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TTC after 35
Did one IUI; go directly to IVF?
Hi Everyone,
This is my first-ever post, so please be merciful. 
I'm 37 and my husband and I just went through our first unsuccessful IUI. For background, I'm hypothyroid with really low FSH. My cycle was already up to 34 days before we even started trying, so prior to the IUI, I wasn't really ovulating at all. Clomid didn't work, but we got 2 decent follicles with Bravelle. My husband's been checked out and his sample was 18 million, so no problem there.
In a follow-up call with the NP, she said things like, "Well, the sperm might be having a hard time penetrating the egg, but we can do some tests" and "Well, your FSH was really low, so we can add some FSH next time." The whole time, all I kept thinking was, "Why didn't you do that BEFORE I dropped $2k?" I'm medically literate and I realize there is an incremental standard of care, but I don't see how you can treat what you haven't even really identified.
Admittedly, I'm a newbie to this and after reading all of the stories on here, I know I need to be reasonable, but sometimes I feel these fertility centers are like extermination companies - if they solved the problem on the first shot, they'd be out of a job, so they have incentive to drag out the process.
For that reason, I'm considering going straight to IVF and insisting on ICSI (and hope they capitulate). Money is a definitely a factor and I'm thinking maybe it's better to go for the best chance of success rather than go another round of IUI.
Any advice?
This discussion has been closed.
Re: Did one IUI; go directly to IVF?
Welcome to the board! I think you will find that we are all pretty kind and respectful.
I'm not sure if I can offer much advice, but it sounds like you are seeing a nurse practitioner? Is he/she affiliated with your ob/gyn? An RE? If you aren't ovulating normally, you might want to consider seeing an RE (if you haven't already). I think they can give you a range of options and give you some of idea of your chances based on your diagnosis.
If you are already seeing an RE, I would want to actually talk over the options with the doctor if at all possible (instead of a NP) before making a decision. My RE identified different options and talked about when/why we would consider each one. Because money is a factor and I am out of pocket for everything, we decided to try more conservative treatments.
So, I don't know that this was very helpful, but I wish you good luck.
Hi there, and thanks for the reply!
I'm actually seeing a fertility clinic (a pretty well-known one), through which I have a fertility doctor and I also have an outside ob/gyn. The NP just makes the follow-up calls to deliver test results, but she's not my regular care provider.
Since the last post, I decided to transfer my whole case to another of their office locations (a much closer one!) and set up an appointment with a different doctor to get a fresh pair of eyes. This doc does have a background in RE, so hopefully he can shed some light on this. I also have a separate endocrinologist who at least was able to rule out PCOS through a glucose tolerance test. As it stands now, they've offered me the option of going straight for the IVF, but my biggest concern is that I want ALL the relevant tests done before I pull out my checkbook again. I don't want to get into this pattern of doing cycle after cycle and hearing everytime "maybe it was...."
Sounds like you and I are in the same boat with insurance, though - mine doesn't pay a dime. I don't think I was totally prepared for how expensive and frustrating this was going to be - and I'm just getting started!
Hope everything works out for you too though, and I look forward to chatting with you on the board again in future!