IUI vs at home

eelankes · February 2012

Hello Everyone,

We have decided that we are going to use an unknown donor instead of using a known donor. One thing down! We are now trying to figure out where/how to conceive. My partner has been reading the pregnancy books for lesbians and she feels we should be able to conceive with frozen from home. After speaking to my OB she advised that it would be a waste of money to try this method. Has everyone gone for IUI? Has anyone tried from home? Please share your experiences. We are also trying to figure out where to get IUI performed. My OB said she could do it but it would be better to go to a fertility clinic. Thoughts??

Any help is appreciated!

E

ball.and.chain · February 2012

We are using frozen donor sperm and started out with unmedicated, unmonitored IUIs with midwives. After 4 cycles we just switched to a fertility clinic/reproductive endocrinologist.

I would have considered at-home insems if our sperm was free, but I agree with your doctor that if you are paying for sperm, you probably want your odds to be better. I think the statistic is that there is a 20% chance a healthy woman will conceive on any given cycle -- that's with sex and fresh sperm -- and my RE says it's more like 10-15% with frozen sperm. So with frozen your cost goes up and your odds go down. IUIs (which typically a medical professional -- nurse, midwife, doctor -- has to do) have higher success rates than ICIs (which is basically what you'd be doing at home). So for me, it was a no brainer that we would do IUIs rather than at-home insems. How much money you are "wasting" also depends on what your insurance covers. Mine covers everything so the only cost is sperm, which is why doing IUIs seemed more cost-effective since it probably means less sperm purchased overall. If you have to pay for IUIs, it could possibly balance out.

Also, if your insurance doesn't cover all the monitoring appointments REs do -- a lot of insurance does not -- those will be more expensive than doing unmonitored IUIs with an OB or midwife -- which would of course be more expensive (if not covered) than doing it at home. It also takes up a lot more time -- this cycle I will be at the office for at least 3 appts vs 1 per cycle with the midwives. But my chances with the RE are better because they keep track of more (frequent bloodwork, ultrasounds to check follicle-size, etc) and will do diagnostic testing so that you know before you start whether you have blocked tubes, hormonal imbalances, etc

I would also take into account age (I am a couple months away from 34 and want two kids, so felt like we didn't have time to mess around much) and health -- if you are on the younger side and are healthy, your odds of conceiving are probably higher so at home might be less of a "waste."

Kershnic · February 2012

Ball.and.chain covered a lot of the relevant bases. My situation is somewhat different because I knew from the beginning that I likely had PCOS (irregular periods, family history, etc.) However, we've also discussed what our strategy would be if DW, who doesn't have these issues, were ttc.

Much like ball.and.chain my philosophy is that sperm costs too much, and frozen sperm puts you at a disadvantage compared to fresh, so why "waste" attempts with ICI. I see using that option if you have access to fresh/free sperm, but for me that's the only way I would really consider that I think. That said, although my insurance is not as good at ball.and.chain's, they are covering ultrasounds, which I have had approximately 9 bazillion of. If I was looking at u/s bills I might change my mind, but I also have a lot more u/s than people with normally functioning ovaries.

In any case I would highly recommend that you investigate what your insurance will or won't cover. Many people have diagnostic coverage - which I would use pretty much regardless of how I was actually planning to conceive.

If you're going for IUI the cost is probably similar with an RE vs. an OB and your OB already gave you your answer. An RE's whole job is to get people pregnant - and why in the world would you choose to have an IUI done by someone who is telling you that someone else can do it better.

betsykerry1 · February 2012

I had my IUI done at my OBs office. I charted using an ovulation predictor (dip-stick in urine) test kit. when I got a positive, I called and they got me in the next afternoon. Honestly, when you think about the amount of money we have to spend on frozen sperm, it made sense to us to give those little swimmers as good of a chance as possible. I got lucky and got pregnant on the first try, but you could set a clock by my periods before conception. I would see if you can find an OB who knows about and does IUI frequently... My OB does quite a few IUIs for lesbian couples and she's not with a fertility clinic. It seriously only took like 30 seconds (plus 20 minutes of sitting around afterwards) and was less painful (for me) than my pap.

Two*True · February 2012

Check the FAQs link at the top of the board for more info.

ball.and.chain · February 2012

I have a follow-up thought based on fresh experience!

I'm doing a natural (no meds) cycle with the RE -- my first cycle with an RE -- and so the main difference from my midwife cycles is that instead of relying on OPKs to detect an LH surge and time ovulation, they check follicle size via ultrasound and LH levels via bloodwork. They checked me Monday and I wasn't ready so I went in again this morning. I was taking OPKs as back-up just to make sure we didn't miss my surge, and my OPK was negative this morning. But they could tell from the ultrasound that my dominant follicle was large enough, and then my RE called later to say based on the blood tests, I am surging today. They scheduled me for an IUI tomorrow morning.

My point is that the OPK did not detect my surge today -- without an RE, the earliest I would have done an insem would be Saturday, and that may have been too late. The OPKs have detected a surge in the past, but I'm wondering if for whatever reason I've been catching the surge late and therefore I've been timing ALL my insems a day late. Either that or I got a bad batch of OPKs, which is also not cool. Anyway, it made me glad we switched.

My point is that there are a lot of variables to get right with insem, and frozen sperm doesn't live as long as fresh so you really need to get your timing right. The more medical intervention you have, the better your timing is going to be, and that may make a difference even if you don't choose to do fertility meds.

eelankes · February 2012

Thank you everyone for your insight! I think we will end up going to either a OB or a RE facility. My wife isn't sold on the idea but, I think once she has an opportunity to learn more about it she will be ok. I am sure I will be back with more questions. I would prefer that we spend less money and have a better shot at getting pregnant. I am grateful to have people out there willing to share their experiences. Thank you.

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