New here! (and a question about IUI)

aaej4 · December 2017

My husband and I started trying for a baby last December. In October, After 12 unsuccessful cycles ttc, I had my hormones tested and showed that I was ovulating. DH then had a semen analysis which showed that he had a low sperm count (13 million/ml) and higher than normal for abnormal morphology.

My OB office wants us to do IUI with DH's sperm. I have no issues with my fertility other than my ovulation day varies between CD12 and CD15, so they are not wanting to use meds for me. They want me to use an over the counter OPK to detect ovulation and then come in the day of or the day after my LH surge is detected for the IUI.

The issue is they aren't open on weekends at all and there are some days my doctor isn't there, so if my ovulation falls on those days then I'm screwed and have to wait until the next month.

On top of that, I've read that the way they're doing it with the opk and stuff is not as successful because washed sperm only lives in the uterus for 4-6 hours and if they're ballparking it in a 48 hour time frame then the chances of it working won't be good..?

I've been reading up and it looks like real infertility clinics have better protocol for inducing ovulation so that they can time the iui better and for weekends and stuff. But I only know what i read and I don't want to think that my Ob would steer me wrong....

Did anybody have experience that could help me?

J1006 · December 2017

I would highly recommend seeing a reproduction endocrinologist at an infertility clinic. We did four medicated IUI cycles with donor sperm with my Ob/Gyn. I also had normal testing. My husband has low count and low morphology so my ob suggested IUI with a donor or IVF with ICSI. We were unsuccessful in all four IUI cycles. Looking back we wish we would have started with a RE sooner. She did additional testing that my OBGYN didn’t even suggest. She also was clear that we should have always been IVF candidates not IUI candidates, especially with my husbands sperm.

In regards to your doctor not being there...there should be someone else in the practice to cover. My actual doctor only did one of my IUIs. I had two other people fill in when she wasn’t available.

RVAmom315 · December 2017

*lurking*

I agree with @J1006 Please go see an RE. I don't think that you should be going to an OB for fertility treatments - even unmedicated. And the fact that the timing is so sensitive with these treatments I would not want to risk missing the window because they are not open, or the doctor is not available. That is added stress to an already stressful situation. My RE is open 362 days a year. And yes, washed sperm does not live as long as unwashed sperm (12-24 hours vs 3-5 days) but the goal is to do the IUI 36 hours after a positive OPK (although I could be wrong on that since my IUI is with a trigger shot).

An OB's job is to take care of you when you're pregnant. An RE's job is to get you pregnant.

ETA spell a word right

kerryann124 · December 2017

I also agree with the statements above, although I will add that I do see an RE and I did three IUI cycles unmedicated with donor sperm. All three were unsuccessful and we have now moved onto medicated with a trigger shot. My husband and I have no other diagnosis besides MFI, so we thought giving it a try first without medication (our doctor also advised this). I think in retrospect I would just medicate and trigger as each cycle costs money and you want the best chance possible.

You are correct on the timing though, you get a positive OPK and then go in for the IUI the next day. I would also schedule an ultrasound somewhere right before ovulation to confirm it was actually happening. My clinic is open every day of the year, even though my doc isn't there specifically, another one will be on call to perform the procedures.

scikap · January 2018

My RE recommended a medicated cycle for IUI, even though I ovulate normally on my own. His reasoning was similar to what kerryann124 just said - that if we are going to the trouble & expense of doing IUI, we might as well ensure that the O that month is really good.

The plan was to watch for LH surge and then trigger if necessary. I ended up doing a trigger shot on top of my own LH surge due to some weird timing - I did not detect the LH by OPK, but I happened to be doing bloodwork that day that detected it. So, I triggered and LH'd simultaneously. (If I'd been trying to time the IUI by OPK alone, I might have missed O altogether!)

Hope that helps a bit with your decision. I just had my IUI a couple of days ago - so don't know if this strategy was successful obviously... But I went along with the doc's suggestion, as I thought it was worth it to promote really good follicles and timed O if possible.

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