WWYD?? IUI vs. IVF

lebradford · July 2014

I'm in the 2WW for IUI #3, and I'm starting to think about when to move to IVF. I was hoping you guys might be able to give me a little insight or reassurance.

Personal Background: I am 29, DH is 41.

Medical Background: I have "only" been TTC since September 2013. I didn't ovulate on my own once in 6 months, so I started seeing a RE. I have hyperprolactinemia, which causes ovulatory dysfunction. That is our only diagnosis.

IUI #1 Stair-stepped Clomid from 50mg to 100mg, ovulated 1 follicle on CD 26, BFN.

IUI #2 Stair-stepped Clomid from 100mg to 150mg, ovulated 1 follicle on CD 21, BFN.

**Benched for cysts**

IUI # 3 75iu of Follistim for 8 days, 1 mature follicle, IUI on CD 12

Insurance Background: We DO have infertility coverage (thanks, IL!!), but it does not start until we have been trying for a year (September). We have been paying OOP for our IUI cycles just because we want to get the ball rolling. Our current insurance company is very disorganized and inexperienced (a new company). We will have different insurance beginning in December (also with IF coverage).

Questions: I am starting to get frustrated by IUIs. I know their success percentage goes down after 3 attempts or so. Part of me wants to move to IVF because my RE gave us the same percentage chance of ONE IVF working compared to 3 injects + IUI cycles. On one hand, we have been seeing the RE for about 6 months, so IVF sounds reasonable. On the other hand, I haven't even been trying a year yet, so is thinking about it crazy? I've only ovulated 3 times!

WWYD? I definitely am waiting until at least September to start IVF, because we won't have insurance coverage until then. Is that too soon? Does it make sense, given our insurance coverage and number of IUIs? Would you do IUIs in the meantime? Would you wait a while? If so, how many IUIs would be your limit? Would you wait for the new/better insurance company/starting fresh with deductibles?

Sorry for the huge ramble. On one hand I think IVF might make sense, and on the other hand, I feel like we're jumping the gun??

Thanks for reading!!

ronniesgirl1981 · July 2014

I know, I know, I know...it only matters how young the female partner is...but as someone with a 40 in a few weeks husband...his age matters at least emotionally. I'm for it! Plus September will be a year and my RE is not a fan of injects and IUIs. He thinks the risks strongly out-weigh the modest increase in success.

RNCrystal · July 2014

I'm kinda in the same boat. Iui#3 last month was a bust and I'm debating to move to iui#4 or move to ivf. My hubby is older then me as well and I'm so torn. I think if I were you I'd move to Ivf I'm sept. When your insurance kicks in. As for iui in the meantime- depends - do u want to relax and prepare for this new step or bust out one more chance at iui ? Either way best of luck

catlover790 · July 2014

I am not sure what I would do. I just wanted you to know I get that feeling about not giving it as many tries since I don't O. I've only O'd twice in 12 months and I'm thinking that we really have hardly even had a chance to get pregnant!

I like the idea that IvF has higher success rates and you'll have insurance coverage. Also, What does your DH think? Good luck with your decision!

lebradford · July 2014

Thanks, ladies! This has helped so much already! It's so good to know that my intuition isn't just crazy hormones and impatience talking!

emmuffy · July 2014

IVF, but if you have to wait until Sept, I'd probably do IUI until then. I'm doing an IUI cycle while waiting to start IVF (on my spouse's urging... because you never know... but in our case, we have to pay OOP for IVF, so we're also doing IUI while we wait on the basis that "anything's cheaper than IVF)

lebradford · July 2014

RNCrystal said:

I'm kinda in the same boat. Iui#3 last month was a bust and I'm debating to move to iui#4 or move to ivf. My hubby is older then me as well and I'm so torn. I think if I were you I'd move to Ivf I'm sept. When your insurance kicks in. As for iui in the meantime- depends - do u want to relax and prepare for this new step or bust out one more chance at iui ? Either way best of luck

This is another part that is hard for me to decide! Personally, breaks are hard for me, and I think I would rather do another IUI. However, I want to start IVF as close to the beginning of September as possible if I'm going to do it now, because I want to avoid it running into the holidays, if possible. However, I'm worried if I do another IUI I'll end up benched for cysts when I want to start IVF. Thoughts?

catlover790 said:

I am not sure what I would do. I just wanted you to know I get that feeling about not giving it as many tries since I don't O. I've only O'd twice in 12 months and I'm thinking that we really have hardly even had a chance to get pregnant!

I like the idea that IvF has higher success rates and you'll have insurance coverage. Also, What does your DH think? Good luck with your decision!

He is pretty open. We have run through all of the different scenarios. ;-) I think he is leaning towards doing IVF sooner rather than later, mostly because he wants our IF journey to end sooner rather than later. He has left it up to me though, which I appreciate.

Pintobean39 · July 2014

If it were me I'd go to IVF when you have coverage because it's a better success rate. I would also keep trying IUI until coverage was available since you don't ovulate on your own anyway it would make a long wait. Also another injectable cycle will give your RE a good idea of how you respond to meds if needed. Then again I can't stand not doing anything. Who knows it might actually work!

ebliss444 · July 2014

If my current IUI cycle doesn't work, I'm moving on to IVF. Because the process takes a while, the nurse at my clinic actually said we can do another IUI cycle while the IVF process is underway and if that works -- then we can obviously stop midway through.

Maybe someone who is more familiar with the timing can enlighten me on how exactly that would work timing-wise, but I throw that out there as one option!

Good luck!

RNCrystal · July 2014

Hmmmmmm because of the risks of cysts I think I would prob take a break if I were you- you can try to take the time to relax and have fun before starting this new experience if ivf. Personally I find a break between cycles to help me mentally and regroup myself. I would hate to see you have to prolong the ivf any longer. Tough decisions

fx for you

gsancho · July 2014

I'd do IVF in September, especially since you'll have coverage. Most REs put you on BCPs for a couple of weeks before IVF, so depending on the days of your cycle and when you'd have to order meds, you may be able to get started in August to prep for stimming in September.

Plus DH and I did a mini break before IVF and I was so glad we did! I think an IVF cycle is more stressful between all of the monitoring, figuring out time off from work, the miserable wait between ER and ET...it's just more ideal to have a little mental cleansing beforehand, IMO.

Kam10 · July 2014

I would move to IVF in September. If I had any sort of insurance coverage for IVF I would be doing it right now myself.

I would probably keep doing IUIs in the meantime, but that's because I'm really bad at taking "breaks". Good luck with whatever you decide!

Hollowvic · July 2014

If I had insurance coverage I would move onto IVF in a heartbeat. I'm also 38 years old, but the success rate is so much better. It would be a no brainer for me,

lebradford · July 2014

Thanks again guys!

I just got off the phone with my nurse and she said that they require you to be on BCPs for at least 2 weeks before your IVF baseline. They also do batched scheduling (is that what it's called??). Unfortunately, for how my cycle falls, if I want to do IVF in September, I will not be able to do an IUI in August, and I will end up on break for about 5 weeks. :-( I know in the end, 5 weeks isn't that long. However, this makes me feel less sure of the decision I *thought* I reached a few hours ago to do IVF in September. If I could give injects + IUI 2 tried first, I would feel pretty confident. If I can only give it one try, I feel a little less sure.

God, there's so much to think about. I hate the idea of the batched scheduling. Is that pretty common?

Pintobean39 · July 2014

I never new this until my ER but my clinic does batching too. The lab takes off 2 weeks every so often so they work everyone around this schedule. I was on drugs at the time but I think it's because it's such a demanding job and they have to be there all the time. It gives the employees days off work and possibly vacation time. I think all clinics do this, mine is just not as big as some in the NE so it's not as noticeable.

BunnyBerry · July 2014

So sorry that IUI hasn't worked for you yet. Does your infertility coverage after 1 year include IVF coverage? If so, I would definitely start as soon as it was covered!

I think if I had not ovulated at any other times, then I would give it closer to the 4-6 chances for IUI until coverage kicked in. Seems to me that in that situation, perhaps there's more of a reason to continue.

Good luck with whatever you choose! And I'd maybe ask the RE about what you could do to get the timing just right for September IVF.

emmuffy · July 2014

My clinic does batched cycles for IVF too. That's how I ended up doing an extra seventh IUI while I wait to be able to start IVF. It's annoying but I suppose they have good reasons. I'm so impatient. I carry around my clinic's IVF schedule in my purse so I can look at it all the time.

lebradford · July 2014

You guys are so amazing. I feel so much better after reading what everyone has said. I spent a lot of time reading and thinking today. I talked to my husband when he got home and showed him the spreadsheet I made (nerd alert!), and I am feeling pretty good about taking August off and starting IVF in September. (Ask me how I'm feeling about the break part a couple of weeks in though....)

@BunnyBerry, our IF coverage does include IVF. In IL, IF has to be covered like any other medical condition (including IVF, up to 6 times). So that means we have our deductible, co-insurance, and an OOP max of about $3,500, which is all we would have to pay in a whole year (for me only, and not counting the money we've already spent doing IUIs OOP). We are incredibly lucky. I do have to submit a pre-approval, and I am a little nervous that they will deny a IVF cycle so soon, but I did talk to them and they said they would basically cover the treatment the doctor recommended. I'm hoping that is true!

Thank you so much to everyone who took time to read my novel and thoughtfully respond.

kristyn831 · July 2014

I'll be moving on to IVF as soon as I can. The chances with IUI are so low and I don't want to waste any more time with all the appointments for something that probably won't work.

lebradford · July 2014

Thanks, @CaterinaC! I was thinking that would probably be the case. And even though I'd rather be doing something in August, August is probably one of the hardest months of the year for a teacher to cycle during, so it's probably for the best. Plus I think I could use some time to come to terms with IVF if this doesn't work. I still have some strong IF denial sometimes.

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WWYD?? IUI vs. IVF

Re: WWYD?? IUI vs. IVF

Me 33, DH 37 -- TTC since Jan'12 -- Low AMH (0.78) & endo, SA w/ low motility
IUI's 1-3 = BFN, IVF converted to IUI 4/13 = BFN
IVF 1.2: 8R 6M 4F -- 2 blastocysts frozen, FET 8/15 = BFP!!
Beta #s = 445;1,098; 9,545 -- EDD 5/2 -- Team Pink!

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Want a personalized experience?

WWYD?? IUI vs. IVF

Re: WWYD?? IUI vs. IVF

Me 33, DH 37 -- TTC since Jan'12 -- Low AMH (0.78) & endo, SA w/ low motilityIUI's 1-3 = BFN, IVF converted to IUI 4/13 = BFNIVF 1.2: 8R 6M 4F -- 2 blastocysts frozen, FET 8/15 = BFP!!Beta #s = 445;1,098; 9,545 -- EDD 5/2 -- Team Pink!

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Me 33, DH 37 -- TTC since Jan'12 -- Low AMH (0.78) & endo, SA w/ low motility
IUI's 1-3 = BFN, IVF converted to IUI 4/13 = BFN
IVF 1.2: 8R 6M 4F -- 2 blastocysts frozen, FET 8/15 = BFP!!
Beta #s = 445;1,098; 9,545 -- EDD 5/2 -- Team Pink!