Overwhelmed. (Incomplete IUI cycle)

stephanie34-2 · April 2017

Hey everyone, I posted a while back when my RE first suggested that we try an IUI. (I'm 26, have PCOS, a blocked tube, I don't O naturally, don't respond to Clomid and we've been TTC since 10/2015)
Right before we began this cycle, I got word that my RE was leaving the practice and they were transitioning me to another. This certainly made me anxious because I have so much going on and we really loved my RE but by this time, we had already paid the $2100 + nearly $700 for medications (not including oral meds; Provera + Letrozole) and they assured me it would be a smooth transition. So I began the monitoring process and new RE changed my dose of Letrozole to a lower dose (2.5 mg from 5 mg I was initially instructed) which now, I'm regretting not catching and saying something because even on the highest dose of Clomid, nothing happened and my original RE said she would start me on a little higher dose than most due to response or lack thereof. So I went through 6 rounds of monitoring (blood + U/S) and no measurable follicles developed on either side by CD 19. RE tells me he wants to try Letrozole again at a higher dose (7.5 mg) and if that doesn't work we move onto injections. The icing on the cake was then receiving an invoice for another $2100 because even though we didn't complete the cycle, supposedly I had over $5700 worth of monitoring in those 6 days. I sort of melted down yesterday when I got home - I received this news at work which was terrible trying to get through the day.
I know injections require a lot more monitoring which will be tough because I live at least an hour - hour and a half from the facility (depending on traffic) but if I'm going to go through the same thing all over again and not respond to oral meds, I'd rather cut to the chase and start injections. I'm so afraid of doing another round of oral meds, then a round of injections only to discover that I'll need IVF.
I guess I'm just looking for suggestions from anyone that has had similar issues or experiences. I'm feeling so overwhelmed right now.

Irisheyes81 · April 2017

@Stephanie34 So sad to hear about your struggles. I am pretty shocked by the cost of your IUI cycles. I also have PCOS and the blood work and the meds I'm on are all covered by insurance because it gets coded under PCOS. Sometimes, they can get creative with U/S monitoring too. Obviously I don't know your insurance situation but just a thought.
If it weren't so costly, it might be beneficial to try the highest dose of famera. I only got one follicle with low dose. It takes a lot to grow and release eggs with PCOS. Are they doing anything for testosterone? Have they looked at insulin resistance?
Is there another reproductive endocrinologist office close to you? We have this 'world renowned' RE close by that gouges people financially. There is a thread about the true cost of IVF and at this clinic, it's $45k. My RE charges $14k. They can do whatever they want so it might be a good idea to look in to another one if available. Especially since your doctor just left.
Good luck with all of this. FX that those follies start to grow!

FuzzyDust · April 2017

Stephanie34, sorry to hear about your IUI struggles. I also didn't respond to any oral medication and had to go into injectables after a round of Clomid. My IUI stems lasted almost a month because of the low response, and then the RE doubled the dose of Menopure and my ovaries started growing something like 20 eggs all of a sudden, so the cycle got cancelled. Luckily, I still had all my insurance coverage back then, so I paid very little OOP, but all the tests + the cycle took more than half of my $15K total lifetime insurance fertility treatment allowance

Do try injections. It's not too bad, and usually things happen much faster than with oral meds. I did IVF last month (and now have 2 frosties waiting for FET), and I don't regret jumping right into it after the cancelled IUI, but I don't regret that IUI attempt either. I didn't want to continue trying IUI route, but at least it gave me some perspective on how my body reacts to injections and I won't have a question in my head going forward if the IUI would be sufficient (and trust me, this question would pop into head a lot during IVF, since it's way more medically and physiologically involved).

Hugs! you're not alone

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