Infertility

Giving up on IUI? Time for IVF?

How many cycles did you do of IUI before you moved in to IVF? I'm on #6, and I feel like I've already given up on the process. I want to move on to IVF, although I'm still a little intimidated by it. My doctor supports trying IVF after this cycle. At what point did you decide it was time for IVF?

Official diagnosis: Unexplained IF. I am 32. I have low ovarian reserve (low AMH), and poor egg quality. I've also been diagnosed with mild glandular developmental arrest (lining problems, detected with EFT).

We are using open ID donor sperm. IUIs #1-7=BFN. IVF September 2014 antagonist protocol, 8R,5M,3F, 5 day transfer of 1 morula = BFN. IVF#2 planned for January 2015 (antagonist protocol + HGH).

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Re: Giving up on IUI? Time for IVF?

  • In general from my understanding after 3-4 it is recommended to move on unless you can change part of the protocol like add injects if you weren't already using them.

    Me: 32  DH: 33  Married: March 2004

    July 2006: started TTC
    2008: HSG (normal), couple rounds of clomid through gyno
    2008 - 2010: dragging my feet out of fear and procrastination
    October 2010: first consultation with RE, dx PCOS and fibroids (DH slightly low count/motility)
    Oct. 2010 - Dec. 2012:  In DENIAL! avoided the issue because I was scared of surgery
    January 2013: returned to RE, fibroids grew significantly
    February 2013: second HSG, fibroids pushed on tubes which blocked them somewhat
    March 2013: MRI to determine what type of surgery may be necessary

    July 29, 2013: fibroids (5) removed via robotic laparascopy
    August 2013 - Nov 2013 : benched due to recent surgery

    IUI #1, Dec. 24, 2013, BFN 
    IUI #2, Jan. 25, 2014, BFN
    IUI #3, Feb. 25, 2014  BFN
    IUI #4 canceled due to lack of response to letrozole
    IUI #4.1 April 28, 2014, BFN

    May 16, 2014: wtf consult, start prepping for IVF in June and add injects for one last IUI in the meantime
    IUI #5 started letrozole and bravelle but canceled after HSG led to new diagnosis

    May 21, 2014: third HSG, tubes blocked, one at the beginning, one hydrosalpinx??
    June 11, 2014: consult, approved to move on to IVF because the hydro is not completely blocked therefore allowing fluid to move through slowly rather than backwards
    IVF #1 August 8, 2014 - 3dt of 2 embryos, BFN
    September 17, 2014 - 4th HSG, the right tube is very patent (open!!) dye went straight through this time. Weird!
    October 2, 2014 - started metformin treatment
    November 14, 2014 - blood work, brought A1C down from 5.8 to 5.5

    November 26, 2014 - RE finally back from vaca and reviewed my chart, no more IVFs for rest of calendar year
    December 1, 2014 - Right after Thanksgiving, I called a new clinic and got in right away! Plan for IVF
    December 17, 2014 - ER! 29 retrieved (!!), 16 mature, all 16 fertilized (ICSI)

    IVF #2 December 20, 2014 - 3dt of 3 embryos, BFN

    We are done with treatment unsuccessfully. :(


    PAIF/SAIF/All Welcome!

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  • Lillovebug79Lillovebug79 member
    edited May 2014
    I did way too many IUIs, 8 to be exact. I wanted to move on sooner because it obviously wasn't working but DH wasn't ready to do IVF yet so I kept trying until he was ready. Our issue is MFI and DH started taking meds at the beginning of December and since they take 3 months to work, I agree that it was at least worth trying to see if it would help. I think after our 7th IUI, when it had been over 3 months since he started meds, he was ready to move on. But we aren't all out of pocket either so that helped make the decision easier. Our IVF still cost us around $7700 and could be more if I need increased doses of meds but it's worth having a good chance at success. My clinic has a 59% success rate and a 54% live birth rate per transfer. I feel much better about that than I do about the less than 15% success rate for IUI. That's how we made the decision.

    Edited for spelling!



    ********Siggy/Ticker Warning***********



    Me (35) no known issues DH (37) MFI. TTC 21 months (24 cycles)
    Dx MFI with low to normal count, low motility, morphology 3%
    HSG normal, ultrasound and labs on me all normal. 

    1 cycle of Clomid 50mg and TI, unmonitored by OBGYN= BFN
    1 cycle of Clomid 50mg and IUI, unmonitored by OBGYN= BFN
    Started seeing an RE!!
    2 more cycles of clomid 50mg (great response), with IUI and Pregnyl trigger (4.8-8 mil good ones after wash) = all BFN
    1 cycle of clomid 50mg (3-7) followed by Follistim 75iu (7-11) + IUI = BFN
    December 2013 DH saw urologist and is taking Anastrozole, CoQ10, and L-Carnitine
    IUI #5 natural cycle (needed a med break) = BFN
    IUI #6 Follistim 75iu (CD3-10) + Pregnyl (CD11) + IUI (final count after wash 300K) = BFN
    IUI #7 Follistim 75iu (CD3-9) + Pregnyl (CD11) + IUI on 2/20 (post wash count 12.5 million)= BFN
    IUI cancelled (DH OOT) Clomid 50mg (CD3-7) 1 follicle +(not well timed) TI = BFN
    IUI #8 and last one!! Clomid 100mg (CD3-7) +OPK before US + IUI 4/17 (post wash 8.5 mil)= BFN

    Pre-IVF testing complete! SHG great and measurements taken! Labs for infectious diseases completed, FSH (5.4), TSH (1.6), Prolactin (11), AMH (2.6), Estradiol (40).

    Started BCP 5/29 and Lupron 6/11 prep for IVF #1! Started follistim 225u/day on 6/28. Monitoring on 7/2 >15 follicles measuring 11-14, E2 758. Monitoring on 7/5 all ready to go!! Great follicle sizes and lining is at 9. Tigger 7/5, ER 7/7 16R 9M 3F. Stimmed too fast in just 7 days. 7/10 3dt of 2 8-cell grade 2 & 4. 7/14 P4 >60.
    Holy crap BFP!!!
    Beta #1 (14dpo) 7/21 112 Beta #2 (16dpo) 7/23 286 a Beta #3 (18dpo) 7/25 761 Beta #4 (21dpo) 2631!!! Hold on tight little embies!!
      First Ultrasound 8/7- 1 perfect little bean with a beating heart 117bpm!! EDD 3/30.
    Second ultrasound 9/2 Little bean measuring a few days ahead with a heart rate of 161!



    PAIF/SAIF/All Welcome!

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    Pregnancy Ticker




    March 15 Siggy Challenge: You had one job

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  • cls78cls78 member
    We did 3 iui/clomid cycles before moving on to ivf. We were self pay plus over 35 and didn't want to waste time and money on less then a 20% chance with iui/injects.
    TTC since May/June 2012 
    Sept 2013 testing:
    SA #1 Low motility (17%) 
    SA #2 Lower sperm count, but much higher motility
    CD 3 Bloodwork and ultrasound - Normal HSG - Clear tubes 
    Oct/Nov 2013 Cycle 1 with RE 50 mg Clomid + Ovidrel + IUI BFN  
    Nov/Dec 2013 Cycle 2 with RE 50 mg Clomid + Ovidrel + IUI BFN 
    Jan/Feb 2014 Cycle 3 with RE 50 mg Clomid + Ovidrel + IUI BFN 
    2/20/14 Follow up consult RE recommends IVF with ICSI 
    3/10/14 New patient consult with RMA NJ 
    3/11/14 AMH and other Bloodwork to prep for IVF with ICSI at RMA NJ
    3/28/14 Saline Sonogram - All good
    March/April 2014 IVF #1 Antagonist Protocol
    BCP/Bravelle/Menopur/Ganirelix
    4/16/14 ER 26 Retrieved!!!
    4/17/14 Fert Report 22 Mature 21 Fertilized w/ ICSI
    4/22/14 Report #2 15 BLASTS
    5/24/14 FET!!!  (Transferring 2 snowflakes)
    6/2/14 Beta #1 575!!! :)
    6/4/14 Beta #2 2060!!! :)
    6/11/14 1st Ultrasound...Saw 2 Gestational Sacs!!  Beta #3 34,312!!! 
    6/18/14 2nd Ultrasound...Heartbeats!! Baby A 112bpm Baby B 117bmp <3 Beta #4 172,080!!!
    6/25/14 3rd Ultrasound...Heartbeats!! Baby A 150bpm Baby B 158bpm <3 Beta #5 232,134!!! 
    7/3/14 4th Ultrasound...Heartbeats!! Baby A 173bpm Baby B 162bpm <3 Beta #6 269,228!!!
    Graduated from RMA!!  First appt with OB 7/8/14

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  • I did 2 and I was done. My RE supports moving unexplained couples to IVF more quickly than those with some other dxs. He's also not a proponent of IUI with injects. He said it only gives a slightly higher chance of success, but with more added risks (HOM). We weren't totally mentally prepared when we took the plunge, but we also want a baby yesterday.
    Me: 34 | He: 40
    TTC since 08/2012
    DX: DOR




  • Sha259Sha259 member
    It is a very personal decision that may differ depending on how you feel, and your financial situation.

    For DH and I, we knew from the get go that IUIs were not likely to bring us success, but our insurance requires 6 IUI Cycles before they allow you to move on to IVF. But considering my and DHs diagnosis, we were able to get them to cut it down to 3. Once we moved on to IVF I ended up converted to IUI anyway, but we will still pursue IVF if this cycle is BFN. 

    We are lucky that our insurance is covering crazy amounts of our treatment cycles and medication costs. If that were different and we were OOP, I think we may have continued to do IUIs for much much longer. Or we may not have been able to cycle at all in order to save more for IVF.

    None of use can tell you what decision you and your partner will feel most comfortable with, but I wish you luck!!
  • gnl42gnl42 member
    We are unexplained and chose to skip the IUIs and go straight to IVF. For us, it was all about the statistics. IUI did not seem like it would increase our chances all that much, so it seemed like the logical choice. According to my RE, the experts are now recommending moving to IVF faster for "unexplained" couples or skipping IUI altogether. Of course, like everyone else already said, it is also a matter of finances/your insurance situation and how ready you are. I can understand the intimidation factor of IVF, but for me, once I realized that I would be on medications and injections in any case, it really did not feel like that big of a jump. I realize that others view it as more invasive and extreme. I'm a physician, so it didn't bother me too much. 

    Good luck with whatever you decide! 
    **warning**
    Me (31), DH (33), one furbaby (7) - unexplained IF 
    hysteroscopy and polypectomy 2/14
    IVF #1 3/2014 - cancelled (early ovulation)
    IVF #1.2  ER 5/16/14: 23R 18F -  freeze all (12) due to concern for late onset OHSS 
    FET #1 in June - delayed due to thin lining, 7/18 SET (7.5 mm lining) resulted in chemical pregnancy
    FET #2 in Sept - 9/4 transferred 2 CCS tested embryos (6.5mm lining)
    9/13 beta #1 - 400, 9/15 beta #2 - 950, U/S 9/22 one gestational/yolk sac - next up 9/29
    3 frozen CCS tested embryos remaining
  • We did 6 IUI's. We probably would have moved to IVF sooner but our insurance covered 6 IUI's so obviously we were going to try those first.

    Good luck!
    Married 8/6/2011 Me (26) DH (33) SA normal,HSG clear TTC since August 2011 7/2012 50mg Clomid+Trigger+IUI+progesterone =BFN 8/2012 100mg Clomid+estrogen+Trigger+IUI+progestrone=BFN 10/2012 100mg clomid+Gonal+Lupron+Trigger+Progestrone+IUI=BFP but ectopic.
  • StacyLH24StacyLH24 member
    edited May 2014
    Our insurance covers IUI forever. We did 3, then I had surgery and we have had 2 more. IVF is not covered, but that is where we are headed.

    Here is why...
    1. We are a same sex couple using donor sperm. $300 per vial and we have one left. We had decided previously to go all out for the last one. Could we buy more? Yes. Do we want to continue to do that? Not unless absolutely necessary. Also, if the donor we like gets low or sells out, then we have to find a new one. I really like the one we have now...based on the information we have anyway.

    2. We moved to injects, which I respond well to...too well in some cases. We have cancelled 2 IUIs because of over responding. We live 1.5 hours from the RE's office. To put all that time into a cycle and not even get a chance is crushing. IVF is much more controlled...we aren't interested in the risks of HOM.

    3. We want a baby (I know, we all do!) and like the odds of IVF better. My RE estimates a 60% chance that I will get pregnant and deliver a healthy take home baby. I like those odds way better than IUI odds. I'm ready to move on from the getting pregnant part to the being pregnant part. Though I do recognize that IVF is not a "cure all" for everyone.

    4. I have endometriosis and that can interfere in all sorts of ways. IVF skips over all of that.

    We have been talking about IVF since January, so it was not a decision we made lightly. The morning that we walked out of the RE's office when we knew IUI #6 was going to be cancelled, we were both exhausted. I was near tears. I looked at C and said that I wanted to go to IVF. She agreed and that's the path we are on now.

    ETA: A few days ago, C said that she wishes we would have just done IVF to begin with, or at least after the first 3 IUIs. It was a hard decision due to the difference in insurance coverage
    though. Had we been OOP from the beginning, we would have done IVF much sooner.

    Me: 30  DW (aka C): 29

    Together since 2/15/11 ~ Legally married in NY on 9/29/12

    ***CP mentioned***

    We've been working on baby #1 since July 2013 using Open ID donor sperm.  8 IUI attempts with 5 actual IUIs and one chemical pregnancy.  We have one fresh IVF cycle under our belts as well as a FET.  I have endometriosis and a uterine septum that was corrected via surgery in November 2013. 

    11/14/14 -  Second HSG shows that tubes are still clear and ute is looking good. 

    12/6/14 - Started BCPs in prep for IVF #2

    12/22/14 - Saline u/s and endometrial scratch (All was clear and OUCH!)

    1/2/15 - Began stimming for IVF #2

     ****All Welcome!****

    We are Mommas to four fur babies - 3 dogs and 1 cat.

    image   

  • jszy10jszy10 member
    I did 3, took a break, and did another 3.  At the beginning I told myself that 6 would be my limit.  They do say that the likelihood of them working after 3 drops significantly....I guess because the majority of people that IUI's will work for get pregnant within 3.  IUI's are included without a limit on my insurance, but I can't see myself going through this much longer.  I think you really just have to decide how much you are willing to go through before you pull on the "big guns".  I thought IVF wasn't even an option for me because we are OOP, but DH is making it happen for us financially, so we are ready!

    GL with your decision.

    ME - 31, DH - 40

    Married 06/25/2011, TTC since 03/2012

    BFP #1 on 11/13/12 -- EDD 7/24/13 -- M/C (CP) on 11/21/12

    BFP #2 on  7/21/13 -- EDD 3/29/14 -- M/C (CP) on 7/31/13

    09/4/13 - 4/16/14 -- IUI #1 - 6 = BFNs :(

    7/13/14 -- IVF #1 w/ ICSI

    ER on 7/26/14 -- 20 R, 15 M, 11 F

    ET on 7/31/14 -- 1 transferred (4bb); 8 frosties!!!

    BFP #3 on 8/8/14 -- EDD 04/18/15

    BETA #1:  473,  BETA #2: 1009, BETA #3: 1975

    ** It's a BOY!!! **

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  • emmuffyemmuffy member

    These are all really thoughtful and helpful responses. I really appreciate the community here. I think this will be our last IUI cycle, and I feel like it's the right decision. I'm Canadian, and in my province, IUI is covered while IVF is not, and while I have additional private insurance, it does not cover any fertility treatments... so IVF will be entirely out of pocket. In addition, we're using donor sperm (we're a same sex couple), so that's another expense, although it's already paid for at this point (3 units left). While IVF is expensive, the barrier for me has always been less about the money and more about the fact that IVF seemed invasive and scary. Then again, the stats are so much better. Our clinic tells us that with a single embryo transfer, the odds of a pregnancy are about 50%, going up to 70% with two transferred. This sounds about in line with what others on this board have said, but since we're in Canada, I don't think there is any information like what you have with SART. I think that repeated IUI can be very emotionally draining if it drags on and on (as it has for me without any success whatsoever). The only other option my doctor suggested at this point would be laproscopy to address potential endometriosis (suspected due to cysts, but I have no other symptoms such as pain), followed by more IUIs. Frankly, I don't want to go through another six months of IUIs only to find out I will need to do IVF anyway.  IVF will also give me more clarity regarding my suspected egg quality issues (low AMH). So it seems like the best choice. I've given it a fair shot with the IUIs but enough's enough. Moving on!! Thanks for your support and wish me luck :).

    Official diagnosis: Unexplained IF. I am 32. I have low ovarian reserve (low AMH), and poor egg quality. I've also been diagnosed with mild glandular developmental arrest (lining problems, detected with EFT).

    We are using open ID donor sperm. IUIs #1-7=BFN. IVF September 2014 antagonist protocol, 8R,5M,3F, 5 day transfer of 1 morula = BFN. IVF#2 planned for January 2015 (antagonist protocol + HGH).

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  • I'm considering this right now also.  I've done 2 IUIs with Clomid, one clomid cycle without IUI.  My only known problem is low progesterone, the clomid fixed that, but I'm not pregnant.  I think we are going to do one injectable cycle with iUI, then move on to IVF.  I am not a patient person and I just have a feeling the IUIs are not going to work for us.  So to continue spending time and money on them just feels like a waste of time.  
  • vpinevpine member
    I did two injectable IUIs and then moved to IVF. Looking back, I would advise women to go straight to IVF if they have insurance coverage. Simply because of the higher success rates
    Me: 32, DH: 34.
    Trying since Jan 2011. Unexplained IF.
    2 IUIs = BFN.
    1 IVF (Dec 2013) = BFN.
    FET, 2 frosties (June 13, 2014)

    14dp5dt-June 27 -BFP, beta 2061. 2nd beta >5000, 3rd beta >5000, 2 sacs 06/30.
    Twin Girls - 02/11/15 - at 37 weeks (no NICU, home with me at 3 days).
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