IUI-->IVF questions

fuzzbumble · October 2014

As my second iui draws to a close without a pregnancy, I am considering some next steps.

Injectable meds: for poor responders to clomid/femara or just unsuccessful? I don't want to do anything to cause my follicles to grow bigger or faster. Just better quality and more of them

How many IUIs before moving on to ivf? (Actual or projected) our RE suggested five, but research seems to say that after three you should move on.

PGD for recurrent pg loss yay or nay? (We've had one missed at nearly 13 weeks, and one cp. RE said I'm only sort of considered RPL because my losses were different types, unlikely to be related, just bad luck.)

sailorgal · October 2014

My clinic suggests CoQ10 (Ubiquinol version) for quality. Of course I have no idea if it's making a difference though I've made DH take it too and am interested to see during our next IUI if he's shown improvements after a few months of it.

Our clinic suggests 3 before moving on but we're planning to do 4-6 as we're unlikely to move onto IVF and will likely call it quits.

I'm weary of injectables due to the even higher risk of multiples. I've also responded well to both clomid and femara but my RE doesn't like clomid.

pettycrocker · October 2014

Are you doing COQ10/ DHEA for egg quality? I'd be doing that for at least 3 months prior to more treatment cycles, and ALWAYS go with IUIs until you have depleted that option (learned that the hard way) IVF is physically, emotionally, mentally, financially, draining. If it's possible to get pregnant ANY OTHER WAY, I'd always say do that.

Yes to PGD for reoccurring losses, but that would be 3+ losses, I would skip it for 1 m/c and 1 c/p.

So if it was me, speaking as a person who felt like IVF was pushed on me way too soon, I would definitely try at least a couple inject IUIs if they are giving you that options, and just do supplements to help with the egg quality.

Good luck.

fuzzbumble · October 2014

Thank you! I will have to ask about the supplements, he didn't mention taking anything besides vitamin d. Although definitely not looking forward to choking down yet another pill.

That is what I was thinking with the PGD. In my case it just seems excessive.

I was going to ask about injects, especially since I only got one follie this time.

Thank you both! So thankful for this board.

Jodee37 · October 2014

i was taking ubiquinol and DHEA for 4 months before ivf. and i've had 4 losses and all my RPL results look fairly normal. my RE does not put a lot of faith in PGS for my situation.

i would recommend you look into the research on pregnancy success rates with PGS versus those without. it's eye opening. not trying to start a war here, i just think you should be an informed consumer, if you will.

Frenchteachermama · October 2014

We did 3 rounds of IUI before moving to IVF. My doctor had me on DHEA and CoQ10 for 3 months before and a Testerone patch for 2 weeks before retrieval. I've had one loss at 8 weeks and a CP. My RE wanted me to do PGD testing but since I only made 9 eggs (7 mature and 7 fertilized) we decided not to do it.

fuzzbumble · October 2014

Of the studies I've been able to find so far, PGD actually decreases the live birth rate, and has only been proven beneficial for those over the age of 37. Also, there was no difference between the PGD group and the control.

interesting.

As far as the CoQ10 goes, is it used your cases for ovarian reserve issues? (I can't see siggys, mobile) or is it an across the board, take this because it might help? The studies I've found on it involve DOR, and older mice.

jen4ny · October 2014

I would do at least 3 IUIs. My RE will do 3 and then he meets with you to discuss the options. My first IUI was just with clomid and for the 2nd we did clomid and follistim. Now for the 3rd he has changed me to femara and increased the dose of follistim. The follistim definitely helped. With just the clomid I had one follicle. The follistim increased it to 2 follicles last month and we will see what the higher dose does this month.

MoFree · October 2014

IVF is much more intrusive, more expensive and takes longer but has a much higher rate of success. It a depends on your DX and insurance.

For us IVF was the only option but with a different DX I would probably have tried 3 IUIs before moving to IVF.

GL.

Davie813 · October 2014

I'm doing 3 IUIs (on #3 right now) before moving on to IVF. However, I'm 40, so time is of the essence. I also started right in with injectables instead of clomid, femara, etc, so IVF is really the only logical next step.

For you, since age and time are not such an issue, I can definitely understand not wanting to rush into IVF. IUI with injectables probably would give you more follicles to work with, and it would also give you an idea how you respond to the drugs before going all out with IVF.

I'm currently taking ubiquinol. I was taking DHEA too, but my RE isn't a fan.

I'm on the fence about PGD testing as well, for a lot of reasons.

Good luck!

sailorgal · October 2014

potatocastillo said:

If it's possible to get pregnant ANY OTHER WAY, I'd always say do that.

I feel like the need to amend this to say "get pregnant and STAY pregnant any other way." Cause that's more my problem.

I think our clinic is humouring me with the IUIs for now. Last treatment plan that was emailed to me shows the upcoming IUI cycles with a note from the nurse that the RE strongly advises against completing it and it's written on the plan itself.

pettycrocker · October 2014

sailorgal said:

potatocastillo said:

If it's possible to get pregnant ANY OTHER WAY, I'd always say do that.

I feel like the need to amend this to say "get pregnant and STAY pregnant any other way." Cause that's more my problem.

I think our clinic is humouring me with the IUIs for now. Last treatment plan that was emailed to me shows the upcoming IUI cycles with a note from the nurse that the RE strongly advises against completing it and it's written on the plan itself.

Really? Why would they make a protocol for you if they think it's pointless? That is so frustrating!

Yes to the getting pregnant and staying pregnant part - or for me, getting pregnant in THE RIGHT PLACE would be nice lol That is another thing to worry about with IVF, it has the highest occurrence of ectopic pregnancy at about 5%, which doesn't seem like much, but I know of at least one other person on our tiny board that has had an IVF cycle that resulted in ectopic pregnancy. It's always effing SOMETHING with IF.

:-q

sailorgal · October 2014

potatocastillo said:

Really? Why would they make a protocol for you if they think it's pointless? That is so frustrating!

Yes to the getting pregnant and staying pregnant part - or for me, getting pregnant in THE RIGHT PLACE would be nice lol That is another thing to worry about with IVF, it has the highest occurrence of ectopic pregnancy at about 5%, which doesn't seem like much, but I know of at least one other person on our tiny board that has had an IVF cycle that resulted in ectopic pregnancy. It's always effing SOMETHING with IF.
:-q

Well it's more my fault...largely because IVF isn't what I'm prepared for right now but I don't want to do nothing

Really I'd like more exploratory stuff done but we're getting there between them, my doctor and the naturopath.

Also our government is working on a plan to fund one fresh single embryo IVF treatment per infertile person plus subsequent frozen cycles from that that cycle. This may roll out next year. Tight lips on the criteria but I'm figuring the more treatment cycles we do, the more likely to be eligible if we need to go there.

I think 5% is significant. Especially when you consider that clomid results in what like 8-10% multiples pregnancy and look how many multiples pop up. Statistics can be nerve-wrecking.

fuzzbumble · October 2014

Honestly, I'm having a difficult time sticking with IUIs. If we did the five my RE suggested we do at consult, we'd be $6-7k into treatments. That is half of IVF. I just have a hard time with paying all that money, since we are completely out of pocket, for a less than 10% success rate. I may get pregnant eventually, but after how long and how much money? I don't know. My clinic's success rate with IVF is 72% in pts with ovulatory dysfunction under the age of 35, 60% for all IVF cycles, all ages and diagnoses. They also had zero triplet pregnancies. I have a lot of confidence in their abilities.

I'm doing at least 3 IUIs, and I truly pray this one works. Ideally, no one would need thousands of dollars, years out of their life, and millions of tears shed just to become a parent. But if this is what gets me pregnant, I'm going to do it. I don't want to spend years seeing an RE.

sailorgal · October 2014

fuzzbumble said:

But if this is what gets me pregnant, I'm going to do it. I don't want to spend years seeing an RE.

I think it's good that you have prioritized it in your mind. I'm willing to spend a bit longer with less aggressive treatments. I found communicating this to our RE was helpful.

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