sooooo many people on here doing TI all the time and I don't get it!

and i am not saying that IUI increases your chances exponentially, but I would think it gives you a bit of an edge if you are giving the 'good' sperm a little short cut!

ellephunt · January 2012

My RE will only do IUI with Clomid. So for me it isn't an option. I'd like to try Femara+TI first since it is our cheapest option and we are OOP.

jessican08 · January 2012

For couples where MFI isn't an issue, TI can be just as effective as an IUI. It's true Clomid can make a hostile environment for the sperm, but that's not a given. Lots of people get PG with Clomid and TI. Heck, Kate Gosslin got PG with 6 babies doing TI (against her Dr.'s advice of course).

And why use up your IUI coverage when you have a shot at it "the old fashioned way"? I would rather try TI first, then move on to IUI when a round or two of TI doesn't work.

And, for a lot of couples, they want to try to conceive with as little interference as possible. I know for me, I have a hard time watching anything on TV about conception happening "the old fashioned way" because I know that will never happen for me. That miracle won't ever happen inside my body and that's a tough pill to swallow.

sbrowns08 · January 2012

Other than cost, I really don't know. I wouldn't take meds without iui. However, we were never given the option of TI due to sperm issues. Some people get converted to TI when they have too many follies; that might be another reason...

hootie123 · January 2012

The cycles I did with clomid I did with my ob/gyn - so I wasn't even offered the option of doing IUI. But if you have no sperm issues and just an ovulation issue - you can definitely get pregnant with just TI. But once that doesn't work one or two times - I think and IUI would definitely be the next step and I see no reason why someone wouldn't want to do everything possible to try to increase their chances.

amd1982 · January 2012

Hmm, you mean doing Clomid and TI without an IUI? Well I am 100% OOP, and we decided to do an IUI with Clomid and TI at our RE's suggestion, even though we have no MFI to speak of (slightly low morph but RE doesn't think it will affect TTC) and CM is ok. She agreed with what you said above in terms of making sure the sperm gets to the desired location guaranteed. It takes the guessing out of it. But there are probably a bunch of reasons why people choose not to do an IUI - for example, if your only issue is anovulation and your DH has super sperm, a TI and Clomid might do the trick. I think many women might take this route if they do not have IF coverage as well. Others I think might be very religious and think that IUI is not necessarily "God's plan," or "natural" but as you can tell neither DH nor I had an issue with that haha.

Anyway, I think that many good RE's out there are minimalists. If they have a patient who seems to be responding well to Clomid and TI they might not try an IUI right off the bat. I think it depends on many factors: age, length TTC, dx, etc.

LexiSophie55 · January 2012

I became pregnant with my 1st cycle of Clomid + TI. I'm currently in the 2WW of another cycle of Clomid + TI. There is no reason for me to do IUI. It would require more money, (yes, covered by insurance, but as another poster mentioned, it is still charges that don't need to be incurred) more appointments, and just be exaggerated measures at this point. My insurance also covers some of IVF...so why not just go right to that....

I think most doctors will agree that taking IF as slow as possible is the best. If the couple is able to conceive with limited treatments, that's probably the best.

Jezebell26 · January 2012

When I did my first injects cycle my RE wanted to do an IUI and even though we have insurance coverage we opted for TI. At that point in treatment my DH was extremely opposed to anything that required medical intervention. He was in denial and wanted things to be as "natural" as possible. As much as I wanted to do an IUI we both had to be comfortable with this. So we came up with a solution that we would try this cycle with TI and if it failed that we would repeat it and do an IUI. He was ok with that and was thankful I was giving it a chance naturally. Imagine the shock on DH's face when after that cycle failed and I never O'd after a trigger shot, when i told him we had to move to IVF. Natural flew out the window. This could also be happening to other people as well.

Citygirl1015 · January 2012

Cost was a big factor for us since we're OOP. But we also wanted to try to concieve as naturally as possible before moving on to more drastic measures.

Shayliz · January 2012

We didn't have any MFI and they suggested we try TI first. Since I had 2 losses before even doing treatment and didn't seem to have any CM issues with Clomid - we went for TI for 2 cycles.

SteFizzRich · January 2012

My RE didn't even discuss doing IUI with us. He has a very mininalist approach to treatments. Only go as far as you HAVE to, start small and work our way up the chain. We have no MFI and our only issue seems to ovulation. We are using Clomid and TI first and seeing how that goes. If we aren't successful this way then we'll move onto more invasive testing and treatment. IUI is not medically necessary at this point even though our insurance provides coverage for unlimited IUI attempts.

brideonjuly8 · January 2012

Since I've gotten pg three times now with TI my doc is 99% sure there is nothing to worry about as far as my DH is concerned. I also don't have an issue ovulating on my own, it's just the endo and long cycles that are working against me. But I'm also not doing any treatment. If my doc thinks we need to move on to IUI we will, but for now he's fine with TI.

maggie2324 · January 2012

Why don't all fertile people get IUIs if there insurance covers them? Heck, a medicated IUI can bump people with normal fertility from a 20% chance to 35%.

Sounds like a fantabulous plan to me!

Since we are MFI, doing the medicated IUI is to compensate for the sperm problem. A medicated cycle of TI just doesn't compensate since I already ovulate fine. This is our alternative instead of jumping right to IVF, which we may need to do anyway.

buckeyebaby814 · January 2012

Because I still get fertile CM with clomid and I've gotten pregnant on clomid once (ectopic) with only TI. In fact, I've been pregnant 3 times in the last 18 months, they just don't stick longer than 5.5 weeks. The primary reason I am even on clomid is because my LPs are only 9 days without it.

d3esika · January 2012

Plus, sometimes it takes a few cycles to figure out dosage for medications.... Some may want to figure out dosages, then introduce the IUI.

sarahtoledo · January 2012

I've gotten pregnant twice with meds + TI. MH has excellent counts, and of my four REs, only one has said we "may as well" try IUI for future cycles. I guess if you're quite sure MFI isn't your issue (helps if you DO have a diagnosis), and you're OOP, you might not choose IUI.

Also, it is against some people's religious beliefs/convictions. Not mine, but some.

BlueEyeZ1981 · January 2012

Our only issue is my ovulation issues and RE wanted to start with TI and not jump straight to IUI. Since I'm not real sure how far I'm willing to go I was ok with that. Plus we would be OOP for the proceedure so cost is minimal with TI since insurance covers the clomid.

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honest question: why wouldn't you do an IUI?

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