Been thinking (UPDATE after seeing RE)...

Frenchteachermama · June 2014

I have my pre-IVF appointment with my RE and my DH at 1:45pm. Even though the plan has been to move straight to IVF, I started to think some more about my body and my summer and was wondering if maybe I should try to do one or two rounds of IUI with injects before moving to IVF. I plan to discuss everything with my RE but I know that he is ultimately going to tell me it's my decision.

Since I'm relatively new to the IF community if I was going to pose a question about ladies success with injects + IUI vs femara or clomid + IUI which board would I post on? Success after IF or PAIF?

Thank you all for your support, I'm so happy that I found you all!

So DH and I went to see my RE for your pre-IVF meeting. DH had never met him and really liked him which was great. Even though this last cycle was my second IUI it was my first through this new RE. Before we got to talking about IVF, he pulled up my records and said that on paper my cycle was "perfect", but obviously what's on paper and IRL are different since this cycle is a BFN. He said based on my response to the femara that he would like me to see do one more round of IUI with femara before moving onto IVF. Part of me was relieved to hear him say that because at some point during the day yesterday I realized that I was rushing into moving to IVF. I asked about injectables and he said like @designer303 said that financially it makes more sense to move to IVF instead of injectables + IUI. I had a great response to the femara it's just with my super low AMH I'm not having success. He said I could stop my progesterone so AF would come and call for CD 3 testing and start the process again.

I realized that part of me was rushing into IVF because of my family situation. Even though I know my low AMH is really an obstacle, I think I was rushing into IVF to make myself feel better about my sister being due in August. The bottom line is that I have to do what is right for me and my family. We had a couple of vacations planned to take DD1 back to see her "old" friends in the town we moved from and I wanted to go home to Chicago to see my parents and my grandmother who isn't doing well. All of those plans were going to be placed on hold for IVF.

So the plan is to do one or two more rounds of femara+IUI and do IVF in the fall once the girls are back in school. My RE spend over an hour talking to us and answered every single question about IVF and the PGS testing we'll be doing if we go that route. I feel like I'm in good hands. Before we left I asked my RE if there was anything else I could be doing on my side and he said "just keep living your life, have a great summer and let me worry about everything else." So that is my plan.

Thanks for listening!!

Momarazzi007 · June 2014

I've never done IUI mfi led us straight to IVF w ICSI, but how many rounds of IUI have you done? Do they recommend only a certain number?

Frenchteachermama · June 2014

Momarazzi007 said:

I've never done IUI mfi led us straight to IVF w ICSI, but how many rounds of IUI have you done? Do they recommend only a certain number?

This is my 2nd round of IUI. The only thing that is "wrong" with me is that my AMH is super low (.20). My RE said that I could do many rounds of IUI but the problem is that AMH never goes up only down so time is my enemy. What he said about IVF was that it would be saving me months of trying. And we could add in PGD where they genetically test the embryos if we wanted to make sure that I'm still producing viable eggs (which is another 4K of course). With my history of having two children in the past 6 years without any trouble whatsoever he isn't so concerned with the quality of my eggs but the quantity of eggs left. My AMH is the level of someone in their mid 40s not mid 30s.

Momarazzi007 · June 2014

Ok, that all makes sense! Again, still learning, and it seems IUI is so flexible in terms of meds and cying where as IVF is a lot more rigid, idk if that makes sense, like we were told IVF only option (obviously w severe mfi and ICSI). I hope the appt goes well and I will be waiting to hear what you guys decide! Good luck!!!

designer303 · June 2014

ok here I go: (warning this may be lengthy)

From what I understand they rule on IUI's is that if you have not gotten PG within three to four cycles it is unlikley that it will work. The being said I believe that is based on those three cycles all being the same protocol and if you have not tried injectibles with an IUI that would be different and the chances are usually better than those with a non-injectible IUI cycle.

When we tried the first time around we did two IUI cycles without injectibles and all BFN. Our first cycle with injectibles we got G, don't get me wrong I think we got very lucky that the first injectible cycle worked. Our plan was to do two injectible cycles and then move to IVF. We are in a similar spot now, we have done two non-injectable medicated IUI cycles which resulted in one BFN and one CP/ crappy pregnancy. We were scheduled to start an injectible cycle this month, but now benched so will have to be next month and if after two injectible cycles we havent gotten PG we will move to IVF in the fall.

Now that I have said all that, here are reasons to move forward with your current plan. Injectible drugs are expensive and spending the $$ on injectibles just to do an IUI may not make sense especially since time is of the essence for you. The price for the drugs for our injectible cycle was about $2000, drugs for IVF will be more and obviously so will the IVF, but if you end up having to do IVF you might be glad to have the money you would have spent on injectible drugs for IUI cycles. Because the numbers as I hear them are 25% chance of sucess with an injectible IUI cycles vs. 60% with IVF. Obviously these are average numbers and from the ladies on this board we know IVF is not always that good. Basically its a crap shoot and you need to figure out what you are comfortable hedging your bets on.

Okay hopefully that made some sense, if you have IUI questions that I didnt address, ask away Good luck and hopefully you, DH and your RE make this decision and it is one that brings you some peace so you dont have to worry and stress about it.

Momarazzi007 · June 2014

@designer303 said "Basically its a crap shoot and you need to figure out what you are comfortable hedging your bets on."
This- yes.

Jodee37 · June 2014

i too have low AMH (0.62) and add to that 1 crappy tube left so my situation is a bit different, but from what RE tells me time is the enemy so i would move straight to IVF. you're going to shell out a lot of money either way (maybe multiple IUIs + meds is just as costly as 1 round IVF), but in that IVF cycle you may be able to bank a few embies, giving you more chances...

we are going to IVF when we can figure out how to afford it.

and i don't have an answer about which board to post your q on, sorry!

MrsLaurenandDan · June 2014

Thank you @Frenchteachermama and @designer303. This has been on my mind too since I also have low AMH too (.46) We've been talking about how many IUIs to do, and we have tentatively decided to rule out Injectable IUI in favor of IVF for basically the reasons @designer303 said.

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