MFI & Success Question **Loss discussed (lurking from TTTC)

MissEm15 · April 2014

We are MFI w/ very low morphology and borderline everything else. We just experienced our first ever BFP w/ our 2nd IUI which sadly ended in a very early chemical; we had doubling beta once but then it went right back down. Anyway, since then, I've been doing a lot of reading regarding MFI and losses and have noticed that it is kind of common. So I had a question (hoping for success stories). Did any of you with MFI (focusing on low morphology) experience more than one loss? Did you have to move to IVF w/ ICSI for a viable pregnancy? I know everyone is different. I am just wondering if we should not waste any more time on IUI's even though it technically worked. Thanks for any success story or words of advice/wisdom!! I can't wait to join this group!

kbeach82 · April 2014

Hi. I am very sorry for your loss. I hope you don't mind me answering, as I am very fortunate and have not experienced loss in my IF journey; however, our MFI issue was morphology related (only). Our RE never recommended IUI for us, and suggested that we move right to IVF w/ICSI. I was a low responder (later diagnosed with DOR), but we were successful in both our first and second IVF w/ICSI cycles (singleton, then twins born). I wish you the best of luck!

JBDamonM · April 2014

I am also MFI. My husbands numbers are low in all 3 areas. So low that we went straight to IVF, which meant IVF with ICSI because my clinic ICSIs everyone. We got lucky on our first cycle though, and have fortunately never had a loss. Good luck to you, if your husbands numbers are high enough I would certainly try another IUI but there is a lot that factors into that decisions. Also, I am sorry for your loss.

kellyrn9956 · April 2014

I'm so sorry for your loss. We dealt with MFI, and we experienced a loss related to triploidy. My RE wanted us to move to IVF with ICSI, but we weren't in a place to afford it at the time. (Like @jbdamonM our clinic does ICSI with everyone). So we did 4 IUI's and got crappy TMS counts every time, but it was the best we could do at the time. Our eventual pregnancy that stuck occurred while we were on a treatment hiatus.

What were your total motile sperm counts at IUI? Ours were 2-3 million, and optimal is 10 million+. If you were over 10 million TMS, I would consider doing another IUI or two. But if TMS counts were lower, I'd consider moving to IVF. I kept thinking maybe I'd get a better TMS count every time. But all I was doing was injecting myself with crap that made me feel terrible and then having little chance because of sperm counts.

MissEm15 · April 2014

I know that our post wash counts were around 5 million both times. Our pre-wash was around 19-20 million I think. The only other numbers I remember are that the grade(?) was lowered from a 2-3 down to a 1-2 and the morphology decreased from 3% to 2%. So his last sample was his worst, but it was the one that worked. I had 2 large follicles. We are for sure doing one more IUI, but the next step is where my husband and I disagree. He just wants to do IUI's (he's the patient, hopeful one) and I want to do IVF. We are lucky our insurance covers us so money isn't really a factor. I just am trying to balance being patient, hopeful and realistic at the same time. From what I can see, IVF is what most MFI couples do to get their BFP. & I don't want to do IUI's and have multiple losses... if there is even a link. I think I'm just trying to solve a problem that can't be solved lol. Our bodies are all so different.

kbeach82 · April 2014

If your insurance covers IVF, can I ask why your DH is against moving in that direction?

kellyrn9956 · April 2014

Although IVF is a hard choice to make (it's hard physically and emotionally), if I had full coverage, I would have moved that way immediately. I live in a mandated state, but work for a Catholic institution that has a waiver. Not saying that's the way you should go - just saying it's what I would have done.

JBDamonM · April 2014

This is JUST ME but if I were you I would do only one more IUI and then go to IVF. Your odds will be much better with IVF and you are blessed to have insurance coverage. Give your husband some time, he is probably still processing that he is the problem in the equation. Even with our BFP and beautiful daughter, my husband still has a hard time with this.

MissEm15 · April 2014

I def. think that he just isn't ready to admit we need IVF. If he was, I'd be ready to do IVF right now instead of wait thru one more IUI. Thank you all so much for the advice and hope of a successful pregnancy!

kbeach82 · April 2014

JBDamonM said:

This is JUST ME but if I were you I would do only one more IUI and then go to IVF. Your odds will be much better with IVF and you are blessed to have insurance coverage. Give your husband some time, he is probably still processing that he is the problem in the equation. Even with our BFP and beautiful daughter, my husband still has a hard time with this.

@JBDamonM Ah, good point. I hadn't thought about that.

KayteeGee · April 2014

You've been given great answers. We are also MFI (low mot, low morph, low count!) and we were told by my Gyn to go straight to IVF, our RE agreed and that's what we did.
No idea if our early losses were related to MFI but here's our story:

DS born 2/11 after 1st IVF w/ICSI (we lost his twin at 10w)
2 BFPs that resulted in early m/c with FET #1 & #2
PGD on remaining frosties gave us two "normal" we tx'ed both and I am now 18w w/DD (only one stuck).

Good luck.

prazenjc · April 2014

kbeach82 said:

Hi. I am very sorry for your loss. I hope you don't mind me answering, as I am very fortunate and have not experienced loss in my IF journey; however, our MFI issue was morphology related (only). Our RE never recommended IUI for us, and suggested that we move right to IVF w/ICSI. I was a low responder (later diagnosed with DOR), but we were successful in both our first and second IVF w/ICSI cycles (singleton, then twins born). I wish you the best of luck!

we, too, were MFI and went straight to IVF with ICSI. we never experienced loss and had 2 singletons a little over 3 years apart.

ThereBeDragons · April 2014

Popping in as a lurker (although it'd be great to move in here in a few weeks)

We have severe MFI. Low everything. So we went straight to IVF. Doing IVF we had a chemical pregnancy, a loss at 6 weeks, a loss at 17 weeks, and our current pregnancy at 33 weeks. We've transferred 10 day 5 blastocysts (4 fresh, 6 frozen) and 1 day 6 frozen morula. We have no idea what part the MFI is to blame for in the early losses and implantation failures but know that it was my cervical failure that lost the one at 17 weeks and almost lost this one.

Unless you're doing PGD with your IVF embryos (which is a valid option but can get expensive) there's really no more or less chance of a miscarriage due to genetic issues with IVF versus IUI. IVF by itself only really weeds out a portion of the embryos which wouldn't even make it to implantation. And no implantation = no positive pregnancy test. Which is not to say that IVF is a bad idea- success rates are undeniably higher. Just that it's not going to inherently prevent further losses.

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