why we're moving on to IVF

tweetyknicks · August 2014

The discussion of when and why to move from IUI to IVF seems to be a common thread on here, so I'll outline my rationale for anyone interested.

1. DH's motile sperm count was only 2 million for both of our IUIs, though I seem to respond well to meds. My best estimate is that gives us a 5-10% chance of ongoing pregnancy each cycle (12% at most). That is not high enough to make it worth it when we could have a >50% success rate with IVF. (I tried asking my current RE a couple of times about his estimate of our chance for success using IUI and he did not answer either time. No idea why.)

2. It also seems like one round of IVF may be less cumulative wear and tear on me than half a dozen rounds of IUI. Each cycle takes a toll, both physically and emotionally. I much prefer one really rough month to death by a thousand paper cuts. Since I am very active, the meds pretty severely hinder my lifestyle and make me act bipolar for a week or two each cycle.

3. We are mostly OOP to the tune of about $1000 per IUI. Finances are a concern. Looking at the cost for a take-home baby, IVF may be cheaper overall than IUI. We also plan to do this again in the future to expand our family, so we hope to have frozen embryos for future use, which would also reduce the cost of future IVF cycles (rather than paying for many rounds of IUI all over again).

4. DH is 53 and I'm 29. Though it may not seem like it to those outside IF, time is an issue. We don't want to waste time waiting to see if DH's numbers will improve or if IUI will work. DH wants to be able to chase around his kids until they're grown and hopefully chase a few grandkids after that. He is in *great* health, so we have decades to work with, but the more time we have the better. On my side, I'll be 30 at the end of the year. That's not old, but I may be pushing the magical and dreaded 35 for future pregnancies. I would like to have all the kids we're going to by then (if we can) to avoid the complications of being an "older" mother.

***adult children mentioned, not mine***

All this means we will be switching REs so we *might* be able to get some insurance coverage for diagnostic or monitoring procedures for me. DH is disqualified from insurance coverage for IF since at one point he underwent voluntary sterilization (since reversed). Our new patient appointment with the new RE is Sept. 22. I think the timing will work out well. It will give me a break from meds and give us time to deal with some issues with DH's two "adult" sons.

(Not relevant to the discussion, so skip if you'd like) About DH's sons: Our goal is to have both of them in apartments on their own by late September. I get along okay with the older one (22yo) and only rarely with the younger one (18yo), for various reasons. Both of them need to learn to live independent of DH for different reasons. I already told DH that I cannot go through IVF while either of them still lives with us. It has already been difficult for me to go through the ups and downs of IUI with them around. Neither of the boys know that we are doing these treatment cycles. The 18yo is far too volatile to trust with that kind of information, and the 22yo has had enough problems with his younger brother that he doesn't understand why anyone would want to have more kids (particularly DH).

The woman I talked to on the phone said I would probably be able to start the IVF cycle (with ovulation suppression and/or FSH shots) within a month or two after our new patient consult. She said that since I am young and have a high antral follicle count (PCOS), the doc would probably want me to take birth control pills before starting the stim cycle. If it looks like I have a follicle developing, they'll wait until after my next period to start me on BCP. If labs and u/s show that I have no follicles getting ready for ovulation, they may start me on BCP right away.

I'm a little concerned we will run into the holidays for the ER and/or ET, but maybe we can somewhat control the likely time period in which we plan to do those by adjusting the length of time I'm on the BCP. I'm not sure how that works yet.

DH and I will have to compile our list of questions over the next month. I'm sure it will be extensive.

**Would anyone on this forum be interested in having me update this post with our questions as we generate them?**

lupineaura · August 2014

That was a helpful read. Good luck, both with starting the IVF process and with your stepsons!

BunnyBerry · August 2014

Thank you so much for sharing your reasoning! It sounds like an excellent choice for you for many reasons.

I'm also 29 and have the exact same thoughts about my age. It might seem like a healthy age to start TTC for someone without IF, but it really doesn't give enough of a cushion for multiple kids by IUI! And, the cost analysis makes so much sense. Everything I read says the chances of one IVF cycle outweigh the chances of 5-6 IUI cycles for those with MFI.

I'm sorry about your SSs. That age is so hard. My bro/sis just went through that and are kind of coming out on the other side now but they are just so self-centered at that time and don't care who they affect!

I hope the timing works out perfectly, so you can get things calmed down at home for you, but also avoid the holidays.

RNCrystal · August 2014

This was super helpful! Thanks for posting! I've been struggling with this decision for a bit so it's nice to hear rational! My husband is also a bit older then me so I feel I should get the show on the road- I'm headed to work so my redponse is kinda short but again thanks for posting!

EmilieT10 · August 2014

I'm on the same page as you and enjoyed reading your rationales (similar to mine and DH's but a low count with 0% morph). It took us a few weeks of discussion and a few more tests to realize that IVF would be our treatment of choice. All that's involved with IVF sounds overwhelming and took us a little while to process. But whatever it is that we have to do will be totally worth the chance of success.

I would definitely be interested in reading any questions that y'all come up with as you go. It sounds like we may start around the same time (we're scheduled to start after Thanksgiving), so definitely want to keep updated with your experience. Hope it all goes well!!

MrsLolaSky · August 2014

tweetyknicks--thanks for sharing all that! I definitely want to hear more from you as you go through everything.

DH and I have decided to try one IUI--but we may also move to IVF-ICSI soon. (We keep going back and forth!)

Good luck!

Hollowvic · August 2014

I am trying to decide whether to try more IUIs or just go for IVF at this point also. DHs numbers are similar to yours. Time is not on our side either as I'll be 39 in a couple of months. DH is 29 here we thought my age would be the issue, joke is on us! Good luck with whatever you decide, I know exactly what you're going through!

swyatt2014 · August 2014

I think making a decision about your plan is awesome and its a good step in this journey. Good luck to you on the IVF and the younger step son. I understand that stress can really impact the process. I'll be possibly trying IVF in the coming months so I would very much like to see you update this thread as well.

bbboyd09 · August 2014

Just saw this after I replied to your post on my board! Good luck, and I'd be very interested in what questions you have foe the RE and their response.

tweetyknicks · August 2014

Thanks for the reference Naria.

I'll update here when DH and I start our brainstorming. Thanks for the well wishes!

@rainbowbridge14: I'd hesitate to have only one child myself. All the single children I've known have been a little strange... :-P

theholmanherd · August 2014

I wish you the very best of luck with IVF. I hope things work out with our stepsons also. (((HUGS)))

LindseyM2012 · August 2014

Like others have said, thank you for sharing your thought process. This line of reasoning could probably be applied to making a decision between any two treatment options. It is not only about what the doctor recommends but what best suits your preferences, ages, finances, timelines, etc.

I like logic so I love this!!

TTCBabyJ · August 2014

I think those are really great reasons for moving on to IVF. It is really odd that your RE won't give you the stats for a successful IUI. I love the fact that you are outlining the reasons. I am a very organized person and it sounds like something I would totally do. And good luck with your stepsons, it sound extremely trying. My stepson is only 11 and everyday it is a real struggle, I could only imagine dealing with him if he were an adult. (((Hugs)))

tweetyknicks · August 2014

@TTCBaby: RE did finally get back to me. I guess he didn't notice the question the first time and was out of town for the weekend the second time. He said 10-15% per cycle at best, and probably quite a bit lower with MFI.

The two IUIs we did were very educational, both in terms of how I react to meds and how the IF medical community works. I think it's allowed me to make a better informed decision about my IVF doc.

BKBABY3 · August 2014

Thanks for taking the time to share all of that. I know it's a decision that many of us struggle with. For me, my coverage with IUI is really good, but IVF would be completely OOP. So I keep chugging along wtih IUI, but I do still feel that clock a-tickin'.

@rainbowbridge14, I totally get it. I'm not sure if I would be up for another round if I can ever get this one to work! (And I'm 35 already--blargh.)

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