Decisions decisions...

mskeenan · November 2015

I am really torn and don't know what my next step for treatment should be. Anyone have any advice? My background: I've done 2 injectable cycles + TI and 2 injectables + IUI cycles. One chemical pregnancy from the four cycles. I have time to squeeze in one more IUI before the end of the year. I'm just not sure I'm up for it. I am exhausted. Exhausted from all the appointments, all the worrying and all the hormonal ups and downs. Our insurance covers IUI procedures for the most part (We only have to pay 250 + 80 dollars for meds which we are very lucky for). Luckily we have great insurance right now. My husband is planning on changing jobs very early next year so we won't have as great of insurance. My husband has elected to put aside 7500 in his flex spending account that we will have available in early January. We already have all IVF meds because we ordered them previously when we thought insurance would cover the IVF procedure. So, we will only need about 5 grand more (only, ha!) to do IVF in January. Should we do it? Or try IUI one last time?

The one thought that I have that is holding me back from IUI is thinking about what will happen a. if it fails b. if it works and I have another loss and c. if we do get pregnant but want more kids. If we have another loss ( I know I shouldn't think negatively) or get pregnant and want more kids later we will just need more IUIS down the road. Our insurance after my husband leaves his job will likely not cover any fertility treatments. I view IVF as an investment in our future because we could store embryos for future use so we won't have to go through more injectable cycles.

I am so sick of making decisions and constantly changing my mind about things. Why can't this just be easy?! Any advice is very much appreciated.

smdrodgers · November 2015

This is a tough spot, but honestly if I were in your shoes, I would go ahead and do the IUI this last time. Most RE's would say if it doesn't work after 3, they would switch you to IVF anyway. Since your IUIs are covered by insurance right now, I don't think it would hurt. If you do get pregnant (and hopefully you would!), then you would have the money in the flex spending account for delivery/apts/other stuff, and if you don't it's still there for the IVF.

I definitely feel you on the deciding one thing, and then changing your mind or second guessing your choice, but do what you feel in your gut is right!

KidShrink · November 2015

I think it depends partly on diagnosis, partly on where you are at emotionally and financially. If you feel that you need a break and don't want to spend the holidays going through appointments, then take a break. I had the option of another cycle vs a break just before my surgery, and I went for the break because I couldn't handle more heartache at that time. The other question is whether you will be losing that amount in your flex account if your DH changes job. If that's the case, and the remaining 5K is feasible for you, then I'd go for IVF in January.

vssbrm · November 2015

I am planning to break if this last IUI is not successful. As this was our 3rd IUI, we will have to figure out if we want to continue with IUI or move on to IVF. Our biggest hurdle is low morphology, so I am not sure that continuing with IUI would be a responsible choice.

vssbrm · November 2015

Opps did not mean to hit post yet.

I would say that if I were you I would try the 3rd IUI only if it is not going to mess up your holiday, esp if you are covered by your insurance!

I agree with you, I am sick of making decisions, I dont even want to decide what to cook for dinner.

wifeinraleigh28 · November 2015

I feel your pain!! My personal opinion is that, if money were no object, I would go straight to IVF and completely skip the IUI process. I don't do so well with disappointment and I would much rather prefer to go straight to the treatment with the best chances at a positive outcome. But we are going to exhaust all our IUI coverage (which includes 3x) if they are unsuccessful, since that's what we get from our insurance and our insurance doesn't cover IVF at all. Realistically, I know that if I was in your shoes I would decide that the best path would be to do one last IUI first... despite not wanting to!! GL with your decision making!! *hugs*

HBamama2B · November 2015

@mskeenan such a dilemma. I've been rooting for you the whole time and was so sad when your last cycle didn't work. This decision is one only you can make, but I'll share my thoughts that you can take or leave as they may be useful to you.

My opinion: I think it's about more than emotional and financial aspects. I suggest you don't do the third IUI given that this will actually be your 5th round of injects. Your body needs rest before your IVF cycle and after so much sustained intervention and heightened hormone levels. 5 rounds of that high of hormones and a miscarriage are all very physically difficult for a body.

Take three months and let your body heal. Three months just happens to be the time it takes for your health and lifestyle to impact those next developing eggs or sperm. This is an opportunity to improve egg quality so you can get the highest grade and largest follicle count your body can produce, which will sustain multiple tries if needed, or like us, be a bank for future siblings. Eat well, excersize, have fun, have sex for no reason or don't have sex Bc now you don't have to, enjoy the holidays and know that in January your odds with IVF will be 40-50% rather than 10% in December with an IUI. To understand the odds, my DH and I flipped a coin. It was a game changer. Just my two cents.

takethelongway · November 2015

I agree with @HBamama2B. I think while it is incredibly tempting to knock out one more IUI, I do not think it would be worth the emotional up and down. I had two failed cycles (one did not even make it to IUI) and jumped right to IVF. The odds of success are so much higher and if you're able to get a few embryos to freeze you do not have to worry about starting all over again for another child. I also agree that a break would probably help your body heal and take your mind off of the craziness of injectables. Reconnect with DH, enjoy the holidays, and start fresh at the beginning of the year.

vssbrm · November 2015

@mskeenan it looks like we are in the same boat as you. We did our 3rd IUI earlier this month, and as of testing this morning it does not look to have taken. Today was 13 dpIUI so its probably an accurate result. I am devistated. I think now, if the doc gave us the option to do another IUI (and we had only done 2) I would save the money and tears and move right to IVF.

mskeenan · November 2015

Thank you ladies for the input. I am meeting with my RE next Monday the 23rd so I'm just going to think about it until then. As of right now, I'm leaning towards not doing the IUI this month and taking off until January . I will need to move quickly if we are doing IVF and do it in January because when my husband quits his job we will use our flex spending account. He is planning on quitting around January of February.

I feel a little anxious not trying this month and next but I think it will be good for my body to get some rest. I want to go back to working out a lot and not worrying too much about high impact exercise. I also want my mood to stabilize..I am just a rollercoaster of emotions right now!!

@vssbrm I'm so sorry. I am so sick of negatives and bad news!! Did you take another test? Do you have another beta? What's your next step??

emsmama15 · November 2015

@mskeenan, as I read @HBamama2B's comments, it really resonated with me. I did 6 injectable cycles, the last GonalF/IUI cycle in August. Since then, I've been taking care of myself, making dietary changes, and trying to just get as healthy as possible for IVF. I also used the time to do a green smoothie cleanse. After a year and a half of taking some form of fertility medication or birth control, I felt awful and the cleanse was AMAZING!! I feel like I'm going into this IVF the healthiest I've been in years and I'm giving myself the best possible chance for success. That being said, I did SIX IUIs prior to IVF, so I totally get wanting to keep trying the IUI in hopes that will work. Best of luck!!!

mtpbadger · November 2015

I think you have a good plan. My husband and I had the conversation over the weekend that if IUI#3 doesn't result in a viable pregnancy, we are thinking of taking the holiday's off and moving forward with IVF where we feel there is a little bit more control and better outcomes.

vssbrm · November 2015

@mskeenan Yes, I too have had just about all the negatives I can tolerate. After years of this, I would like to see one + even if just for a moment so that I know it is possible. I took another test today, it was negative at 16dpIUI. My RE does not do a beta unless you get a hpt + or are beyond CD38 with no AF and have a reg cycle. I will also be going to the GI doc to get reexamined for other issues and to see if he thinks any of it is affecting our sbility to conceive.

I will also be calling our RE today to set up an apt to see what he recommends and to see about what other tests they can perform on me... I feel like with my husbands numbers only getting better something should have happened by now... but I am not a doc and what ever but I just want to make sure we cover all the bases.

My SIL had 11 unsuccessful IUIs but was successful on her first round of IVF, after talking to her I do not think we are going to mess around with any more IUIs and move on to IVF. We will probably wait until the spring to do so. That way we can save up some more $$ so we do not have to take out such a big loan. We will also be looki.g at goi.g abroad for IVF, as we have some family over in europe. And it would be good to have a few months to get healthier - i have probably put on 10 lbs from the process so far and my husband is no longer in his fit soldier 20s any more so he could stand a few mths to get more fit and hopefully raise his numbers even more.

katie121209 · November 2015

My husband feels that I need an emotional break and so we aren't going to try a 3rd iui, going to take some time off with goal of IVF in late February. He also feels that another iui would be unsuccessful due to morphology issues. @vssbrm I'm also going to try and lose some of the stress weight I've gained and focus on saving money these next months.
Good luck with whatever you choose- but it might be nice for your body and mind to have a break.

NicWalker10 · November 2015

@mskeenan I'm so sorry your last IUI didn't result in a BFP. I was pulling for you! I transferred after IVF around the same time you did and resulted in a chemical so I took some time off from checking here to just take a bit of a break from all of this. I was hoping to see good news for everyone I was following and I really and sorry for your negative. I understand your feelings of frustration and devastation completely. There's def a sense of hopelessness and a kind of a feeling of being lost when you go through all of this and it doesn't work out.

I think I would take December off to relax and like you said, get yourself back to a good spot hormonally and physically. The rollercoaster of emotions of doing all of this really messes with you and I think you might enjoy being able to enjoy the holidays and some down time. We are meeting with our RE Friday to figure out where to go from here. We only had 1 good embryo from our first IVF cycle and were doing IVF due to MFI so now my mind is really screwed up about this whole thing. My RE was extremely confident before our cycle that it would work because all of my stuff checked out and well, it didn't and we have no frozen embryos so I fee lost and totally out of control of this process. I'm definitely in a very negative headspace about all of this so I have told DH that I would like to take December off to take a break. I'm starting acupuncture next week, so maybe that will help. I was really hoping to be able to tell our family during Christmas that we were going to be having a baby, so i'm struggling a bit as to how to emotionally get through the holidays with this on my mind without adding the extra hormones to it!

Good luck Monday. Keep us posted!!

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