IVF or IUI?
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Anonymous
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I’m 39. We have two children conceived naturally, both under age 5, though one took a long time to conceive. We desperately want one more child. Have been trying for 10 months. One miscarriage, nothing else. Numbers look good - AMH 3.05.
We have two options: 1) Up to three rounds of IUI, then if it doesn't work, moving on to IVF. 2) Going straight to IVF. Per the doc, in my situation, chance of live birth after three rounds of IUI is about 30%. Chance of live birth in the first round of IVF is about 54%. After three rounds of IVF, it's about 88%. IUI rounds each just take a month, IVF takes about 3 months each round (including testing the embryos). All options are basically off the table in 14 months when I turn 41 and age out of Shady Grove Shared Risk. The money: Each round of IUI is about $2k. For IVF, we would buy into shared risk, cost is $35k up front, plus $5k per round in medication. That gets us up to six rounds (though I’d age out before we could finish all of them) included in that $35k. And of course if we don’t end up with a baby they refund the $35k. We can easily pay the $6k for three rounds of IUI. For IVF, we'd probably end up asking the grandparents for the money (they’ve got plenty of it but I feel crappy asking). Couple other factors - IVF is more physically demanding/overwhelming. Risk of twins is dramatically higher with IUI (10-15% of successful pregnancies will be twins, that number for IVF is super small, less than 1%). While we would deal, we don't want twins. There are some risks to IVF but they're pretty small. The other thing is, with IVF, part of how the numbers are so high is that they test the embryos to make sure they're chromosomally normal, so your chances of something like Downs is vanishingly small, whereas at my age, that's a real risk of chromosomal abnormalities via IUI (the same as there would be just from getting pregnant naturally). Also, while it's factored into those 30% and 54% numbers, the risk of miscarriage is higher with IUI. Honestly, I'm SO TIRED of the try, hope, test, disappointment cycle. I've spent almost two years of my life on that cycle and it's emotionally exhausting. Throw in a miscarriage with a night bleeding in the ER by myself, recovery from that, fertility testing... I'm kinda ready for just the most likely option, so I'm leaning IVF. One round, better than even chance of a baby. The money gives me GREAT pause though. My husband, on the other hand, is leaning IUI. He thinks we can get pregnant ourselves, mostly, and we just need a little boost so let's try something small, even just for one month. He mostly seems nervous about the physical/hormonal aspect of IVF (which I know did a number on the wife of his best friend). FWIW, the doc said with my age it’s unusual they would recommend IUI but with my history, it’s a good shot, so it’s up to us. But when pressed, she said if it were her, she’d do IVF. Thoughts? What would you do? We desperately want a third child, so we're definitely going to do SOMETHING, but we’re really torn. |
Anonymous
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I started IF treatment when I was 39, also with decent AMH number.
My RE recommended starting with IUI. If nothing else, to learn how my body responds to the injections. If nothing takes after 3 IUIs we move straight to IVF. So that's what we did. The IUIs were kind of like trial runs to get me comfortable to give myself shots, for the RE to tweak the medicine, etc. We had success with our first IVF. Good luck to you. |
Anonymous
| You have 2 children. Get over your ridiculous desperation. It’s obnoxious. |
Anonymous
| Desperate to have a third child? Why are you and your husband desperate as you’ve stated numerous times in your post? Some things are legitimately reasons to be desperate but this is over the top. This is obsession and really not a reason to have yet another child. |
Anonymous
| IVF. You’ll age out soon enough. Take your best shot while you can. |
Anonymous
| Insufferable people who aren’t satisfied with the children they have. |
Anonymous
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OP here. In rereading, you’re right that I mentioned desperation twice, that’s just a consequence of typing a long thing on a phone and not realizing what I’d said already! It’s not an obsession or anything, I mentioned it simply because I was trying to avoid answers of “honestly with two kids I’d just stop” - we’re definitely moving forward with some kind of treatment protocol. We adore and are grateful for the wonderful kids we have now, and if we never have another child, it will hardly be a disaster. But, yes, it’s something we both really want.
And I do apologize to those reading this forum who may be struggling and unable to have any children (or any children yet!) I know that must be dramatically more painful, and I’m sorry for all you’re going through. Unfortunately, there’s no secondary infertility forum or anything, so this was the best place for this post. I should have put a warning in the thread title though, and I do apologize. |
Anonymous
| I am in the same boat. Decided to stop at 4 IUIs, I don't want an IVF for a third. |
Anonymous
NP. You are ridiculous with your desperation and I hardly believe your husband is as invested as you are. Be happy with the children you have. It’s unbecoming to be this way and go to these extremes when you have children. You can’t any more without assistance, it’s time for you to stop. |
Anonymous
| If you qualify for the shared risk program but will age out before you can complete the covered number of transfers, start with IVF. This way you maximize your chances. I also know more than one person who got pregnant with a third and had to TFMR due to trisomies, so at your age and with the clock ticking, I'd want the reassurance of genetic testing. IUI just improves your odds that the sperm meets the egg, not that either are decent quality. |
Anonymous
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IVF but think about the ramifications of you end up creating more than one pgt embryo. How will you choose which one? What happens to the others? Are you guys doing this for gender selection? Surprised at your age they are allowing risk sharing. Another alternative is finding a job with fertility coverage. You can always pay cobra.
I personally wouldn't put my body through the risk now and future with two healthy kids at home. |
Anonymous
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What? You have 2 children and if you need to do I’ve, you would ask the grandparents for money to have a 3rd?
You need to kick rocks. |
Anonymous
| Something wrong with the two kids you have? |
Anonymous
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I was in a similar boat trying for my 3rd 4 years ago. I had two chemical pregnancies, nothing for 8 months and then a 8 week miscarriage. I surprisingly got pregnant naturally without getting a period after my 8 week miscarriage. I was going to schedule a HSG that month but then never ended up making the appointment because my period never showed up.
I think its a very personal decision. My DH and I decided if we couldn't get pregnant naturally or with IUI we wouldn't move forward since it would be taking funds and time away from our current children. I think the statistic is after 35 1 in every 7 eggs is of good enough quality to make a viable pregnancy. That gives you 1.5 chances or less every year. Not great odds. I tend to get pregnant very easily but clearly my eggs aren't great anymore. |
Anonymous
+1 If you can’t afford it, you don’t do it. You also are takin money away from the children you have. This is absurd! |