New to The Bump - IUI or or straight to IVF?

shannongabmac · January 2016

Hi everyone, I'm new to The Bump (or I had an account, which I don't remember...whatever!) but am not new to the infertility circuit.
So here is a little backstory:
Been with DH for almost 13 yrs, married for 8. Came off BC in 2009. Were not TTC after that time, just winging it or using condoms if we had them. I didn't like how I felt on BC. I had tried the Depo shot for years, moved on to the patch (gave me morning sickness at the start of each new month), BC pills, low-dose pill, Nuvaring. I basically ran the gamut.
Fast forward to January of 2014 and we decided to actively TTC. I am 36, will be 37 in a few months, hubby is 40. I was under no preconceived notion this would happen immediately, however, nothing was happening. I did not have insurance that would cover any type of infertility or testing, so we were kind of in the dark. I figured our timing was wrong, the apps I was using was wrong, something we were doing was wrong. I temped daily, used ovulation kits, apps, but it was frustrating, I began to dread the sex each month because it felt SO TIMED (I'm sure so many of you can relate!) and it was causing rifts in our relationship. I even tried to stop using those things thinking, maybe organically I'd have luck with "chance". By the summer of 2015, we had moved back to MA and our insurance covered testing.
When we went to the Dr. I fully expected her to say that we just needed to keep at it. She scheduled hubby for sperm analysis (came back fine) and me for an HSG. The HSG SUCKED (and completely changed my mind on a drug-free birth LOL!) But it did reveal that I have a blocked left tube. She tried to unblock with the solution/dye and it didn't budge, so that's probably where the majority of the pain came from.
Next we scheduled an ultrasound during my ovulation week and discovered that my left ovary appeared to be dominant (I don't know if it was that month, or in general). But we were told, basically because of my age our best bet was to go straight to IVF. Only my insurance at the time didn't cover IVF or any kind of infertility treatments, just finding out what was wrong.
So in January (had to wait till open enrollment) I switched a new plan I'm paying out of pocket (expensive, but still cheaper than paying outright for IVF). I now have another appointment in late Feb to review my options and decide a game plan.

This is where my question comes in:
My insurance will only cover a few tries at IVF and once you do IVF you cannot go back and try IUI, however it will cover IUI first. So I'm wondering if I should push for the IUI and do as many as I can (as is covered) of the IUI before going to the IVF to try and get the most tries possible?

Would you do this if in a similar situation? I don't want to undermine the doctors, but I also realize that my IVF success rate is only around 25% at my age...
Basically, I hate to say that money is the reason, but let's be realistic, we aren't made of money and it is.

cmm012 · January 2016

Welcome to the group! IUIs only get the sperm past the cervix. They still need to get into the tubes to fertilize the egg. If one of your tubes is still blocked, that would significantly reduce the chances of the IUI working. It's great that you have insurance that will pay for both procedures! I hope you are able to make a decision you feel good about.

vssbrm · January 2016

Hi, welcome!! We did 4 IUIs. Not one BFP. It took a lot out of us for the tiny odds that it would work. We are now moving on to IVF. If I could do it over I would have skipped the IUIs and went right to IVF. But we are also completely out of pocket too...

Good luck making the decision, ultimately it comes down to what you guys feel most comfortable doing.

shannongabmac · January 2016

I can see that (where it still needs to get up to the tube), I guess if they are going to monitor which side I'd be ovulating on, that might help? Honestly I will have to ultimately see what the Dr. says and go from there. It's just so much to process!

tvh1982 · January 2016

Hi and welcome!
I did 5 IUI before moving to IVF. The not knowing part if I was there at the right time, did I had an mature egg, did I ovulate killed me.
I wasn't an 'option' for IVF as everything seemed fine. They only found out I had PCOS after 3 attempts of IUI which by then I was a year of BC (apparently it hides itself pretty well until then)
If I could do over I would have started IVF from the beginning as knowing a fertilised egg got placed back took other worries away.
It is much harder on the body, but I know I'm one step closer.
I have to pay everything out of pocket, from A to Z, so I went for the 'cheaper' version first...not knowing it would be this difficult to get pregnant.
GL on your journey, listen to your Dr. and to your gut (us women should listen to our gut more often I believe)

suchaglencoco · January 2016

***bfp, loss, children mentioned***

I'm so sorry you're dealing with this.
If it were me, I'd go straight to ivf. I agree with PP that the blocked tube is a huge concern with iuis. They will monitor you and your ovulation but if your left side is blocked and dominant, you could essentially waste a month, money and medicine on the iui due to blockage. Also, your age may be a concern and they may want to do testing on the ivf embryos to ensure they're good candidates to transfer into you.
Ivf is a lot of money, work and pain, but will hopefully be worth it.

We did 2 iuis and our doctor let us decide between trying a 3rd or going on to ivf. We chose to do ivf and got a bfp. Unfortunately, it ended in a loss and we had to do a frozen transfer a few months later and got another bfp. That pregnancy thankfully stuck and I am currently holding our twin newborn as she sleeps while my husband holds her brother.
I'm so glad we chose to listen to my gut and move on to ivf. Good luck on your journey!

2015dee · January 2016

If I were in your situation (blocked tube combined with age), I'd definitely move to IVF. If your dominant ovary is on the side of the blocked tube, then you're potentially putting yourself through many rounds of medications when the chances of pregnancy are slim to none. I think IVF will be the quicker and more successful route, IMO. Good luck!!

AandDM2014 · January 2016

If I had to make the choice, and it was going to be OOP anyway, I'd totally skip IUI and go to IVF. I feel like the percentages doctors give you are higher than they actually are. I've been told for both my IVF transfers that I had around a 70% chance of it working, yet here I am at the beginning of another FET cycle. I'm betting for IUI it's probably about 15-20% each time, if you ovulated on the unblocked side. GL in whatever you decide to do!

Piperella · January 2016

Hi there! I also had a blocked tube and my dominant ovary was on the same side. My RE also said I could keep trying IUIs or go straight to IVF. I asked what he would tell his daughter. He said if money wasn't an issue, he'd tell her IVF. We went with IVF with a shared success refund program, but paid more than what you would have for a single IVF. We were totally OOP, but with time not on our side, we went straight to IVF without hesitating.

I'd recommend going straight with IVF, but you could always try IUI if you are wavering. IVF does take a toll on the body and mind, more so than IUI, so if you are not ready for all the injections, etc., I would go IUI for a month to see if you can get your right ovary to do something. That being said, with your age, IUI success chances are pretty low (speaking from experience). You may also want to join the TTC after 35 group. It's a fantastic group of women there as well!

beckihall · January 2016

I have the same thing going on, both of my tubes are blocked. Went straight to IVF. It's not an easy journey, but it's worth it and I'm thankful we knew right away what we needed to do.

takethelongway · January 2016

I personally recommend going straight to IVF. The success rate is so much higher and I'm the kind of person who hates waiting around. Personally, I wish we had skipped our TI cycle and the cancelled IUI cycle and had gone into IVF quicker.

oxinfree · January 2016

I'm just here to echo the other ladies. I personally skipped IUI because of husband's morphology, and never once regretted it. Even doing IVF we have not been successful, and yet never would I want to take a step back and try IUI. If IVF doesn't work, IUI very likely wouldn't either. You never know, but the process is hard on the body, and given your diagnoses I feel like you'd be better off saving yourself the pain/process of IUI, and save your body/energy for IVF and give yourself the best chance possible. FX for you. Best of luck with whatever you decide is right for you!

shannongabmac · January 2016

Thanks everyone!

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