IUI with gonal f injectibles question

maryfari · September 2015

Hi ladies,

I'm scheduled for an iui this month. My protocol would be clomid (100mg) + gonal f shots + Ovidrel + iui .

I respond fairly well on clomid because I already have a healthy natural ovulation. The doc still wants me on clomid for iui. My question is, why would my doc prescribe gonal f shots despite responding well on clomid alone?

Any insights would be appreciated.

tripledaggerWed95976 · September 2015

Hmmm I'm not sure. When I did clomid iui cycles I wasn't prescribed gonal or anything else, and like u I always responded really well to clomid. I'm sure ur doc has a reason though. Good luck w ur iui!

maryfari · September 2015

Thanku for the good vibes... bumping this in case anyone else may know why..?

maryfari · September 2015

Bump again!

ArtlessIbex · September 2015

There is a board for Trouble TTC and one for success after infertility where you may have more luck.
My only advice (no experience in this area) is that if you're wondering why your doctor is doing what they're doing, ask them. If they can't explain why it is being prescribed, or you feel the reasoning is off, get a second opinion.
It's your body, and in the end, you have the final say.
I hope you find someone who can answer your question.

bsckgb7 · September 2015

My doctor put me on Follistim (another injectible) and said the egss are stronger and healthier with injectibles (ie more likely to fertilize). Maybe they are trying to boost them up. How many and how big follicles do u get on Clomid alone?

maryfari · September 2015

@bsckgb7 ... last time around I got 2 on each side.. one having 19mm and 18mm, the other having 19mm and 22mm. Just clomid. No injection

bsckgb7 · September 2015

That's awesome!! How many cycles with just Clomid? My doctor changes the protocol after 2-3 cycles with no BFP (even w good results from the previous meds).

maryfari · September 2015

@bsckgb7 wish you luck. I'm still pondering over whether to convince my doc to drop the idea of gonal f or not

KLake42 · September 2015

Be your own advocate. Medicated IUIs carry a risk of multiples, and while it's fun to think of having two babies, it's a high risk pregnancy. Asking to skip the gonal f in order to minimize that risk is reasonable.

My RE would really like to see me with 3 fat follicles right before the IUI, because with my age and low reserve, there are egg quality concerns, so 3 follicles doesn't necessarily mean 3 good eggs. I'm expecting a protocol with femara, menopur, and trigger shot before my next IUI, since that's given me 2-3 follicles in the past.

One question-- if your ovulation is good, why are you doing IUI? You can tell me it's not my business, but if you're doing IUI just because you're relying on donor sperm or because your partner's sperm needs a bit of boost into the cervix, then it makes sense to maybe not use too many medications (aside from perhaps ultrasound monitoring and trigger, to make sure the timing is good). Get a second opinion, if you're not comfortable with what your RE recommends.

bsckgb7 · September 2015

I am doing IUI and have no issues with sperm or ovulation. I had a PC test that showed his swimmers were dead. So it appeared I had hostile CM. SO my RE recommended IUI. Most doctors will move onto IUI after several cycles with TI and no BFP (even with what appears to be no underlying (conditions).

maryfari · September 2015

@KLake42 thanks for the insightful response. The decision to coming to iui is a complicated one (emotionally) so let's leave it at that. As for the medications, did I understand correct from your reply that gonal f can further increase my risk of multiples? I still have 2 more days to decide whether I want the gonal f or not, so your answer was very helpful to me.

maryfari · September 2015

bsckgb7 said:
I am doing IUI and have no issues with sperm or ovulation. I had a PC test that showed his swimmers were dead. So it appeared I had hostile CM. SO my RE recommended IUI. Most doctors will move onto IUI after several cycles with TI and no BFP (even with what appears to be no underlying (conditions).

When are you scheduled for the iui? Mine would be around 29th or 30th Sept.

KLake42 · September 2015

@maryfari,
Yes, the gonal f increases the risk of multiples. Your doctor will likely plan to do an ultrasound before the IUI, and if you have too many follicles, you might cancel the IUI to the avoid the risk of too many.

But of course, talk to your doctor about this and don't just rely on my word. I know that my doctor is very cautious about using injectibles with IUIs because of the risk. Since I'm over 35 and have low reserve, I'm one of the lucky few who get injectibles under her care. She still keeps me on a low dose compared to what some women get. My protocol is femara, menopur or bravelle, and trigger shot (and progesterone, after the IUI).

My next IUI (#6) will also be around Sept 30.

There is a very active (so active, it's hard to keep up) thread on the Infertility board with women getting September IUIs.

bsckgb7 · September 2015

^^ i agree with all this. On Letrozolle, I had 3-4 follicles and with Follistim I had 4-5. Didn't sound much different to me. The nurse freaked out and said me might have to cancel (this was last cycle). Seemed odd to me because it wasn't many more follicles. She said injectible eggs were more likely to fertilize. They said injectables give a 20% chance of twins. I had to sign all kindsof waivers about multiples and OHSS with injectibles. My IUI is scheduled for Tues.

maryfari · September 2015

@KLake42 and @bsckgb7 thanks for the info you both gave me.. after ttc for 6 years, me and DH would love to have twins, although when I think of the practicalities and complications involved, I think otherwise.
I was not aware of the September iui board. I will most definitely check it out.
I wish all of three of us the best of luck for this iui cycle

maryfari · September 2015

@KLake42 can you please send me the link of the September iui thread? Would really appreciate that!

bsckgb7 · September 2015

https://forums.thebump.com/categories/trouble-ttc

This is the infertility board.

There is a thread for Sept IUIs

KLake42 · September 2015

I would be delighted to have two healthy twin babies. I am scared about the risks involved with a twin pregnancy, though!

here's the link: https://forums.thebump.com/discussion/12612276/september-iuis#latest

maryfari · September 2015

Thanku so much!

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