TI vs IUI *TW

carterh33 · March 2017

After two failed femara TI cycles (both produced a good 8-9 lining and each cycle had one good follie each) my RE is suggesting we consider IUI. Well, not only is that more $, we have no known male factor issues. I have read in some places that if there aren't any male factor issues, that IUI won't increase your chances by much.
*TW* I have gotten pregnant twice in the last year naturally, I just can't stay pregnant. So obviously I can at least seem to get pregnant. *END TW
My RE can't seem to give me a straight answer either. All his nurse says that is would increase our chances, but unsure how much. What have you all heard? He said we could switch off of femara as well and either to clomid/injectables. Well, the insurance doesn't cover my heparin so I doubt it would cover injectibles and I've heard terrible things about clomid. Thoughts for this as well?

pawcall · March 2017

honestly my RE told me that IUI really doesn't give significantly better outcomes than intercourse if you don't have male factor.

that said, we're doing IUI because we're more or less unexplained and a year of having sex didn't get the job done.

This was my first cycle with clomid, and I did get some headaches, but it wasn't terrible.

funkykey · March 2017

Ugh, sorry for your losses and also your your BFNs.

My RE had us jump right from TI to IUIs with clomid. We're unexplained, though I suspect the issue is on my side, as my H's SAs have all been optimal. I'm different from you though in that I've never been pregnant, so perhaps my RE wanted to be aggressive, just to see if he could get me KU-ed. For me, it really could be anything that doesn't show in bloodwork, u/s, or HSGs - like my eggs, something at the cellular level or something with my cervix (like too tight/not dropping right).

My RE's reasoning is to give 3-4 IUIs a try, as if the issue is something that clomid & IUI could resolve, it'll save me the cost and pain of IVF. Say (for me) 1 out of every 15 eggs is viable, there's a chance (with clomid) that I'd get to one of those good eggs faster, as on clomid I'm producing more follicles. Or say there's something with my CM or cervix that makes it nearly impossible for my H's semen to get through, an IUI would increase those odds. (But for you, it doesn't seem your CM or cervix are an issue.)

I don't know enough about femara and how it works compared to clomid, but if you produce more follicles with clomid, you will increase your chances. The IUI will ensure that there is sperm there to meet that egg, too.

pawcall · March 2017

You know what I hate? How much clomid + IUI sounds like it should work. more follies! more eggs! tens of millions of fresh happy sperm definitely right there in the end zone! Ugh, maybe it's just me, but I feel like it should be more effective than it is, somehow.

funkykey · March 2017

@pawcall - I know. For me it's not that I think IUI + clomid should be more effective, it's that I wish they knew more in general. What causes PCOS? What causes MFI? Is there a drug that can be developed for them? For me, it's even: what is causing this? Like, is there anything they can find? One day, can they have a test that's less invasive than an egg retrieval?

Frustrating! But also makes me feel so grateful I live in this time, and I'm not dealing with this 100 years ago, and makes me hopeful for the future. If everyone and everything worked perfectly all the time, we'd have nothing to learn.

Irisheyes81 · March 2017

So sorry for your losses. I totally understand what you are going through with the next steps! It seems like all they can do is add eggs and put more sperm next to them. I think they try the less invasive procedures and hope they work. They don't have answers a lot of the time and, as @funkykey said, even when they have answers they don't know causes. It's frustrating. Have you tried to have progesterone checked 7DPO?

carterh33 · March 2017

I've never had progesterone checked but RE has me take progesterone orally stating 5dpt

Irisheyes81 · March 2017

@carterh33 I'm going to ask my RE about progesterone orally instead of the HCG shot. Do you know the brand and dose you are taking?

carterh33 · March 2017

I think it's prometrium? 200mg

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