IUI and IVF fertility app

dawn_rosie · May 2021

Hi lovely people, I'm new here. I'm 35 and DH is 37. We tried for 1 year before going to a fertility clinic. We went through extensive tests and it looks like we are unexplained. Our RE recommends IUI or IVF. She left it up to us to decide. I was hoping to find a software app or a site that can do personalized success rate prediction for both IVF and IUI for a given scenario (age, history, diagnosis, ...)? Does any one have found such a tool? I'd really appreciate your help. How did you choose to go with IVF or IUI in your case? What kind of things I should pay attention to? By the way, we don't have insurance for any fertility treatment except for meds.

cashewchicken · May 2021

Hi,
For IVF, Society for Assisted Reproductive Technology (SART) has an IVF success calculator on its site:
https://www.sartcorsonline.com/Predictor/Patient/
SART is an organization that collects and reports IVF outcomes data from its member clinics.

I’m not sure about IUI. I think I’ve read somewhere that the IUI success rate for someone young with no obvious fertility issues is 20% per month.

Like you, my infertility diagnosis was also unexplained. I paid for all treatments out of pocket. I ended up doing IUI first, as IUI was less invasive and also less expensive than IVF. I moved on to IVF after 6 IUIs with no success. I think most of us with ‘unexplained’ infertility have tried IUI before IVF. But there’s nothing wrong with doing IVF first though. There are a couple of benefits of IVF over IUI: 1) you can bank embryos for future pregnancy; and 2) you can screen embryos for chromosomal abnormality.

Word of advice, if you are going to try IUI first, move onto IVF after 3 failed IUIs. Most people who successfully conceive via IUI do so within the first 3 tries. And if you are paying OOP, ask your clinic if they will give you any discount for not using insurance. I did my IUI at a large hospital chain and they gave me a 30% discount.

mbradfo2 · May 2021

We were also 'unexplained' when we were TTC our first kiddo (now, several years later, I am firmly in diminished ovarian reserve category; at the time we started fertility treatments - when I was 32 years old - my AMH was low but my AFC was fairly normal so I didn't technically fall into that category. Now at 37, I do.)

My RE recommended 3 IUI's first before moving onto IVF -- as was said, most people who are successful with IUI are successful within the first 3 cycles. I wanted to do IVF right off the bat because I'm a person who is 'all in' or 'all out' but my RE did not since there was no reason IUI wouldn't work and it was not invasive and cheap compared to IVF. Our IUI's were not successful but while we were waiting to start IVF, I became pregnant naturally (which my RE says its not uncommon and attributes it to the medicines for IUI 'resetting' the body). Unfortunately, I had an early miscarriage likely due to chromosomal abnormality. At that point, my RE was very confident that our best option was IVF since he felt, after my miscarriage, that the problem was embryo quality and that could only be seen/managed via IVF. We have been very fortunate that both of our IVF cycles thus far have been successful (one 3 year old girl from the first and I'm currently exactly 9 weeks pregnant with a second girl from our most recent cycle).

You can calculate out probability of success -- I did during my first IVF cycle and it was pretty average (about 50 percent for success with 1 cycle and up to 80 percent success after 3 cycles). The thing is -- no matter how dismal that number might seem (or how great it might be) doesn't really ultimately matter to you much as a patient (at least it didn't to me). It doesn't matter how low your success rate might be -- if you're successful, you are successful and that's all that matters. And if you have a failed transfer, it doesn't matter how high your success rate could be... a failure is a failure and devastating whether you had an 80 percent chance of success or a 20 percent chance. The important thing, I think, is to have a doctor you trust and a clinic that you are comfortable with. I go to a small clinic that doesn't do as many cycles or have as much success as some of the large ones, but I loved my doctor and my team at the clinic. I trusted their judgement.

The CDC has a success rate calculator that is based on success rate data submitted by clinics so it's probably fairly accurate.

https://www.cdc.gov/art/ivf-success-estimator/index.html

dawn_rosie · May 2021

Thank you so much @cashewchicken and @mbradfo2 for sharing your experience. This community is amazing.
You are right. 3 IUIs seems to be the rule of thump. Probably that's what we are going to do. I'm worried about losing time in the meanwhile. But, I don't feel ready to jump into IVF immediately.
Thank you for sharing the links to the CDC and SART tools. I'll check them out.

Lisa3379 · May 2021

I went into our first meeting with an RE thinking we’d try IUI to start. We left the meeting way more open minded to going straight to IVF (TW, LC and loss: I’m 39 with 2 kids and a history of miscarriage). Our insurance covered $20,000 lifetime for fertility, and while we didn’t really compare the cost of potentially several IUIs to a round of IVF, we figured that with my age, going straight to the big one would be better - we could insure any embryo we’d transfer would be PGS tested, and we’d have the peace of mind knowing we went for the solution that had the best chance of success, even if it was more expensive. Plus we could have several embryos ready if we wanted.

Good luck with your decision.

[Deleted User] · May 2021

I'm sorry you find yourself here, OP. (((hugs))) I probably sound like a broken record, but if we had had IUI on the table, we totally would have done that first. 100% It's so much less invasive, and it works for a lot of people! I even know someone who used IUI to get KU recently, and then magically had another spontaneous pregnancy shortly thereafter! Of course, YMMV, but you never know if you may be one of those people who just needs a little extra nudge, vs. breaking out all the big guns. GL!!! I know whatever decisions you make going forward will be the right ones for you and your family.

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